A small group of Pacific eye care specialists are determined to make a difference despite the challenge of a heavy workload, large areas to cover and often minimal resources at their disposal.
There is also a glaring shortage of specialists across the region which has exacerbated the problem.
However there is hope on the horizon with a number of countries recently getting their first Ophthamalogists or eye doctors and reinforcements imminent.
Eye health has a long history of being an issue with cataracts common and responsible for 80 percent of avoidable blindness in the Pacific.
But the field is under more pressure now with the emergence of diabetes eye disease off the back of a non-communicable disease crisis.
People wait for eye care in Vanuatu Photo: Fred Hollows Foundation NZ
Duke Mataka is the only Ophthamalogist in Tonga, having just graduated from the Pacific Eye Institute in Suva.
Dr Mataka said he became interested in eye care when observing the work a visiting PEI team was doing in the country.
"In one week, they did more than 100 surgeries and I was like, wait, wait, wait, these people stay - I met them everyday, I see them every week and I never knew they were living with blindness," he said.
"So I guess I was thinking to myself, I guess this is an area where Tonga needs a service to be provided."
Dr Mataka returned to Tonga this year to continue the work and found it very challenging, and not just because of the large number of patients he was seeing.
"There are equipment that haven't been used, equipment that is incomplete, microscopes that are not very clear, consumables that the clinic doesn't have so you have to improvise and use other equipment," he said.
Dr Mataka said it also took some time to convince locals that a Tongan could give the same level of care as they had experienced from foreign-based outreach teams.
But he has started to gain the community's trust slowly but surely, with the assistance of church leaders and town officers who have endorsed his work.
Kiribati's only Ophthamologist, Dr Rabebe Tekeraoi Photo: RNZ Pacific / Koro Vaka'uta
Like Dr Mataka, Rabebe Tekeraoi is the only eye care specialist in her country, Kiribati. She said while she was attending to up to 40 people a day at her clinic, there were more people in need in the outer islands.
"Half of the population live and access the eye care resources where I'm based but the other half are divided by ocean so we have to travel across to see them or for them to travel across to see us. It's obviously a problem. It involves a lot of cost."
Basil Aitip is the National Eye Care Co-ordinator in Vanuatu, another country with just one ophthalmologist. He said accessing patients in the provinces was also an issue for them, however another obstacle was having to deal with the problems that traditional beliefs could create.
"You can have patients coming in and you tell them 'oh you have this, you have this' but they might think no it's not this. It must be a devil or something and that's when they start going for traditional treatment and healing, and that's when they go to witch doctors and they go and they just go and take anything and then, the next thing that will happen is that it will have an effect on the eye and they will have to come back again," he said.
Mr Aitip said the challenge was to be persuasive but respectful at the same time and to build relationships with the community.
He pointed to the recent establishment of a National Eye Care Centre in Port Vila, which deals with around 400 patients a month, as a good start.
Photo: RNZ Pacific / Koro Vaka'uta
The centre is well supported both by donors associated with the charitable organisation the Fred Hollows Foundation and from the New Zealand government.
More government support is something Dr Rabebe Tekeraoi would like in Kiribati.
"Our local ministry hasn't taken on our programme, funding-wise, so we still depend on other programmes to go out and reach those in the outer islands," she said.
Despite all the challenges, Dr Duke Mataka, said the joy he witnessed when people's sight was restored made it all worthwhile.
"It's an awesome feeling to have an immediate impact on their life and when you remove the pads the next day and they change from not seeing anything to seeing everything.
"I guess, I just feel like this is where we should be."
Both Dr Mataka and Dr Rabebe Tekeraoi are hopeful a second Ophthalmologist will arrive to help them in a few years once another set of graduates emerge from the Pacific Eye Institute, currently the only island-based, training facility in the region.
Tonga's sole Ophthamolohist, Dr Duke Mataka Photo: RNZ Pacific / Koro Vaka'uta
The author travelled to Suva to the Pacific Eye Care Society conference courtesy of the Fred Hollows Foundation NZ.
