An optometrist who understands you 20 January 2017 Living with type 1 diabetes, Clinical Optometrist and Industry Speaker Dr Amira Howari has a unique insight into the challenges of maintaining good eye health for people with diabetes, so we sat down to talk to her about her career and any insights she might have to help people look after their eyes. “When I was shy of five years of age we had a family friend who would always spoil me when I would come over,” Amira said when we asked her about her decision to become an optometrist. “One day I noticed she was not looking straight at me when she spoke to me. My mother later explained that she was blind. “This perplexed me and made me very curious. How was she able to live on her own? Recognise people? Go out? “Our family friend Irene explained that her other senses were heightened and so she could ‘smell’ people, hear the slightest sounds and calculate her bearings. That same afternoon I went home and blind-folded myself to see how long I could walk around without being able to see. My experiment lasted less than a minute. This was the turning point for me. I realised how important our eyes and vision are to our quality of life.” Amira says her job as a health professional has given her a golden opportunity to help people like herself and others. “I was diagnosed with type 1 diabetes when I was nine years old and have lived with the condition for 24 years,” she said. “In my job, I am able to share my journey with people as well as my mistakes, my lessons and my achievements. Ultimately, I can connect with people on a deeper level… because… I know. I am living it. All of it. The ups and downs, the in-betweens. The naivety at times, the frustrations, the confrontations and the exhaustion. “But on the other side I have also seen the breakthroughs, the enlightenment, the wisdom, the discipline and the empowerment that comes with it when you push through and persist.” She also encourages eye health professionals to take a more active role in understanding the health situation of their patients with diabetes. “Health professionals need to ask more than ‘How are you managing your diabetes?’ This doesn’t give you much meaningful information and a real insight on their true level of management,” she said. “Instead, ask details. What is your most recent HbA1c? How do your blood glucose readings in the morning compare to those in the evening? What medication are you on and how often you remember to take it? When was the last time you saw your endocrinologist?” “As optometrists we know that a person’s diabetic retinopathy can reflect their diabetes self management and the length of time they have been living with diabetes. We should be working proactively with an ophthalmologist to help preserve people’s vision. Keeping their GP and endocrinologist in the loop is also vital for complete co-management. As health professionals we need to collaborate with our patients to set realistic and positive goals.” Dr Howari also had some advice for the entire health system about how to reduce the number of people with diabetic retinopathy. “More eye checks for people with diabetes are being conducted but there is still a huge gap between access to health professionals for people living in and around major cities and those living in rural areas and people from Aboriginal and Torres Strait Islander backgrounds,” she said. “More community-based screenings and information sessions need to be conducted to ensure people get the education and information they need. There is a desperate need to set up diabetes clinics that can take the strain off public hospitals and ensure people with diabetes can be seen by qualified optometrists and health professionals in a timely manner.” Dr Howari said she was looking forward to channeling her passion and drawing on both her professional and personal experience to support people with diabetes in 2017 and helping Diabetes Australia raise awareness about the need for a Diabetes Blindness Prevention Initiative.