I received information from VOSH International that a team was needed into Sint Maarten to provide eye care for the primary school children and being sponsored by the St. Maarten Lions Club. I requested permission from the VOSH-Ohio president to pursue this mission.

On August 16, 2017 a letter was sent out to a list of optometrists offering this mission from VOSH-Ohio. I received responses from 13 optometrists showing interest in this mission. By August 21st, I had a team set up to be able to provide the services needed. Working with the Sint Maarten Lions Club and Lion Davey Woods, the dates determined were November 11 through 19, 2017. Invitations were received from the Lions Club, the Ministry of Education and the Ministry of Health wishing us a success with the project.

Our lead OD suggested that we obtain sunglasses for the children and I proceeded to find enough sunglasses to provide for 5,000 children. These were received from VOSH Southeast in Florida and the Lions Sorting Center in Indiana. Our local Bluffton Lions Club assisted us in sorting and packing these sunglasses for shipping.

The mission was cancelled due to a major hurricane; however, the sunglasses were ready to go and we decided to ship these ahead, hoping that the mission would be on again soon.

January 22, 2018 I received an email from Lion Davey Woods from the St. Maarten Lions Club indicating that they were working hard to get the project going for May 12 through 18, 2018.

I again notified team members; however, some were unable to attend due to difficulty with those particular dates. We did complete the team with eight optometrists and one optician to fill the seventeen member team and the process of formulating a mission was on. All members of the team, with the exception of three, were experienced VOSH members having completed numerous missions in the past. Our team came from Alaska, Canada, Washington, California, Connecticut, Florida, Pennsylvania and of course Ohio.

Thanks to the precise plans made by the Lions of Sint Maarten, arrangements for a successful mission were made. Extraordinary accommodations for transportation, lodging and food were provided by the Lions Club.

Children were bussed to the Belair Community Center from seventeen schools for the clinic site. This was an ideal setting as children came with their registration form and consents already completed and were able to work their way through our various stations with ease. Seventeen RN and LPN students, working through the National Institute for Professional Advancement, assisted the team for the entire week with the acuity station, distributing the sunglasses and moving the children through the various stations.

Monday morning the team cared for 383 students and 26 teachers. Glasses were provided for 86 hyperopia students and 46 myopia students. Because of astigmatism, 24 pairs of glasses will be ordered from an optical company or obtained from our local sorting center in Ohio upon return to the States. These will then be mailed back to the Lions Club. An optician has been obtained to fit these glasses. Our work day is shorter than on usual VOSH missions as the children were bussed in for clinic starting at 7:40 AM and needed to be returned to school early, leaving a close of the clinic no later than 3 PM.

Tuesday brought 424 students and 34 teachers to the clinic. Glasses were given to 120 students. Teachers were provided scripts if needed. 48 students had myopia and 72 hyperopia. 35 pairs of glasses will need processed in the States.

Wednesday the team saw 531 students and 45 teachers. 112 glasses were provided with 46 for myopia and 66 hyperopia. 32 pairs of glasses need processing.

Thursday we saw 551 students and 52 teachers. Glasses given to 73 students, 43 hyperopia and 30 myopia. 42 glasses to be processed.

Friday, our final day of clinic, saw 660 students with 84 teachers/clinic helpers being cared for. 42 pair of glasses provided, as we were running out of some scripts. 28 glasses for myopia and 14 for hyperopia. This leaves 65 pair of glasses to be provided later. There was a request to see some patients in the hospital, as one boy had been hit by a car and had a broken leg and arm. Two ODs traveled across the street to the local hospital and examined three children while there. The remaining of the team packed up and cleared out the clinic site.

A grand total of 2,795 patients were cared for at this clinic as recorded by registration. The final day we ended up with 9 referrals to an ophthalmologist. This has been arranged by Lion Davey. Reasons for referrals are exotropia, cataracts, amblyopia, keratosis, reduced vision OD, glaucoma and other health concerns.

Upon return to the States we will be filling the prescriptions from our sorting center, as reviewed by our local OD, and those not able to be filled will be sent to an optical laboratory. These will then be returned to the Sint Maarten Lions Club for distribution.

Respectively submitted, PDG Barbara Plaugher, VOSH-Ohio Mission Coordinator

Brief statements from participating ODs:

I had one child cataracts referred boy cause could not even do retinoscopy. Was surprised by how many astigmatism and high amount could not have predicted that. Also had more myopes then thought that we would have and thought we would rather of had more high hyperopes yet did not.

My impression of the kids is that they are so well behaved. As far as glasses, there were far less high hyperopes, more with high astigmatism and less high myopes. Luckily there was minimal pathology.

Hosting and facilities were wonderful. Student volunteers were a wonderful addition. Children very polite and well behaved. A number of children were found to have farsightedness, nearsightedness and astigmatism. Glasses were dispensed to approximately 30% of children. Thankfully only a small percentage of children had eye disease some of whom we were able to treat and the remainder was referred. Lions were instrumental in the success of mission. Lion Davey Woods was very organized. Seeing the joy on the faces of the children was very rewarding.

The children were very well behaved. There were quite a few children with high prescriptions that had never had glasses. It is very rewarding to make such an impact on their lives. Children need good vision for their education. Our nurse helpers have been wonderful.

Many hyperopes with astigmatism a majority, very few high hyperopes. A few uncorrected myopes and few high myopes. Lots of astigmatism from 0.50 to 1.50. A fair number of students with near point difficulty who benefit from reading glasses. Amazingly polite and disciplined students.

The majority of children wearing glasses had vastly incorrect prescriptions when they arrived to the clinic. They may have been wearing their family member’s glasses. There were children with astigmatism, hyperopia and myopia in equal amounts. There was minimal eye health concerns.

I didn’t notice any significant trends in terms of refractive error or ocular disease. The children’s eyes were healthy. I noted two who had strabismus. The children and adults who we saw that already had glasses on, we found their glasses seemed way off.

Very well organized facility, accommodations, meals and transportation. Higher percentage of hyperopia and astigmatism than any clinic of memory of my 43 clinics. Not any extraordinary pathology. Few minor lid and conjunctive problems. Used a Welch Allyn Spot Screen for retinoscopy, instrument of choice for children, fast and accurate