“A lot of rural patients haven't been able to
get healthcare, much less vision care,” White
said. “Even when medical care is available,
patients sometimes feel intimidated about seeing a
medical provider. They're fearful about what might be
found or the instructions they might be given. I know
sometimes they say to themselves, 'But I can at least get
my eyes checked and maybe get glasses if I need them.'
When we determine their glasses prescription, we also do
dilated fundus exam. If we see signs of diabetes, we
can check their blood sugar and get them in to see the
primary care provider. Or if there are signs of high
blood pressure, we can check that and explain how
uncontrolled blood pressure affects their eyes. We can
share what might happen to their vision if they don't get
care. Sometimes we're the first provider to make that
important connection between their vision and their
Sometimes we're the first provider to make that important
connection between their vision and their overall health.
White shared more about the basics of this optometry care
“Optometrists are primary eye care
doctors,” she said. “You don't go to
a cardiologist for your yearly physical and you shouldn't
have to go to an ophthalmologist for a yearly eye check.
It's really important that ophthalmologists have time to
do surgery and specialty evaluations, rather than routine
primary eye care. As rural optometrists, we need to be
part of the strategic use of these eye care workforce
resources. The medical model of optometry fits this need.
Eyes are as important as hearts, lungs, and kidneys,
organs that are so carefully monitored by our medical
providers. In the medical model of optometry, we
carefully monitor the eyes, do complete eye exams by
using drops to dilate so we can see into the eyes. Think
about the eye as being the only organ where you can
actually look inside the body and see what's happening.
You can see blood vessels that give you information about
undiagnosed diabetes or signs of high blood pressure or
even brain tumors. Looking into the eye, we can see
findings that are smaller than a millimeter in size and
measure them to the micrometer with tools like the OCT,
optical coherence tomographer.
White said although all recent optometry graduates are
capable of practicing this type of optometry, if others
like her desire more in-depth training within a
particular area, they can do an optional one-year
residency with a special focus. She chose a residency in
community health optometry, but said that other
programs, like ocular disease residencies, fit the need.
If an optometrist wants to serve in FQHCs or the
Veteran's Administration (VA), she mentioned this extra
training is usually required. White, who lived on New
Mexico's Zuni and Jicarilla Apache Nation reservations
while working at the Gallup Indian Medical Center that
primarily serves the Navajo Nation, shared that the
Indian Health Service (IHS) also offers special
residencies for optometrists.
White said she appreciates the community health setting
where she knows and refers her patients to colleagues in
primary care, behavioral health, and other specialties.
For her – and her husband, also an optometrist – working
with underserved populations in a rural setting is a
Our patients can come in, be respected, get great service
and the kind of care they most certainly deserve. And for
me? I love being able to pour out great care on them.
“It's so satisfying to discover the changes
people make in their life because of the education you've
shared about what's going on in their eyes,”
White said. “We get to do not just eye care,
but we can help patients access total care. It's
been my experience that underserved patients are super
grateful about the care they receive at their community
health center. Where I'm working now, I have the latest
equipment in a new building in a gorgeous setting. I love
being able to serve people who often have complicated
health conditions, sometimes complicated even more by
their life situation. Our patients can come in, be
respected, get great service and the kind of care they
most certainly deserve. And for me? I love being able to
pour out great care on them.”
With a perspective gained from many years as a physician practicing in rural and urban locations, Dr. Kay Miller Temple writes on a variety of rural health topics and programs for RHIhub's Rural Monitor and Models and Innovations. She has a master's degree in Journalism and Mass Communication. Full Biography