Ezell Fellowship Winner Combines Passion for Vision Care with Public Health

Afua Asare - Vision Impact Institute Ezell Fellow 2019

Afua Asare sees the big picture when it comes to ensuring good vision for all. Through her research, she is investigating how vision care fits into the broader public health discussion and how costs and socioeconomic status impact an individual’s ability to receive care.

The University of Toronto Ph.D. candidate is the 2019 Vision Impact Institute Ezell Fellow. Established by the American Academy of Optometry Foundation (AAOF), the Ezell Fellowship program provides talented post-doctoral students who are pursuing an advanced degree in optometric research with industry recognition and monetary support to further their work.

We recently asked Afua about her work and plans for the future, and here’s what she told us:

VII: Why did you focus your studies on vision?

Asare: Growing up in Papua New Guinea and Ghana, I was disheartened to see blind people who had become destitute and homeless due to a lack of social and economic support. I also had elderly family members with severely impaired vision due to glaucoma and cataracts because of a lack of access to vision health care services. In high school in Ghana, I was inspired by the efforts of Unite for Sight to provide sight-saving treatments and surgeries for those suffering with blindness.

The urgent need for comprehensive vision care in low-and middle-income countries, and the hope inspired by Unite for Sight, were the main factors that persuaded me to pursue a career in vision.

As an optometry student in Ghana, I volunteered with several vision outreach programs and saw firsthand the significant burden of debilitating treatable eye diseases and refractive errors among women and children.

The complexity of vision care delivery in low-and middle-income countries and the unique social and economic challenges inspired me to pursue further education in public health. I believed that a degree in public health would equip me with the tools to conduct meaningful research into some of these challenges. I subsequently obtained a Masters in Public Health (MPH) Degree from the T.H. Chan School of Public Health at Harvard University.

VII: Your research focuses on health services. Why did you choose that topic?

Asare: Health services research examines how people get access to health care, how much care costs, and what results when patients have access to care. The main goal of health services research is to identify the most effective ways to organize, manage, finance, and deliver high-quality care; reduce medical errors, and improve patient safety.

My experiences in vision care led me to conclude that some of the most pertinent issues among vulnerable populations with impaired vision are related to access to care, which is directly and indirectly associated with the costs of vision care and socioeconomic status.

VII: Why led you to apply for the Ezell Fellowship?

Asare: To be honest, it was serendipity. I found information about the fellowship online.

The William C. Ezell Fellowship is unique in that it recognizes and supports young and upcoming researchers pursuing careers in vision science, including researchers with an interest in the public health of vision care. I believed that recognition by the Ezell Fellowship selection committee would help me secure my future career as an academic and humanitarian supporting vision care and public health initiatives.

VII: Now that you have won the fellowship how will you focus your upcoming research?

Asare: I’ll focus my research on the access and utilization of vision care services to detect amblyopia (lazy eye) and refractive errors amongst children in the province of Ontario in Canada.

Amblyopia and uncorrected refractive error (URE) are the most common vision conditions affecting children, and a public health problem in Canada and other developed nations.

These conditions are best detected through a comprehensive eye exam. Despite the availability of vision care coverage for comprehensive eye exams through the Ontario Health Insurance Program and several other initiatives in the province, only 14% of children under the age of six in Ontario had received a comprehensive eye exam in 2013, and a significant number of primary care professionals are not conducting vision screenings as part of well-child checks.

Through my research, I’ll investigate the cost-effectiveness of mandatory screening initiatives in schools for young children and whether they can aid in preventing amblyopia and URE. I’ll also investigate how rates of utilization of vision care services are affected by socioeconomic status. This is critical to understanding potential gaps in access and any potential geographic disparities that could be contributing to the low rates of comprehensive eye exams among children.

VII: What are your plans for the future?

I hope to extend my work to developing countries where the need is often greatest. I’d like to, not only conduct research, but also provide humanitarian support to combat avoidable, blinding eye disease.

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NOTE: This interview has been edited for length and clarity.

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