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Keeping their eyes open

Posted on | October 7, 2009 | 1,682 views |

College of Optometry staffs a visionary clinic at downtown Faith Mission

By Julia Harris

She might not call it a mid-life crisis, but the fact remains: Eight years ago, Joan Nerderman decided she needed a different job.

“I was getting kind of stale, a bit too comfortable with what I was doing,” she said.

What she was doing was working as an optometrist in a private practice in Worthington. Today, she’s still doing eye exams and dispensing glasses; she’s just doing it in an entirely different place, with an entirely different patient population.

As the attending optometrist and faculty director of the Faith Mission eye clinic, an outreach program run by Ohio State’s College of Optometry, Nerderman works with homeless people.

“The first time I saw evidence of drug abuse in the eyes, I had no idea what I was seeing,” she said. “Same thing with domestic abuse. I think I sort of had blinders on before, but I’m much less naïve now. I’m definitely more street smart.”

It’s an intelligence she’s learned the hard way, by looking into and through the eyes of people who, for a variety of reasons, are struggling through impossibly difficult situations. She sees diabetics with such poor blood sugar control that they are nearly blind from retinal hemorrhaging; she has seen people with old gunshot wounds that continue to affect their vision. And she sees people with malignant, life-threatening tumors in their eyes.

“One woman had been hit so badly that the lens inside her eye had been knocked loose and was floating around in the fluid inside her eye,” Nerderman recalled in a quiet voice.
“The force involved with that kind of injury is just unimaginable.”

In the face of such hardship, Nerderman chooses to focus on what she can do for her patients. She and a rotating crew of third- and fourth-year optometry students staff the clinic three days per week, providing more than 1,000 free eye exams annually and dispensing on average 2,000 pairs of glasses. Every patient gets a complete eye workup, from glaucoma screenings to pupil dilations that check for conditions like diabetic retinopathy or high blood pressure.

Many patients are surprised at what an in-depth exam can reveal about their overall health, says Stephen Denny, an optometry student who just completed an externship at the clinic. “They come in because they say they can’t see very well and want us to give them glasses, but a lot of systemic problems are manifested through the eyes,” he said.

He cites one example where an elderly Somali woman came in with severe cataracts, and when he did an exam he noted severe inflammation and scarring at the back of her eye. “When I mentioned it to her, she said quickly, ‘Oh I don’t have tuberculosis,’” he said. “Well, that kind of scared us a bit, but mostly it made us sad because she had no access to health care. We were able, though, to get her to a primary care physician.”

For Denny, working at Faith Mission was — in his own words — “An eye-opening experience. You get great exposure to a very diverse population and see a lot of eye diseases you wouldn’t ordinarily see.”

Through long-term partnerships with groups like Fight Blindness Ohio and Select Optical in Worthington — a family-owned company that donates eyeglass frames and puts lenses in them for Faith Mission patients — the clinic is able to provide both fashionable and functional eyewear.

“I’d be very happy to wear some of these styles,” Nerderman said, cheerfully modeling a golden-rimmed pair.

“I mean, you can’t be taken seriously at a job interview if you’re wearing big red frames like Sally Jesse Rafael from 15 years ago!”

As she spoke, a dark-haired woman roamed the selection of frames, trying on various pairs and peering at herself in the oval mirrors. Her name was Tracy, she said, and she was a recovering alcoholic with scar tissue in her right eye from having been abused.

But today, her eyes were filled with hope rather than pain. “In three months, I graduate from paralegal school,” she said, her chin lifted. “And I’ve got stacks of business cards from attorneys who want to hire me.”

Nerderman watched her slide a slate-gray pair of glasses onto her face. “You’re going to make it, aren’t you?” she said.

Tracy peered down her nose, smiling behind her new glasses. “Hell yeah,” she said.

Stories like these keep Nerderman going. “At the end of the day I feel I’ve accomplished a lot in helping people who couldn’t get help otherwise, and if I can get some students to think that way too — so that when they graduate they do the same — well, that’s what it’s all about.”

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