I Want the Gringo! The Pleasures of Visual Acuity Testing in Guatemala

This was my very first time going on an eye mission, and I didn't know what exactly my role would be when I tagged along with Laura on this trip. I didn't have any medical training whatsoever, and I certainly had no eyecare training, beyond what little I'd picked up by osmosis from being married to Laura.

So I was surprised to find out that I'd be doing the preliminary visual acuity tests. And not only doing the tests, but training local volunteers to do these tests too.

The visual acuity exam is the first thing we do for the patient in these clinics. We have them read down a simple eye chart (usually with numbers, but in some cases we have a special chart with hand symbols for any patients who are illiterate), and we'd document on the patient's information card how far down the chart he or she could read. The exam provides the eye doctors with a relatively simple measurement of the patient's distance vision.

After the visual acuity test, we'd send the patient over to have an autorefraction test, and then over to see one of our team of four optometrists for their eye examination.

Our team of eye doctors saw some two thousand patients over four very long clinic days, and every single one of those patients got a visual acuity test. I personally gave 700-800 acuity tests, and I was helped out immensely by an incredibly hardworking team of local volunteers, including Juan, Anna, Anika, Meylina, Katy and Joel.

It was a great place to be as a newcomer on one of these trips. I got to personally interact with hundreds of patients, teach our team of helpers how to assist and do the exams themselves, I had a bit of a role of directing patient traffic by speeding up or, if necessary, slowing down the rate that our team processed patients.

It was wonderful to help each one of these patients, many of whom were profoundly grateful for our help. And there was always a surprise waiting around the corner too. One minute I'd be doing an exam with someone who spoke neither Spanish nor English, and we'd have to call over a Quiche-Spanish translator. I had patients who came right out of the fields with machetes stapped to their belts. I had patients who were as nearsighted as I am (that's really nearsighted)- but who had no glasses. And I had hundreds of patients who had clearly never received any eye care before in their lives.

And while at times it would get a bit old saying "cubrace su ojo izquierdo!" two hundred times a day, every so often something would completely shatter the monotony. One of my most memorable patients showed up in my line on our third day of clinic. It was a cantankerous older woman, who was impatiently waiting for me as I returned from a rare bathroom break. I walked to my station and Juan, one of our local helpers doing visual acuity tests, told me that she refused to be examined by one of the two other Guatemalan helpers. He was laughing and telling me that she demanded me specifically.

"I want the Gringo!" she said.

I obliged and did her exam.