EACH MONTH, Contact Lens Spectrum broadcasts a livestream series called CLS Live! during which the host sits down with leaders in the world of contact lenses to discuss new and future products, the latest research, and worldwide trends in prescribing—and even brings viewers up to date live from the floor of CLS conferences such as the Global Specialty Lens Symposium.

This episode, which aired on March 27, was hosted by Ashley Wallace-Tucker, OD, a partner at Bellaire Family Eye Care in the Houston area. She spoke with Ruth Shoge, OD, MPH, immediate past chair of the Association of Schools and Colleges of Optometry (ASCO)’s Diversity and Cultural Competency Committee (DCCC) and the associate clinical professor and director of diversity, equity, inclusion, & belonging at UC Berkeley School of Optometry & Vision Science. This episode launches a three-part series on diversity, equity, and inclusion (DEI).

Q: Ashley Wallace-Tucker, OD: It is really important that we all embrace the concepts of diversity and multiculturalism in optometric education and in the profession to provide a better education for our students and, ultimately, better care for our patients. Why is it important that we discuss diversity as it pertains to optometry?

A: Ruth Shoge, OD: Diversity includes people who have disabilities, different gender identities, race, ethnicity, and many other categories. The conversations around diversity that have been most prominent in our field pertain to race and ethnicity, because racial and ethnic disparities in in eye care continue to be prolific and chronic.

We’ve had to have these sometimes difficult conversations, because we have to be aware that there is a problem and acquire the knowledge and skills around what causes disparities and what causes them to persist. Then, we need to take action to reduce them.

That is why organizations continue to have diversity leaders, because we have to keep having these conversations if we want to make a change and improve the visual health of our communities.

Q: Dr. Tucker: I agree. Your story on how you went into practice and 10 years later decided to go back and get your master’s in public health is very important. Can you share?

A: Dr. Shoge: I worked for a number of years in the clinic that was majority Black. I started to see more patients who were experiencing concussion or traumatic brain injury (TBI), but it was no longer a 90% Black population but maybe 10%. I knew that in terms of risk factors, Black people still had the same kind of risks for concussion or TBI. So, my question was: What is preventing them from coming in?

Is it that they don’t know that an [eyecare practitioner] is part of their health care team? Do they show up to their primary care [physician] or to an emergency room depending on the severity of the incident? Are they not being referred to an eyecare specialist?

I wanted to understand the barriers that were preventing people to come in for vision care after concussion and TBI. That was the central question that I had going into the master’s program. Completing this degree really got me to think more broadly about vulnerable populations, how we could improve the care in those populations, and the responsibility that clinicians have to improve that kind of access.

Q: Dr. Tucker: Did you uncover that these patients didn’t know that they could have access to care, or what was the disconnect?

A: Dr. Shoge: There are a lot of reasons. Even just learning the common language in public health, so you know social determinants of health and what it means to have access or not have access. Obviously, education is a big part of it. But do [patients] have eyecare benefits? That’s a big part of it as well.

Is there disconnect between the primary care doctor that they may see more regularly and them referring [patients] to us? Are their symptoms taken seriously? Is there some discriminatory barrier that’s preventing that referral process, and what does the completion of a referral look like?

That’s where we start to look at how we do business and how we take care of people and the completion of that care. It’s multifactorial; it’s understanding where we can influence that process.

Q: Dr. Tucker: ASCO’s DCCC promotes racial and ethnic diversity and inclusion initiatives at optometric institutions. Why is it important to have this committee?

A: Dr. Shoge: It’s important to have a committee like this in all organizations and institutions because it keeps those issues at the forefront of everyone’s minds, on the agenda, and ingrained into the organization’s different initiatives.

People are busy. Sometimes you don’t have time to make space on your plate for something else, even though you recognize that it’s super important. You need a team of people that can at least steer that ship in terms of “How does it address diversity?” and “How do we make sure it’s equitable?”

Q: Dr. Tucker: Can you share any positive changes that came out of your tenure as the chair?

A: Dr. Shoge: We did a lot of work that I’m proud of. We had different conversations. We hosted several town halls, and that was just a place for our community members to ask questions that they might not otherwise feel comfortable asking.

I’m an optometrist and now I do some DEI work, but I can’t necessarily speak on Supreme Court rulings. So let me find a lawyer who can who’s also involved in DEI work. Helping to put together those conversations was a really good experience.

We’ve revised and updated cultural competency guidelines that all ASCO members have access to, and this has a lot of clinical bearing in some of the skills and knowledge we should be acquiring as clinicians as well as educators in order to take action to make sure that we are continuing to be lifelong learners in this area.

We’ve done a lot of work in a short amount of time. There are still some great people on the committee continuing that work, initiating new work, and I’m really proud of what we’ve been able to do in the last few years when I was more of an active participant.

But, also, this committee has been in existence for at least a couple of decades now.

Q: Dr. Tucker: A lot has changed since you and I have been in school. Are there things that optometrists or students can do to help make this less of an issue?

A: Dr. Shoge: I want people to feel engaged without scaring them off, because it is an all-hands-on-deck thing. I need students to keep asking questions and pushing the boundaries. A lot of the initiatives that we see in the academic areas are because students speak up and say, “We want to have this as part of our education.” Faculty and leadership have to respond to that.

People within private practice should get to know the people within their practice a bit more because we all have diverse perspectives. Understand the community that you’re serving. Who has the greatest needs and how can we meet those needs? Are you able to do eye screening at your child’s school and get the students, parents, and teachers to understand the need for vision care? What are ways that you can integrate into the community in non-transactional ways, on a volunteer basis?

There are a lot of things that folks may already be doing, and hopefully, they recognize that’s them playing their part. We need to make sure that we’re educating our community, educating future optometrists, and sparking that curiosity in pediatric patients about the possibility of them being optometrists.

There are different ways that everybody can play a role in understanding what these disparities are, understanding the role of diversity in our in our profession, and helping to create a healthier community. CLS

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