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Unravelling the Psychology of Eyewear

Layal Naji | 28 February 2018
Working with patients at the Newtown Asylum Seeker Centre has highlighted the need to be cognisant of each patient’s psychological perspective.

It was while I was trying to unpack one of my patient’s self-esteem issues that I first became aware of the power of eyewear as protection.

My patient had been bullied and she told me that her psychologist said ‘her glasses were a barrier’… although they made it easier for peers to pick on her, they also served as a mask behind which she could convey whatever persona she wanted, including one that seemed to others to be ‘un-phased’.

That got me thinking. What better egoic mask than one presenting physically on the face?

Since working at the Newtown Asylum Seeker Centre (ASC) in Sydney, I have become even more aware of the psychological power that frames can have on a person’s sense of identity.

The Centre offers comprehensive ocular examinations and access to relevant goods such as spectacle correction or therapeutic eye drops to asylum seekers with no access to Medicare. It is supported by the University of New South Wales, Royal Prince Alfred Hospital and the Essilor Vision Foundation.

There are no automated processes here: no autorefractors, NCT, retinal photographs or optical coherence tomography. What we do get is the formal health status of every patient we see – access to blood work, a reliable (not patient reported) medications list, emotional and psychological histories, as well as their living/work status.

Working within this arrangement has taught me a great deal –  like how a patient’s circumstance and state of mind influences their physical and verbal communication and compliance to their health plans.

Spectacles as Defence

I have seen the spectrum of defence mechanisms people use to hide or hold on to the past – and spectacle frames are just one of them. They can be worn as self-expression, to hold on to a lost perceived status… or to mask raw emotions. Having worked at the ASC, this is completely understandable – imagine leaving your home, loved ones, way of life, perceived status, then to top it off, your means of self-expression.

One patient in survival mode held on to his out-dated multifocals rather than accept single vision spectacles from our limited range of frames that would certainly have provided better vision. He returned every three months to ask whether we’d expanded our range, even though I’d told him those chances were slim to none.

Another patient, who had been a supreme court judge in her home country, gratefully accepted single vision spectacles. She told me, “you just have to suppress your old life as if it were a dream and keep moving along. Then if you get lucky enough to pass this stage and have a regular life, you forget the interim stage and tell yourself that was just a dream”. Food for thought.

My saddest encounter was with a teenage girl whose father, a diplomat, sought political asylum. She had grown up brunching in fancy hotels with prominent political, social and cultural figures. Now in asylum in Australia, she’d lost her expensive wardrobe, felt confronted by the stigma associated with wearing a hijab in a western country, and the last straw… her beautiful Versace glasses broke. With few frames to suit her, I referred her to a colleague whose practice offered a wider selection at a subsidised price. My patient dutifully went along and chose the lowest price generic frame (comparable to what we had on offer). She bought the frames just to save face, but the act of doing so probably broke down the last remnants of the mask she’d been wearing to hold on to her former life.

The Power OF Retail

Like many optometrists, I have tended to skew my energy towards my clinical work rather than paying attention to the ‘retail’ side of the practice. However, as a portal for patient trust in the health-care system, I have come to realise that we must acknowledge the power of frames to enhance people’s self-esteem, and remember that retailing can be an important aspect to our job.

Layal Naji graduated as an optometrist from UNSW (2014) with her honours research project focusing on asylum seekers’ access to eye care in NSW. She currently divides her time between her locum work, the Asylum Seeker Centre in Newtown and UNSW where she is a visiting clinical supervisor. Ms. Naji is passionate about optometry’s role in public health, and ocular manifestations of chronic lifestyle related disease.

The University of New South Wales provides support to the Asylum Seeker Eye Clinic through infrastructure and access to expertise particularly from Program Director Blanka Golebiowski, and Clinic Director Kathleen Watts.

' That got me thinking. What better egoic mask than one presenting physically on the face? '