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Defeating global blindness

There are more than 36 million blind people worldwide, the vast majority of whom live in developing countries. About 75 percent of this blindness is completely avoidable. The Ohio State University Department of Ophthalmology and Visual Science has established a tradition of providing sight-restoring eye care for hundreds of people in Ghana, Nicaragua, Peru, Ethiopia, Haiti and India.

We are expanding our vision and hope you will join us in support of the Global Outreach Project–a sustainable outreach and education program to restore sight and change lives in the developing world. Become a global visionary and help bring eye care to those who need it most.

Ethiopia

Gondar, Ethiopia

EthiopiaEthiopia is often referred to as the “cradle of civilization” because it is widely believed to have been the origin of the human race. Today, it is home to over 100 million people and has one of the fastest growing economies in east Africa. Despite this, there are fewer than 100 qualified eye doctors in Ethiopia, with the majority located in the capital city and biggest towns. Consequently, there are only 15-20 eye doctors serving the remaining 70 million people in rural areas. It is estimated that Ethiopia has one of the highest rates of blindness compared to other developing countries at 1.6 percent of the population. Most of these cases are due to cataracts. 

“That is a huge number and it is just terrible,” says Amit Tandon, MD, Ohio State University ophthalmologist. “Cataracts are a reversible condition—something that can be fixed. They just need to have access to eye care and cataract surgery.”

Dr. Tandon, along with Ohio State University Ophthalmology residents, packed up the necessary cataract surgery equipment and traveled to Ethiopia. Because of rural conditions and lack of supplies, the team had to perform extracapsular cataract surgery (removal of the cataract in one piece) instead of the more modern phacoemulsification (the cataract is broken into tiny pieces using sound waves and is removed using suction).

“It's the old-fashioned way to do it, but it still works," Dr. Tandon says. "We were able to perform about 70 surgeries in a week.”

Dr. Tandon spent time with residents and faculty of a newly established residency program in Ethiopia. The program's residents enjoy having visiting ophthalmologists teach, lecture, and demonstrate western medical techniques.

With the successful trip now behind him, Dr. Tandon is making plans to return and do more to help.

“We went to do cataract surgeries,” said Dr. Tandon. “But we also wanted to learn what is needed there and to see how Ethiopians practice medicine. The plan for the future is to go back, to take supplies, and to train them in phaco surgery. That way the doctors in Ethiopia can be more efficient, see more patients and help more people.”

 

Data sources: International Council of Ophthalmology, Gondar Ethiopia Eye Surgery

Ghana

Akim Akroso, Ghana

Ghana (2)In, Ghana, there are 90 ophthalmologists for 26 million people—that's roughly one ophthalmologist for every 290,000 people. In addition to having few ophthalmologists, almost 30 percent of Ghanaians live below the poverty line and are unable to access healthcare. 55 percent of blindness cases⁠ in Ghana are caused by cataracts. 

Thomas Mauger, MD, former Department Chairman, and community faculty members, residents and fellows of the Ohio State University Department of Ophthalmology, have traveled to Ghana to help. Dr. Mauger traveled to St. Theresa Eye Center in Akim Akroso, Ghana. The team also volunteered at the Bishop Ackon Christian Eye Center in Cape Coast, where they performed surgeries and trained Ghanaian physicians and residents, including providing instruction in phacoemulsification (a modern cataract surgical technique).

“I admire the many people in ophthalmology at Ohio State who have done multiple mission trips over the years” said Dave Adam, MD, community faculty member and alumni of the Department. “We made several trips to Ghana with Ohio State residents, and that helped inspire me to go, too. Restoring sight to people who otherwise would not have access to care at any price helps me to get back to the best reasons we all went into ophthalmology.”

The Ohio State University Department of Ophthalmology is proud of its faculty and alumni who have volunteered their time and efforts.

“It kind of gets you back to why you went to medical school in the first place,” said Dr. Mauger, in describing why he makes time for global trips to to help people who would not otherwise receive care for eye diseases and conditions.

 

Data sources: UNICEF, International Agency for the Prevention of Blindness, Ophthalmological Society of Ghana

Haiti

Croix-des-Bouquets, Haiti

tandon haitiOut of Haiti’s 10 million population there is only one ophthalmologist per 180,000 people, and as many as one of 10 Haitians is blind. The need for eye care is urgent, and every January for the past six years Dr. Amit Tandon has traveled to Croix-des-Bouquets to help.  

It is almost part of Haitian culture to accept blindness with age, Tandon says. But it doesn't have to be that way; a large portion of blindness in Haiti is due to fixable cataracts. 

“We see people who are really a burden to their community because they’re older and they’re completely blind,” Tandon explains. “Haitians get cataracts at a younger age because they mostly don’t wear sunglasses and the UV light is so strong.

“So you do the surgery and not only do you fix them so they can see again, but you allow them to be able to contribute to their communities again. People who were previously relying on their family or neighbors are now not only independent, but can continue working and contributing.”

Tandon is joined on each trip by former colleague Dr. Matt Thompson who practices at Tower Clock Eye Center in Wisconsin. The pair try to bring a new ophthalmologist every year with the hope that they’ll want to return.

“Now we have 12 doctors, so every two months there are two who go to Haiti,” Tandon explains. “It’s great because if we see someone who needs a follow-up, there will be two ophthalmologists back in two months.”

The team does 60 surgeries per visit. One of the most memorable cases Tandon has seen was an 8-year-old boy who had developed cataracts to the point that he was blind in both eyes.

“I was especially touched by his situation because my daughter is the same age. I don’t do children’s surgery, but since there was no one else there who could do it, I had to try,” Tandon says. “The next day when he came back for a follow-up he had a book with him and was reading.

When you leave, you feel like you really did something – like you really made a difference. When you’re there you’re sometimes a little stressed out, but for me, on the plane home it hits me that I really made a difference.”

 

Data source: SEE International

 

India

Kutch, India

India (2)With a high concentration of people living below the international poverty line and only one ophthalmologist per 100,000 people, eye care in India is often out of reach for those who need it most. Thomas Mauger, MD, former Department Chairman traveled with Ohio State ophthalmology residents to Kutch, a desert region in northwest India. Earthquakes have devastated the already underdeveloped area leaving very little infrastructure. Lena Chheda, MD, a resident in the group, had always wanted to participate in international missions and felt especially drawn to the region of India where her grandparents grew up. 

“All my family moved to the city, so going back there always reminds me of my grandparents because I never met them," Dr. Chheda said. "It’s really nice to be able to give back to people who support you.”

A friend of Dr. Chheda had started a clinic that hosts a medical specialty every month and treats as many people as possible. The clinic staff hold large screening events in villages across the state. Patients wait in line for hours and are divided into different ophthalmic categories including cataracts, surgical patients, and those who need glasses. Surgical patients are then brought to the clinic and given food and housing for the duration of their surgery and post-operative care.

“When I was growing up I heard about this amazing clinic that helps so many people. It’s why I got into ophthalmology," Dr. Chheda said. "When you go to other countries, it’s a completely different attitude. They are so grateful for their opportunities and the physicians that help them. There is so much appreciation; it makes you enjoy what you do so much more. I can’t wait for my next opportunity to go back.”

During the week of their visit, Dr. Mauger and Dr. Chheda saw patients in the morning and performed surgeries in the afternoon. They also saw many Vitamin A deficiencies, old corneal scars, traumatic injuries and corneal burns.

“We did a fair amount of cataracts on a wide variety of ages; including a three-month-old with bilateral congenital cataracts. He and his mother had come from three hours away," Dr. Chheda said. "Ministers, priests, and even local area doctors all came to be operated on by Dr. Mauger.”

To aid in treatment, antibiotics, intraocular lenses, eye drops, and medical supplies were provided by the pharmaceutical company Alcon.

 

Data sources: International Council of Ophthalmology

Nicaragua

Managua, Nicaragua

Nicaragua Group picNicaragua has a rocky history. Due to decades of internal political conflict, the country has struggled providing healthcare to all its citizens. In 2014, a team from Ohio State traveled to Managua for a week to perform cataract surgery. The team was led by Ohio State Ophthalmology alumni Dr. John Pajka, Dr. Robert Derick, Dr. David George, and resident Dr. Julia Reid. The team performed over 150 surgeries in three days.

“I’ve always wanted to do medical missions, but I didn't really have the opportunity or time earlier in my training,” said Dr. Reid, a third year resident. "When Dr. Pajka offered me the chance to participate, I was thrilled.”

At the National Center of Ophthalmology (CENAO), local doctors and international volunteers work side-by-side to restore sight for Nicaraguans who have gone blind from cataracts.

“I’ve been going on mission trips at least once or twice a year for 25 years,” Dr. Pajka said. “I’ve been to Haiti, Uganda, Honduras, El Salvador, Guatemala, a bunch of different places, but Nicaragua is different. With the national eye hospital, it is a much easier trip. They expedite the process and get us through customs with all of our equipment. They also have residents to help get us set up for surgery.”

While CENAO provides the best available care in the country, a lack of resources means that Nicaraguan ophthalmologists must perform extracapular cataract surgery, an older method with longer recovery times and more side effects.

Because of this, Nicaraguan doctors try to postpone the really difficult cases and monocular patients—patients with only one eye who are more at risk for going blind if something happens during surgery—until there are doctors who can perform phacoemulsification, a more advanced type of cataract surgery.  "Phaco" uses an ultrasonic device that breaks cataracts into tiny, easily removable pieces.

“The three surgeons that I went with are all excellent and routinely perform phaco, which is critical for these high-risk patients," Dr. Reid said.

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