Ophthalmology Abroad

I started my year by working with the Himalayan Cataract Project (HCP), an organization founded by Dr. Geoff Tabin and Dr. Sanduk Ruit to help eradicate preventable blindness with high quality ophthalmic care in the developing world.

I went to one of the base of their operations in Asia, the Tilganga Institute of Ophthalmology, for one week, followed by a peripheral hospital in Nepal, the Geta Eye Hospital, for one month. The purpose of the trip was 2-fold: to learn small incision cataract surgery (SICS), and to help create educational programs for patients. 

The Medical Director of the Geta Eye Hospital is Dr. Bidya Pant, MD, who is a phenomenal cataract surgeon and extraordinarily hard working and kind. He and his team does phenomenal work. The ophthalmologists there diagnose and treat patients meticulously and thoroughly, and were able to see over  300 clinic patients per day and do over 60 cataracts per day during my stay there. Their volume increases 3-4 fold in the winter and spring seasons.

Examining a child at the Geta Eye Hospital 

Cataract post operative exam in patients with uncomplicated cataract surgery

Slit Lamp Exam of a child with active intraocular toxoplasmosis 

During my time there, we started a few educational programs there that I am excited about. I am lucky that in Geta, as it borders the eastern part of India, 80% of the patients are from rural India and speak Hindi, which I can speak as well. I saw that just like diabetes and macular degeneration is very common in the USA, corneal ulcers and end stage glaucoma are rampant in rural Nepal and India. 

Corneal ulcers (which are usually fungal) come from agricultural injuries while people are working in the farm. They come at the very end stages when the cornea is typically white. The best treatment option for this, in my opinion, is prevention with sunglasses, as corneal transplants are not readily available or affordable for most of these patients. The patients' families live outside while the patients are getting care, and we initiated a "small group discussion" program about the importance of sunglass wear, as well as the importance of routine eye check ups after the age of 40 to catch glaucoma early. We encouraged the families' to take educational sheets we had written (in Hindi lettering) to their small villages and educate the people there. The patients were very receptive to the small group discussions, and were eager to teach their families and buy safety glasses before leaving the hospital, which inspired us even more to create a system of low cost sunglasses for patients to buy. 

Distributing glaucoma and corneal ulcer educational material to patients and their families  and encouraging them to educate people in their villages after returning home from their visit to the Geta Eye Hospital

Discussing how to protect against ocular diseases that are largely preventable and promoting regular eye exams 

Mina, one of the ophthalmic assistants, explaining to patients and families about the loss of peripheral vision which slowly occurs in patients with glaucoma 

This was done along with an ophthalmic assistant and another ophthalmologist who is working there long term; they will continue the program now that I have left. 

We also made very large colorful posters about a few important subjects (corneal ulcer, glaucoma, phacoemulsification vs SICS as options for surgery, and cataract post operative instructions) which are up in the hospital now and look beautiful.