Moorfields in West Africa

Raising the standard of eye care across West Africa, where there are approximately 2.6m blind people

Raising the standard of eye care across West Africa

Staff at Moorfields Eye Hospital are working with the Lions Clubs International to raise the standard of eye care across West Africa through the development of sub-specialty surgical training. The World Health Organisation estimates that 90% of blind people live in developing countries, yet 80% of those affected suffer needlessly because their blindness is treatable and/or preventable. Increasing the numbers of adequately trained eye care personnel is integral to tackling this problem.

At the end of 2015, a new standalone eye centre and surgical training facility at Korle Bu Teaching Hospital in Ghana was built and equipped. As well as being home to the hospital’s ophthalmology department, the new centre is enabling eye specialists from across West Africa to be trained to deliver sight-saving treatments for many of the major eye diseases. The following video tells you more about this project:

Surgical training underway

Working with the West African College of Surgeons, the first training course took place during the last two weeks of November 2016. Four ophthalmologists from hospitals in Ghana and Nigeria attended a medical retina course in diabetic retinopathy. The course was supported by two experienced trainers from the UK and one based at Korle Bu.

Medical retina is a vast sub-speciality. As such it was decided early on that sub-specialist training in medical retina should begin with the management of diabetic retinopathy. The main reason for choosing diabetic retinopathy is that diabetes is a disease of ever increasing importance in sub-Saharan Africa. In Africa the current prevalence of diabetes is 14.2 million. This is predicted to increase to 34.2 million by 2040, which represents an increase of 141%; the greatest in the world. Diabetic retinopathy affects one third of the diabetic population and represents 50-75% of medical retina disease in West Africa. Sight threatening retinopathy affects 10% and it is a significant cause of blindness in the working age population. The main problem faced by a number of eye units across Africa is that the majority of patients with diabetes present late to eye clinics, already displaying advanced retinopathy and blindness. Having robust screening mechanisms in place, in addition to suitable treatments, will help to alleviate this significant cause of blindness since it is well recognised that early detection and timely treatment of sight threatening diabetic retinopathy saves sight.

The medical retina training course was divided into two parts, commencing with an online training and assessment to ensure a high level of background knowledge before the practical training got underway. The hands on training involved assessing and treating over 50 diabetic patients over four mornings. These cases were reviewed and the merits of different treatments discussed in group sessions over several afternoons. Treatments provided were preceded by simulation sessions. The training also included a number of lectures. The nine day programme was intensive, starting at 9am and running until 6pm or 7pm each day.

In addition to training in diagnosis and treatment, wider issues concerning diabetic care and care pathways were also covered as part of the training. Protocols and strategies for case detection and screening were also provided so that the trainees left equipped with the tools to set up full diabetic eye services in their home units. In addition, the diabetic retinopathy service at Korle Bu was strengthened and improved as a result of the course.

The nine day practical training was supported by Sightsavers, while the Tropical Heath and Education Trust assisted the development of the online training resources.

Support needed

Donations to support the training, as well as to purchase some items of medical equipment are still being sought. The next training course will focus on glaucoma and is expected to take place at the Lions International Eye Centre in February/March 2017. You can make a donation online to Moorfields Lions Korle Bu Trust or contact Rachel Jones, associate director of fundraising, on 020 7521 4610 or by email at Rachel.Jones3@moorfields.nhs.uk