Ophthalmology in Developing countries faces a substantial financial strain because of the blindness rates. Blindness can affect anyone at any age, but it is more prevalent among the elderly. Due to dementia being one of the problems among the elderly, dementia care at Seal beach provides services that might eventually feel overwhelming to you when caring for a loved one, especially since blindness can also accompany the disease.
According to the WHO, there are approximately 285 million people in the world that are visually impaired and 39 million who are blind. Among that, 80% of visual impairments can be preventable or treatable. While 60% of blindness can be cured, 20% are preventable. Despite this, millions are at risk of visual loss due to a lack of proper resources.
5 Major Challenges In Ophthalmology In Developing Countries
1. Cataract Blindness
A disproportionate number of over 50 % suffer from cataract blindness in developing countries, while cataract makes up only 20 percent of blind people globally. Fifty percent is small since this percentage does not account for those blind in one eye from cataracts or those yet to undergo surgery for cataract prevention.
Additionally, the population of developing countries undergoes far fewer cataract operations due to inexperience, lack of demand, lack of good services and outcomes, and inadequate resources. In developing countries, the CSR (cataract surgical rate) per year varies from two hundred to over six thousand.
Efforts to provide more facilities are ongoing, but steps toward increasing demands still require much more attention. People still need to gain awareness of the benefits of seeking cataract surgery.
Trachoma is caused by repeated attacks of infection from Chlamydia trachomatis. It is endemic in many remote areas of the Middle East, Africa, and Asia. Trachoma targets the most vulnerable individuals of families and communities, and those often tend to be women or children.
The signs of trachoma result from the immunopathologic response to C. trachomatis. It occurs when children or adults develop tarsal scarring. Lid surgery is needed to correct the inturned eyelashes and prevent corneal damage. The most effective way to combat trachoma is to eliminate diseases in children.
3. Corneal Blindness
Corneal ulcers can ultimately result in blindness and are reported to be the fourth leading cause of blindness globally. However, corneal blindness tends to occur at a tenfold higher rate in developing countries compared to the US.
Ophthalmologists have been developing newer variations of antibiotics, but it is difficult to determine whether the new ones are a better alternative than the previous treatments. Thus, many specialists treat their patients with older fortified treatments that have been in use for over 20 years.
4. CMV Retinitis
Cytomegalovirus (CMV) retinitis is an infection that strikes immuno-compromised individuals. It commonly includes people with HIV/AIDS. Retinitis infection may lead to irreversible loss of an individual’s eyesight. CMV Retinitis is known to progress slowly in untreated eyes, giving one much time to seek treatment and prevent vision loss.
Countries, where HIV and Aids are prevalent have statistically more cases of CMV Retinitis. An example is Southeast Asia, where one-third of patients have been diagnosed with Retinitis blindness. Treatments for CMV Retinitis are relatively costly for developing countries.
5. Retinopathy of Prematurity
Retinopathy of prematurity or ROP is a neovascular retinal disease occurring in premature infants. It is one of the leading causes of childhood blindness worldwide. In the 1950s, the relationship between ROP and supplementary oxygen was identified. While this decreased ROP cases, it caused a hike in neurological and respiratory disorders in infants. Only recently have the oxygen requirements been categorized for premature infants.
The developing nations struggle to obtain the availability of medical care for ROP. For instance, supplemental oxygen is provided to infants in NICUs that lack pulse oximetry, air-oxygen blenders, or efficient nursing care. Additionally, the accessibility to ophthalmologists usually tends to be unavailable.
While cataract blindness makes up 20 percent of the world globally, developing countries have to deal with above 50 percent of cases. It does not include people with blindness in one eye or those who require treatment before losing vision. Trachoma is endemic in remote areas in the Middle East, African, and Asia areas and strikes vulnerable individuals like women and children. Corneal blindness is reported to be the fourth leading cause.
Furthermore, developing nations with rampant HIV or AIDS cases will likely suffer from CMV Retinitis.
Developing countries must tackle Retinopathy of prematurity and a neovascular retinal disease occurring in premature infants. Although many of these issues are rampant in developing worlds, there are efforts towards bringing education, spreading awareness, and sending resources to many of these countries. We hope this article helped give you enough insight into the significant challenges in Ophthalmology in Developing countries.
Dr. Oliver T. Brooks received his undergraduate degree in chemistry from Morehouse College. He received his M.D. degree from Howard University College of Medicine. He completed a residency in Pediatrics at Children’s Hospital- Oakland.
He practiced in the underserved communities of North Oakland and Richmond for four years before accepting a pediatric position at the Watts Health Care Corporation where he is presently Associate Medical Director and Chief of Pediatric and Adolescent Medicine, Chairman of the Quality Management Committee.