Saving Sight in Developing Countries

Abstract

As the world population has increased dramatically over the past century, so has the burden of eye disease and blindness. Globally, the World Health Organization (WHO) estimates that 246 million people suffer from low vision and 39 million are blind. Ninety percent of the visually impaired or blind live in developing countries. The main cause of visual impairment is refractive error and the leading cause of blindness is cataracts. Although 80 % of cases occur among adults older than 50, low vision affects an estimated 19 million children worldwide, the majority of whom suffer from refractive conditions easily amenable to treatment (World Health Organization, http://www.who.int/mediacentre/factsheets/fs282/en/, 2013). However, these statistics likely underestimate the overall burden of ophthalmic disorders, which include other conditions such as strabismus, trauma, amblyopia, eyelid malpositions, and periorbital malignancies. While there has been considerable inertia in the past several decades to eradicate blindness, through such initiatives as Vision 2020 (World Health Organization, Vision 2020—The Right to Sight: Global Initiative for the Elimination of Avoidable Blindness Action Plan 2006–2011, 2007), it is likely that in the foreseeable future, medical and surgical ophthalmic expertise will continue to depend in part on oversees volunteers working individually or in tandem with local or foreign nongovernmental organizations and academic institutions.

Given their relatively low cost, limited need for aftercare, and high value in terms of Disability-Adjusted Life Years (DALYs) May eliminate this reference asit significantly decreases test readability-not a critical reference. Ophthalmic interventions are particularly well-suited for international missions. As long as proper preparations are made for comprehensive screening and adequate postoperative care, thousands of patients may receive life transforming ophthalmic surgery in a matter of days to weeks. In addition, opportunities may be arranged to interact with local specialists and forge long-term collaborative projects and academic exchange beyond the time spent on the ground. This chapter represents an overview of best anesthesia practices pertaining to ophthalmic and periocular surgical care for international medical missions.