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| What is Community Ophthalmology? |
| Most people know that an ophthalmologist is a medical doctor who diagnoses and treats diseases of the eye. These diseases may range from simple things like "red eye" to more serious infections of the inner or outer eye, cataract, glaucoma, misalignments of the eyes, diseases of the eyelids, retinal diseases and diseases in the bony eye socket (orbit). People tend to become aware of their own eye problems either because they have pain or because their vision decreases. People with money, education, or easy access to medical services may even go to see doctors when they have no problem, just to be reassured that everything is OK. It's easy for an ophthalmologist to work in a clinic or hospital and simply examine and treat the people who come to see him; most busy ophthalmologists won't think about the patients that need eye care who don't come in for examination. Out in the community, however, there may be many people with eye disease for every one who shows up at a clinic for examination and treatment. We know about this because of population-based surveys, in which trained teams go into the community, track people to their houses or work, and examine nearly every member of a community. Results from such surveys are often surprising; for example, in much of sub Saharan Africa we know that there are about 10 patients blind from cataract in the community for every patient who gets his cataract operated at the hospital. Of course this varies widely from place to place depending on many factors, but overall, among those blind from cataract, generally less than 10% get an operation to restore sight. To assume that the reason so many go untreated is that there is a lack of doctors is overly simplistic. In fact, many hospitals in poor countries are not very busy and do not work to their full capacity. The fact is that most blind people do not ever get to the clinic or hospital for treatment. Community ophthalmology examines the problem of blindness from the perspective of the community. We look at the question of why there may be 10 blind in the community for every 1 who makes it to the doctor to receive treatment. This requires investigating the size of the problem, the causes of blindness and eye disease in the community, the availability of eye services, the attitudes of the people towards visual disability or eye diseases, the attitudes of the people towards the services, and the many barriers that prevent people from using services. When these issues are defined, then solutions can be sought, agreements can be reached among all those concerned, and programmes can be implemented to put solutions in place. Community ophthalmology training complements clinical ophthalmology; it includes training in survey methodology, needs assessments, proper data collection and interpretation, programme design and implementation, management, and communication and effective teaching. Legions of ophthalmologists trained only in how to diagnose and treat eye diseases will not prevent blindness in most poor countries. Blind and visually impaired people must come from communities to receive medical care; we must look at the processes they go through to receive care if we hope to make a significant decrease in the number of blind and visually impaired. |
More about KCCO What is Community Ophthalmology? KCMC College/KCMC Eye Department and KCCO |