Michael P. Phillips, MD, D.Min.
Ophthalmology Coordinator
Global Health Outreach
Clinical Assistant Professor in Ophthalmology
University of Illinois - Chicago
“The Spirit of the Lord is upon me, because He has
anointed me to preach the gospel to the poor; He
has sent me to heal the brokenhearted, to proclaim
liberty to the captives and recovery of sight to the
blind, to set at liberty those who are oppressed; to
proclaim the acceptable year of the Lord.”
(Luke 4:18-19)
This is clearly our assignment and our
anointing in the world missions enterprise.
Once we understand our assignment it is easy
to identify our direction.
The prevention of blindness is one of the
most cost effective health interventions that
can be undertaken. It begins with the
individual, family and community level.
Primary eye care as a part of primary health
care is a strong priority of the World Health
Organization and the International Agency of
Prevention of Blindness.
“All authority has been given to Me in heaven
and on earth. Go therefore and make
disciples of all the nations, baptizing them in
the name of the Father and the Son and the
Holy Spirit, teaching them to observe all
things that I have commanded you, and lo, I
am with you always, even to the end of the
age.”
(Matthew 28:18-20)
“Love the Lord your God with all your heart,
with all your soul, and with all your mind.
And the second is like it: you shall love your
neighbor as yourself, on these two
commandment hang all the law and the
prophets.”
(Matthew 22:37-40)
Elimination of avoidable blindness in
developing countries:
A. Cataracts
B. Uncorrected Refractive Errors
C. Glaucoma
D.Other Eye Diseases
You do not have to Re-Invent the Wheel.
There are a number of Organizations and
Agencies that will send or support Eye
Missions all over the World.
Since we do not live in a vacuum nor can we
be successful if we operate as if we do. The
successful person in International Health
Care, will value and understand how to form
successful partnerships.
Successful partnerships between mission
organizations, government, non-government
organization are critical to success in
missions.
1. Partnerships with national churches, mission organizations and
NGO’s in developing countries.
2. Partnerships with local church organizations, mission
organizations, and non-governmental organizations.
3. Partnerships with organizations that promote eye care and primary
health care.
4. Examples of local mission organizations that promote eye care and
primary health care.
• Global Health Outreach
www.cmda.org
• Vision Outreach International
www.visionoutreach.org
• Mission Eyes Network
www.missioneyes.net
• Mercy Ships
www.mercyships.org
• SEE International
www.seeintl.org
• Christian Blind Mission International
www.cbmus.org
Primary health care is community based. It is
dependent on community involvement and
participation.
Health care workers, sometimes chosen by
communities, serve to promote better conditions and
health through public health education, teaching good
hygiene and improving waste disposal practices.
The principles of prevention of blindness and
treatment of common eye disease – primary eye care
must be incorporated into successful primary health
care programs.
1. Diagnosis, treatment and referral of patients with eye
disease.
2. Prevention – those that prevent blindness, such as
installation of tetracycline ointment in the eyes of newborns
to prevent ophthalmic neonatorum. The prevention of
Vitamin A deficiency in children, thus preventing over a half
million children from going blind annually and save a million
or more lives.
3. Promotion – education of community leaders, elders,
traditional healers, and citizens in the importance of eye
care, surgical treatment, and hygiene.
1. Testing Visual Activity
2. Referring patients with visual acuity of less than
20/60.
3. Training in administrations of eye medications.
4. Training in application of dressings to the eye.
5. Recognizing and managing eye infections.
6. Removal of conjunctival and corneal foreign bodies.
7. Promotion of face washing and improve personal
hygiene.
8. Recognizing Vitamin A deficiency
9. Carrying out antibiotic, prophylaxis of newborns
10. Recognizing serious injuries.
▸ The World Health Organization published a
report in 1998, estimated that there were
19.34 million people who are bilaterally blind
from age-related Cataracts.
▸ This represents 43% of all blindness.
The number of blind people in the world and
the proportion due to Cataract is increasing
due to:
1. Population Growth
600 million now in the world will increase
to around 800 million in 2020
2. Increasing Longevity
True for developing countries a well as the
industrialized world.
Population over 60 years will double to 800
million in 2020.
A Figure of 1,000 new blind people from
Cataract per million population/year is used
for planning purposes in developing
countries.
Cataract Surgery Rate
In order to reduce the backlog of Cataract
Blindness and operable Cataract, it is
necessary to operate each year on at least as
many eyes as develop Cataract.
Low demand because of fear of surgery.
Low demand from poor people because of
high cost of surgery.
Low demand because of poor visual results.
Lack of eye surgeons, particularly in Africa.
Manual Small Incision Cataract Surgery
A Safe, Cost-Effective Cataract Procedure for
Developing Countries
Cataract Surgery
Advantages:
▸ Shorter Learning Curve
▸ Simple and Inexpensive
▸ Reduced Cost of Surgery
▸ No Maintenance Needed
▸ Technique Applicable in any remote part of the Country
▸ High Volume Output
▸ Inexpensive Instrumentation
▸ Easy Learning Curve
▸ Lesser Operating Time
▸ High Patient Turnover
▸ No Reusables
▸ Recurring Cost Per Case
$6.00 - $8.00
Poor Visual Activity following Cataract
Surgery will affect the demand and uptake of
Surgical Services.
World Health Organization developed a
method to monitor and evaluate outcomes
following Cataract Surgery.
Post-Op Best
Vision Vision Corrected
Good 6/6 – 6/18 80% 90%
Borderline <6/6 – 6/60 <15% <15%
Poor <6/60 <5% <5%
Identify causes of poor outcome of Cataract
Surgery
To address their causes and improve
outcome of surgery
To improve outcome and thereby increase the
output of Cataract Surgery services
1. Alcon Medical Mission Program
2. Allergan Mission
3. See International
4. Aravind Eye Hospitals
5. Advanced Medical Optics
There are 133 Million people with visual
impairment due to uncorrected refractive
errors, excluding presbyopia. Globally,
uncorrected refractive errors are the main
cause of visual impairment in children age
5 – 15.
Provide refraction and optical services that
have a high rate of success in terms of
visual acuity and improved quality of life
and are affordable, of good quality and
culturally acceptable, to rural as well a
urban populations.
1. Myopia (near-sighted)
2. Hypermetropia (far-sighted)
3. Astigmatism
4. Presbyopia
1. Establish comprehensive eye-care services.
2. Train human resources to ensure high
quality refraction and optical services.
3. Provide spectacles in low-income settings
that are of good quality, accessible and
affordable.
1. Reduce the proportion of people with
uncorrected refractive errors that cause
visual impairment.
2. Particular attention should be paid to
children, the working poor, and adults over
50.
3. Provide a correction that is affordable, of
good quality and culturally acceptable.
Resources Available:
Lions Club International
Rotary Club International
Kendall Optometry Ministry
Fellowship of Christian Optometrists
International Inc.
Kendall Optometry Ministries provides a
computerized system that allows a ministry
group to provide high volume provision of
glasses in developing countries.
Glaucoma is responsible for 10-15% of
blindness worldwide; i.e., 6-7 million people.
Angle Closure is more common in Asia.
Open-angle is more common in Africa.
Difficult treatment that requires follow-up.
1. Treatment is aimed at stopping further
vision loss. It will not restore vision.
2. Medical treatment is difficult because of
poor follow-up, compliance and cost of
medication.
3. Surgery treatment option of choice;
extended follow-up, with complications.
Trachoma
Childhood Blindness
Vitamin A Deficiency
Ocular Trauma
Help Build Infrastructure.
Introducing Appropriate Technology.
Empowering Local People.
Work Within System.
Look at those beautiful eyes!
Thank you!
