Introduction

The East Asia Vision Program in 2013 estimated 43,800 people are blind in both eyes in Cambodia. The main causes are cataract, uncorrected refractive errors, glaucoma, corneal scarring, and pterygium. 80-90% of these problems are preventable or treatable with relatively simple and affordable operations, yet the eye care workforce is small in relation to the need for eye care services, which are available in only 21 of our 80 hospitals.

Around 3,000 eye operations are performed at CSC each year to either restore or prevent further deterioration of eyesight. The operations range from cataract surgery to more complex vitreoretinal surgery, and lengthy oculoplastic operations where the Ophthalmology and Reconstructive surgeons work together on complicated cases.

Eye

These operations are commonly performed at CSC:

• Cataract surgery
• Pterygium removal
• Glaucoma surgery
• Corneal wound repair
• Squint repair
• Lid surgery
• Eviscerations
• Dacryorhinostomy
• Dacryocystectomy
• Enucleation and Implant
• Cyst removal

Training

In 2016, CSC has four ophthalmologists and four trainees, in addition to six specialist ophthalmic nurses and five ophthalmic assistants. As part of our Training Programme, three ophthalmologists received formal residency training of 3 years in Manila and annually, three or four members of the ophthalmology department receive specialised training at the well-respected Mettapracharak Hospital in Thailand.

Case Example

Cataract is the cause of 3 out of 4 cases of blindness in Cambodia. In a typical cataract operation, an operating microscope is used to allow the ophthalmic surgeon to remove the diseased, opaque ‘crystalloid’ lens and replace it with a plastic, transparent implant. The surgery requires only one suture and the patient may return home after as little as one night’s stay in the centre. Only local anaesthesia is necessary for adults and the procedure can cost as little as $15 (lens $6.50, suture $4, medications, drugs and dressings $4.50) in  materials imported from other developing countries.

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Thou is a 77-year-old grandmother who developed a cataract in each eye in 2015 causing her blurred vision and headaches. It became difficult for her to join religious ceremonies at the pagoda. After a small incision cataract surgery (SICS) and intraocular lens (IOL) implant in each eye, Thou was able to see clearly again and go to the pagoda every week on her own.