Cataracts, the clouding of eye lenses, are the leading cause of curable blindness worldwide. They’re incredibly treatable, but for people who have lost their ability to see clearly, not being able to get the surgery can mean a life with no livelihood.
Last week, a handful of North Texas doctors spent time learning to help people with cataracts in the poorest parts of the world.
In a learning laboratory on the sprawling campus of eye care company Alcon in Fort Worth, a handful of doctors were learning to remove cataracts manually. It’s a technique that’s relatively uncommon in the U.S. these days.
Helena Ndume, in a bright room filled with state-of-the-art equipment, looked through a huge training microscope as one trainee cut into a pig’s eye. It was tacked to a piece of Styrofoam in the shape of a human face.
Ndume lives in Namibia, and the small incision cataract surgery method she’s teaching is kind of her stock and trade. It requires a tiny cut by hand to get at the lens that’s gone bad, and it isn’t always easy.
Ndume has performed more than 30,000 cataract surgeries in her country on the southwest coast of Africa. Cataracts are incredibly common – especially in older folks -- and they’re super-fixable. But eye surgeons are needed to do them, and in many developing nations, like Namibia, medical needs often outweigh capacity.
“There are so many other diseases that have to be tackled too, like HIV and AIDS,” Ndume said. “And ... things like diabetes and hypertension.”
So, in a lot of places, foreign doctors – including some from Texas – volunteer a week or two to help perform surgeries on medical missions.
Ndume operates eye camps in remote parts of Namibia, and she says Western doctors – folks like the ones she was teaching by cutting pigs' eyes -- need to know how to operate outside of the high-tech surgical theaters they’re used to.
“Most doctors, 95 percent of the operations they’ve done are with the machines,” said Daniel Gold, an ophthalmologist based in Palestine, Texas, who’s done medical missions all over the world. “They’re dependent on those machines.”
Gold says in private practices in the U.S., most cataracts are typically treated early using expensive machines that break up the bad lens in order to replace it with an artificial one. He says the manual incision process means getting back to basics, which aren’t often taught in medical schools in the West.
“The manual small incision, we’ve been able to perfect it to where it can be done without stitches, but there are cases where you’ve got to put in stitches, and many of the doctors haven’t done much suturing," Gold says.
Randal Avolio says cataract surgeries are simple, but their impact is huge. Avolio runs SEE International, a California nonprofit that plays matchmaker for eye doctors who want to go on medical missions. The group also supports doctors in developing countries, like Ndume, by helping them get surgical equipment and eye care supplies from companies like Alcon.
Losing vision means lower life expectancy for the blind person he says and it also impacts the whole family.
“When an individual is blind, often a child is taken out of school, and they tend to the adult who needs the help," Avolio says.
Avolio says 80 percent of curable blindness is caused by cataracts worldwide, which means millions of people die early because of something treatable. A cataract surgery is literally life changing, he said. It’s also pretty easy -- and cheap: About 20 minutes and $100 per patient on average.
“I don’t know many other things that for so few dollars delivers so much result,” Avolio said.
The challenge is getting enough surgeons who know how to do the right kind of surgery to the patients who need them. Avolio says there's a promising sign: SEE International has a waiting list for the trainings for doctors who want to help.