Vision Myanmar Program

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Vision Myanmar Program
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Vision Myanmar Program

• Ophthalmic surgery support program to Myanmar
• South Australian Institute of Ophthalmology in
  Adelaide
• Commenced 1996
• Aim is blindness prevention through comprehensive
  sustainable aid

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Vision Myanmar Program

• MOU signed with Myanmar Ministry of Health in
  2003 (for re-signing in Feb 2008)
• Funding contract for 4-year blindness project
  signed with AusAID in Oct 2007

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Vision Myanmar Program

• Excellent ophthalmic training program at Yangon
  Eye Hospital
• Poor continued medical education
• texts journals
• o/s conferences
• limited internet

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Vision Myanmar Program

• Invitation from faculty at YEH
• Initially focused on subspecialty surgical
  teaching
• Activities have expanded as needs recognised and
  requests fulfilled

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VMP Activities

• Research
• Education
• Equipment facility
• Public health

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VMP Activities

• Research
• Education
• Equipment facility
• Public health

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Research

• Epidemiologic data necessary to
• understand the ophthalmic problems (causes and
  prevalence of blindness)
• best direct limited resources and manpower
• 11 papers published

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Meiktila Blindness Survey

• Comprehensive blindness survey
• November 2005
• Random sampling of villages in central Myanmar
• 2076 adults gt40 yrs
• Visual impairment in rural Myanmar. Casson R,
  Newland HS, Muecke J, et al. Ophthalmology 2007

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Meiktila Blindness Survey

• Highest published blindness rate
• point prevalence blindness 8.1
• point prevalence low vision 40.4
• Blindness visual acuity lt6/60 in better eye

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Main Causes of Blindness
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Main Causes of Low Vision
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Childrens Blindness Survey

• Feb 2007
• 7 schools for blind
• 206 children lt16
• Measles keratitis in assoc with vitamin A
  deficiency

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Childrens Blindness Survey

• Provision of low vision aids for poorly sighted
  children
• Orientation and mobility training

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VMP Activities

• Research
• Education
• Equipment facility
• Public health

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Education

• Surgical teaching
• Registrar teaching
• Fellowship training
• External examiner
• Microsurgical skills re-training

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Surgical Teaching

• One week at YEH one at MEH
• Sub-specialty teaching
• Components
• interactive clinics
• hands-on surgery
• videos lectures

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Registrar Teaching

• Two weeks at YEH
• Emphasis on
• differential diagnosis
• treatment plan
• case-note keeping
• communication

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Subspecialty Fellowships

• 12-month fellowship training at SAIO
• Three fellows trained
• x2 vitreo-retinal surgery
• x1 oculoplastic surgery
• Two fellows to come
• paediatric ophthalmology 2008
• anterior segment-glaucoma 2009

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External Examiner

• SAIO provides an examiner in annual Master Course
  examination at YEH

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VMP Activities

• Research
• Education
• Equipment facility
• Public health

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Equipment and Facility

• Three Primary Eye Centres (ophthalmic teaching
  hospitals)
• Yangon Eye Hospital
• University of Medicine 2, Yangon
• Mandalay Eye Hospital

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Teaching Hospitals

• Need to supply
• teaching aids
• diagnostic equipment
• slit lamps
• operating microscopes
• Operating microscope maintenance training

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Equipment and Facility

• 16 Prevention of Blindness Centres CBM have
  upgraded
• 33 Secondary Eye Centres VMP 4-year upgrade
  project

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Secondary Eye Centres

• Need to supply
• slit lamps
• operating microscopes
• biometry equipment
• cataract surgery instruments

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Secondary Eye Centres

• Need to upgrade facility
• painting
• air-conditioners
• electricity generators

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Secondary Eye Centres

• Also need to
• re-train ophthalmologists who have lost skills
• encourage public surgery
• train theatre nurses handling equipment,
  sterilisation

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VMP Activities

• Research
• Education
• Equipment facility
• Public health

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Public Health

• Yangon diabetic eye disease campaign
• Cataract surgery awareness
• Trachoma eradication
• Vitamin A supplementation

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Yangon Diabetes Campaign

• Poor awareness of need for annual ophthalmic
  screening
• 57 of 480 patients never visited an
  ophthalmologist
• Multi-media public awareness (2006-07)
• TV radio
• newspapers mags
• posters pamphlets

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Cataract Surgery Awareness

• Barriers to cataract surgery 76.3 of 216
  patients with low vision refused referral for
  surgery
• cost 15.2
• fear 9.15
• no problem 8.5
• no time/support 4.9
• no reason given 55
• Regional health promotion and social mobilisation

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Trachoma eradication

• 50,000 cases of trachoma remain in the Dry Zone
  of central Myanmar
• SAFE strategy
• Eyelid Surgery
• Antibiotics
• Facial cleanliness
• Environmental changes

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Vitamin A Supplementation

• Need to discuss the findings of the Childrens
  Blindness Survey with MOH
• Recommend annual high dose vitamin A for children
  lt5yrs

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visionsofmyanmar.com.au
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Thank You !