You may congradulate me, I passed my final board exam and am now fully board certified as of June 2012. It feels great, it is essentially the final test after 12 years of higher education. I feel blessed to be able to call myself the only American Board Certified Opthalmologist in Angola. This step was important as it paves the way for me to become a fully qualified trainer/educator for Angolan doctors to learn the art of cataract surgery.
On that note, I, and my Boa Vista team are preparing to start training our first Angolan cataract surgeon. We feel highly optimistic about this opportunity and can sense God's leading in this direction. Through a cooperative agreement with an Ophthalmology Residency Program in Paraguay (South America) we are so happy to have received Dr. Manuel (Peruvuin), a 3rd year resident. He has agreed to come for 3 months to help take the surgical load off of my shoulders while we have a surgical student.
Dr Mavitidi is the Angolan doctor who will arrive on August 10th for the start of the cataract training. He will be here for 6 months. I am praying that God will bless this opportunity. The need for cataract surgeons here in Angola is massive. Imagine this: Angola has a rate of blindness that is 10x higher than the USA, however, the rate of cataract surgery in the USA is 65x higher than Angola's. I simply can not put a dent in this level of cataract blindness by myself. However, by multiplication of cataract surgeons we can make a difference!!
Congential cataracts
This boy is blind from cataracts. He needed a surgery when he was a baby, but didn't get it. I operated on both of his eyes with good surgical technical results, but his brain and eyes never learned to communicate well, so his vision is still limited. I will still continue to try to rehabilitate his vision.
Fun with corneal perforations (and medical jargon)
This 23-year-old male was seen by the most well equipped clinic in the country. He was treated for allergic conjunctivitis and sent away, he returned to them with this peripheral cornea perforation of at least 2 weeks duration. He was promptly referred to Boa Vista. I think he actually had a bad scleral/corneal inflammatory condition. I treated him with a gram of azithromycin, topical antibiotics and ointments for two days along with oral steroids. This picture is the appearance after medical treatment.
After thinking about surgical options to restore integrity of his eyeball, I decided to do a peripheral patch graft with my supply of glycerol preserved corneas ( thank you Global Sight Network).
Here is the first operative day #1 appearance. I could not get all of the old fibrotic iris tissue out of the wound/angle, so the iris is still peaked (after doing many of these old perfs, I know why in the USA we do this surgeries in the first 24 hrs). However, the chamber is nicely reformed, his vision has improved from counting fingers to 6/18. I did a partial conj flap to cover the peripheral portion of the graft. I'm highly optimistic about his chances to retain good vision.
The same story here for another 20 something male. The only difference is the location of the perforation. Here we have a pericentral ulcer. I treated him much the same as the previous case. Here is the before and after photos.
John
