[Eye surgery in Sudan]

A seven-week stay in the Sudan in the winter of 1988/89 revealed the ophthalmological problems of this Third World country. As a result of the catastrophic shortage of local doctors, many cases of eye disease have progressed to terminal stages. Of 990 patients examined, 80% were unilaterally or bilaterally blind. The three main causes of blindness were cataract, trachoma, and glaucoma. The most effective treatment for these conditions was surgery. Operable cases were identified by a simple examination method, and a total of 330 operations were performed, of which 63% were for cataract and 21% for trichiasis. Trabeculectomy was performed in 9% of the cases in order to prevent absolute glaucoma. Owing to the many technical, personnel, and specific local problems complicated surgical methods were inappropriate. As in war surgery, the methods applied had to be simple and fast. In order to achieve any success it was necessary to abandon perfectionist western methods and adapt to locally available facilities. In the author's view, a well-prepared assignment of this kind can be a useful experience for any ophthalmologist.