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Establishing a surgical outreach program in the developing world: pediatric strabismus surgery in Guatemala City,
Lauren C Ditta1, Lilia Ana Pereiras2, Emily T Graves3
1Hamilton Eye Institute, Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee; Le Bonheur Children's Hospital, Memphis, Tennessee; St. Jude Children's Research Hospital, Memphis, Tennessee.
Insights
Establishing a sustainable pediatric surgical mission in Guatemala for strabismus treatment proved successful. International cooperation and local partnerships enhanced patient care and increased surgical volume by 57%.
Area of Science:
- Ophthalmology
- Global Health
- Pediatric Surgery
Background:
- Underserved populations in developing countries often lack access to specialized pediatric eye care.
- Strabismic disorders in children require timely surgical intervention to prevent long-term visual impairment.
Purpose of the Study:
- To detail the establishment and outcomes of a sustainable pediatric surgical outreach mission for strabismus treatment in Guatemala.
- To assess the feasibility of international cooperation in providing specialized eye care to underserved children.
Main Methods:
- A multidisciplinary team of pediatric ophthalmologists and orthoptists conducted surgical missions over two years.
- Patient screening, surgical intervention, and postoperative care were coordinated with local Guatemalan healthcare providers.
- Surgical procedures were performed at the Moore Pediatric Surgery Center.
Main Results:
- Patient screenings increased by 47% in the second year, with over 60% pre-screened by local specialists.
- Surgical volume increased by 57% in the second year (58 surgeries vs. 37).
- A wide range of strabismic diagnoses were treated, with no significant complications reported.
Conclusions:
- Sustainable pediatric surgical outreach programs for strabismus are achievable through international collaboration and local partnerships.
- Integrating local ophthalmologists and medical directors is crucial for long-term success and best practice management.
- Such missions effectively address the needs of underserved pediatric populations with strabismic disorders.
Purpose:
To report our experince in establishing a sustainable pediatric surgical outreach mission to an underserved population in Guatemala for treatment of strabismic disorders.
Methods:
A pediatric ophthalmic surgical outreach mission was established. Children were evaluated for surgical intervention by 3 pediatric ophthalmologists and 2 orthoptists. Surgical care was provided at the Moore Pediatric Surgery Center, Guatemala City, over 4 days. Postoperative care was facilitated by Guatemalan physicians during the second year.
Results:
In year 1, patients 1-17 years of age were referred by local healthcare providers. In year 2, more than 60% of patients were prescreened by a local pediatric ophthalmologist. We screened 47% more patients in year 2 (132 vs 90). Diagnoses included congenital and acquired esotropia, consecutive and acquired exotropia, congenital nystagmus, Duane syndrome, Brown syndrome, cranial nerve palsy, dissociated vertical deviation, and oblique muscle dysfunction. Overall, 42% of the patients who were screened underwent surgery. We performed 21 more surgeries in our second year (58 vs 37), a 57% increase. There were no significant intra- or postoperative complications.
Conclusions:
Surgical outreach programs for children with strabismic disorders in the developing world can be established through international cooperation, a multidisciplinary team of healthcare providers, and medical equipment allocations. Coordinating care with local pediatric ophthalmologists and medical directors facilitates best practice management for sustainability.
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