Infectious eye diseases such as onchocerciasis are despite of the very efficient WHO Onchocerciasis control programme (operated between 1974- 2002) still a health problem in Sierra Leone. Intense control from this program ended in 2007.
Trachoma may be the oldest infectious disease known to mankind, but it is still a problem because of environmental risk factors such as water shortage, flies, poor hygiene conditions, and crowded households. Repeated eye infections scares the insides of the eyelids, causing the eyelashes to turn in and scratch the delicate surface of the cornea causing much suffering and impaired vision.
Refractive errors with the need for eyeglasses are present in all societies, but eyeglasses are difficult to get in Sierra Leone.
Deficiency of vitamin A can lead to serious eye symptoms including xerophthalmia and vision impairment.
Cataract, where loss of sight is surgically preventable, is still responsible for 48% of world blindness, but inadequate health services have led to a high prevalence, especially in countries such as Sierra Leone. At our screening of the first 300 patients examined at the Hospital, 125 suffered from cataract.
Glaucoma is another challenge, since many low-income countries lack the necessary equipment and expertise for diagnosing and managing glaucoma in their eye-care services, if existent. Glaucoma is four times more common among Africans than Caucasians and much more likely to cause blindness.
Within the Tonkolili District there are no other eye care facilities.
In a neighboring district, Lunsar Baptist Eye Hospital is functioning.
Surgical services are available at Connaught Hospital, Kissy UMC Eye Hospital, Lunsar Baptist Eye Hospital and Bo Eye Department. They conduct screening of school children in Freetown, Bo, Pujehun, Kenema, Kailahun, Kono and Kabala.
The staff also perform optical services (refraction, prescription, glazing and fitting of lenses) at Connaught Hospital, UMC Eye Hospital, Bo eye Department and the Baptist eye Hospital in Lunsar.
We estimate that no more than a total of 2000 cataract surgeries are carried out on a yearly basis presently in Sierra Leone.
We aim to establish equitable, quality, comprehensive eye care, especially for refractive error and cataract, within and beyond Tonkolili District, Sierra Leone, run by locally trained staff.
The objective is to reduce the burden of blindness and low vision through establishment of correction of refractive error and cataract operations, within and beyond Tonkolili District, Sierra Leone.
Specific targets:
- Establishment of a general eye care clinic with focus on the reduction of refraction abnormalities and operation of cataract.
- The eye clinic itself will focus on the treatment of infections and minor eye traumas.
- One of two main activities will be an optical service with focus on refraction, distribution and production of glasses.
- The other main focus will be establishment of a cataract surgery unit.
- Establishment of a training program for local staff enabling them to run the facilities
When fully functional we aim do see 25 patients daily in the general clinic, and to do 10 cataract surgeries on a weekly basis.
We plan to train:
- 1 practically trained state registrated nurse (SRN) who can conduct cataract surgery.
- 1 ophthalmic assistant
- 1 nurse, specially trained in post-operative eye care.
According to Vision 2020 priorities for combating blindness are cataract as first and refractive error/ low vision as a second.
