Training of Cataract Surgeons
Cataracts are the eye disease that blinds the most people in Kenya, and it’s on the rise due to the country’s rapid population growth, currently at 2% per year. Since the AIDS epidemic in the 1980s and 90s, the average life expectancy has increased from 50 in 2005 to nearly 70 in 2024. The infant mortality rate has decreased from 76 in 2005 to 37 per 1,000 children under 5 years old. While cataracts commonly affect the elderly worldwide, in developing countries, they also affect children, adolescents, and young adults far more frequently than in Western countries.
A shortage of eye surgeons who can operate on cataracts is a major problem in Kenya. Since its inception, Right to Sight has collaborated with several eye clinics in Kenya, including Kisii Eye Hospital (2015-2020), to provide further education for eye surgeons. We supported the establishment of a training center for Small Incision Cataract Surgery (SICS), a highly time- and cost-effective surgical method. Kisii Eye Hospital has provided further education to 29 ophthalmologists in SICS.
Today, we collaborate with Kwale Eye Centre. The clinic primarily educates Ophthalmic Clinical Officers (OCOs) in SICS. This education was introduced in East Africa in the 1980s to address the critical shortage of ophthalmologists. OCOs can specialize in cataract surgery. Kwale Eye Centre has provided further education to nearly 30 OCOs in SICS with support from Right to Sight.
Patients with cataracts undergo surgery while candidates receive instruction. The instruction is displayed on a screen in the operating room and recorded so that candidates can review the surgeries. Candidates practice on animal eyes in so-called wet labs, and eventually, they perform surgeries on patients under supervision. After 70 to 100 surgeries, most become proficient SICS surgeons.
Patients in need of surgery are identified through outreach activities. Approximately 10% of those attending outreach camps have cataracts. Without surgery, they eventually become blind. Kenya still falls far short of the target set by the WHO’s “Vision 2020” project for developing countries, which is 3,000 surgeries per 1 million inhabitants per year. Kenya currently stands between 700 and 800. An increase in cataract surgeons is essential to improve the surgery rate.
Pediatric Cataracts
Children born with cataracts or developing them during childhood is not uncommon in Kenya. They must be treated quickly to save their sight. Surgery on a child is more complicated and costly than on adults, and with previously used methods, the child requires long-term follow-up care.
However, a technique has now been developed that radically reduces the need for post-treatment (Bag-in-the-lens (BIL)). Right to Sight’s ophthalmologists have introduced this technique to Kwale Eye Centre, the first in Kenya to adopt it. The BIL technique has the potential to revolutionize the treatment of pediatric cataracts. Read more about the technique here.
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