Postcards from the Field

Cornea Training in Accra, Ghana

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Himalayan Cataract Project International Fellow, Dr. Allison Jarstad spent two weeks in Ghana this month conducting a cornea subspecialty training workshop with Cornea Specialist, Dr. Gladys Fordjour from Korle Bu Teaching Hospital in Accra, with tissue donated by HCP Partner, SightLife. HCP's approach to eliminating needless blindness has always focused on building capacity at the local level. Sub-specialty, hands-on skills transfer experiences such as this are highly valuable.

                Postmark: January 28, 2019

The most exciting part of the week (other than helping so many patients regain sight) was to work with Dr. Gladys, who is a phenomenal and talented surgeon. Because tissue donation has not yet been improved in the country, there are no eye banks in Ghana. Because of this, Gladys must wait until surgeons from other countries visit and bring donated [cornea] tissue with them in order to do transplants.

Despite not being able to perform cornea transplant surgery on a regular basis, Gladys has excellent surgical technique and am happy to report that all surgeries were a success! She started learning Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) surgery just one year ago and her DSAEK case went perfectly.

I truly love teaching. It gives me so much excitement to watch someone else master a skill that I personally enjoy doing. What a rewarding experience that has been for both Dr. Gladys, her patients, and myself!

Here are some of those patient’s stories:

               Korle Bu Patient Stories: January 14 - 28, 2019

Meet Leticia Darkuah, a 17 year old female high school student living in Koforidua, which is located in the eastern region of Ghana, about a four hour drive from Accra. She is the 3rd of seven children in her family and was brought to the hospital by her mother. She had developed cataracts for unknown reasons (no report of trauma and did not seem to be congenital), and she had cataract surgery at a different hospital about five years ago. She had a complicated surgery in the right eye and an Anterior Chamber Intraocular Lens (ACIOL) was placed. Additionally, Leticia’s vision had never improved after her first cataract surgery so she developed pseudophakic bullous keratopathy. So we did an IOL exchange (removing the culprit lens and placing an iris-fixated lens) and a penetrating keratoplasty in the right eye. She said it has been difficult to do well in school because of her decreased vision. Leticia is very excited for her vision to improve after her cornea transplant and wants to continue to got to school and study to become a nurse.

Meet Princess, a 25 year old nursery school teacher from Accra. She came in with a penetrating keratoplasty done about five years ago in India. This cornea failed and her vision began to become cloudy and blurry about two years ago, making it difficult for her to function at home and at work. She underwent a repeat cornea transplant and is doing very well. She is less than 1-week post-op and she can already see some of the small letters on the eye chart. She is so grateful for her new cornea and has a beaming smile. She is excited to go back to work.

Meet Samuel, a 19 year old man who was born with a progressive disease of the cornea called, granular dystrophy. In this disease small opacities develop within the cornea and over time, the opacities become very dense and affects the vision in both eyes. Samuel was blind in both eyes, he could see a hand waving in front of his face in one eye and could count fingers in front of his face in the other eye, but could not see anything on the eye chart. It was impossible for him to work. We did a cornea transplant where we removed the central part of his cornea (to remove the visually disabling opacities) and replaced it with a donor cornea. He is so happy and can see much better even just 1 week after surgery. We expect his vision to continue to improve as he heals from surgery.

Meet Francis Davi, a 36 year old man from Jirapa, a small town in the far northwest of Ghana. He was referred here for inability to see with both eyes and pain. He was found to have bilateral cataracts and corneal opacities. He travelled for 12 hours to come to Korle Bu Teaching Hospital. Francis is a tutor to medical nursing students, and is excited to go back to work to help his students. He says God bless us and thank you so much for giving me my new eyes and asked immediately when the second eye could be done. When he was a university student he was interested in nursing and enjoyed reading and knowing more about disease conditions. Then he became interested in teaching others about it.

- Dr. Allison Jarstad

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