ICO focuses on third-world countries

The need for appropriate eye care in third-world countries is acute. Bruce Spivey, MD, president of the International Council of Ophthalmology (ICO), described the efforts of the organization to spearhead ophthalmologic advances in those countries.

The need for appropriate eye care in third-world countries is acute. Bruce Spivey, MD, MEd, president of the International Council of Ophthalmology (ICO), described the efforts of the organization to spearhead ophthalmologic advances in those countries.

The number of individuals worldwide who are visually impaired is approximately 314 million, with the largest majority in Africa and the fewest in the Americas and Europe.

The key issues in underdeveloped countries in the efforts to combat blindness are related to training appropriate eye-care personnel.

"There are not enough ophthalmologists and eye-care personnel to provide the care needed. There is also a mal-distribution of eye-care providers and a lack of providers in the areas where they are most needed," Dr. Spivey stated.

Sub-Saharan African, especially Nigeria, and Haiti are some of the worst affected areas of the world. Basic education and equipment are lacking in those areas as well as continuing medical education.

"The greatest need is to provide leadership for training ophthalmologists and other personnel needed," Dr. Spivey said.

The ICO asks national ophthalmologic societies to do work with the national Vision 20/20 programs and others involved in eye care, to assess the need for ophthalmologist and other providers in the respective countries, and to evaluate training programs. Dr. Spivey emphasized the importance of a team approach to meet ophthalmologic needs in underdeveloped countries that are comprised of ophthalmologists, subspecialists, and primary-care physicians.

"There is a gross inadequacy of mid-level personnel," he said. "The fundamental need is management expertise. This is especially true in Sub-Saharan Africa where the idea of management does not pervade."

The focus of the ICO is to develop educational curricula by international task forces and to provide the underdeveloped areas with clinical guidelines. In Nigeria, for example, the ICO provided broadband and Internet access to residency programs. In Latin America, the ICO has been running directors' courses during which all training directors from a country meet for 2 days and work on developing residency programs with the emphasis on such things as delivering better lectures and developing teaching skills.

"There is huge improved energy and activity for community ophthalmology and focused disease approaches," Dr. Spivey concluded. "Latin American has been generally energized. This type of leadership should be shared worldwide."