MBARARA MARCH 2015 OPHTHALMOLOGY FACULTY VISIT

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Dr. Roberto Pineda follows-up with a corneal transplant patient four months after his procedure.

In early March, Roberto Pineda, M.D., and Ankoor Shah, M.D., Ph.D., led the second OGSH Ophthalmology Faculty visit to the Mbarara University and Referral Hospital Eye Centre (MURHEC) and Ruharo Eye Centre (Ruharo) with a focus on cornea and pediatrics.  Four months after Dr. Pineda worked with faculty, staff, and residents at MURHEC and Ruharo to perform five cornea transplants in OGSH’s first faculty visit, the ophthalmologist returned with nine more donated corneas. Drs. Simon Arunga and Sam Ravuma again primarily assisted on the transplants along with residents Dr. Lloyd Williams and Dr. May Tambula.  Previous cornea transplant patients have been followed by faculty and residents at MURHEC and Ruharo, who presented these outcomes at a recent regional Ophthalmology conference. Patient outcomes thus far have been overall excellent, with faster than expected healing rates and no incidences of infection.

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Dr. Ankoor Shah and MURHEC resident Dr. May Kambula perform a postoperative check on a strabismus patient.

Dr. Shah, a pediatric Ophthalmologist practicing at Boston Children’s Hospital and Mass Eye and Ear, led participating faculty and residents through two pediatric cataract, one adult cataract, and seven pediatric and adult strabismus surgery teaching cases. The strabismus cases provided a concentrated surgical skills transfer opportunity with Dr. Freddy Mbumba Bwetsia and Dr. Lloyd Williams. They discussed pre-, intra-, and post-operative decision making, and Dr. Freddy led the local team acting as primary surgeon with Dr. Shah as an assistant. The final two cases were performed by Drs. Freddy and Lloyd with Dr. Shah simply as a guide.

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Drs. Lloyd Williams and Freddy Bwetsia during a strabismus procedure

While this trip allowed for a great deal of one-on-one surgical teaching, future faculty visits will strive to conform to an academic template agreed upon by the MURHEC and Ruharo leadership and OGSH faculty team. This structured template would more closely follow that utilized by the ENT residency collaboration OGSH has with the ENT Department at the same institution, integrating testing assessments, didactics, clinical and surgical instruction with the residents’ customary academic schedule. Expanding upon previously established weekly lectures and case of the week presentations, the OGSH faculty will provide a week-long academic program focused on a prioritized subspecialty that fits into the footprint of the existing schedule.

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Dr. Lloyd Williams, a third year Ophthalmology resident at MURHEC, examines a cornea transplant patient

The residency program at MURHEC continues to serve as a regional resource with five of six residents coming from outside of Uganda. Dr. Lloyd Williams, who graduates the program this summer, will return home to Sierre Leone where he will become the fifth ophthalmologist in the entire country. Training opportunities for ophthalmologists in sub-Saharan Africa are limited and the role of regional bodies like the College of Ophthalmologists of Eastern, Central, and Southern African (COESCA) in coordinating and aligning educational resources is vital for addressing the unmet need for ophthalmic care.

While not as effected by trachoma as much of the rest of the region, unusually high incidences of retinoblastoma and keratoconus, in addition to the usual cataracts, glaucoma, trauma, corneal ulcers and scarring require comprehensive eye care services. In Mbarara, these services are provided through the joint efforts of MURHEC, where one of two Ophthalmology Residency programs in the country resides, and Ruharo Eye Centre, a mission-based hospital that acts as its training partner and provides 40-years of experience addressing vision issues in the region.

We would like to extend our thanks to the faculty, residents, and staff at MURHEC and Ruharo Eye Centre, especially Drs. Freddy Bwetsia at Ruharo and Drs. John Onyango and Amos Twinamasiko at MURHEC for their support and leadership.

A special thanks to SightLife and Tissue Bank International for their cornea tissue donations.

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