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Cloudy Skies, Clear Vision

The picturesque Tibetan Qinghai Plateau is very hard to reach. Many of its inhabitants suffer from cataracts. Successfully treating the disease requires special equipment and medical expertise. In July 2017, experts from the Tianjin Eye Hospital and engineers from ZEISS set off from Shanghai to provide humanitarian surgery to cataract patients in this remote area.

The vast and beautiful Tibetan Qinghai Plateau in western China is a unique landscape with thin air and sparse vegetation. Unfortunately, Tibet suffers from the world’s highest rate of blindness. According to the World Health Organization (WHO), the main cause of blindness in China is cataracts. Local statistics show that more than 430,000 people in the Qinghai Plateau experience reduced vision or vision loss due to clouding of the lens in the eye. At the same time, people in the region lack effective treatment options.

In Tibet, like other high-altitude areas of the world, the disease is twenty times more prevalent than in the Western hemisphere. There are many different reasons for this, but the most common cause is the higher dose of ultraviolet radiation up in the lofty mountains that accelerates the disease – even in children. A cataract is a disease that normally affects older people, but it also has an inherited component as an autosomal-dominant genetic trait. Children with this trait have roughly a 50 percent chance of contracting the disease at a younger age.

Bringing medical technology and expertise to a rural, mountainous area

Cataracts can be successfully treated – that’s the good news. However, the surgery demands high-quality medical technology, equipment and expertise. The remote rural plateau area lacks all three, mainly because of slow economic development in such high mountain areas.

The initiative “Gansu Qinghai Bright Action” is changing that. In July 2017, specialists from the Tianjin Eye Hospital and engineers from ZEISS set off from Shanghai to provide humanitarian surgery to cataract patients in the western plateau region – a 2000 km journey.

Their gear consisted of technological equipment for performing ocular examinations, a surgical microscope to carry out the cataract surgery, surgical instruments, medications and the ZEISS CT LUCIA intraocular lenses (IOL). These IOL implants are used to replace the cloudy lens in the patient’s eye.

The regional hospital, Huangnan People’s Hospital, had started to offer cataract screenings one month before the expert team arrived, and arranged for as many patients as possible to receive treatment during the short period. They screened approximately 1,700 patients of all ages, the oldest being 83 and the youngest just nine years old. During the screenings, the ophthalmologist first measured the patient’s visual acuity and their sensitivity to the glare. A biomicroscope (slit lamp) was used to examine the front of the eye, including the presence of a cataract.  This screening was very effective at identifying who was suffering from cataracts.

Regaining vision within a few days

The hospital identified many candidates for this life-changing surgery. In just two days, the team of ophthalmologists and medical personnel performed 89 operations.

Once the surgery had been performed, patients were instructed to rest and avoid any pressure on the eye. The eye patch affixed during surgery was removed one day later. The patients’ vision was significantly better and further improved over the next several days. Within a week, they returned to their daily activities and enjoyed clear vision. For many patients, this surgery gave them a new lease on life and hope for the future.

“This is the fourth year of the cataract surgery project between Tianjing Eye Hospital and Huangnan People’s Hospital,” said Dr. Lang Ke, Dean of Huangnan People’s Hospital. “We have already performed more than 300 surgeries. And it is very much appreciated by the residents.”

Dr. Lang Ke, Dean of Huangnan People’s Hospital

The surgeries are very much appreciated by the residents. 

Tibet faces certain challenges. People report that seeing a doctor is “difficult” or “expensive.”  The number of people who need medical care is increasing, while the supply of experts, such as ophthalmologists, is not growing at the same rate.

The ultimate goal: to improve medical care

“Helping those in need is not the only goal of Bright Action, the more sustainable long-term goal is to improve local medical care. ZEISS donated the retina screening OCT-instrument PRIMUS 200 to this initiative. With the advanced medical devices, the local hospital can perform accurate diagnoses and provide effective treatment for eye diseases, especially the common ones like macular edema and diabetic retinopathy,” said Dr. Tang Xin, Dean of Tianjin Eye Hospital.

Macular edema is the accumulation of fluid in the macula, an area in the center of the retina, and distorts vision. It can occur with a variety of conditions, such as age-related macular degeneration or as a result of inflammation in the eye. One of the more common causes is diabetic retinopathy, a disease that occurs in patients with diabetes. There are effective treatments available for macular edema, but early diagnosis and management is important.

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