June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Pediatric Cataract Training, Referral, and Surgical Program in Peru
Author Affiliations & Notes
  • Van C Lansingh
    LA, HelpMeSee, Quer�taro, Queretaro, Mexico
  • Luz Gordillo
    Instituto Damos Vision, Lima, Peru
  • Danielle Michaels
    LA, HelpMeSee, Quer�taro, Queretaro, Mexico
  • Stefany Marranzini
    LA, HelpMeSee, Quer�taro, Queretaro, Mexico
  • Kristen Eckert
    Independent Consultant, Ajijic, Mexico
  • Footnotes
    Commercial Relationships   Van Lansingh, None; Luz Gordillo, None; Danielle Michaels, None; Stefany Marranzini, None; Kristen Eckert, Van Lansingh (C)
  • Footnotes
    Support  USAID PGRD 14-0002-14  
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 2433. doi:
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      Van C Lansingh, Luz Gordillo, Danielle Michaels, Stefany Marranzini, Kristen Eckert; Pediatric Cataract Training, Referral, and Surgical Program in Peru. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2433.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The red reflex examination detects for abnormalities of the posterior segment and opacities in the visual axis in children and is federally mandated in Peru, but it has not been taught in most training programs, resulting in a gap in pediatric cataract detection and referral services. The purpose of this pilot study was to train health professionals to establish a pediatric cataract detection, referral, and surgical program in 6 provinces of Peru to increase the number of children referred and operated on for pediatric cataract. The training in pediatric cataract detection and referral is presented.

Methods : This study has 4 components. First, nurses, fieldworkers, and neonatologists/pediatricians were trained from 16 institutions in Peru (including 12 from Metropolitan Lima, 3 from the North, and 1 from the South) on how to perform the red reflex examination on children. A direct ophthalmoscope was used in a darkened room at arm’s length. Forty field nurses were also trained on how to use the Geographic Information System on their smart phones to register patients with suspected pediatric cataract in the field and ensure their uptake and follow-up of services. Patients with suspected pediatric cataract were referred to the Instituto Damos Visión (IDV) in Lima, Peru. The third component of this study was to operate on the patients with pediatric cataract at the IDV. The final component was to train 4 pediatric cataract surgeons, which is ongoing.

Results : From April 21, 2016-September 15, 2016, 147 health professionals were trained on pediatric cataract detection and referral services, including 80 nurses, 7 nurse technicians, 29 neonatologists/pediatricians, and 26 pediatric residents. Twenty children were referred to IDV; 18 had a confirmed diagnosis of pediatric cataract. Sixteen cataract surgeries have been performed on 12 children (mean age: 7.5 years; range: 1.9-15.8 years), 3 girls and 9 boys, 8 of whom are from the interior of Peru. All children had good postoperative visual outcomes. Seven children have 10 more cataract surgeries programmed.

Conclusions : The red reflex examination should be performed on all children in Peru. Following a low-cost training program, we created a growing national pediatric referral network in Peru, which integrates community-based outreach using satellite-positioning technology. Training is ongoing of 4 pediatric cataract surgeons to better respond to local population needs.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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