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thibaut Chapron, Tony Barthelemy, Pierre Henri Dalens, Qiuhua Zhang, Max Gerard, Paul Brousse; Ophthalmic Care Needs Assessment for Indigenous Peoples living in Isolated Environments in French Guiana. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5439. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
The objective of the study was to assess the ophthalmological care needs of indigenous populations living in remote areas in French Guiana in order to establish a care network adapted to the needs and geographical constraints.
The study was carried out from May to November 2017 in 16 isolated health centers in French Guiana, 10 were only accessible by plane or canoe. The main end-points were the presence of avoidable low vision defined as visual acuity (VA) less than 3/10 and the presence of avoidable blindness defined as VA less than 1/20. The number of health referrals requested by General Practitioners from health centers for ophthalmological reasons avoided by off-site consultations as well as the number of health referrals to Cayenne organized as a result of the study were also studied.
During the study period, 723 eye consultations were performed. 188/723 (26%) found an avoidable low vision. The first three causes were: cataract 105/188 (56%), uncorrected refractive disorder 38/188 (20%) and pterygium 14/188 (7.4%). 49/723 (6.8%) found an avoidable blindness. The causes were: 32/49 cataract (65%), 12/49 glaucoma (24%), 4/49 corneal opacity (8%) and 1/49 amblyopia (2%). The off-site consultations have avoided 65 (9%) medical repatriations for ophthalmological reasons. During the study period, 257 (36%) health repatriations at the Cayenne hospital were organized to perform surgery or further examinations.Three ophthalmic care networks with indigenous populations were considered based on geographical constraints and care needs. A first on the coast whose health centers are accessible by road with a truck fully equipped. A second on the Oyapock River where the villages are only accessible in one or two days of canoe with consulations made using portable equipment. Finally the third on the Maroni River where two main centers equipped with fixed material in the future are accessible by plane. From there, the villages accessible by canoes can come to centers equipped with fixed equipment in less than 5 hours.
The number of avoidable low visions and blindness reflects difficulties in accessing ophthalmic care for indigenous populations living in isolated areas in French Guiana. A first step of catching up and then a second step of setting up three screening and treatment care networks will help improve the health of these populations.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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