This is Africa

Last Thursday as I was operating, I went to stick my empty syringe into a small cup of Lactate Ringers (LR) solution so that I could fill it up in order to repressurize an eyeball.  But as my gloved hand was hovering over the fluid, my eye caught a glimpse of a small black critter with 8 legs swimming frantically in the cup.  Inadvertantly, I let out a yelp.  I admit: I have arachnophobia.  The other surgeons peered over from their microscopes and chuckled softly as they saw what caused my distress.  As the theatre nurse hurried over to remove the spider-flavored LR from my sterile tray, she smiled and stated, “This is Africa.”  

Later that same day, I saw a patient in clinic whom my colleague referred to me for a corneal problem.  He was a young, 20-year-old male who had an obvious corneal problem.  As he closed his eye, I saw a prominent bulge from under his right eyelid.  

And when he opened his eye, a big ball of white and gray seemed to jump out at me like a costumed mummy from a Halloween haunted house coffin.  He had apparently had a bad corneal infection, likely a fungal ulcer, about 2 years ago.  And his eye went on to develop this horribly large anterior staphyloma involving the entire cornea.

This is Africa.

When I see corneal processes this advanced and this horrific, I can’t help but think to myself: “Why does it get to this point in Africa?  Lack of appropriate eye care?  Lack of funds?  Lack of resources?  Is it even fair that in the U.S. we have such wonderful access to world-class research, beautiful hospitals, cutting-edge technology, and efficacious medications while much of the rest of the world does not even have access to basic eye care?” 

This is Africa, indeed.

p.s. For the ophthalmologists reading this blog, any suggestions on how to proceed/treat this case would be appreciated.