A special guest post from Battambang, Cambodia by Dr. Gary Barth, ophthalmologist and Seva volunteer. Posted Jan 22, 2011 For the past two days, the Seva staff and volunteers have been attending rural government-run health clinics around the old Cambodian capital of Siem Reap. These clinics are the precursor to next week’s cataract and pterygium surgery camps to be held in the old capital city near the world-famous Angkor Wat temples.

Seva eye screening camp in rural Cambodia

The program is skillfully organized. For months, 5 rural health centers have advertised that free cataract and pterygium surgery would be sponsored by Seva next week. Those interested in obtaining surgery were to show-up on the appointed day at each rural clinic. No appointment was necessary.  An optometrist and ophthalmic screening personnel staffed the clinic for that day. Each day, many dozens were seen and about 20-30 patients were referred in to the city for free surgery the following week.

visual acuity testing in Cambodia at Seva eye camp

The screening methods were creative. At the first clinic, an outdoor “tumbling E” eye chart was used to determine visual acuity. It was a bit “odd” to see these Khmer speaking patients using a tumbling “E” since they do not have an E in their script! An example of their script can be seen in the last blog concerning the vitamin A supplements. During the morning, the chart was fixed to a chair on one side of the clinic. A bit later as the sun moved, the chart was moved to the back of the clinic and attached to the water tower. Another unusual aspect was that patients were all crowded together, laughing and encouraging each other to read the chart. It was amazingly friendly and jovial. Later when they were brought in to the exam room for an ophthalmic exam, the waiting patients were so eager to get into the exam room that they were practically on top of each other in their zeal to get “examined”. Another curious aspect was the patients’ quick decisions about whether to have surgery or not. In not one case was a family member with the patient when they were examined and the options discussed. Instead each patient agreed to surgery if it was indicated.

Hypermature cataract. All photos courtesy of Dr. Gary Barth

One lady was completely blind. She had to be led into the room and could not see anything as evidenced by the way she searched with her hands for the chair to sit in. She had “hypermature cataracts” that had dislocated into the middle of the eye. She was therefore not a candidate for cataract surgery given the equipment available in Cambodia. In interviewing her, she began to lose all vision about 10 years ago. Perhaps with earlier intervention, her cataracts could have been extracted when it was safe and possible to remove them in the conventional way. She was quite unhappy to learn that surgery was not possible. She is seen here in the middle of her family, leaving the clinic in a small wagon attached to a small tractor.