Projects & Initiatives
Retinopathy of Prematurity in Uganda
A collaborative project with Stop Infant Blindness in Africa (SIBA) and TinyEyes.org began is 2021 in Kampala, Uganda at the Nsambya Saint Joseph’s Hospital and included collaboration with Mengo Hospital, University of Makerere, Nakesero Hospital, Kawempe Hospital. Donations from Grants from individuals, Knights of Templar and Alcon were used to purchase oxygen blenders as well as ophthalmology lasers required for ROP treatment. Our multi-disciplinary team of ophthalmologists (Drs. Ells, Rodriguez, Blair), neonatologist (Dr. Vaucher) and neonatal nurse (Ms. Carroll) travelled to Kampala for 3 consecutive years to educate (lectures and skill transfer courses), advocate with hospital administration and Ministry of Health, and participate in prospective research from 2021-2024.
Ongoing prospective research comparing neonatal and vision outcomes from before and after implementation of oxygen resuscitation equipment and education are ongoing.
TinyEyes.org in Uganda aims to support a sustainable ROP national program that involves neonatal and ophthalmology care, education, and advocacy to parents, health care workers, hospitals, and Ministry of Health.
• Africa is the world’s 2nd most populated continent (>1 billion people) and SSA accounts for 28% of preterm births globally
• < 40% of NICU’s in LMIC settings have controlled oxygen environments and ROP screening programs. In Uganda, it is estimated that 98-99% of NICU’s use 100% oxygen. This foreshadows the emerging epidemic of childhood blindness in LMIC, especially in Africa/Uganda. Hence the importance of primary prevention of ROP with appropriate oxygen management of the premature infant in the NICU.
• In developed countries, ~10% of screened infants developed severe ROP so we need to examine many babies in order to identify those infants needing treatment. ROP screening programs are resource intensive. For example, in Kampala, there are only 17 ophthalmologists for ~20 million people, a tremendous burden of eye disease for small number of physicians, leaving very little time for ROP exams. For this reason, the development of a national ROP program for Uganda that involves neonatologists, pediatricians, ophthalmologists and NICU nurses is so important.
• Education of health care providers, raising awareness of ROP and the complications associated with being born too soon is critical. Additionally, parent education is vital because parents are the most passionate advocates for change to our health care system.
• Leverage available digital imaging technology, such a infant retina camera’s, which can be operated by a non-physician to take pictures of the ROP. These images can then be securely transmitted via the internet to ophthalmologists for screening and decisions on treatment. This telemedicine approach would radically reduce the burden of exams for resource-scare ophthalmologists in Kampala and throughout Uganda. Camera systems are also used for education and world-wide consultations with ROP experts.
ROP in Vietnam
The TinyEyes.org team collaborates with Dr. JD Ferwerda in Ho Chi Ming City, Vietnam since 2018 to educate and advocate for ROP diagnosis and treatment in Vietnam. TinyEyes.org supported an international faculty to participate in a 2 day conference in February 2018. The next seminar and skill transfer workshops are currently being planned for 2025.
ROP in Rwanda
TinyEyes.org faculty, in collaboration with Dr. Armie Harper from Small World Vision and O2 Science, are participating in an education and training of residents (ophthalmologists in training) at several universities in Kigali in diagnosis and management of ROP and pediatric retinal diseases. Innovative telemedicine solutions will be used to train ophthalmologists and residents and skill transfer workshops are planned for 2025 and 2026.