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.
glaucoma in Uganda
Since its inception, TinyEyes has made meaningful contributions to retinopathy of prematurity (ROP) care in Uganda. On a recent trip, Ugandan physicians asked the team for clinical and surgical support for their glaucoma patients, and in May 2026 TinyEyes brought a glaucoma specialist on its Uganda mission for the first time. What the team found was a staggering, urgent need. Glaucoma is an irreversible, blinding disease, and in Uganda most patients seek help only once it has reached an advanced stage. In one clinic, roughly 95% of patients already met the criteria for surgery, and across the country a single glaucoma-trained ophthalmologist serves a population of more than 50 million.
With the support of our industry partner, the team introduced minimally invasive bleb surgery (MIBS) to its Ugandan colleagues. Our glaucoma specialist worked side by side with local ophthalmologists, sharing her expertise across a range of glaucoma procedures and post-operative care. It was inspiring to see how much Uganda’s ophthalmologists accomplish for their patients with such limited resources.
Goals and Initiatives for Future Trips
Uganda lacks the equipment, training, and diagnostic tools needed to fight this disease. Our goals are twofold: to provide surgical training so Ugandan physicians can care for their own communities, and to establish continuing medical education for residents and junior ophthalmologists. We believe that combining hands-on and didactic teaching is the key to sustainable capacity building. Finally, we are working to grow the team. The need far outstrips what any one specialist can meet, and we are calling on glaucoma specialists across Canada and the United States to join us in this work.
Stories from the Field
In the pediatric glaucoma clinic, we saw several infants with end-stage primary congenital glaucoma. Their eyes showed the classic signs: enlarged, cloudy corneas with a bluish-grey hue, the same colour captured in the disease’s name, from the Greek glaukos. This presentation is extremely rare in North America, where the condition is usually caught early. In Uganda, the team watched one child after another arrive at this advanced stage.
In the adult glaucoma clinic, we met a young mother with advanced glaucoma in both eyes and dangerously high intraocular pressure (IOP). Both eyes needed surgery. She asked what each operation would cost. The local ophthalmologist explained that the surgical and medication fees would be waived, but that she would still need to cover the hospital fees. She paused, then asked if she could make a few phone calls. An hour later she returned: four relatives had agreed to lend her money, and she now had enough for one eye. She asked which one to save. It was a decision no one should have to make, and a wrenching one for the surgical team as well. We chose to operate on the eye with milder disease, to give her the best chance of keeping useful vision.
Stories like these remind us of the realities Ugandans face, and why this work matters.
• 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.