Baxter's Blog

Last year the IAPB and WHO released the latest figures for world blindness. The good news is the world blindness numbers have turned downward. There previously had been rather depressing predictions for future blindness rates [ stats ] especially in the developing world due to the increasing Read more:

I am writing concerning the AAO / Rotary Host an Ophthalmologist program which has existed for ten years and has resulted in 73 young ophthalmologists from developing world countries visiting the States and attending the AAO annual meeting. Each year our AAO / Rotary committee, chaired by Ken Tuck Read more:

Although I would not recommend using expired drops in the States or if other choices are available, I have used expired eye drops in many eye situations in many countries over many years. I have never had a problem using expired drops. Off the record, most drug representatives will acknowledge Read more:

Unfortunately corneal fungal ulcers often present quite late in the developing world. There is usually a history of minor injury [ abrasion ] to the eye with plant or vegetable material. Often the patient has a dense diffuse corneal abscess and perhaps a descemetocele at initial presentation. Read more:

Ideally the visiting eye team / surgeon should be seeing and operating on poor patients rather than middle class patients. If you are operating on middle class patients than you might be weakening any eye care infrastructure already available in that community. Depending on where you are working, Read more:

In cases of subluxated lens, zonular dehiscence, vitreous in A.C. pre op, or the need for secondary lens exchange with a posterior capsule rent, I would strongly recommend pre op IV mannitol.
A capsular ring may be indicated but would also advise IV mannitol 2 - 2 - 2 : 20%, 200ml rapidly Read more:

If you are operating for a limited time overseas, it may be helpful to leave written instruments [ check list ] on seeing the one week post op cataract patient. Here are some of my suggestions but I am sure you can write out [ leave behind ] your own suggestions for the eye nurse or other Read more:

Your supply of fluorescein strips can be extended [ prolonged ] by cutting each strip in half lengthwise. See attachment. Each " half " strip is enough to check the IOP in both eyes.This will obviously add to your supply of fluorescein strips. Read more:

Fluorescein drops can be made in the eye clinic by adding 0.4 ml of a 10% fluorescein solution [ such as what is used for IV fluorescein angiography ] to a 15 ml eye drop bottle of proparacaine or tetracaine. This will be the same concentration in the commercially prepared drops for checking IOP Read more:

My deceased good friend, John Cheatham MD, used to get upset how many times poor patients in the developing world were required to come back, over and over, prior to having a local cataract operation. In the States, no one requires lab work, EKG, chest X - ray, consultation on routine, healthy Read more:

I recently received a copy of Dr. William Dean's DVD " Sutureless ECCE " which is excellent. His DVD shows clearly the manual small incision cataract extraction technique. One nice thing, there is a written part [ text ] that is on the screen while the instructor is also speaking. Therefore an Read more:

Seeing patients with markedly updrawn pupils, for whatever reason, is not rare in the developing world. When living previously in east Africa, I used to operate on these patients, using a lot of viscoelastic and a long blade van ness scissors to do a pupilloplasty and reshape the pupil. I still Read more: