Today is my last day with the main mission, and I'm working with the ophthalmologist since it's his last day too. I feel like I'm starting to get the flow of things, so here's to a positive attitude.
We make our way to the camp on-time for the first time and go to the back hallway to find the ophthalmology clinic. Before we let in the first patient, the doctor gave me a quick intro to ophthalmology, the anatomy of the eye, and the equipment they have available in the camp. He explained that ophthalmology required a lot more equipment than we had here - an ophthalmoscope, a slit lamp, a tonometer, an autorefractor, and corrective lenses.
The hardest case for a patient that we encountered was a 17 yr old girl with almost complete blindness but only a mild cataract. Other associated symptoms include completely uncontrolled diabetes, with blood sugar ranging from 35-700, which definitely plays a factor. After being unable to make any conclusions from the preliminary eye exams, the doctor dilated her pupils to get a better look. 30 minutes later, she was brought back in, but the doctor wasn't able to see anything conclusive now either. We ended up referring to a proper retinal scan, which was expected to take months at best. The doctor was not happy.
The most common complaint by far is dryness and eye irritation, presumably from the dry, arid climate and the dust storms that happen almost daily. Unfortunately, there aren't many good treatments besides staying indoors to avoid the dust and eye drops. Cataracts, or "white water" as they're called in Arabic, however were much more common than I expected, even in younger adults. All of those had to be transferred to a hospital outside the camp that could actually perform the operation.
In the room with me the entire time, the technician and medical scribe was learning how to use some of the more automated machines, for example to measure an eyeglasses prescription using the autorefractor. At the very end, the doctor gave him a brief introduction to the lenses, but it seemed like he zoned out.
The doctor asked, "So are you going to start using this equipment?" and he replied "Probably not anytime soon. We're out of glasses, doctor".
Something I found depressing was even after we were "done" with the patients for the day, there were 8 more waiting outside who were unregistered. The doctor and I decided to stay a little bit longer so we could see the patients, and to be honest they needed the care just as much as anyone else. More of the same: cataracts, itchy and dry eyes, and glasses prescriptions.
Reflections
As the day comes to an end, I start wishing I could stay with the mission longer. At the same time, the magnitude of the issues here is simply incredible: there's great need, and these doctors only come for 10 days every few months and they're still unable to treat the glut of patients that come daily. That's not even touching the public health issues of sanitation, nutrition, and immunizations which are largely handled by humanitarian organizations like the UNHCR but it's simply not enough.
All I could do on the way back was stare out the window and ponder.
