IRELAND 
NORGE Right to Sight is led by leading eye surgeons and world experts in sub-specialties and is committed to adapting latest developments in eye care to reach the African population urgently. We will support and mentor research and development of such treatments and innovation in critical areas, through our leading African colleagues. All our programmes are supported with internet communication and conferencing. In 2012 we will see the completion of pilot models of delivery in all communication and programme areas. Examples of such programmes to date are:
Surgery
- The cataract operation has been simplified by the development of excellent portable A-scanners to predict intraocular lens calculation.
- Local anesthetic with intraocular lignocaine allows safe surgery without an anesthesiologist.
- Digital photography allows easy surgical observation and recording for optimal training.
- Cataract surgery techniques have been customised to the density of the cataract and are patient led, as opposed to economically led. Lighter cataracts ahve phacoemulsification and denser cataracts (the majority) have Small Incision Cataract Surgery (SICS).
- New intraocular antibiotics (Zinacef) allow reduced infection rates.
Diagnosis
- Digital photography, internet and GPS (smartphone) transmission.
- Portable tonometry and eye pressure measurements (ICARE).
- Rapid digital visual fields analysis.
These developments all allow widespread screening by non doctors (e.g. teachers, mobile phone shop keepers) for blinding glaucoma and cataract with referral of endangered eyes to primary services. Right to Sight will perfect the digital screening models in 2012 and scale up the services from 2013, reaching millions of new patients rapidly.
Treatment
Glaucoma
New advances in laser and surgical valve innovation will allow pressure control for millions of patients who could not afford or access drops, or find a surgeon to treat their glaucoma. Right to Sight is developing a Center of Glaucoma research and Excellence in Africa in 2012, in partnership with International experts in glaucoma research and development.
Selective Laser Trabulectomy (SLT): Right to Sight has launched the African multicenter glaucoma trial and was delighted to receive a loan of two Selecta Portable SLT lasers in 2011 from Lumenis. SLT has been shown to replace the need for drops in many patients who can successfully have their pressure controlled with Latanoprost. In Africa, glaucoma drops are unavailable or usually prohibitively expensive, costing more than a daily wage for a months supply. Furthermore, worldwide, compliance (remembering to instill drops once a day) is very poor because glaucoma is not usually assocaiated with any pain or visual symptoms in the early stages of the disease. SLT laser treatment can control eye pressure for up to five years in current studies in caucasian eyes. Right to Sight is researching the potential for early control in African patients and is extremely grateful to Lumenis for their support.
Vernal Eye Disease
Right to Sight is researching new treatments, avoiding the use of steroids, for this allergic eye disease which in africa can blind patients due to corneal scarring from severe damage to the lining of the eye (conjunctiva).
Squamous Cell Carcinoma
The prevalence of HIV/AIDS in Africa has resulted in a devastating increase in squamous cell carcinoma of the conjunctiva. in some African hospitals, the most common operation performed in their eye departments is enucleation, removal of the eye, to stop the spread of the cancer and death from metastasis (secondaries). Right to Sight has established the Squamous Cell Carcinoma Trial in it’s partner hospitals, exploring non-surgical treatment options.
