A Unique Experience of Retinal Diseases Screening in Nepal

Arjun Shrestha,1 Bijay Khatri,2 Takeshi Naito3 1Department of Ophthalmology, BP Eye Foundation, Hospital for Children, Eye, ENT & Rehabilitation Services, Bhaktapur, Bagmati Province, Nepal; 2Academic and Research Department, BP Eye Foundation, Hospital for Children, Eye, ENT & Rehabilitation Services, Bhaktapur, Bagmati Province, Nepal; 3Department of Ophthalmology, Tokushima University Hospital, Tokushima, JapanCorrespondence: Arjun ShresthaDepartment of Ophthalmology, BP Eye Foundation, Hospital for Children, Eye, ENT & Rehabilitation Services, Bhaktapur, Bagmati Province, NepalTel +977 1 6631705Fax + 977 1 6639735Email drarjuns@hotmail.comBackground: Recently, the number of retinal patients is increasing in Nepal. The retinal problems are the second common cause of blindness in Nepal. Retinal diseases are challenging to manage due to the lack of simple and cost-effective screening methods, limited human resources, poverty, and lack of awareness in Nepal. Hospital for Children, Eye, ENT & Rehabilitation Services (CHEERS), Nepal conducted retina screening camps and education in communities through Retina Eye Care of Nepal project (RECON) in the years 2017 and 2018.Materials and Methods: We screened retinal patients with an indirect ophthalmoscope coupled with plus 20 Dioptre lens and portable fundus camera. We referred the patients needing interventions to the base hospital (CHEERS) using a screening algorithm, where they received retinal laser and surgery. Besides, we also provided on-site educational programs for retinal disease awareness to the community.Results: Retinal problems found from two static outreach clinics (SORC) and a day screening and treatment service (DSTS) were 18.3%, 20%, and 20%, respectively, while from a remote rural health camp (RRHC) was 2.61%. Likewise, patients referred to CHEERS for retinal laser or other retinal interventions were 15%, 16.6%, 16%, and 1.96% from 2 SORCs, 1 DSTS, and 1 RRHC, respectively.Conclusion: Retina camp is a cost-effective approach to early detection and referral for retinal-related vision impairment patients. It is also one opportunity to educate the community. The purpose of the project was to provide retina care to the community who otherwise could not afford it. We recommend a similar screening model on a large scale in a low-resource setting for the maximum benefits to the rural community.Keywords: screening, retina camp, Nepal, outreach