The Spectacle Makers' Charity

Some years ago, the WCSM pledged its support to Vision 2020, an international initiative to halve the incidence of preventable blindness throughout the World by 2020. Substance to that pledge is provided by grants made by the trustees of the Spectacle Makers' Charity. Here are two "case histories".

The Ophthalmology Link between
St Thomas' and Muhimbili, Tanzania

[The Editor is indebted to Liveryman Denise Mabey for explaining how grants from the Spectacle Makers' Charity are helping the drive for better eyecare in at least one part of East Africa.]

"Give a man a fish and you feed him for a day.
Teach a man to fish and you feed him for life"

The staff of the eye department at Guy's & St Thomas' Hospital are now well into a programme aimed at teaching and developing the skills of their colleagues at Muhimbili University of Health Sciences (MUHAS), in Dar es Salaam, Tanzania. This project has been running, with support from Spectacle Makers' Charity, for 5 years, and its main focus is paediatric ophthalmology and retina problems.

In 2007, Muhimbili had no paediatric clinic, no-one could measure visual acuity nor refract children, and there was no way of recording or treating posterior segment disease. Now, thanks to this project, there is a busy paediatric clinic, two ophthalmologists with an interest in retinal diseases, and a functioning Optical Coherence Tomography (OCT) machine for recording retinal images. Such success has spurred the Tanzanian Government into providing a laser for treating retinopathy, only the third such machine in that Country.

The training is delivered through exchange visits for ophthalmologists, optometrists, orthoptists, nurses and technicians, and includes individual patient diagnosis, clinical management, equipment maintenance, LVA provision and refraction in children, as well as embracing research projects. In 2011, six Tanzanians visited St Thomas' for 2-4 weeks at a time, whilst seven members of its staff visited Muhimbili for 1-2 weeks contributing to the 1508 paediatric consultations, 100 paediatric cataract operations, 384 paediatric refractions and 89 OCTs performed there during the autumn.

The success of the Link has now received wider recognition, with the Eye Department adopted as the Guy's & St Thomas' representative on the King's College Global Health Partnership. The Department is also registered with the Tropical Health & Education Trust, and has recently been awarded a grant from the British Council to work with the Royal College of Ophthalmologists, the Eastern Africa College of Ophthalmologists and 3 other parties to improve training standards for ophthalmologists throughout East Africa.

It is hoped to keep the Muhimbili project running beyond the 5 years originally envisaged as it is proving so beneficial to both parties. St Thomas' staff are gaining exposure to a raft of diseases that they would not otherwise come across, and much remains to be done in Tanzania, with perhaps the provision of a new optical workshop the most critical item on the "shopping list". The trustees of the Spectacle Makers' Charity very much hope that your continuing generosity will enable them to fund at least some of this work.

Combatting Trachoma

"Neglected tropical diseases" (NTD) is the term given to a group of 17 diseases, all parasitic or bacterial infections, that affect 1.2 billion people worldwide. Some NTDs can kill, and others cause severe and often lifelong physical impairment. Two specifically can blind, one of them being Trachoma, a painful eye infection that is spread by flies and unwashed hands. The World Health Organization estimates that it affects around 84 million people, of whom 8 million are visually impaired. Africa is the most affected continent, with 27.8 million cases.

Each infection of Trachoma causes scarring on the inside of the eyelid. This scarring eventually makes the eyelid turn inwards. Each time the eyelashes are lowered to blink, they scrape against the surface of the eyeball which causes intense pain. If left untreated, it results in damage to the cornea, which eventually leads to irreversible blindness. To relieve their suffering people often try to pull out their eyelashes using makeshift tweezers but the relief is short lived, as the lashes will always grow back, thicker than before. The only way Trachoma can be treated at this late stage is with surgery to reverse the turned-in eyelids.

The trustees of the Spectacle Makers' Charity therefore had little hesitation in making a grant to Sightsavers, a charity established in 1950 that does much to prevent and treat this terrible disease.

Its approach to the problem is summed up in one word, "SAFE", which is shorthand for a strategy approved by the World Health Organization. The acronym stands for Surgery to reverse the advanced trachoma, Antibiotics to treat the infection, and Facial-cleanliness, and Environmental health to prevent the disease from spreading.

Typical of the beneficiaries of this strategy is four-year-old Sadati, who is from a small rural village in the Kaleri District of Eastern Uganda. Along with his two brothers and his mother, Sadati was found to be suffering from trachoma when a Sightsavers-supported Ophthalmic Officer visited the village on his motorbike to check families as part of a community outreach programme. The infection was causing Sadati immense pain, and making him rub his eyes. A course of antibiotic ointment was administered and soon cleared the problem.

With each dosage costing a mere 50p, and surgery as little as £5, even a comparatively modest grant such as that made by the trustees of the Spectacle Makers' Charity can, in the right hands, easily and swiftly make a huge difference to many hundreds of people for whom, without such help, life would be one continuous torment.

At the Court Luncheon on 6th March, the Master was able to make two presentations that demonstrated that, notwithstanding their justifiable concern with the situation in the some of the developing countries, the trustees are not neglecting the fight against visual impairment closer to home. The first was to the orthoptist, Pretty Garrett, as continuing support to her in her role as the Visual Impairment Adviser to the Treloar Trust, where she is known as "the eye lady".

The second was to Harinder Paul, founder of the Charity Vision Care for the Homeless, which receives generous support in kind from optometrists, dispensing opticians and the optical industry, but struggles to meet the overheads associated with the premises needed for its clinics.

On 11th July, the Master was able to present a substantial cheque to members of 16 Medical Regiment who managed to break away from the preparations to secure the Olympiad to make a brief visit to the Hall. The money will enable the Regiment to obtain some advanced training aids and medical textbooks to enhance its members' preparation for their new role of providing emergency medical care in the remoter parts of the world, and without recourse to such stateof- the-art facilities as are now available at Camp Bastion in Afghanistan.