SE Asia Collaboration

Current State of Eye Health in Myanmar

In Myanmar, with a population of 55 million people, 500,000 people are blind, and approximately 10% of the rural adult population suffers from blindness. The prevalence of blindness in Myanmar is the highest of any country in Southeast Asia, but 90% of the blindness in Myanmar is preventable. With proper subspecialty care and corrective surgery, this grim state of eye health can improve. Lack of subspecialty care in ophthalmology is a common, pressing public health issue worldwide in developing nations. In Myanmar, a country with great need for skilled ophthalmologists, only two cornea, one oculoplastics, one retina, and two pediatric subspecialists are providing care to the population. Currently, no training program exists to increase the number of subspecialists in ophthalmology. 

Casey Eye Institute's SE Asia Collaboration

Casey Eye Institute, partnered with OHSU Global, and led by Mitch Brinks, M.D., M.P.H., is determined to bring positive change to eye care in Myanmar. After two years of preliminary evaluations and planning, Casey Eye Institute has initiated an exciting new relationship with four medical institutions in S.E. Asia. Casey Eye Institute, along with Mandalay Eye Hospital (Myanmar), monastery-led Tipitaka Eye Hospital (Myanmar), Siriraj Medical School (Thailand) and BDMS/Bangkok Hospital System (Thailand), are partnering to build a better future and brighter prognosis for the people of Myanmar. The collaboration between these organizations includes four main programs: the Mid-level Ophthalmic Personnel Training Program, a pediatric vision health screening program, an improved health records database, and an ophthalmic specialty fellowship program. 

Burma Myanmar trip with Dr. Lauer and Deb Carter

In September 2016, Dr. Andreas Lauer (retina surgeon), Deborah Carter (operating room nurse) and Ellen Redenbo (ultrasonographer - not pictured) worked with Drs. Yee Yee Aung (chief ophthalmologist), Dr. Win (retina fellow), ophthalmology residents (not pictured) and operating room nursing staff to deliver vitreoretinal surgical care at the Mandalay Eye Hospital in Myanmar. Surgical treatments were provided for conditions such as retinal detachment, diabetic retinopathy, ocular trauma, congenital abnormalities and complications of cataract surgery. (Photograph courtesy of Ellen Redenbo)

Mid-level Ophthalmic Personnel Training Program

The Mid-level Ophthalmic Personnel Training Program will provide training at Tipitaka Eye Hospital, a destination for many rural citizens who cannot afford medical care. The monk-led hospital works solely on charity care, with no plans to change this model. Ophthalmic technicians and nurses are actively working on program design and development of educational materials, with special consideration of technical needs unique to Tipitaka. Two trips were compeleted in June and September, 2017, and one additional teaching visit is planned for 2017 with plans to train up to 100 mid-level ophthalmic staff.

Pediatric vision health screening 

Daniel Karr, M.D. and Allison Summers, O.D., F.A.A.O., M.C.R., are Casey's leaders working to develop and establish a pediatric eye screening program at Tipitaka Eye Hospital. Effective detection and treatment of vision problems early in life can have tremendous impact on children's physical and behavioral development. As opposed to making annual or semi-annual trips to perform pediatric eye screening, the goal is to develop a program that can be delivered by local eye nurse assistants, using resources provided by Myanmar Ministry of Health. With proper staff training and technology improvements, the eye screening program will be an essential, sustainable element toward prevention of debilitating eye conditions in Myanmar.

Ophthalmic Specialty Fellowship Program

An important element in this collaboration is the development of an oculoplastic and glaucoma subspecialty training program. John Ng, M.D. M.S., F.A.C.S., and Eric Steele, M.D., hosted the first oculoplastic fellow from Myanmar Eye Hospital, Dr. Thi Thi Tin, from June to September, 2017. Her year-long training will include six months of training at Casey Eye Institute, three months of training at Siriraj Medical Hospital in Bangkok, and two months of supervisory training back at Mandalay Eye Hospital. 

Dr. Zaw Nyein Chan's subspecialty training in glaucoma runs from August to November, 2017 at Siriraj Medical School. Beth Edmunds, M.D., Ph.D., will serve as Casey's Glaucoma International Fellowship Director and lead training for Dr. Zaw at Casey. In addition to training at Casey, he will also receive CEI supervised training at Mandalay Eye Hospital. 

This extensive training will be an essential initial step in capacity building--developing local talent to provide complex oculoplastic and glaucoma care to those in need in Myanmar. Plans are already in motion to extend this opportunity to other qualified junior faculty in Myanmar, including subspecialists in pediatrics, medical retina, and neuro-ophthalmology.