Huge range in prevalence of diabetes. The Masai women walking 10km or more per day to get water are not getting diabetes. Increasing urbanization of africa leading to rise in diabetes. Estimate 35% prevalence of retinopathy with most countries in Africa not having any laser. Free screening in Kilimanjaro yet still only 29% of DIABETICS had eye exam in previous year. Working to improve screening in different communities.
Laser training is needed. Residents in Nairobi learning, courses being given and innovation in the works. They are moving a laser between six different centres to deliver the care where it’s needed. What is the most dangerous component of the laser - the counter! Hung up on need to give 1500 burns but only about 260 burns on average actually are ones that take. Many patients therefore actually think they had adequate treatment. Better to give full and adequate treatment, even if leads to macular edema, then multiple under-treatments.
Gives case history, of young lady who had lost her vision more than one year prior to getting seen and was left with tractional retinal detachments. Other cases shown where patients have been seen too late considering they have known diabetes.
Concludes talk showing a surgical video of patient with tractional retinal detachment. Talks about how the traction acts like a third hand so as long as cut upward, even if visualization not great, can cut upward.