Improving eye care in Peru

There is a critical need to tackle some of the more complicated and less understood causes of eye disease in the region such as retinopathy of prematurity in premature babies and diabetic retinopathy.
 

It is estimated that 7.3% of babies are born prematurely in Peru, which means retinopathy of prematurity has become the leading cause of childhood blindness in the country. Retinopathy of prematurity leads to abnormal blood vessels growing in the retina causing it to detach from the back of the eye, leading to blindness.

From 2007 to 2016 we spearheaded two projects in 36 hospitals across Peru that focused on the urgent situation surrounding retinopathy of prematurity. At the outset of the program, most hospitals had close to zero resources to address retinopathy of prematurity, and local staff had very little understanding of the issue.

We worked alongside our partner, Instituto Damos Visión, to create an retinopathy of prematurity referral network across Peru and a digital database to collect data on the prevalence and treatment of retinopathy of prematurity in the northern and central regions. This evidence is used to advocate for change and suggest improvements to retinopathy of prematurity protocols.

From 2014 to 2017, we worked with the Regional Institute of Ophthalmology (IRO) to improve screening, referrals, and treatment for diabetic retinopathy for people with diabetes–specifically lower-income patients enrolled in the public health insurance program. We trained professionals across the health system to ensure patients received the care they needed early enough for treatment to be successful.

In this time, we helped screen nearly 12,000 diabetic patients, a 78% increase from the previous years. From these, nearly 3,000 patients were found to have some form of diabetic retinopathy. In total, 923 patients were saved from a lifetime of blindness thanks to this partnership.
 

With approximately 4.5% of adults suffering from diabetes and diagnosis rates as low as 50% in some regions, diabetic retinopathy poses a huge risk. Everyone with diabetes is at risk of developing the condition as excessive blood sugar levels can cause irreversible damage to the vessels in the retina, which is why early detection and intervention is crucial in preventing blindness.

Since 2016, our efforts to improve access to eye care for infants and children have led to huge improvements in the quality of care available. We work directly with local partners to strengthen professional training, allowing residents to learn hands-on techniques to improve patient outcomes. We are also actively participating at a national level, working with the Ministry of Health (MINSA) to improve access to services and quality of care across the country.

Thanks to our supporters and partners, we've had a number of key successes in Peru:

• Tripled the number of babies screened for retinopathy of prematurity, and provided subsequent monitoring and oxygen therapy to those affected, leading to a significant reduction in the number of newborn babies requiring treatment
• Implemented international best practices at partner hospitals that led to a decrease in the number of babies developing retinopathy of prematurity
• Established the first-ever Orbis Vision Center in Latin America
• The Orbis Vision Center – part of the Hospital de Apoyo Leoncio Pradode Huamachuco - will give access to 80% of the population living in the Sanchez Carrion Province free access to comprehensive eye care
• Successfully rolled out the mobile phone application "TeVeoBien" to conduct screening and follow-up for children in vulnerable communities.
• Established DR services in three hospitals in Northern Peru.
• Introduced ophthalmic services to Julcan, a remote rural town that previously had no access to eye care. Patient outreach in Julcan grew from 35 to 234 per month, demonstrating the transformative power of integrating vision centers into rural health systems.

Our Orbis Latin America and Caribbean team have created a Spanish language animated video "El Árbol Palanchin" or "The Singing Tree" - a heartwarming educational story about the challenges children face when living with visual impairment.

The video was inspired by the book of the same name, written by Orbis supporter Ken Youngstein as part of a project supported by The Foundation for Health and Mind Development to improve patient education, counselling, and public awareness of eye care.

Through creative awareness projects like these, we can promote early screening, diagnosis, and treatment of eye diseases among families in Peru.

Since 2015, we’ve been piloting a telemedicine program with the Regional Institute of Ophthalmology to train residents in cutting-edge techniques.

We are continuing our work with the Instituto Damos Visión to reduce blindness and visual impairment in premature babies in two regions of Peru – Lima and La Libertad. Together, we have worked tirelessly for a decade to make this disease a priority for health institutions, and more work is needed to ensure sustainability.

For almost a decade, we have also supported the Ministry of Health of Peru to improve eye care systems in the country. Our current work with the Pan American Health Organization (PAHO), International Eye Foundation (IEF) and Divino Niño Jesus (DNJ) is focused on the development, monitoring and evaluation of Peru’s national eye health plans and the strengthening of public eye care services.

With your ongoing support, other work will include implementing a global education and technology program to provide real-time surgical mentorship from our team of Volunteer Faculty using Cybersight, our award-winning telemedicine platform. We will also offer live case consultations and support to help improve the quality of training and the number of skilled ophthalmologists across the country.

• Instituto Damos Visión
• Instituto Nacional De Oftalmologia (INO)
• Instituto Regional De Oftalmologia (IRO)