The International Centre for Eyecare Education distributes and receives financial benefit from the sale of readymade spectacles in developing countries. However, the authors, who are no longer employees of this organization, have no personal pecuniary interest in the manufacture, distribution or sale of spectacles. None of the authors has any pecuniary interest in any other product mentioned or in the outcome of this study.
Eye disease and care at hospital clinics in Cook Islands, Fiji, Samoa and Tonga
Article first published online: 3 SEP 2007
Clinical & Experimental Ophthalmology
Volume 35, Issue 7, pages 627–634, September/October 2007
How to Cite
Ramke, J., Brian, G. and Du Toit, R. (2007), Eye disease and care at hospital clinics in Cook Islands, Fiji, Samoa and Tonga. Clinical & Experimental Ophthalmology, 35: 627–634. doi: 10.1111/j.1442-9071.2007.01556.x
- Issue published online: 24 SEP 2007
- Article first published online: 3 SEP 2007
- Received 26 March 2007; accepted 28 June 2007.
- Cook Islands;
- refractive error;
Purpose: To obtain eye disease and care data to assist with service planning in Cook Islands, Fiji, Samoa and Tonga.
Methods: A hospital-based rapid assessment including interviews and examination of clinical records.
Results: An overview of equipment, staff and services was attained. Visual impairment was associated with increasing age but not gender of clinic attendees. Cataract was the most common cause of low vision and blindness. A substantial proportion of visually significant cataract, particularly that causing low vision but not blindness, was not offered treatment. The vision outcome of cataract surgery in Fiji was less successful than elsewhere. Only Samoa achieved the World Health Organization suggested outcomes. Refractive error was a significant cause of low vision, but poorly treated. Diabetic retinopathy was a substantial contributor to visual impairment at all locations except the Cook Islands, but not all was treated with laser. Trauma/corneal opacity was an important cause of blindness in Cook Islands and Tonga. Pterygium-induced low vision and glaucoma blindness were diagnosed most frequently in Samoa.
Discussion: This methodology enabled quick and cost-efficient collection of data about hospital eye services, the conditions diagnosed and treated, and the outcome of treatment. It could easily be repeated by local clinicians to measure the impact of service planning and implementation. In the four countries audited, the management of, and intervention outcomes for, cataract, refractive error, diabetic retinopathy and trauma need attention.