Armenian EyeCare Project’s 38th Medical Mission and International Conference

Dr. Thomas Lee examines a premie

‘One Year Later—36 Infants Saved from a Lifetime of Blindness’

Since its founding it 1992, the Project has undertaken medical missions to Armenia twice a year. The 37th Medical Mission in June 2010, launched the Project’s Infant Blindness Initiative—“Prevention of Retinopathy of Prematurity in Armenia.”  The purpose of the mission was to train Armenian physicians in the care of premature babies—specifically, to identify and treat Retinopathy of Prematurity (ROP). All babies born prematurely are susceptible to this disease.

“One Year Later” —36 infants saved from a lifetime of blindness.  The EyeCare Project’s July 2011 Conference, as part of the Medical Mission, reported on the exciting progress, accomplishments and the future programs of the Infant Blindness Initiative, “National Program of Retinopathy of Prematurity.” The sponsors of the conference included the EyeCare Project, its partner in the Initiative, the Vision Center of Los Angeles Children’s Hospital, the Armenian Ministry of Health and USAID.

More than100 Armenian ophthalmologists and neonatologists attended the International Conference, held on July 15 -16 in Yerevan, to learn about the results of year one and the programs planned for 2011, and beyond. Led by Dr. Thomas Lee, Director of the Retina Institute at the Vision Center of Los Angeles Children’s Hospital and Dr. Elisabeth Raab, Deputy Medical Director at the Children’s Hospital of Philadelphia, they summarized the results of the first year of the ROP screening and treatment program and outlined future plans. Dr. Ruzanna Harutyunyan—AECP Fellow trained in the United States—a pediatric ophthalmologist and coordinator of the ROP program in Armenia also participated along with some of her Armenian colleagues.

The most exciting news of the conference was the announcement that over 400 Armenian infants have been screened since the program was launched last year and 36 infants received laser surgery, at no cost to their families, saving them from a lifetime of blindness. The project was able to accomplish this because of the equipment donated by extraordinarily generous benefactors over the last year. Dr. Ohanesian was also proud to announce to the conference that the ROP national program in Armenia has been so successful that it has the potential to become a model for other developing countries.

Following the lecture sessions of the conference the participants moved to the hospitals where Dr. Thomas Lee examined infants with his Armenian colleagues.  He demonstrated advanced techniques in eye screening and treatment and all cases were analyzed.  An extensive debriefing meeting concluded the second day of the Conference. 

Prevention.  During the conference a special emphasis was made on the importance of cooperation between ophthalmologists and neonatologists in oxygen supply regulation and control as a major factor in the prevention of ROP. The AECP plans to support the Armenian neonatologists in two major capacity building directions: import and installation of necessary oxygen control equipment and advanced training of Armenian specialists.  

Dr. Elisabeth Raab met with the neonatal staff at several NICUs in Yerevan. She was quite impressed by the capacity of the Armenian doctors who manage to provide quality care to infants with minimal resources. She said that with more advanced equipment they will be able to significantly improve neonatal care, which will be a major factor in the prevention of ROP in Armenia. 

What is Retinopathy of Prematurity (ROP)?  Retinopathy of Prematurity (ROP) is a devastating disease that affects infants born prematurely and leads to blindness in a matter of weeks. The enormous economic and social burden of lifelong blindness makes it absolutely critical to treat this disease.

Up to 60 percent of infants born at less than seven to eight months (30 weeks) develop some form of the disease and 10 percent will progress to the advanced form. If left untreated, the advanced form of ROP causes rapid and irreversible blindness due to retinal scarring and detachment.  However, timely and repeated examinations of at-risk infants and the application of laser treatments will lead to a complete regression in the disease in up to 90 percent of these tiny patients. 

Developing nations like Armenia have only recently developed neonatal intensive care units (NICUs) to provide the necessary inpatient medical care to infants born prematurely. Over the past 10 years, Armenia has established seven NICUs in Yerevan and a handful in remote rural areas. These units now treat approximately 1,600 premature infants per year and this number is expected to grow. Because ROP is a disease affecting premature infants, Armenia now faces a sudden and dramatic rise in the number of children going blind. Unfortunately, over the past 10 years none of the babies at risk for ROP have been screened for the disease, because Armenian ophthalmologists have had no experience with ROP. Consequently, an estimated 100-200 infants in Armenia are going blind each year — the result of a treatable cause of blindness. As a cautionary tale, the United States experienced a similar trend in the 1940s and ‘50s just after the advent of NICUs resulted in 7,000 American children with blindness.

If the EyeCare Project fails to intervene in Armenia, the resulting epidemic of blindness will have profound social and economic repercussions and have a devastating impact on families and children.

Sustainability of the ROP Initiative is based on three primary factors.  First, teaching Armenian physicians to diagnose and manage babies with ROP independently.  Second, to provide Armenia with the equipment required to manage ROP including Ret-Cams and lasers.  Third, to ensure sustainability last June the AECP submitted a formal proposal to the Armenian parliament and the Ministry of Health for long-term funding of ROP care.  The Ministry of Health responded with a directive that regular eye screenings will be held at all Neonatal Intensive Care Units (NICU) in Yerevan. Infants requiring surgery will receive them locally, at the NICU premises by a laser surgeon trained in that technique.  They also have committed to paying for the screening costs and the salaries of personnel involved in ROP Care after the program becomes mature.

Participation in the Third International Medical Congress of Armenia Announcement of AECP’s Eye Vulnerability Index
Dr. Roger Ohanesian, founder and president of the Armenian EyeCare Project, opened the ophthalmological session of the third International Medical Congress.  The International Medical Congress fosters relationships and collaboration among Armenian medical professionals throughout the world to improve the quality of medical care in Armenia and Artsakh.

Nearly 600 specialists from Europe, Asia, USA, Canada, Germany, Australia, Russia and other countries participated in the Medical Congress.  A total of 179 scientific reports were released during 40 sessions of the Congress, July 7 through July 9.

Dr. Ohanesian’s talk was titled “AECP initiatives: Eye Disease Prevalence and the ROP Program in Armenia.” Dr. Ohanesian presented an overview of the activities of the AECP, provided an update on the first year accomplishments of the Project’s Infant Blindness Initiative—36 infants saved from a lifetime of blindness—and announced the development of an Eye Vulnerability Index, which provides data on the prevalence of eye diseases in Armenia.

For the first time in the history of Independent Armenia, the AECP gathered, processed and analyzed information from over 96,000 questionnaires, introduced the concept of an Eye Vulnerability Index, and calculated the prevalence of eye disease for the country as a whole and each of the regions. 

According to AECP data, cataract is the most widespread eye disease in Armenia (8.4%) followed by fundus diseases (7.9%). The AECP data also revealed that 0.7% of population in the country is blind and another 4.1% has low vision. Eye disease is more prevalent among the 50+ population and eye diseases causing blindness among the 50+ population is 2.8 times higher than those under 50.

First Large Corporate Donation to the AECP from an Armenia-based Private Company
Shirak to Receive EyeCare

Announced during the Project’s annual mission at a joint press conference held on July 13, Orange Armenia, one of Armenia’s largest telecommunications companies, is the first large corporate donor to the AECP from an Armenia-based private company. The company’s foundation has provided a significant donation to underwrite free eye care for all residents of the Shirak Marz during August and September.

Bruno Duthoit, Orange Armenia CEO and Chairman of the Orange Armenia Foundation board, said: “We join the EyeCare Project with great joy because it really changes peoples’ lives. People with eye disease are at the center of Orange Foundation’s attention not only in Armenia, but also in other countries where the Foundation works. The first mission of our company is to ease communication between people and sight is a vital component of human communication. Today, a partnership is beginning which will allow people of all ages to see the light again, and a larger number of people will get medical support to prevent such diseases in the future”

Dr. Roger Ohanesian, Founder and President of the Armenian EyeCare Project said, “During the two last decades the Armenian Eye Care Project has been supported primarily by the Armenian Diaspora. We are now very pleased to have Orange Armenia as a corporate partner in Armenia. With their major contribution the Orange Foundation will support the EyeCare Project and the people of Shirak who will receive eye care services. We are happy to see such a good example of corporate philanthropy in Armenia.”

The first project of the AECP-Orange partnership includes free eye screenings for all residents of Shirak marz during August-September, as well as treatment, including surgeries for socially vulnerable people. Beginning August 16, groups of ophthalmologists will visit two cities and 44 villages in the Shirak Marz, in the regions of Ani, Artik, Akhurian, Ashotsq and Amasia. The AECP Mobile Eye Hospital will be stationed in three regional centers: Maralik, Artik and Akhurian, where people who are identified during the screening process as requiring further care will receive detailed examinations and necessary treatment, including surgeries and laser procedures.

The EyeCare Project estimates that 3,000 adults and 1,200 children will be screened in Shirak; 250 surgeries and laser procedures will be performed; and 1,200 eye glasses will be provided. As part of the project, public education sessions on eyecare will be conducted in nine schools of the Shirak region. AECP has also planned to involve local ophthalmologists in the screenings, who will assist in finding people who need treatment or glasses.

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