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Ophthalmology in Oman – Village Eye Health Care (VEHC) and High-tech Medicine

1Bialasiewicz A., 2Wallenburg H. C. S.,
1Dept. of Ophthalmology and School of Ophthalmic Technicians, Sultan Qaboos University Hospital, University of Oman (Muscat)
2Office of the Dean, College of Medicine, University of Oman (Muscat)

Purpose: Ophthalmology in Oman comprises the fundamental aspects of prevention, building of awareness, sampling of cases and teaching of advanced instrumental diagnostics and surgical possibilities of interventions as a third-level referral center.
Patients: Uni- or bilateral blindness in the population has been estimated at 16.6 resp. 10.8/1000 in 1997. Main causes of blindness were complicatoins due to trachoma (1.1-1.5%), cataracts (0.3-0.5%), PEX-glaucomas (0.46-0.56%) and proliferative diabetic vitreoretinopathy (PDVR). Of 10049 new OPD cases in the year 2001 3.5% had a PDVR.
Results: VEHC serves to pinpoint epidemiological data for trachoma, the building of „awareness“ in the population, sampling of trachoma cases, and teaching of patients and medical students: thus in January 2002 in a trchoma-free municipal area 5 children with acute trachoma TF and TI could be identified in one day. Absolute numbers in the population were 1998 TF,TI: 21.9, TT: 11.2, CO: 14.8/1000. Acute trachoma cases are decreasing (1990:13103, 1994:11328, 2000:1012), eyelid and corneal complications increase due to the precipitation of late sequelae of patients infected 10 years back. In 2001, 405 of 429 of cataract patients above 40 years suffered from sequelae of trachoma (stages TS, TT, CO), more than ¾ had PEX.- Diagnostics are confined to cornea, glaucomas and PDVR.- Surgical epidemiology: Of 976 major surgery in 2001 471 were cataracts, 76 vitrectomies, 66 trabeculectomies and 64 surface reconstructions incl. mucus membrane/amnion grafting.
Conclusions: Traditional diseases (trachoma), population specifics (PEX, glaucomas) and diseases of developed countries (diabetic retinopathy) require a bridging of basic primary health care and highly technicized Ophthalmology in Oman.