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Malawian visitors to learn how to establish diabetic eye screening service

St Paul’s Eye Unit at Royal Liverpool University Hospital has welcomed three Malawian visitors from the Lions Sightfirst Eye Hospital, Malawi, this week.

The visit is part of St Paul’s Eye Unit’s support of Vision 2020, a programme to eliminate avoidable blindness by 2020, and embraces its close and long working partnership with the main teaching hospital in Blantyre, Malawi. 

Luke Msiska, an Ophthalmic Clinic Officer at the Lions Sightfirst Eye Hospital in Blantyre, Eunice Themuka, a nurse, and Diana Lakudzala, an administrator, will learn how St Paul’s Eye Unit runs its Diabetic Eye Screening programme with the aim of establishing a similar programme in Malawi.

During the week the team will be shadowing Diabetic Eye Screening Director, Tici Criddle, and sitting in on diabetic eye clinics to discover how the service works and explore how it can be implemented.  Malawian eye doctor, Moira Gambiwa, will visit St Paul’s Eye Unit next week and will work with Luke to create a strategy to establish diabetic eye screening in Malawi. Future plans include an automated computer grading of patients’ eyes.  

Malawi, like many African and east Asian countries, is experiencing a dramatic rise in cases of both diabetes and diabetic retinopathy. At the moment about 6% of the Malawian adult population has diabetes, a presumed consequence of improvements in live expectancy, urbanisation, westernised diet and sedentary lifestyles. The rates of diabetic retinopathy – a condition which is caused by diabetes and can cause permanent sight loss – are five times higher than in the UK, and the disease progresses at three times the rate.

St Paul’s Eye Unit Consultant Ophthalmologist, Mr Nick Beare, who is leading this initiative, said “We are delighted to be able to support our colleagues from Malawi in this way. 

"St Paul’s has a long and illustrious history of tackling diabetic eye disease, having established one of the world’s first diabetic eye screening programmes in 1991. That model for that service is now used in over 40 countries around the world."

“We have also been working in Malawi to prevent sight loss and in medical research for over 20 years. Initially we were involved in malarial retinopathy but more recently also looking at the effects of corneal ulcers and diabetic retinopathy.

“We understand the challenges developing countries like Malawi encounter. Given that diabetes and diabetic retinopathy affect the working age population, this has huge implications for the Malawi health care system, the economy and society in general.

“It is vital diabetic retinopathy is detected, diagnosed and treated as early as possible.

"Studies have shown that laser treatment is the most effective way to prevent diabetic eye disease, and our studies in Malawi have shown it to be cost effective, even in a country with few resources."

We need to pick up the disease before it becomes symptomatic and diabetic eye screening is the most effective way to do this to prevent people losing their sight unnecessarily.”

The visit is been made possible with the additional support of the Commonwealth Eye Health Consortium and the International Centre for Eye Health. Vision 2020 is a global initiative that aims to eliminate avoidable blindness by the year 2020. It was launched in 1999 by the World Health Organization together with the more than 20 international non-governmental organisations involved in eye care and prevention and management of blindness. The International Centre for Eye Health supports links between UK eye departments and those in Africa and other commonwealth countries.

Moira will also be speaking at the annual Royal College of Ophthalmologists Annual Congress that is taking place in Liverpool next week.