Kigali

Week two at the RIIO residency proved to be a very productive week with the new residents. The years working as General Practitioners set the group up with good clinical skills, from which we have tackled the ophthalmologic exam and evaluation. Many of the Wills Eye faculty were kind enough to provide lectures for me to present as part of our introduction course for which I’m extremely grateful. With their assistance, we have been able to spend several hours per day going over the major subspecialty systems in ophthalmology so that the residents will enter clinics with a broad overview of what they may encounter.

As part of the introduction course, we had the first Journal Club for the RIIO. The residents discussed a pair of papers including the first Rapid Assessment of Avoidable Blindness (RAAB) conducted in Rwanda. RAABs are an important tool for evaluating the disease burden of a region, and describes a specific technique to minimize bias or error while collecting data from a rural population. They have been used throughout Africa, Asia, South America and beyond to identify areas of preventable blindness. The primary goals of a RAAB are to:

– Estimate the prevalence and causes of avoidable blindness and visual impairment in people aged 50 and above

– Assess cataract surgical coverage

– Identify the main barriers to the uptake of cataract surgery

– Measure outcome after cataract surgery.

More information can be found on the website located here:

http://iceh.lshtm.ac.uk/rapid-assessment-of-avoidable-blindness/

The original RAAB performed in Rwanda was completed by Dr. Mathenge in 2006 which found approximately a 2% rate of blindness, largely preventable, throughout the western province. A subsequent RAAB was repeated by Dr. Mathenge and the first Wills CAGO fellow (and current fellowship co-director), Alessandra Intili.