Diabetes Threatens Samoans’ Vision in Paradise
Eye Institute surgeon helps address high incidence of diabetic blindness among Samoans.
magine living in paradise and losing the ability to see it. This is a growing reality with the high rate of diabetes in the Samoan community causing long term eye problems, in particular a condition called diabetic retinopathy. Dr. Peter Hadden, a cataract and retinal surgeon from Eye Institute in West Auckland is seeing approximately 20 Samoan patients a year with this condition that is the leading cause of blindness among patients under 65. The most severe form of diabetic retinopathy (“retinopathy” means damage to the retina, the back of the eye, and is the usual reason why diabetics lose vision) is uncommon among the general population. However a study by the International Diabetes Institute in Australia has found a high incidence among Western Samoans. It points to the need for cost-effective programs for the detection and early treatment of diabetes.
For the past two years, Dr Hadden has voluntarily assisted local ophthalmologists in Samoa to treat a range of vision problems. “Samoan clients locally and fellow doctor, Dr CS Benjamin, an cancer specialist who for many years has been running a programme to enable Pacific Islanders to receive specialist medical care in private hospitals in New Zealand, have inspired me to go there to see what I could do to help,” said Dr Hadden. “In Apia, examinations rely on what the ophthalmologist can see with their own eyes and it’s invaluable to have another experienced colleague to call upon to offer a second opinion, particularly in difficult cases.”
FAST FACTS
- Dr Hadden, a cataract & retinal surgeon sees 20 Samoan patients with potentially blinding eye problems caused by diabetes.
- Dr Hadden treats Samoan patients locally from Eye Institute’s West Auckland clinic
- According to a study of International Health Professionals published 2004, the number of Pacific Islanders with diabetes is expected to increase 148% by 2030. Among Islanders 65 years and under, the predicted percentage rises to 198%. (Sarah Wild et al, Public Health Sciences, University of Edinburgh, Edinburgh, Scotland)
- Diabetes can cause many eye problems, including temporary blurring, cataracts, glaucoma, corneal disease, and retinal problems.
Correcting diabetic retinopathy
Diabetic retinopathy is the leading cause of blindness among patients under 65. This progressive condition affects the fine network of blood vessels in the retina, the back of the eye vital for vision. At the earliest stages of diabetic retinopathy, the blood vessels are only slightly affected so vision remains normal. However, as the condition progresses, the diabetic’s ability to see distance and detail worsens and blood vessels in the eye can become blocked. The blocked vessels deny the retina oxygen and nutrients causing new blood vessels to form. These blood vessels are abnormal and fragile and grow inside the eye in places they should not. They bleed easily and can cause scarring, distorting the retina. At this stage, visual loss can be sudden and severe and total loss of vision is possible. Surgery performed by Dr Hadden removes blood from the eye and the scar tissue that has pulled the retina out of place, allowing the retina to return to its normal position. “Eye problems that result from diabetes may begin without the person noticing any change in vision,” said Dr Hadden. “My aim is to give people back as much vision as I possibly can, but perfect vision is often not possible because of how much damage the diabetes has done to the blood vessels of the retina.”
Providing eye care in Samoa
Resources in Samoa are limited to cope with vision problems. In Apia, there are only two ophthalmologists, Dr Hemant Pathak and Dr Mau Imo. Ophthalmologists also lack the investigational equipment commonly relied upon, like visual fields, OCT and ocular photography. They are, however, able to perform laser treatment that can mean that the diabetic eye disease never gets to the stage that surgery is required. Unfortunately, laser treatment should be started before the patient notices any problem with their vision, and it is often hard to convince patients of the need for eye checks and laser when they feel they can see perfectly well.
Dr Pathak, who has worked in Apia for two years, said the problem of diabetes and retinopathy is significantly high in Samoa. “My aim is to catch retinopathy as early as possible and provide laser treatments to prevent irreparable vision loss. To assist this, mass-funded screening programmes should be a reality in the near future, especially with the new established Samoa National Health Services.”
Dr Pathak continues: “It is wonderful to have Dr Peter Hadden provide a second opinion in difficult cases. It also saves patients the time and expense of having to go to New Zealand if it’s not necessary.”
During his week-long visits, Dr Hadden sees about 50 patients. “I enjoy the challenging work and the cases are interesting,” said Dr Hadden. “Visiting Samoa allows me to see patients that might benefit from coming to New Zealand for treatment. Also, the people are very friendly and take very good care of me while I’m there!
New Zealand, Auckland – June, 2006
top
