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January is Glaucoma Awareness Month St John Eye Hospital's combat against the Silent Sight Stealer

As this month is Glaucoma Awareness month St John Eye Hospital is joining the international ophthalmic community in promoting awareness of this common condition.

Glaucoma is a condition which damages the nerve at the back of the eye and will often cause irreparable damage before vision is affected. This leads it to being described as the ‘silent sight stealer’ as people do not realise they are suffering from the condition until it is too late.

Caption: The Separation Wall in the West Bank is one of many barriers to eye care that Palestinians face.

St John is solving this issue with our commitment to making eye care accessible to every Palestinian.

An area where the need is particularly desperate is the struggling Gaza Strip, and that is why this year we launched a project in partnership with Medical Aid for Palestinians that specifically targets access to glaucoma in Gaza.

Caption: Two-year-old Rimas in our Jerusalem Hospital paediatric ward awaiting surgery. Unfortunately, as she is a Bedouin Gazan she has little access to eye care and her Glaucoma was caught too late to save much of her sight.

Through this partnership we have been able to invest in the training of an onsite Glaucoma Consultant, Dr Al Walid, who completed a fellowship on the condition in the Arvind Hospital in India last year. Since his return, our Gaza Hospital has been able to offer expert glaucoma treatment in the region regularly for the first time, which saves local sufferers from having to navigate a complicated permit system to seek treatment outside of the strip.

Caption: Some of our Gazan staff outside of our eye hospital in November 2017. The two on the right are our Jerusalem Glaucoma expert Dr Ahmed Muhsen and our Gazan Glaucoma expert Dr Al Walid.

If we did not offer this our patients would have a 55% chance of being allowed access to treatment outside of Gaza – the unlucky half would be left with no option and eventually needlessly go blind from a condition which needs constant monitoring to ensure the eyes are not damaged beyond repair. Dr Al Walid explains his experience of working at St John:

“I chose to work at St John Eye Hospital as I believe it is the only state-of-the-art eye hospital in Gaza. I love working here and I know that I am making a big difference to the lives of our patients. It is important that we provide treatment for Glaucoma as it involves regular management to ensure our patients’ vision is not permanently damaged.”

Caption: Dr Ahmer Mohsen performing Glaucoma Surgery in our Gaza Hospital as Dr Al Walid shadows him, November 2017.

Dr Al Walid has been aided throughout the year with visits from our Jerusalem-based Glaucoma Consultant, Dr Ahmer Mohsen, who visits Gaza to perform more complex surgeries, and once again prevent the need for our locked-in patients to travel to the Jerusalem Hospital for treatment.

As is often the case when our Jerusalem doctors visit Gaza, Dr Mohsen makes the most of his short time with our most vulnerable patients, working 12 hour days to ensure he sees as many patients as possible. This is particularly remarkable given the fact the entire region is running on only 4 hours of electricity per day, which means that all of our surgeries are achieved on our emergency generators which are supposed to be saved only for rare occasions.

Thankfully Dr Mohsen’s three-day visit in November 2017 was a great success, in spite of these trying conditions. In total, 45 patients received complex diagnosis, and nine patients received advanced glaucoma surgery.

Caption: Our Mobile Outreach van parked in a remote region of the West Bank. Our vans travel to every area of the West Bank and Gaza seeking out eyes which need treatment.

Of course, Dr Mohsen’s day job is in Jerusalem. Whilst the accessibility is slightly better here, the need for eye care is just as urgent as it is in Gaza. Patients are referred to our Jerusalem Hospital from across the West Bank, sought out by our mobile outreach vans who roam the most isolated villages of the region in order to find those in need of treatment.

Sometimes the cruel condition is caught too late for us to save the sight of these patients however the Outreach Team will always refer Glaucoma cases to Dr Mohsen to ensure he has the best chance at saving their sight, and almost always we can offer these patients some kind of hope through treatment. A similar mobile programme was also launched this year in Gaza.

Caption: One of our Mobile Outreach Team staff conducting an Awareness Session in the West Bank.

With each Outreach Session comes an awareness session in which we teach local Palestinians on the importance of regular eye check-ups and symptoms to be aware of, in order to ensure we catch any eye condition they may have early. This is in stark contrast the belief of many of our patients, who until we visit their village, have often needlessly resigned themselves to blindness as they believe it is ‘God’s will’ or they simply do not know how to seek treatment. They therefore live their life needlessly suffering where they could potentially return to full sight. This is the benefit that our education awareness sessions offer our patients.

Caption: Dr Amer Mohsen receiving his award from Dr Anne Coleman, September 2016.

In 2017 alone we have managed to treat almost 2,000 patients across the West Bank and Gaza for Glaucoma. For Dr Al-Walid each of these patients are unique, and each have their own story to tell:

“A very memorable patient that I have treated this year was a young man named Ismail, only 25 years old, who was married with two daughters, one of whom was severely disabled. His wife was deaf and he was unable to work to support his family because of severe complications in his eyes, it was a pretty desperate situation. His right eye was severely affected by glaucoma and his left eye was badly damaged in an accident just after his wedding so he was almost blind. We were able to provide him with three surgeries and are now monitoring his condition. His vision has greatly improved and so has his social situation.”

Mohammad Ramadan's sight has been saved thanks to the efforts of St John.

Another patient who understands the value of treating this condition is 25-year old Mohammad Ramadan, a Car Wash Attendant from near Jerusalem, who is supporting his wife and young daughters. Mohammad had an unfortunate access to uncontrolled steroid use which caused severe glaucoma in both eyes and badly damaged his optic disc, leaving him almost blind. For now his condition is able to be monitored with regular trips to Dr Ahmer Mohsen in Jerusalem for laser treatment. When asked what vision meant to him he responded simply:

“Vision is for me, everything in my entire life.”

In 2017 our hospitals received great support for the treatment of Glaucoma, not only through MAP, but also through trusts and individual givers. Thanks to an appeal in our Winter Jerusalem Scene we were able to purchase four portable tonometers. This was supplemented further when two Birmingham-based ophthalmologists Dr Fadi Alfaqwi and Dr Gibran Butt fundraised and bungee jumped their way to purchasing a fifth tonometer.

This equipment is used mainly by our mobile outreach teams in both the West Bank and Gaza in order to diagnose the condition at the earliest possible opportunity and will undoubtedly be saving the sights of the thousands of patients our teams treat each year.

Although it is unrealistic to assume the hereditary disease will ever be eradicated, we do hope for a future in which no person in Palestine will needlessly be blinded due to lack of access to treatment for the condition. This is a dream we invite you to share.

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