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  • Armenian Infants Saved from a Lifetime of Blindness

    Armenian Infants Saved from a Lifetime of Blindness

    http://asbarez.com/124517/armenian-infants-saved-from-a-lifetime-of-blindness/
    Friday, June 27th, 2014

    Neonatal Intensive Care Unit in Yerevan.


    Roger Ohanesian received an emergency phone call -- it was the middle
    of the night. The director of the Armenian ROP (Retinopathy of
    Prematurity) Clinic in Yerevan, Dr. Tadevos Hovhannisyan, was calling.
    He told Roger there were 11 infants and seven children under the age
    of five who required immediate eye surgery. If they were not treated
    they would lose vision in one or both of their eyes and be fated to a
    lifetime of blindness. Because Armenia's ROP Clinic is the only one in
    the Caucuses and the surrounding regions with the ability to perform
    this very challenging surgery some of the infants were from other
    countries.

    After learning about the situation from Dr. Hovhannisyan, Dr.
    Ohanesian set out to plan his trip to Armenia. He needed to leave
    immediately, but first it was essential for him to find a highly
    skilled pediatric retinal specialist (fewer than 30 worldwide) who
    would join him in Armenia to perform these difficult surgeries.

    Roger called Dr. Tom Lee, an international ROP expert, who has been to
    Yerevan each year since 2010 with the EyeCare Project's Medical
    Missions to train the ROP physicians how to diagnose and treat at-risk
    infants. Dr. Lee has been instrumental in developing the ROP screening
    and laser program which has resulted in a significant reduction in
    advanced ROP cases requiring surgery in Armenia. Dr. Lee has also
    established a telesurgery connection between the Children's Hospital
    of Los Angeles and Hospitals in Armenia. Interactive lectures and
    supervision during surgery provided by pediatric academics in the
    United States to colleagues in Armenia, with highly specialized
    cameras and surgical equipment, has significantly impacted the lives
    of Armenian children.

    Unable to travel to Armenia on such short notice, Dr. Lee referred Dr.
    Ohanesian to Dr. Chien Wong, a London-based pediatric specialist who
    is experienced in ROP surgery and related disorders. Dr. Ohanesian
    filled Dr. Wong in on the situation and, recognizing the urgency of
    the matter, Dr. Wong immediately rearranged his duties at Moorfield
    and Royal London Free Hospital and made plans to travel to Armenia.

    While Drs. Ohanesian and Wong were making their arrangements and
    traveling, the EyeCare Project's ROP surgical team in Yerevan was
    making preparations to operate on the babies. The doctors met in
    Yerevan late Saturday night and saw all of the babies on Sunday in the
    Neonatal Intensive Care Unit.

    They had an enormous task ahead of them -- 18 complicated surgeries on
    the tiniest of patients and very little time. Dr. Wong, lead surgeon,
    Dr. Ohanesian and the Armenian ROP team -- Dr. Adik Hovhannisyan, Dr.
    Hasmik Haratunyan and Dr. Ruzanna Haratunyan -- performed multiple,
    extremely difficult surgeries. One surgery, on a five-month-old
    infant, required nearly four hours to complete.

    While Dr. Wong taught the Armenian surgeons the delicate intricacies
    of his surgical techniques and endoscopy -- operating from within the
    eye -- Dr. Lee was at his home in California, electronically connected
    to the operating suite. He was able to view the exact images seen
    through the endoscope and surgical microscope and to advise the
    surgeons in real time during the surgeries. Despite the 12-hour time
    difference and surgeries lasting well past midnight in California, Dr.
    Lee participated for two days providing invaluable training for the
    Armenian physicians.

    Infants examined following surgery

    Soon after the first surgeries were complete, Dr. Hovhannisyan took
    over as lead surgeon and Dr. Wong assisted. Dr. Ohanesian said these
    were the worst cases of abnormal intraocular vascularization he had
    seen in 40 years of practice.

    The day following the surgeries the exhausted physicians examined
    their patients and all of the babies were doing well -- a lifetime of
    darkness averted. Since the development of the Project's ROP Program
    in Armenia, with physician training, extensive screening of all
    premature infants in the NICUs and laser treatment of those found to
    have ROP, the EyeCare Project has been able to reduce ROP-related
    blindness in infants by more than 90 percent -- from approximately 60
    infants per year to little more than six.

    Retinopathy of Prematurity (ROP)
    The EyeCare Project established an ROP Program in Armenia in 2010, to
    treat infants and young children afflicted with this devastating and
    potentially blinding disease. ROP affects the developing vessels of
    premature infants between the eighth and ninth month of pregnancy.
    These abnormal blood vessels grow and spread throughout the retina --
    the paper thin tissue that lines the back of the eye -- causing
    blindness.

    The risks of Retinopathy of Prematurity have been known in the United
    States for decades. First encountered in the early 1950s, an epidemic
    of ROP left an estimated 7,000 American children blind in one year
    alone. In Armenia -- a country the size of Maryland landlocked between
    Iran, Turkey, Azerbaijan and Georgia -- awareness has come only
    recently. As the health care infrastructure is advancing in Armenia,
    with improvements in the medical care of smallest premature infants,
    the rate and severity of ROP have increased. Previously, infants did
    not live long enough to show the effects of ROP. With higher levels of
    oxygen in their incubators they survive, but develop ROP.

    Neonatal Intensive Care Unit nurse with her tiny patient.

    Now, every year in Armenia, many children are born prematurely and
    survive because of advanced care in the NICUs, but tragically grow up
    blind because of ROP. Approximately 60 percent of children in a
    neonatal intensive care unit will go on to develop some degree of ROP
    and 10 percent will progress to the advanced form even with laser
    treatment. Without surgery more than half of the children with the
    advanced form will go on to develop irreversible blindness. This
    process can occur in as little as one to two weeks.

    The first treatment for ROP is a non-invasive laser therapy that can
    be performed at the child's bedside in as little as 30 minutes. One
    treatment is generally sufficient to produce complete regression of
    ROP if it is performed in a timely fashion. The success rate overall
    is 90 percent, although in the most aggressive form of ROP, the
    success rate falls to 50 - 70 percent. In those cases where laser is
    not enough

    To halt the progression of the disease, surgery is necessary to
    physically remove the residual scar tissue that remains and tugs on
    the retina.

    With Dr. Lee's telesurgery medical education program, Armenian doctors
    are able to receive ROP surgical training that is the equivalent of a
    medical residency or fellowship. The Armenian physicians scan the
    retinas of infants in local NICUs and send the images to The Vision
    Center at Children's Hospital in Los Angeles via the Internet.
    Experienced pediatric ophthalmologists at the Vision Center review
    them and discuss the appropriate treatment with the Armenian
    physicians.

    Dr. Wong will travel to Armenia again in July and September to train
    the Armenian physicians and to perform surgeries. Dr. Wong will assume
    the role of assistant surgeon while the Armenian retinal surgeons with
    the Project's ROP team will be the primary surgeons. The long-range
    goal of the EyeCare Project is to have the Armenian physicians reach a
    level of competence equal to that of retinal surgeons in the United
    States so they will be able to perform independently.

    A lifetime of darkness averted.

    In September, the EyeCare Project will host an international
    conference on the diagnosis and treatment of ROP. Pediatric
    ophthalmologists and retinal specialists from CIS and other countries
    will attend. A number of these countries have sent their patients to
    the Armenian ROP Center for treatment, which has been designated as a
    "Center of Excellence" by the United States Agency for International
    Development (USAID) and the United States Ambassador to Armenia, John
    S. Heffern.

    The Armenian Eye Care Project
    The Armenian EyeCare Project, a nonprofit organization founded in
    1992, by Dr. Roger Ohanesian, is based in Orange County, CA. Their
    mission is to eliminate preventable blindness in Armenia and to
    provide access to eye care for all Armenians. This is accomplished
    through a comprehensive, integrated approach with medical education
    and training as the cornerstone. Components of the program include
    eight specialty clinics and a mobile eye hospital that travels
    throughout the country.

    Initially, the Project provided eye care for those wounded in the
    Nagorno-Karabakh War that Armenians fought with Azerbaijan from 1988
    to 1994. After the war Ohanesian redirected the project toward
    conducting specialized trainings for Armenian ophthalmologists and
    providing eye screenings and eye surgery for isolated and vulnerable
    members of the population with a Mobile Eye Hospital that travels
    throughout Armenia. The ROP program was added to the mix of eye care
    programs after learning that better neonatal care was increasing the
    survival chances for Armenian preemies, but lack of proper eye
    screenings meant many were going blind. In 2010, he recruited Dr. Tom
    Lee, chief of Vision Sciences at Children's Hospital Los Angeles, to
    travel to Yerevan and to teach ophthalmologists how to diagnose and
    treat ROP. www.eyecareproject.com

    The Vision Center
    The Vision Center at Children's Hospital Los Angeles is an
    international referral center known for its family friendly
    environment of children afflicted with all forms of eye disease and
    provides a full range of inpatient and outpatient services. It is the
    largest pediatric ophthalmology program in the nation with multiple
    subspecialty programs that are considered to be among today's finest
    resources for diagnosis, treatment and research. Children's Hospital
    Los Angeles is one of America's premier teaching hospitals, affiliated
    with the Keck School of Medicine of the University of Southern
    California since 1932. It is a national leader in pediatric research.



    From: Emil Lazarian | Ararat NewsPress
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