The Asia Pacific Ophthalmic Trauma Society (APOTS) held its first meeting of the new year on January 9, 2021. To be honest, this writer had to delete 2020 and write 2021. It always takes some time getting used to writing a new year. Perhaps readers will understand.
The term “Asia Pacific” indicates an enormous part of the world — much of Latin America is located on the eastern edge of the Pacific ocean, after all. To represent this vast constituency, Dr. Hugo H. Ocampo, from Cali, Colombia, gave a run down of the state of ocular trauma in Latin America.
He’s the right man to talk to for such a topic. Among many other distinguished titles, Dr. Ocampo was once president of the Pan-American Association of Ocular Trauma (APTO). So, to say he has experience and knowledge in exactly this field would be right on the money.
He thoughtfully broke down his talk into three segments: the good, the bad, and the ugly. So, we’ll follow his organization and begin as he did by first discussing the bad.
Ocular Trauma in Latin America: The Bad
Of course, ocular trauma of any sort is bad. But Dr. Ocampo pointed out some statistics and facts specific to Latin America.
For example, ocular trauma is one of the main causes of ocular surgery in Latin America. And there’s further cause for concern: A poll of ocular trauma patients indicated that exactly none of them were wearing eye protection when the trauma occurred.
It may be possible that this is a chicken and the egg question — that those wearing eye protection wouldn’t have suffered trauma in the first place, and thus wouldn’t have presented with eye trauma. Regardless, the statistic raises eyebrows.
Dr. Ocampo presented some statistics from a few countries that give an indication of the rates of ocular trauma in the region. For example, in 2009 Guatemala treated 5433 patients for ocular trauma. To save you number crunching time, that’s 14.8 patients per day in a country of 14 million at the time.
Between 2016 and 2019, Chile treated some 41 patients per day. At a population of 19 million, that’s a significantly higher rate than in Guatemala. Whether that’s because there’s actually more eye trauma or because patients go to the hospital to treat eye trauma is unclear.
Colombia experiences around 1000 cases per year, with 68% of them male. Dr. Ocampo drew no conclusions from the gender differences, but one can reasonably extrapolate that men often work more dangerous jobs than women — as well as generally have a higher propensity for risky behavior. The classic “hold my beer” scenario is universal, anyway.
An interesting note that Dr. Ocampo pointed out is that ocular trauma rates are not particularly different after COVID-19 than before. One may have assumed that ocular trauma rates would be lower after the pandemic spread; in this case, one would have been wrong.
Ocular Trauma in Latin America: The Good
As mentioned earlier in the article, Dr. Ocampo was formerly president of APTO. For those curious or wanting to know the term in Spanish, that’s the acronym for Asocatión Panamericana de Trauma Ocular. The organization was founded in 1995, and its upcoming president will be Peru’s Dr. Carlos Wong.
The goal of the organization is laudable. It aims to educate people — both lay people and doctors — about eye trauma management and prevention. The organization shares ideas and gives ophthalmologists a forum to discuss one of the most common ailments facing the industry.
It has organized conferences, with the first transnational ocular trauma conference in Latin America taking place in 2008. Like most other conferences in 2020, it was moved online — but soldiered on nonetheless.
Dr. Ocampo also played a leading role in an online international ocular trauma course, offered every Saturday for three months between September and December, 2020. The webinar featured 37 speakers from 21 countries, and had an average attendance of 500. Clearly, there are many interested in learning more about ocular trauma management.
Furthermore, collaborators have developed an app to help manage ocular trauma. Called OTSApp, it aims to teach and share information for ophthalmologists who treat ocular trauma.
Ocular Trauma in Latin America: The Ugly
Dr. Ocampo noted, with a touch of humor that ophthalmologists in Latin America have lots of experience treating ocular trauma. This was followed by a protracted and emphasized “but…”, and it’s an important caveat.
He pointed out that, while the doctors may have lots of experience, they publish very little. Indeed, he stated that there is not really a strong culture of publication — so that knowledge gained doesn’t get shared as readily as would be ideal.
Furthermore, it’s very difficult for doctors to obtain funding to investigate cases of ocular trauma. This is perhaps what drives the lack of publishing — and, in the medical world, what isn’t published doesn’t exist.
Ocular Trauma in Latin America: Government Highlights
There are some positive trends underway, many of which are tied to governments. For example, Chile covers 100% of all costs associated with ocular trauma — which, this writer wonders, may explain the high rate of ocular trauma reporting. Patients are more likely to go get treated if they know it won’t break the bank, after all.
Guatemala has created a clinic exclusively for treating ocular trauma management — a valuable step to saving eyes. Mexico has done the same, creating a clinic that uniquely treats ocular trauma.
The nation of Colombia is offering a fellowship for ocular trauma beginning January 15. It will include 18 months of training for retina damage and ocular trauma, leading doctors to be more proficient in such treatments.
APTO, the aforementioned organization, recently received a new team in the form of PETIT: the Panamerican Eye Trauma Investigative Team. This will perhaps help with the dearth of publishing Dr. Ocampo lamented.
Dr. Ocampo flatly stated that 2021 will likely look very similar to 2020 in terms of the effects of the pandemic. While many of us are screaming inside our hearts at such a prospect, such is life and the world must continue on.
And it’s not all bad. There indeed have been some positive effects. For example, the accelerated advent of telemedicine has opened the door for greater doctor-patient accessibility than ever before. In terms of ocular trauma, Dr. Ocampo has said that this move toward a more location-independent mindset means that ocular trauma specialists from around the world can work more as a singular unit than in scattered clusters. And if that’s not a positive trend, what is?
Kudos to Dr. Ocampo for all his work and for a presentation on a topic that must concern all ophthalmologists. He provided us with a fine example of what can be done when doctors work together. With him and others like him stepping up to leadership positions, we can remain confident the future of ophthalmology is in good hands.