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Orbis' Online Course Proven Effective in Training Health Workers to Identify Glaucoma

Orbis' Online Course Proven Effective in Training Health Workers to Identify Glaucoma

November 29, 2023

Global eye care nonprofit Orbis International has unveiled a short online course that successfully equips healthcare workers to identify signs of glaucoma at a proficiency comparable to local ophthalmologists.

The findings of this innovative initiative were published in a peer-reviewed study in the British Medical Journal (Open).

The research indicates that non-ophthalmic health care workers, already trained in identifying diabetic retinopathy, can effectively broaden their expertise to include glaucoma detection. Both conditions necessitate a meticulous examination of images of the retina, located at the back of the eye.

Conducted in Vietnam, the study introduces a novel approach to recognizing glaucoma, a common and potentially blinding eye disease, particularly rampant in low- to middle-income countries. In such regions, the scarcity of trained eye care professionals often leads to delayed diagnoses, with half or more of glaucoma patients discovering the disease at a stage where effective, sight-saving treatment is no longer possible.

The online course, initially designed for diabetic retinopathy identification, emerges as a versatile solution to the shortage of trained professionals. By extending its applicability to glaucoma detection through retina image analysis, the program addresses the critical need for increased screenings in regions where the limited number of ophthalmic professionals hinders comprehensive eye care.

"Glaucoma is the leading cause of irreversible blindness around the world," said Dr. Olusola Olawoye, lead researcher of the study, Glaucoma Specialist and Consultant Ophthalmologist, College of Medicine University of Ibadan, Nigeria. "High-risk patients who have regular screenings can be prevented from going blind from glaucoma by receiving prompt treatment. This study demonstrates that non-ophthalmic diabetic retinopathy graders can screen patients for two major causes of blindness in one appointment, freeing up time for more highly trained ophthalmic experts to focus on patients with more complicated cases that need their services."

The Study

The research, backed by funding from the Novartis independent grant program, eXcellence in Ophthalmology Vision Awards (XOVA), engaged 43 diabetic retinopathy graders, comprising nurses, technicians, and non-ophthalmic physicians. These individuals had previously received training through a project supported by Orbis and the Fred Hollows Foundation in Vietnam. As part of the study, each grader underwent a pre-test, completed a five-hour online course on Cybersight (Orbis's telemedicine and e-learning platform), and subsequently took a post-test. The course, along with the pre- and post-tests, was meticulously crafted by Orbis medical experts for this specific study.

In contrast, the control group, comprising 29 Vietnamese ophthalmologists, underwent a single test without participating in the online training. The key finding of the study revealed that the scores of the graders doubled after completing the online course, reaching a proficiency level akin to that of local ophthalmologists. This outcome signifies the effectiveness of the training program in elevating the skills of non-ophthalmic health care professionals to a standard comparable to their ophthalmologist counterparts.

"Asia has the highest number of people living with glaucoma," said Ngoc Pham, Country Director, Orbis Vietnam. "There is a growing gap between the burden of glaucoma in this region and the number of trained ophthalmologists. A new screening model that utilizes lower-level health workers is necessary to fight this disease, in Vietnam, the rest of Asia, and beyond."

Following the encouraging outcomes of the Vietnam study, Orbis, supported by the Sidra Tree Foundation, has initiated additional glaucoma screening studies in Eswatini, a sub-Saharan African nation. Researchers at Orbis anticipate that this precise and cost-effective approach to glaucoma detection will significantly alleviate the impact of this prominent cause of blindness in the country, marking a transformative development in eye health.