Surgery and Healing in the Developing World - Dartmouth-Hitchcock

Ophthalmology
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ml of 40 mg/ml IV gentamicin to 5 ml bottle of commercial guttate gentamicin (3
mg/ml).
Administering Eye Drops
Valuable time and materials can be wasted while trying to administer eye drops
to an uncooperative patient. A simple, yet effective method is as follows
Position the Patient Prone
Ask the Patient to Keep Their Eye Open
Administer the require drops slightly medially to the eye, on the nasal canthus.
This usually prevents the blink reflex. If the patient insists on closing their eyes it is
of little consequence. The drop will run into the eye as soon as it is opened.
Glasses on a Budget
A simple pair of prescription glasses can make a world of difference to individuals
with poor acuity. One major factor preventing the uptake of glasses is their cost.
However, it is quite possible to make a pair of prescription glasses for under $10. If
facilities do not exist to grind and shape lenses, glasses of standard strengths can help
to improve sight in the majority of patients. Many optometrists in the developed
world collect unwanted glasses for distribution to those in need. Contacting these
companies can lead to new sources of glasses for your patients. It is also beneficial to
buy-back glasses from individuals who change prescription. This provides an incentive
for patients to keep up to date with prescription changes and can provide a
supply of cheap glasses for reuse, reducing overall costs.
Manufacturing Glasses
The description of glasses manufacture that follows is designed as a basic guide
to making glasses with a minimum of equipment or expertise. People who are familiar
with this process should modify it based on their previous experience.
Equipment (Fig. 5)
Standard glass lenses (ranging in power)
Permanent marker pen (and acetone for removal)
Axis chart
Diamond-tipped pen (for scoring glass)
Pliers
Sturdy gloves
Protective eye-ware
Glass grinder or alternative (see later)
Optical polishing cloth
Selection of frames
Small durable flat-head screwdriver
Method
Preparation
After determining the patient’s prescription the correct lens (or best available, it
is always best to under-correct a defect in acuity) and desired frame should be selected.
Sturdy gloves and protective eye-ware should be used at all times to prevent
possible injury. The right and left lens should be so marked using the permanent
marker.
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