As a world-renowned ophthalmologist who specializes in infantile nystagmus syndrome, Dr. Richard Hertle likes to travel to places like Brazil, Prague, China and India to care for patients who otherwise would not have access to treatment for this rare eye disorder.
Nystagmus, a wiggling of the eyes, affects all aspects of visual function and can also impact a child’s self-esteem.
The director of Akron Children’s vision center has been traveling to India for about 10 years to help build a pediatric ophthalmology department at the Goutami Eye Institute in Rajahmundry. The institute was established by his friends and colleagues, Drs. Ghanta Madhavi and V.K. Raju.
His most recent weeklong trip last month was unlike any he has ever experienced. The state governments of Andhra Pradesh and Telangana identified 399 children from 14 districts of the Telugu states who suffer from nystagmus.
Over a period of 5 days, Dr. Hertle and a team of 12 pediatric ophthalmologists from Maharastra worked 14 hours a day to see 514 patients. The goal of the trip was for Dr. Hertle to train the Indian doctors in how to recognize and treat nystagmus.
“The other physicians learned by helping me evaluate patients,” he said. “The work-up and data collection was done by hospital staff so I could strictly focus on assessment and treatment plans.”
Approximately 50 to 60 patients and their families were bussed daily to the hospital.
“They would stay the whole day and night,” Dr. Hertle said. “We would triage the patients and identify those who needed surgery. The government paid for everything – food, lodging and surgery.”
Although a staggering number needed surgery, Dr. Hertle was only able to perform between 5 and 10 operations daily. The remaining children will be scheduled for surgery at a later date.
“Only in 1 out of 3 cases does nystagmus exist by itself,” he said. “We saw and treated all kinds of eye diseases that ran the spectrum of pediatric ophthalmology.”
He would see patients in the morning, perform surgery in the afternoon and often see more patients after surgery – wrapping up his day around 10 p.m. “Surgery is just part of the treatment,” Dr. Hertle said. “If we can get them diagnosed early, medication and rehabilitation can improve their visual function and quality of life.”
One of the biggest problems Dr. Hertle saw was uncorrected refractive errors.
“It’s a cultural thing,” he said. “Many Indian people associate glasses with other defects of personality or development.”
Dr. Hertle refers to India as a place that is chaotic on the outside and peaceful on the inside.
“The Indian people are very generous, accepting and grateful – even when I say I can’t do anything to help their child,” he said.
He will be going back on a regular basis and hopes to participate in another government-run program if he and his counterparts can train another group of doctors.
“I don’t have to spend any time on the computer or doing paperwork,” said Dr. Hertle. “It’s medicine in its purest form.”
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