I recently had the pleasure of organizing a global-health seminar with a special visitor to campus: Geoff Tabin, MD. A renowned ophthalmologist, world-class climber and humanitarian, Tabin shared his circuitous road through global medicine and his vision to eradicate unnecessary world blindness.
“Most of the blindness on our planet could have been prevented or is easily treated,” Tabin told the audience. “It’s one of the few areas of global public health that we can really do a lot about – and, when you cure someone, they’re 100 percent cured.”
Blindness disproportionately impacts people in developing countries where malnutrition, poor water quality and lack of sanitation and health-care infrastructure lead to high incidence of eye disease. It comes with a heavy economic burden – Tabin explained that in the developing world, blindness is associated with a two-thirds reduction in life expectancy, or typically less than 10 years.
But tackling world blindness is also a story of hope. Cataract – which accounts for more than half of world blindness, according to the World Health Organization – can easily be treated with a low-cost, one-time procedure that restores full sight. A person who undergoes cataract surgery can go from being blind to being able to pass his or her driver’s test the next day.
Through a serendipitous series of events, Tabin co-founded the Himalayan Cataract Project with Nepali ophthalmologist Sanduk Ruit, MD, with the vision of restoring sight to as many of the world’s 18 million cataract patients awaiting care as possible. Since 1995, the organization’s doctors have performed over 445,000 cataract surgeries in the developing world.
Ruit had started an intraocular lens factory in Kathmandu that dramatically reduced the cost of cataract surgery. In the 1980s, the standard procedure for cataract surgery in the U.S. involved replacing the eye's natural lens with an intraocular lens. However, the costly implants were not accessible to cataract patients in the developing world. That was until Ruit who, seemingly overnight, brought the cost of an intraocular lens from $200 to $4 on the world market. Today, the life-changing procedure can be completed in less than 10 minutes at a cost of just $25 per surgery.
How did Tabin end up in Nepal? His journey to global ophthalmology was hardly a straight path. After graduating from college, he received a scholarship to study at Oxford University as well as an adventure travel grant that enabled students to spend holidays mountaineering abroad. The more he traveled internationally, the more he noticed the vast disparities in health care, especially in the rural mountainous regions throughout Asia.
Shortly after starting medical school at Harvard, Tabin was offered an opportunity to join the first expedition to ascend the East Face of Mount Everest. But, in order for him to be granted a leave of absence from his studies, he’d need a better excuse than mountaineering. As if by fate, Tabin was contacted by a Harvard ophthalmologist studying the effect of altitude on the retina. He was sent to Mount Everest on a dual mission – to collect data and make climbing history.
His return to Nepal after residency was prompted by his realization that unnecessary blindness was a condition that he could really do something about.
He has now teamed up with ophthalmologists at Stanford and DigiSight Technologies who have created a new technology that utilizes cell phone cameras to take high quality photos of the front and back of the eye. The Paxos Scope™, developed by Stanford ophthalmologist David Myung, MD, PhD, and Robert Chang, MD, will be rolled out through the Himalayan Cataract Project in Nepal. With funding support from the ASCRS Foundation, the team hopes to increase access to eye care in the most remote areas of the world.
Rachel Leslie is the communications officer at Stanford’s Center for Innovation in Global Health. Tobin's seminar was sponsored by the center.