First, some exciting news – we had a VIP patient in clinic today. One of the stars of the Nepalese national cricket team came in with a corneal abrasion sustained in a match earlier this week. After a thorough exam, there was a collective sigh of relief when it was determined that he will recover fully and be back on the pitch in no time to protect his wicket and humiliate opposing bowlers from around the globe. I’m not really sure what any of that means – I’m still trying to figure out the rules of the game.
Now an update on my research – though I originally planned for a retinal telemedine project here at LEI, I’m now headed in a slightly different direction. I learned soon after my arrival that the fundus camera I hoped to evaluate was undergoing repairs, and in the mean time the retina specialist has relocated to another site 150 km west of here. The good news is that the local cornea doc is also very interested in telemedicine for rural screening purposes, has a functioning slit-lamp-mounted anterior segment camera, and is exciting about working on a project to evaluate image-based diagnosis.
So after shifting gears a little bit, I’ve spent the week in cornea clinic accumulating anterior segment images. Amar, one of the ophthalmic technicians, has been taking all of the photos along with an assistant, Sherzana (both pictured above). At the time the photos are taken, Dr. Dhakhwa also examines the patient at the slit lamp to provide a diagnosis based on a traditional exam. The idea is that I’ll accumulate a number of images – hopefully 40-50 cases – that I can then review with Dr. Dhakhwa in the future to see if she is able to assign the same diagnosis based on only the photo and history. I can also go through the same exercise with some of the other local docs to get a sense of intra- and interobserver reliability.
Otherwise, all is going smoothly in Bhairahawa. While my stomach initially resisted some of the spicier local fare, my taste buds have now adjusted and the snacks I brought from home taste hopelessly bland. Now if I could just master the language…