Stop Blindness caused by Diabetes in Nigeria

Nigeria has the highest population of people living with Diabetes Mellitus (DM) in sub-Saharan Africa; as at 2018 the national DM prevalence stood at nearly 6%, about 11.5 million people. DM can affect the back of the eye by damaging the tiny blood vessels of the retina resulting in a condition called diabetic retinopathy (DR). This, if not treated early this can lead to loss of vision and blindness. It is not uncommon to find people presenting to the eye clinics with one blind eye and vision in the second eye drastically reduced due to advanced DR. Sadly access to eye healthcare in Nigeria can be costly, particularly for those from low income areas
Diabetic retinopathy occurs without symptoms in its early stages; hence it’s imperative that it’s imperative that retinopathy is screened for early enough to prevent permanent visual loss and blindness. There is no national DR screening and treatment programme in Nigeria so currently, detection of cases is largely opportunistic when those with diabetes present to eye clinics with visual loss.
The economic burden of the management of DM without blindness in a Low- and Middle-Income Country (LMIC) is already huge. When associated with visual impairment or blindness, the effects are devastating as this mostly affects the economically active age group between 20-60 years of age.
 The Ophthalmology Departments at the University of Calabar Teaching Hospital (UCTH) and Lagos University Teaching Hospital (LUTH), with the help of their VISION 2020 LINK partners - the Royal Wolverhampton NHS Trust and Bolton/Sheffield have given themselves the task of setting up DR screening and treatment programme in Calabar and Lagos. The aim is to offer screening services free of charge to people living with diabetes, to encourage uptake and make it available and accessible to them in order to prevent and reduce the burden of blindness.
To be able to reach out to a large number of people living with diabetes for screening of DR in these areas we urgently need;
·      Fundus cameras to take the images of the back of the eye for assessment
·       Optical coherence tomography (OCT) to enable doctors to confirm sight threatening diabetic retinopathy, monitor its treatment and progression.
·       Training of new screeners and graders
·      Purchasing of consumables such a tropicamide and phenylephrine drops used to dilate the pupils ready for fundus image capture
 
 
Efforts are currently being made to improve public understanding and encourage uptake of routine screening for DR. With equipment in place we would expect a fourfold increase in the number of people living with diabetes being screened and, for those who need it, referral for treatment such as injections to the back of the eye and surgery to the back of the eye. One of the main benefits of additional equipment and resources is that diabetic eye screening could be carried out every day instead of the current once-weekly clinic.
The centres being set up in Calabar and Lagos would serve as pilot Screening and Treatment centres to demonstrate what is possible and strengthen the case for a national programme in Nigeria.
 
The current Covid-19 pandemic, along with declining economic fortunes of government, have taken away some focus on prevention of visual impairment, making the provision of this equipment by government extremely unlikely.
 
Our appeal is for ninety thousand pounds (£90,000) to cover the cost of two fundus cameras, two OCTs and training of personnel to kick start the Calabar and Lagos DR screening programmes.
 
With your support and generosity, you can help us save the sight of many people living with Diabetes in Nigeria