Common Caribbean Eye Diseases & Remedies

Due to many factors, individuals living in the Caribbean experience a disproportionate risk of developing several eye diseases that have the ability to cause blindness. Although many are considered common, treatment options that are readily accessible in more developed nations are lacking in the Caribbean. There are also numerous barriers to treatment, which are not easily remedied.

Keratoconus

• Although rare in North America and Europe, keratoconus is fairly common in the Caribbean. The progressive disease typically forms in both eyes. It causes an increase in the curve of the cornea, which is the clear part of the eye, resulting in a thinning of the cornea and a progressive astigmatism because the cornea bulges forward. It is often seen in teenagers and tends to progress until they reach 30 or 40 years of age. The cause of keratoconus is unknown. Although there is some evidence of genetic predisposition, more evidence suggests exuberant eye rubbing, wearing rigid contacts and chemical imbalances may contribute to the development of this eye disease.

Treatment of Keratoconus

• In its earliest phases, vision loss is usually correctable with glasses or contacts. As the disease progresses, specialized contacts usually are needed for vision improvement. When the disease progresses to the point that contacts become too uncomfortable, surgery often becomes necessary. Several procedures are used, including penetrating keratoplasty (PK), lammeler keratoplasty, corneal ring segments or corneal transplant. LASIK is contraindicated because of the chance of accelerating the bulge.

Diabetic Retinopathy

• In the Caribbean, where there are a large number of mixed-African descent residents, there is an exceptionally high incidence of diabetes. Among the many side effects are changes to the blood vessels of the eyes, macular degeneration, which results in bleeding and clotting in the eye with consequent blindness. While treatable with laser surgery, there is a lack of equipment, trained personnel and limited access for most of the population in need. Treatment often is not affordable to those who do have access.

Glaucoma

• Glaucoma is an eye disease that is symptom-free, easily treatable and can cause blindness when untreated. Although it is mostly found in adults over 40 in North America and Europe, in the Caribbean it is often found in adults as young as mid-20s. This is due in part because in diabetics the incidence of glaucoma is twice the normal population.

  Dr Francisco Martinez of the Vision 2020 Subcommittee on Diabetic Retinopathy reports it is estimated that up to 25 percent of residents in some areas of the Caribbean are diabetic. Glaucoma is treated with eye drops and can be managed easily when caught in the early stages. Left untreated, it eventually causes blindness, which is irreversible.

Cataracts

• Life-long exposure to harmful ultraviolet rays causes cataracts. Because of its location along the equator of our planet, residents in the Caribbean are exposed to an excess of these rays. Therefore, it is common to find cataracts in mature adults on the island.

Treatment Obstacles

• It is estimated by the Survey of Ophthalmology that the Caribbean has only a ninth of the number of eye care specialists available as those in richer countries. These limited specialists are often under-utilized by those in areas served by poor road systems, isolated by rain forests and mountains and a lack of public transportation. Even those with physical access to specialists often are without means of payment, so what might be easily correctable eye problems in developed countries often results in vision impairment or blindness in the Caribbean.