Ophthalmologist wins prestigious award for programme supported by CBM that prevents baby blindness.

In her capacity as Senior Physician for Pediatric Ophthalmology from the organisation Unidad Nacional de Oftalmología, Dr. Ana Lucía Asturias is receiving the Else Kröner Fresenius Award for Development Cooperation 2024 in distinguished acknowledgment of her project “Retinopathy of Prematurity in Guatemala”. The award-winner developed a programme to keep premature infants from going blind. The award from the foundation Else Kröner-Fresenius-Stiftung (EKFS) is endowed with 100,000 euros and is among the most renowned distinctions in the field of development cooperation in medicine. The formal award presentation ceremony will be held on October 15th at the Berlin-Brandenburg Academy of Sciences and Humanities in Berlin.

To prevent so-called baby blindness, Dr. Ana Lucía Asturias and the Unidad Nacional de Oftalmología organisation have developed and established a programme in Guatemala. The programme has been implemented with the support of the Christian Blind Mission (CBM) since 2019. The Unidad Nacional de Oftalmología is a nationally active, partly state-run entity that provides the highest-quality eye care at affordable prices and training for professional staff. Key mainstays within the programme are the screening and treatment of preterm infants and the active use of telemedicine.

“With this year’s award, we are acknowledging an outstanding project in the area of child health. Through straightforward and very effective measures such as extensive screenings, a project that can distinctly improve children’s health,” is how Dr. Jochen Bitzer, responsible for humanitarian funding at EKFS, explains the award allocation.

CBM, a supporter of the programme for years, nominated the project. “We are very pleased about this award,” adds Dr. Rainer Brockhaus, co-CEO of CBM. “With the work they do, Dr. Ana Lucía Asturias and her team contribute substantially toward reducing preventable visual impairments and blindness in children in Guatemala.”

The retina is not fully developed until around the calculated date of birth. In the case of retinopathy of prematurity (ROP), this development has been interrupted. Particularly at risk are babies born before the 31st week of pregnancy, who weigh less than 1,500 grams at birth, and those requiring artificial respiration. In a worst-case situation, retinopathy in the newborn infant can lead to a detachment of the retina and progress to blindness.

In Guatemala, the number of premature births in association with a low weight at birth is high due to malnutrition and nutritional deficiencies. An elevated dosage of oxygen in the incubator and other readily existing disorders are additional risk factors. Moreover, standard medical examinations lack eye screening as an integral element.

Screening and treatment

In the course of the programme around Dr. Ana Lucía Asturias, all premature infants undergo a screening at the Unidad’s Outpatient Department, which is affiliated with and adjoins Roosevelt Hospital in Guatemala City. Dr. Asturias clarifies the screening procedure: “We examine all babies born before the 36th week of pregnancy and newborns who weigh less than 2,000 grams. This also includes preterm babies who have already been taken home and still have to be monitored following release. They continue to be looked after and cared for by us.”

The screening of babies merely requires a strong light source and a lens. “The fascinating thing about the eye is that I’m able to see everything. I can monitor the blood vessels and their growth,” the ophthalmologist explains. The means for treating ROP include via laser or by injecting medication, for example.

Network and telemedicine

To make this service accessible, even in remote regions, the Unidad Nacional de Oftalmología and Dr. Asturias have built up a network. Of the 43 government hospitals with neonatal departments, 15 are affiliated with the programme. In all of Guatemala, there are barely a dozen eye doctors who specialise in children. That’s why telemedicine for training ophthalmologists is a crucial pillar within the project.

Yet another factor for the programme’s success is the assumption of financial costs for examinations and follow-up treatments. Otherwise, many families couldn’t afford them. In 2023, around 1,750 babies were examined within the scope of the project: ROP was diagnosed in 281. In the majority of them, the disease disappeared by itself. Fifty-five preterm infants received the necessary treatment – either using injections or a laser.

Programme objectives

The award money from EKFS will be used to advance and consolidate activities. One goal is to integrate more hospitals and expand the programme nationwide. Therefore, cooperation with the Ministry of Health and educational training constitute further key mainstays in the programme. Healthcare staff are being schooled via courses given online throughout the country; all ophthalmologists in the process of obtaining a residency within the scope of specialisation at the Unidad Nacional de Oftalmología are trained to perform screenings.