As the team Oculofacial Plastic Surgeon, I will be working with Moroccan and American specialists, eyecare providers, and volunteers to screen and perform surgery on patients with orbital, eyelid, lacrimal, and facial injuries, tumors, and disorders. These procedures are inclusive of any soft tissue and/or bony reconstructive and restorative plastic surgery of the face, with a focus on the eyes, ocular and visual function, and vision preservation. We will pre-screen patients prior to travel, screen patients locally at the start of our work week there, perform surgery while providing hands-on surgical teaching, and also deliver didactic lectures on relevant topics in oculoplastic surgery. Our team will also perform postop care and checks during the week, instruct patients and the local teams on how to maximize patient outcomes, and continue our connection and communications post-trip to maximize access to care and more seamless care transitions. The mission goals are education and developing a sustainable early program in oculofacial plastic surgery to improve access and provide more consistent patient care year round. The rest of the team of Ophthalmologists will be providing other eye care functions throughout the week, including vision screening, glasses, cataract, glaucoma, and retina surgeries.
Our team works at medical and surgical facilities in Agadir, Morocco, and performs screening there locally within town, as well as in the nearby mountains and highlands, with arrangements made well in advance with local leaders and authorities. The mission trip serves the local Moroccan population, specifically the Berber population in improving their access to eyecare. This group of people has limited access to specialty eyecare and vision services, and there is a high rate of preventable blindness and reversible vision loss. There are also a large number of untreated oculoplastics issues such as involutional eyelid disease, orbital tumors and trauma, and environmental exposures and dust exacerbating sinus problems and lacrimal disease. We will address many of these factors through screening and education to improve access, earlier diagnosis and referral.
From an oculoplastics case and learning standpoint, our immediate team will be working directly with local plastic surgeons and ENT doctors in the care of patients, and so there will be bilateral learning - we will all learn from each other! Also, there are other community surgeons and trainees from a local residency program in Agadir that will have the opportunity to interface with us and attend our lectures, so the information we share - both didactic and skills transfer - will carry forward in the care of future patients from the area population. The 2022 Mission saw 180 eye procedures performed (all specialties), and the 2023 Mission had 334, along with 58 vision screenings, and 28 pairs of eye glasses prescribed and donated. We anticipate larger numbers and volume in all areas this year. We very much plan and hope for our work to have an enduring effect, and also anticipate our return to this location in the future to continue growing the program.
During this surgical mission trip to Agadir, Morocco, due to the combined efforts of our Ophthalmology team, the people most impacted were those with sight-threatening conditions, including eyelid, orbital and periocular conditions, retinal disease, corneal pathology, glaucoma, and cataracts. Our team performed over 200 operations restoring and preserving vision for the traditional rural and urban communities in and around coastal Agadir, Morocco (and old port), as well as patients who were screened in advance and then specially transported down from the mountains - the Berber community. A team of 3 optometrists also spread their efforts through various communities over a 10 day period to assist the Ophthalmologists with their surgical patients, as well as (importantly) screening children for refractive error (need for glasses to achieve correction) and treating if needed amblyopia (pediatric vision loss).
As the team Oculofacial plastic surgeon, our week was productively occupied with patient screening, triage, and formulating surgical plans, diagnostic evaluations of certain patients needing orbital CT's and MRI's, and then scheduling surgeries. We operated daily at the academic hospital (local medical school) during the mission program, and performed about 20 surgeries for eyelid and conjunctival reconstructions, tear duct repairs, and orbital and facial tumors requiring restorative surgery to follow.
Most impactful from a surgical standpoint was the formal teaching and hands on skills transfer training of local surgical teams, and hospital residents learning ophthalmic/microsurgical soft tissue skills. We provided didactic lectures, as well as a skills wet lab using instruments we transported and donated to their education lab for future applications. We were very excited to see the growth and further potential for educational collaborations with this institution. Now in the completion phases of a new medical school campus and hospital, we are looking forward to the next operating room and teaching experiences in Agadir at their newest facilities.
