Earlier this month I went to Cambodia as a volunteer on behalf of Sight For All (SFA) a charity I have blogged about before. The project I’m involved with sends Australian ophthalmologists to help locally-trained ophthalmologists develop sub-specialty skills. It’s a great cause and SFA has demonstrated impressive results, with projects also ongoing in Myanmar, Vietnam, Laos, Bhutan, Nepal and other Asian countries. The founder and head of SFA is Dr James Muecke AM, a man of true vision and relentless energy who has succeeded in drawing together a team of ophthalmologists from all around Australia. It’s a privilege to be included with the team, and it’s a wonderful project to work on.
Last month Dr David Hubel died, aged 87. He was a giant in visual neuroscience, and his work with Dr Torsten Wiesel led to the collaborators sharing (with Roger Sperry) the 1981 Nobel in Physiology or Medicine.
As I’ve written before, macular degeneration is the leading cause of blindness in Australia, and 1 in 7 Australians over 50 suffer from it. Although the wet, aggressive, neovascular form is justifiably feared, there are pharmacological treatments widely available that for many patients salvage or restore vision. The dry, atrophic, form remains untreatable, and in some patients it inexorably progresses to its most advanced form, geographic atrophy (GA). In patients with GA there may be no functional macula tissue remaining, and central vision is lost.
The emergence of “superbugs”, bacteria resistant to multiple antibiotics, is shaping up as one of the greatest world-wide health-care challenges of the (still relatively) new century. Infectious Diseases (ID) Physicians warn of a coming “Red Plague” that threatens to effectively take us back to the pre-antibiotic era, when people died of what are currently considered minor infections, due to increasing Gram-negative resistance.
Hypertension (high blood pressure) is one of the most common medical conditions seen by doctors in Australia and other Western industrialised countries, and causes more deaths than any other cardiovascular risk factor, including smoking and high cholesterol. Although we understand the role of lifestyle factors and have many medications available to treat hypertension, for many patients and doctors it remains frustratingly difficult to control, and in many patients remains undetected. In the American National Health and Nutrition Study (NHANES III) 68.4% of hypertensive patients were aware of their hypertension, 53.6% were being treated, and only 27.4% had control of their hypertension. These figures are worrying because inadequate control of hypertension can lead to “end-organ damage” including kidney disease, peripheral vascular disease, eye disease, stroke and heart attack.
Today is World AIDS Day. Around 34 million people worldwide have HIV. 25 million have died from AIDS, 1.7 million of them in 2011. Just try to imagine what that number means. When I was a medical student and trainee ophthalmologist sight-threatening complications of HIV infection, such as CMV retinitis, acute retinal necrosis and progressive outer retinal necrosis, were fairly common, and many of our patients with AIDS ultimately died.