Jono does it all

As I have mentioned before, on Thursdays Jono is in the O.R. Yesterday, he had 19 surgeries! We started at about 9:30 a.m. and he was finished by 4:30 p.m.



The OR team having coffee before starting surgery

Operating "theater", as it is referred to here in Swaziland

One of the cases was ocular trauma in a small boy under the age of 5. I think it was another "stick to the eye". Anyway, we couldn't get a good exam in clinic, so we had to book him for an EUA (exam under anesthesia). I wondered when the anesthesiologist would arrive.

Next thing you know, Jono is administering anesthesia to the little boy! He anesthetized his own patient! For those of you wondering, he trained in anesthesia prior to taking up ophthalmology. It was so slick. The kid was under five minutes after getting into the O.R. He used an LMA (laryngeal mask airway) to secure the airway. We examined the child, found that the tiny corneal wound had self-sealed (common theme yesterday), and he was awakened from anesthesia. I was impressed.

Dr. Pons at work

Dr. Pons and Welcome ("Wellie")

Today (Friday), I took care of clinic while Jono met with some workers from CBM South Africa (Christian Blind Mission). They are located worldwide and help support Jono's mission and work at Good Shepherd Eye Clinic.

The post-op cataracts looked phenomenal! The corneas were crystal clear, the lenses well-centered, the IOP within normal limits, and the patients had minimal intraocular inflammation. I honestly couldn't tell a difference between the patients who had undergone phaco versus the patients who underwent small incision cataract surgery. It was incredible to witness patients whose vision had improved from "hand motions" or "light perception" to being able to see and navigate (unaided) around the exam room! This will sound super lame, but a smile needs no translation: despite the fact that I couldn't understand what the patients were saying, the huge grins on their faces gave it all away :)

I also saw a cute little baby in clinic with a limbal dermoid.

Limbal dermoid of left eye. For those of you who are ophthalmology residents: it is most commonly located inferotemporally, as in this photo. It can cause astigmatism leading to amblyopia. The patient may also have an associated eyelid coloboma. It can be associated with Goldenhar Syndrome (Oculo-Auriculo-Vertebral syndrome).



Limbal dermoid.



My cutest patient of the day :)

We are just moving out of winter here and it is slightly chilly, so I turned on the gas heater for a bit tonight. This is my "living room" at the beautiful Mabuda Farm.

My living room at Mabuda. The double doors lead to my patio that overlooks the Lobombo mountains.

Another gorgeous sunset at Mabuda