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Here’s to Your Health

BY JOAN JACOBSON

Dr. Geoffrey Tabin, M.D., professor of ophthalmology, University of Utah, and director and founder of the Himalayan Cataract Project and a world-renowned ophthalmologist, spoke recently at the university.

He describes a cataract as a cloudy opaque area in the lens of the eye, which is normally clear. Symptoms include cloudy, fuzzy, foggy or filmy vision, loss of color intensity, impaired vision at night — especially while driving — caused by glare from bright lights. In addition, there may be glare from lamps, or the sun, and halos around lights. Double vision in one eye may also occur. The treatment for cataract is surgical removal. Some individuals may get along without surgery by using stronger bifocals, or a magnifying lens.

Tabin grew up in the suburbs north of Chicago. His undergraduate studies were at Yale. From there he received the prestigious Marshall Scholarship to complete his master’s in philosophy at Oxford University. His medical degree was awarded by Harvard Medical School. His general surgery internship was at the University of Colorado. From there he went to Brown University for a residency in ophthalmology. A fellowship in corneal disease was spent at Melbourne University, Australia, followed by a year in Nepal, teaching native doctors ophthalmology techniques. If this isn’t enough, Tabin is a renowned mountain climber. So far he has climbed mountains on seven different continents. He has climbed Mt. Everest, the highest peak in the world, three times. The second time he reached the "top of the world."

Park City residents Geoff and his ophthalmologist wife, Jean, practice at the University of Utah Moran Eye Center. One day a week they conduct clinics at the Redstone Clinic in Park City. They have five children including three from his wife’s first marriage, and two of their own.

The Himalayan Cataract Project is an 11-year-old U.S.-based, nonprofit project that has raised more than $2.9 million to provide eye care to the impoverished areas of Nepal, Bhutan and Pakistan. The bulk of the money — $2.2 million — has gone to the Katmandu-based Tilganga Eye Center. The doctors there, including Tabin, have performed an astonishing 74,903 cataract surgeries since 1994. Included in these numbers are 34,070 surgeries that were performed in 10 mobile eye camps initiated by Tabin. In Katmandu, there is now a manufacturing plant that is making inter-ocular plastic lens implants that replace the diseased lens in the eye.

Tabin’s enterprise sees a high volume of patients who receive high-quality and low-cost procedures. Each surgery costs the individual $28 U.S. He notes that 60 percent receive free care, 25 percent may actually pay $100 and the others pay less than $100. Should a Westerner choose to go to one of Tabin’s clinics, the cost is $250. That beats the thousands of dollars charged in the U.S. Of course the airfare may need to be taken into consideration, says Tabin.

Tabin is also involved in training doctors in Nepal. His group is educating assistants who can help with screening, surgeries and post treatment of patients. These technical assistants undergo three years of training post high school.

Recently, the Moran Eye Center welcomed Dr. Sanduk Ruit, M.D., to discuss his work with the Tilganga Eye Center, a nonprofit organization he helped to form in Katmandu along with his colleague, Dr. Tabin. A collaborative training effort is being developed at the University of Utah Moran Eye Center for medical students and Tilganga physicians.

In addition, Tabin developed an eye bank that is now housed in a temple where the monks encourage donations of eyes. Some finesse was needed to convince a non-Christian patient to receive an eye from a Christian. Tabin convinced the patient by having him hold a Koran in his hand while he performed the implant.

In the country of Bhutan, the king is encouraging primary eye care for his subjects. As a result, there are great screening programs, and some of those native doctors are coming to the Moran Eye Center to be trained.

Recently, the North Korean government has requested Tabin to come and set up clinics and train the doctors. Mongolia is also in need of his services. All of that may occur in the future. Tabin says that Africa is also on his map to go train doctors and establish links with the medical school at the University of Utah. He has been to Ghana and will soon go to Kenya.

Tabin says that 20 million people have cataracts. He predicts that by 2020, 40 million will be blind because of untreated cataracts. Throughout the world, 100 million people are blind because of untreated cataracts. Sadly, in these developing countries, only three in 100 persons receive treatment. In the United States there are over 1.5 million cataract surgeries performed every year. Nine out of 10 people who receive the surgery regain good vision somewhere between 20/20 and 20/40.

Tabin also discussed other kinds of conditions affecting the eye. In the U.S. three in 1,000 individuals are blind. This is because of age-related macular degeneration that has no known cure. The disease manifests in a decrease in nerve cells and is treated with anti-oxidant medications and vitamins to arrest its progression.

Another cause of blindness is glaucoma. This affects two to four million people worldwide. The cause is unknown; there is no pain or other symptoms. The incidence is higher in Caucasians and lower in blacks. Untreated it results in blindness. Tabin says that individuals with glaucoma are not candidates for cataract surgery because the lens cannot be implanted in a diseased eye.

With aging, there is also a problem of dry eye. Tabin says that the dry climate may make dry eyes worse. He says that over-the-counter eye drops that resemble real tears appear to be the best treatment. Restasis is also prescribed. It is approved by the Food and Drug Administration (FDA) and acts to lubricate the eye and prevent inflammation of the eye.

Other words of wisdom from Dr. Tabin are that wearing UV protection sunglasses protects the eye, prevents cataracts and other damage from the sun. There is ongoing research to develop drops or nutritional products that may one day prevent cataracts.

Dr. Tabin is on his way back to his Himalayan center to perform more surgeries and to train more doctors. His energy and commitment is unflagging. He is a genius and a great man. We are blessed to have him here in Utah.


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