Kabul Medical University students clamoring for ophthalmology lectures!

Beware owners of this breed, the Afghan hound: Your animal is predisposed to glaucoma and should have a complete eye exam from a veterinarian (not an ophthalmologist).


The efforts of the Navy medical mentoring team at the National Military Hospital are inspiring the medical students from Kabul Medical University who rotate through the medical center for clinical instruction. After a recent trauma care course presented by the Navy team, the several dozen medical students presented the course director with a list of topics they would like addressed in a lecture series. I was shocked to see that the twenty-three proposed lectures included two involving the eye: glaucoma and blindness. I’m accustomed to seeing lists of “essential” medical topics include well-worn issues such as sepsis, cardiac artery disease and gastroenterological dysfunction, but not eye problems.

My experience is that most medical students know very little and care even less about the eye, and that medical schools reinforce the negligence by giving scant instruction in ophthalmology during core courses. You would think that the phrase “life, limb and eyesight” would prompt a little more attention to vision. I cannot remember thinking much about the eye while I was in medical school, except for the day in the anatomy lab when we cut open cow eyes to peek inside. I can’t even recall a lecture on eye diseases and ophthalmic treatments. During our physical examination course I did learn the basic eye exam, although I didn’t really understand everything I was doing; and I remember an emergency medicine resident emphasizing to me that a patient’s visual acuity is measured separately for each eye at the Snellen chart (you know, the sheet of paper on the wall with the big black E).

I doubt most people could define optician vs. optometrist vs. ophthalmologist. Many patients of mine have commented that is must be wonderful to be able to do my work with only a bachelor’s degree. I’ve encountered nurse practitioners and even physicians who have no idea that ophthalmologists handle severe medical problems with the eye and perform surgery. What people presume about ophthalmologists these days is that we all spend our days performing LASIK surgery and making $1 million annually.

Even though the practice of ophthalmology in the US might suffer from the disinterest and confusion of the greater medical establishment, its status in no way compares to the lack of attention to eye maladies in Afghanistan. I attempted an internet search for information on glaucoma in Afghanistan, and found only two articles. I wasn’t investigating a rare disease such as kuru or Sanfilippo mucopolysaccaridosis. Glaucoma is the second leading cause of blindness worldwide. The two articles were simple surveys, valuable but limited in scope. In contrast, I was able to find dozens of internet resources for glaucoma in the Afghan hound, a beautiful long-haired animal that apparently is one of the more than forty canine breeds predisposed to developing glaucoma. I may write the American Kennel Club and try to shame it into a donation for ophthalmic research in the homeland of that distinctive champion dog.