Preserving Sight for Premature Infants in Vietnam’s Mekong Delta

October 2019

For young doctor Le Thi Mong Kieu from Can Tho Pediatric Hospital, providing screening and treatment for Retinopathy of Premature (ROP) is now a skill she carries out with confidence, but this wasn’t always the case.

“Previously we thought [the infants] were too weak and vulnerable to do so”, explains 27-year-old Dr. Kieu.

Dr. Kieu wasn’t alone among local eye health professionals who needed to build these critical skills. ROP screening was absent for premature infants from Can Tho and surrounding provinces in the Mekong Delta until the 2016 launch of the project “Sight for children and people aged over 50 of in the Mekong Delta.”

Funded by Standard Chartered Bank and implemented by Orbis in collaboration with the Can Tho Health Department and Can Tho Eye Hospital and Pediatric Hospital, the project has ensured doctors, nurses and technicians from the two hospitals have been trained to screen and manage ROP, together with a number of other pediatric eye diseases.

In Vietnam, ROP is estimated to lead to more than 30% of blindness in children under 10 dispite being preventable and treatable.

Dr. Kieu remembers the very first infant she and her team treated for ROP this March, after a full ROP management process had been put in place, including medical staff training, equipment provision and setting up referrals between neonatal care and ROP management services.

“I felt pressure because of the responsibility, but I was confident because I got sufficient training and support from an experienced doctor from Ho Chi Minh City’s Children Hospital 1 and colleagues from Can Tho Eye Hospital,” she says. “We are delighted because we can preserve a baby’s sight for life.”

A premature infant is screened for ROP.

Since March, three additional ROP cases have been treated, and more than 600 premature infants have been screened for ROP by the Can Tho team. Those infants are not only from Can Tho, but also from other provinces in the Mekong Delta, including Vinh Long, Tra Vinh, Hau Giang and Soc Trang.

Ensuring families can access screening and treatment close to home is critical. “For premature infants, their first screening should take place three or four weeks after birth, and this should be repeated twice a month, every week, or even every couple days, depending on each situation,” explains Dr. Kieu. Before she and her colleagues were trained, premature infants had to be taken to Ho Chi Minh City, which is four hours by bus from Can Tho, for screening and treatment, making it difficult or impossible for many infants to get the care they needed.

For the Can Tho medical team, this has also been a long journey to being able to make ROP and other valuable eye health services available to residents in Can Tho and the Mekong Delta.

Dr. Kieu (far left) and her team treat their first ROP case with support from an Orbis-trained doctor from Ho Chi Minh City.

“I graduated from medical university in 2016 and immediately joined Can Tho Pediatric Hospital,” remembers Dr. Kieu. “A year later, I had a chance to attend trainings on the Flying Eye Hospital.” She continued her learning through hospital-based trainings focused on children’s eye diseases.

Now, in addition to ROP screening and management, she knows about basic pediatric eye care, and treating refractive errors, which often occur after ROP treatment.

Can Tho is the sixth center that has received Orbis support for ROP treatment nationwide. Others include Ha Noi, Ho Chi Minh, Da Nang, Hue and Binh Dinh.

It’s fundamental to have a team in place with a full set of knowledge and skills. Our hospital is also working on a plan to train more ophthalmologists to be able to meet the region’s needs.

Dr. Kieu

In Vietnam, ROP prevalence among children born prematurely is 16%, which is estimated to lead to more than 30% of child blindness cases, despite being preventable and treatable. What’s more, the increasing number of premature infants saved thanks to recent medical achievements has also meant a respective rise in the number of infants at risk of ROP. Therefore, the need for training like that Dr. Kieu and her colleagues obtained has become greater.