title: Establishing a surgical outreach program in the developing world: pediatric strabismus surgery in Guatemala City, Guatemala.
abstract: OBJECTIVE
  To report our experince in establishing a sustainable pediatric surgical outreach mission to an underserved population in Guatemala for treatment of strabismic disorders.
  
  
  METHODS
  A pediatric ophthalmic surgical outreach mission was established. Children were evaluated for surgical intervention by 3 pediatric ophthalmologists and 2 orthoptists. Surgical care was provided at the Moore Pediatric Surgery Center, Guatemala City, over 4 days. Postoperative care was facilitated by Guatemalan physicians during the second year.
  
  
  RESULTS
  In year 1, patients 1-17 years of age were referred by local healthcare providers. In year 2, more than 60% of patients were prescreened by a local pediatric ophthalmologist. We screened 47% more patients in year 2 (132 vs 90). Diagnoses included congenital and acquired esotropia, consecutive and acquired exotropia, congenital nystagmus, Duane syndrome, Brown syndrome, cranial nerve palsy, dissociated vertical deviation, and oblique muscle dysfunction. Overall, 42% of the patients who were screened underwent surgery. We performed 21 more surgeries in our second year (58 vs 37), a 57% increase. There were no significant intra- or postoperative complications.
  
  
  CONCLUSIONS
  Surgical outreach programs for children with strabismic disorders in the developing world can be established through international cooperation, a multidisciplinary team of healthcare providers, and medical equipment allocations. Coordinating care with local pediatric ophthalmologists and medical directors facilitates best practice management for sustainability.
authors.affiliation: Hamilton Eye Institute, Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee; Le Bonheur Children's Hospital, Memphis, Tennessee; St. Jude Children's Research Hospital, Memphis, Tennessee. Electronic address: lditta@uthsc.edu.
authors.forename: Lauren C
authors.initials: LC
authors.lastname: Ditta
authors.affiliation: Le Bonheur Children's Hospital, Memphis, Tennessee.
authors.forename: Lilia Ana
authors.initials: LA
authors.lastname: Pereiras
authors.affiliation: Hamilton Eye Institute, Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee.
authors.forename: Emily T
authors.initials: ET
authors.lastname: Graves
authors.affiliation: Hamilton Eye Institute, Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee.
authors.forename: Chantel
authors.initials: C
authors.lastname: Devould
authors.affiliation: Hamilton Eye Institute, Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee.
authors.forename: Ebony
authors.initials: E
authors.lastname: Murchison
authors.affiliation: Moore Pediatric Surgery Center, Guatemala City, Guatemala.
authors.forename: Ligia
authors.initials: L
authors.lastname: Figueroa
authors.affiliation: Hamilton Eye Institute, Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee; Le Bonheur Children's Hospital, Memphis, Tennessee; St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Natalie C
authors.initials: NC
authors.lastname: Kerr
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003159:Community-Institutional Relations; D003906:Developing Countries; D005260:Female; D006166:Guatemala; D006801:Humans; D007223:Infant; D008297:Male; D008493:Medical Missions / Q000458:organization & administration*; D013508:Ophthalmologic Surgical Procedures; D010348:Patient Care Team / Q000458:organization & administration*; D010372:Pediatrics; D013285:Strabismus / Q000601:surgery*; D035862:Vulnerable Populations