Vision For The Masses

In addition to his reputation as an excellent ophthalmic surgeon, Dr. Strauss is known for being a kind and humble person. Friend and colleague Alison Brieseman, Operating Room Supervisor onboard the Africa Mercy, has worked with Dr. Strauss for several years. She describes him as a "team player," who even helps mop the floors after a long day of surgeries in the OR.


Hundreds of people wait outside of a Mercy Ships eye clinic in Benin, West Africa, hoping to be scheduled for cataract surgery. According to the World Health Organization, cataracts are responsible for 48% of world blindness, affecting 18 million people.

This is a story I wrote about Dr. Glenn Strauss and the amazing things he has doen this year in Benin. And at the end of the day, he and his wife, Kim, are two of the kindest, humble people you will ever meet.

Vision for the Masses
By Megan Petock
Photos by Bebra Bell and PJ Accetturo

According to the World Health Organization, cataracts are responsible for 48% of world blindness - affecting 18 million people. Although surgically curable, cataracts are the leading cause of blindness and visual impairment in the developing world, where nine out of ten of the world's blind live. Barriers to surgical care include high cost, inaccessibility due to lack of trained surgeons, and poor visual outcomes. If no action is taken, it's estimated that the number of people blind from cataracts will swell to 40 million by the year 2020.

Having a diameter of only 2.5 cm (1 inch), the human eye is slightly smaller than a ping pong ball. Most of the eye remains hidden and protected within the bony orbits of the skull. Only the cornea - the eye's clear, outer wall - is exposed to the environment.

The optics of the eye are comparable to a camera. The cornea allows light into the eye, which continues through the pupil until reaching the transparent, flexible lens. The lens focuses a precise amount of light onto the retina - a light-sensitive tissue on the eye's inner surface, filled with visual receptor cells. These cells, called rods and cones, generate an electronic impulse which transmits images to the brain. The images are transcribed by the brain, and the result is sight.

A cataract is the clouding or loss of transparency of the lens. The lens cannot focus light onto the retina, which means that a clear image cannot be transmitted to the brain. The affected individual's vision becomes blurred and unfocused. If the cataract is not removed, the clarity of vision continues to deteriorate, eventually causing blindness.

In the Western world, cataracts are removed long before vision is threatened. They are most commonly removed using a technique called phacoemulsification. A small ultra-sound probe breaks the cloudy lens into pieces and suctions them out through a tiny incision. Then a new lens is inserted. However, in the developing world, where resources and personnel are scarce, this technique is not feasible.

Traditionally, the alternative method used in developing countries has been the extra-capsular technique, in which the surgeon makes an incision in the eye and removes the entire cataract in one piece. The procedure takes 20 to 30 minutes and requires stitching the eye, which results in a prolonged recovery.

Dr. Glenn Strauss, an American ophthalmic surgeon, has spent more than a decade performing free eye surgery in developing countries. Serving with the global charity Mercy Ships, he and his wife, Kim, live onboard the world's largest non-governmental hospital ship, the Africa Mercy.

Dr. Strauss received his medical training at the University of Texas Medical Branch in Galveston,Texas. It wasn't until his last year of medical school that he became interested in ophthalmology. "It was the fourth year of medical school when we had a very short rotation through the eye department - only two days," said Dr. Strauss. "It caught my attention, and I really hoped it was something I could do. However, obtaining an ophthalmic residency was very competitive. There were 500 people that applied for four positions. I was given one of the positions. I thank the Lord for opening the door and allowing me to do it."

His first experience performing ophthalmic surgery in the Third World was with Mercy Ships in 1997, when Dr. Charles de Haven, a local ophthalmologist, invited him to work onboard the Caribbean Mercy. "After that experience, I continued coming back, and it became an annual routine," said Dr. Strauss. In January 2005, he left his successful ophthalmic practice in Tyler,Texas, to serve with Mercy Ships full-time.

It was during this time that Dr. Strauss recognized the need for an alternative cataract removal technique.

"The ultrasonic device needed for the phacoemulsification technique is expensive, the cost per use is very high, and maintenance of the machine is very difficult," explained Dr. Strauss. "In underdeveloped countries, the environment can be very harsh. I've seen machines that have been donated just sit there after being used just once or twice. And that's it. We needed to find a solution for people that did not require a lot of technology but produced the same quality. That was the objective," he said.

Over four years, Dr. Strauss developed a high-quality, sutureless cataract-removal technique, that can be performed in only five minutes and requires basic surgical instruments.

"It's been developed out of a concept that was already being used in all areas of ophthalmology for cataract surgery," he explained. "I applied the same principles in making a tunnel in the eye-wall through which you can do all your work. The cataract can be slipped out, and the new lens can be slipped in. When that tunnel is properly constructed, it is self-sealing and doesn't require any sutures."

Dr. Strauss has seen positive results while using the sutureless technique in West Africa. The absence of sutures results in decreased trauma to the eye and an overall increase in recovery rate. "Patients are healing faster. The post-operative reports on our patients show that the day after surgery, the vision is extremely good. Some are even 20/20 or 6/6, which is considered perfect vision," he said. "They are seeing that well the first day, which says a lot about the quality of the procedure."

Because the procedure is inexpensive, faster, and more accessible, Dr. Strauss believes it has the potential to revolutionize ophthalmic care in developing nations and possibly decrease the escalating numbers of cataract blindness.

"Currently, the number [of those blind from cataracts] is not going down. It's my hope that because this technique can be done using local resources, it will start to turn the trend and chip away at that number," he explained. "We've needed the right tool to have that impact. At this point, this procedure looks like a very good option to do just that."

Although he has developed his own methodology, Dr. Strauss is quick to point out that he is not the only surgeon utilizing these principles.

"It was certainly something I developed as an application of these principles to this specific condition that we have here, but developing this technique is not really the same as inventing something. There are several other ways that the same thing is done, and there has been interest in doing this since about 2003. There have been similar techniques developed in Indiaand Nepal, and they have had a parallel development."

This year, Dr. Strauss has taught the technique to five ophthalmic surgeons from Benin. Currently, they are using the technique at their local hospitals and teaching it to other surgeons. "This new method is very quick and less expensive, which has been very helpful," said Dr. Doutetien, a Beninese ophthalmic surgeon who is now performing the technique at her hospital.

In addition to his reputation as an excellent ophthalmic surgeon, Dr. Strauss is known for being a kind and humble person. Friend and colleague Alison Brieseman, Operating Room Supervisor onboard the Africa Mercy, has worked with Dr. Strauss for several years. She describes him as a "team player," who even helps mop the floors after a long day of surgeries in the OR.

Brieseman believes that the work Dr. Strauss is doing and the knowledge he is sharing is revolutionizing ophthalmic care in developing nations around the world. Indeed, the technique Dr. Strauss has developed has the potential to impact millions of lives. "It doesn't replace what is being done in the developed world, but the quality of it is quite comparable," Dr. Strauss said. "Just because someone lives in a poor country doesn't mean they ought to be getting second-best. It's not offering a second-best, and that's what I really like about it. I think it's a terrific step forward," he concluded.