Monday, December 15, 2008

Ophthalmologists are never at war

Political tensions may continue to cast a shadow over relations between Russia and some of the other countries that were once part of the Soviet Union. Despite such clouds, the clear message from the delegates attending the recent IXth International Congress of the Russian Society of Ophthalmologists is that the international brotherhood and sisterhood of ophthalmology is, if anything, growing stronger.

This point is strongly borne out by Merab Dvali, MD, professor and chief of the Eye Department at the Tbilisi State Medical University Ophthalmology Department in Georgia.

“Years ago we were one big country with a common education, the same teachers and the centre of ophthalmology in the Soviet Union was Moscow,” Dr Dvali remembers during a break in the congress at the Fyodorov Complex in Moscow.

“I worked in Moscow for 19 years, and it continues to be a very important centre. Unfortunately, over the last 12 months, we have had political differences with Russia but I think the doctors in both of our countries have stayed friends. We were, and will be, brothers and sisters. We have no borders. Ophthalmologists never war. I hope our governments will take the same approach."

Dr Dvali says for Georgian ophthalmologists it is very important to have close links both with Russia and other European countries.
“It is very difficult for our patients to go abroad and get treatment. We are a small country and we do not have enough eye surgeons, but we are doing our best and we try to use the latest technologies.”

While state-funded clinics in Georgia often struggle for funds, an increasing number of private clinics are being developed, says Dr Dvali. Young ophthalmologists in Georgia are also being encouraged to travel overseas for training. “We are supporting one young doctor who we have sent to India to get training in vitreo-retinal surgery. He knows the theory, but he needs practical experience and in India he will get that experience. Another doctor has gone to Spain to study keratoplasty surgery.”

So what should be the model for developing ophthalmology in Georgia? While Dr Dvali is full of admiration for the work done at the Fyodorov Complex, he does not think that a complex of that size should be replicated in his country.
“It is my opinion that eye clinics should not be as big as Fyodorov. Under the old socialist system it was possible to build a big clinic like Fyodorov, but I do not think it is necessary to have a complex of that size,” he says. “For example, my own clinic is a 200-square-metre outpatient clinic. We do laser, we do phaco, and we do all surgery in this clinic. The most important thing is good equipment and good doctors.”

In 1999, Prof Dvali bought the first excimer laser into his clinic. “It was very difficult to raise the money,” he recalls. “But I was able to raise the finance with the help of five friends who were not ophthalmologists. They believed in me and they supported me and that was very important.”

Because of the lack of resources in government clinics – like the one he runs – Dr Dvali is using his private clinic to train his residents.
He notes that in many western European countries, ophthalmologists are concerned about the growth of the private ophthalmology sector at the expense of the public sector. In Georgia, however, private clinics are essential for the development of ophthalmology, he says.

“Public and private patients get the same treatment,” he says. “We also have a mobile clinic that allows us to go to small villages and carry out surgery. If a patient does not have money, he does not get a poor service.”

* A full report on Ophthalmology in the new Europe will be published in December EuroTimes. You can also visit our website at

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