Every Day Heroes: Dr. Kourosh Sabri

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McMaster University’s Department of Surgery has developed the Every Day Hero Award to help shine light on our staff members who go above and beyond to help and serve others in their daily lives. These incredible people sacrifice their own time to bring about positive change in the lives of those around them. One such example is Dr. Kourosh Sabri, who is being presented the award for the ICEE project, which stands for Indigenous Children Eye Exams. This is just one of many projects that Dr. Sabri has worked on to create accessible healthcare within Canada.

His passion to help others is evident, in particular he aims to improve quality of life in underserved communities and vulnerable sectors.

Dr. Sabri is currently working on a project that will help create accessible vision care for Indigenous children living in northern Ontario. The three-year project will visit six or seven communities and will involve screening children as well as training local healthcare workers in how to conduct vision screenings. The project is very intentional about creating a self-sustainable model and limiting unnecessary long-distance travel of patients. We had the opportunity to sit down with Dr. Sabri and ask him a few questions about how this project came about.

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ssociate Professor, oPhthalmology

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You have a strong passion for eye care and vision screening can you tell us how this passion started for you?

This all started four or five years ago when we were approached by a number of public health nurses in Hamilton. The concern was that there were children sitting in schools in Hamilton that probably had vision problems but nobody knew about them. We started a program called EYE-MAC where we trained McMaster Students to go into schools to do vision screening on elementary school children. We found that there were many children with vision problems that were going undiagnosed and through this program we referred them to local optometrists. The program has now expanded to having screened over five thousand children in Hamilton. That really launched the idea for us to develop vision screening programs for children.

Describe how you have become involved in Indigenous health up north and what have you learned from it?

The Indigenous communities started because I was approached four or five years ago by one of my colleagues, Dr. Vandermeulen, who is a pediatric endocrinologist. He goes up to the James Bay area to carry out exams on children who are diabetic. He explained to me that we should also be doing something for vision. I began going up to these communities such as Attawapiskat and Moosonee. We realised that there really wasn’t any eye care for these children and that started the idea in my mind that we should work to develop some kind of vision screening program

for these children. For the last 4 or 5 years we have been gathering support from these local communities and the Weeneebayko Area Health Authority. We have been very fortunate to secure funding for ICEE this year 2019 through the federal government, specifically the Ministry for Indigenous Affairs. There is a section within the Ministry for Indigenous Affairs called Jordan’s Principle whose mandate is to provide funds to address any gap in healthcare Indigenous children are receiving due to where they live. We were able to successfully argue eye care is a public health need that all children should have access to and these children on the reserves don’t have access to it because of where they live. The other point to make here is that these communities do have good access to telemedicine networks. Another big part of what we are doing is going to be trying to develop a telemedicine arm of the project so we can try to use a remote linkage to assess children remotely. If we can avoid children being brought across hundreds of miles for eye exams that would be great, especially because many of these communities become shut off from the rest of the country in the winter months.

What impact are you hoping that the project will have?

The impacts are going to be quite significant. On the most immediate level the plan is to screen 4,000 children between the ages of six months and 16 years for eye problems. On a larger scale this will provide evidence of how such a model can be implemented in these communities. Unfortunately there are many underserved communities in Canada. There may be geographic challenges, socioeconomic barriers or even political reasons

as to why these communities are underserved.

This project can become an evidence based model for delivering eye care to these communities and particularly the children, who are the most vulnerable sector of any community. I think another significant part of the project is that we want to develop it as a self sustained model. It is very important to develop these models where the local community can take over some of the vision screening aspects of the project. If the projects rely solely on outsiders to do something then these projects won’t have any longevity. If you can make it self-sustaining where members of the community can carry out many steps in both the screening process and delivery of eye care; these projects can become successful and have longevity. The ICEE model will focus on these principles. I think the impact can be to improve delivery of care to many such communities across Canada.

What predictions do you have for the future of pediatric ophthalmology?

One area I see developing is the use of future technology to help address the gap in accessibility for children to see a pediatric ophthalmologist. Pediatric ophthalmology is a relatively subspecialized area of ophthalmology.

For example, in the whole of Ontario we have

less than 15 pediatric ophthalmologists for one of the most populated provinces in the country.

This creates problems as one can imagine. Many children would have to travel long distances to see us and our wait times can be lengthy. I think we are at a point in medical and scientific advancements where we can allow for the delivery of an accessible model for children to see a pediatric ophthalmologist. We have just started to collaborate with McMaster’s Computer Software and Engineering Departments to develop applications. We want to develop what appears to the child to be a game but through the steps of this game the app is actually doing an eye exam on the child. The child may have to look left and right to follow an object, this assesses ocular motility of the child. The app might for example, use infrared light to check the red reflex of the eye, this is to determine if the child has a cataract.

The app will be able to check if the child needs glasses. All of this can be done through the child playing a game. I think this is very exciting because this way we are doing an eye exam on the child, the information can be fed to a pediatric ophthalmologist who can assess if there is a problem area where the child needs to come in and be seen. I think technologies like this can allow for access to eye examinations for children who live long distances away from pediatric ophthalmologists.

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