Dr. Ian Yeo: On a Mission to Train Rural Ophthalmologists

Dr. Ian Yeo On a Mission

to Train Rural Ophthalmologists by Chow Ee-Tan

With his expertise in retina and his passion for education, Prof. Dr. Ian Yeo is an integral team member of the ORBIS volunteer faculty’s training programs. Together with other industry experts, they travel to rural areas in China and around Asia to train rural ophthalmologists in the detection, management and treatment of sight-threatening eye disease.

While he primarily focuses on retina, Dr. Yeo, senior consultant at Singapore National Eye Center (SNEC), has also participated in humanitarian trips to China, Vietnam, Laos and Myanmar to assist at cataract camps.

His first trip with ORBIS was in 2017 to Shenyang, China. Dr. Yeo said that this particular one-week trip was special: During that visit, the new ORBIS airplane was unveiled, stocked with the latest diagnostic and audiovisual equipment for giving lectures and performing live surgeries.

The ORBIS volunteer program is fortunate to have some of the world’s leading ophthalmic experts, including ophthalmologists, nurses, anaesthesiologists and biomedical engineers, from over 30 countries. These experts share their professional skills by providing ongoing training and support to eye care teams around the world. For Dr. Yeo, his main role is training young ophthalmologists to identify and treat retinal disease. “The ORBIS programs generally take place in thirdtier cities, away from the bright lights and resources of the bigger cities. This is where there are many people in need of care,” shared Dr. Yeo.

The Importance of Training the Trainers

The program in Shenyang was a focused endeavor to provide training to local doctors. Dr. Yeo gave lectures to ophthalmologists, nurses, medical students and allied health professionals, and showed these trainees the latest diagnostic tools (when available) on the ORBIS plane.

“We were there to help the local doctors,” shared Dr. Yeo. “I worked with one or two doctors at a time to optimize their hands-on skills. But there was also a large team of local senior and junior ophthalmologists who joined to observe and to be trained.”

Basically, the volunteers’ role was to help local junior and senior doctors learn to better manage patients. “Most importantly, we worked with the trainees to optimize the equipment and therapeutics in their own clinics. We also touched on screening and telemedicine to help improve in these areas,” added Dr. Yeo.

Prior to the ORBIS team’s arrival in Shenyang, the local doctors screened patients. This allowed for additional tests to be performed and provided time for discussion.

“The local Chinese ophthalmologists often failed to pick up symptoms in the early stages, thus diagnosis and treatment were delayed. But after training, they were equipped with the necessary skills and knowledge to notice these symptoms and provide prompt treatment — thus, lowering chances of blindness,” said Dr. Yeo.

Taking Every Opportunity to Help

While there, volunteers also spent time seeing patients. Dr. Yeo recalled a case that involved a young diabetic man with severe bleeding in both eyes.

“The patient was operated on by an earlier team but was not doing well. I managed to redo the case and helped save at least one of his eyes,” he shared.

It’s clear that such programs truly make a difference, with the philosophy: “Give a man a fish, and you feed him for a day. Teach a man to fish, and you feed him for a lifetime.”

“The local ophthalmologists were very eager to have the opportunity to learn from experts from around the world,” said Dr. Yeo, who is still in touch with his previous trainees. Together, they continue to share knowledge and discuss cases over emails or WeChat.

“This means the learning never stops,” he said. “It is an ongoing effort in rural areas where education can make a difference, along with the availability of healthcare.”

A Passion for Ophthalmology and Volunteerism

In 2018, Dr. Yeo was also the primary ophthalmologist in another ORBIS volunteer program in Linyi, China. He said there are more serious eye cases in fourth-tier cities with limited medical resources.

“The majority of the population there lacked knowledge and true understanding of diabetes, which is a lifelong disease that damages blood vessels, resulting in blindness,” he shared.

He said there are many misconceptions about diabetes in the more rural parts of China. Patients do not seek eye care until their vision starts to drop. They will only come forward for treatment when more severe symptoms appear.

According to Dr. Yeo, diabetes is the predominant problem in China, where a large number of patients require laser treatment (as it is the more affordable option). However, laser is a preventive measure that slows down the disease, but it does not correct the underlying problem.

At the training, Dr. Yeo asked the ophthalmologists to review angiogram and optical coherence tomography (OCT) for diabetic conditions. He also taught them to use B-scans and how to apply a systematic way of categorizing all the scans for future references and records.

Dr. Yeo, training the trainers

Dr. Ian Yeo is passionate about ophthalmology as he is about volunteering.

Photos courtesy of ORBIS Singapore and Dr. Ian Yeo

Another problem in Linyi was the lack of trust in doctors by the local patients. He said this can be improved by better public education and training. This is necessary so that moving forward, there will be better traction and acceptance of the medical workers.

Dr. Yeo believes that despite the great scientific and medical progress in China today, there are still areas where ORBIS has a role to help. “Most facilities and trainings are done in primary, first-tier cities. Going to outer cities in China allows us to bring knowledge and technology to the doctors there. It is useful to be able to bridge some of these gaps,” he added.

Dr. Yeo feels that it’s in places like Linyi where they can really help. “We hope that more and more rural patients receive quality eye care done in an ethical and evidence-based manner. The program had also opened up avenues for the doctors who have potential to go further, by giving them opportunities to do more for the rural folks in outer China,” he shared.

Funding and Donations Go a Long Way

While volunteers can give their time and expertise, there is a real cost to provide medical training and equipment. “I am thankful for work done by ORBIS and their staff with the volunteer faculty,” said Dr. Yeo.

Dr. Yeo at work

Donations from the public also ensure that there are enough resources to continue this meaningful work.

“No kindness will go unnoticed and we will be rewarded in many ways. I’ve been truly blessed from the experiences I’ve had, the friends I’ve made and the patients I’ve helped. I urge everyone able to help to experience this, too,” Dr. Yeo concluded.

Contributing Doctor

Dr. Ian Yeo is a vitreoretinal surgeon with the Singapore National Eye

Centre Retina Service. He manages both medical and surgical retinal patients in conditions such as age-related macular degeneration, diabetic eye disease and retinovascular conditions. He is also the deputy medical director and academic vice chair in charge of education and in charge of all training of medical personnel, including nurses, allied health professionals, and doctors starting from medical school to fellowship. Dr. Yeo is passionate about training the next generation of ophthalmologists and is actively engaged in their clinical practice and cataract training. He is also involved in humanitarian work in places like China, Vietnam and Myanmar. His contribution to training doctors in Singapore (and around Asia) is Dr. Yeo’s way of “paying it forward” for the training that he, too, had received in the past.