The Orbis Flying Eye Hospital

Caution: This post contains graphic medical images that some people may find upsetting.


In April of 2018, I travelled to Trujillo in Peru to see the work carried out by the staff and volunteers of the visual health charity Orbis during a planned visit to the region by their Flying Eye Hospital. Getty Images has featured Orbis in its production a number of times before, but usually only when a charity ambassador or patron is in attendance. I hoped to focus on the work that the organisation does, and the changes that they can make to the lives of individuals.

Founded in 1982, on an idea conceived in the late 1960s by Dr. David Paton, a renowned US ophthalmologist, Orbis aims to prevent blindness and provide treatment through the training of medical staff in Asia, Africa and Latin America, and to provide health education for local communities and regional partnerships.

Discussing the patients with the team who had attended a screening day, I decided to follow two women to see how their experiences went. First, a seventeen year old girl called Diana, who has a condition called Reis-Buckler syndrome. This form of corneal dystrophy is a rare genetic condition which causes the Bowman's layer of the cornea to disintegrate. Diana's mother Rosa has the same syndrome and has struggled with sight loss since the age of nine. When Diana was only three, a doctor explained to her parents that she had the same condition as Rosa and that her cornea was “peeling like an onion”, causing her immense pain. She received her first cornea transplant at the age of 13, but the symptoms of the condition are again now taking hold, with her vision rapidly deteriorating. With this in mind, Diana was chosen for a "penetrating keratoplasty" procedure, commonly known as a cornea transplant.

For someone so young to have to suffer from this life-long genetic condition is a real tragedy, but the hope is that a fresh cornea transplant will give Diana a number of years of improved vision before her eye begins to break down once more.

Living at home with her parents outside Trujillo, Diana's sight had deteriorated to the point where she had been forced to put her studies on hold. She found herself spending more and more of her time at home, while her friends were free to enjoy the lifestyle every teenager craves. During my visit, it was clear just how hard Rosa, Diana's mother, was finding the situation. With the knowledge that the condition’s effects are unavoidable, she knows exactly what hardships Diana will face in the coming years.

Despite these worries, Diana put on a brave face during our time together, talking passionately of her interests and ambitions in life, including a hunger to travel and see the world. As we talk, her career ambitions bounce between becoming a photographer, a translator, a hair and make-up artist and a psychologist. It was obvious how poor the neighbourhood was, with every store being a grilled window in a wall, in a bid to avoid the ever-present threat of crime. Paula, my translator for the trip, spoke with concern about showing a mobile phone in public, never mind the multiple cameras I had hanging around my neck. With this in mind, it wasn’t surprising that Diana was looking to the horizon. It was the hope of the surgeons involved that they would provide her with some of that freedom, for some years at least.

When the day of her transplant arrived, Diana and her mother arrived at the IRO (Regional Ophthalmology Institute) before being transferred to Trujillo airport, and the Orbis Flying Eye Hospital. Once onboard, her nerves were clearly apparent, but she held herself together, answering a series of procedural questions on her health and identity, as well as listening to information about the procedure. With the paperwork complete, she was moved through to be prepared for the operation.

The Orbis Flying Eye Hospital is a self-sufficient surgical unit on a converted McDonald-Douglas MD10 aircraft. Surgery happens to the rear of the plane, while local doctors and medical staff sit in a classroom in what would traditionally be the first class area, where they can watch a live 3D streaming feed of the operations taking place onboard.

On a personal level, the work carried out by the team was genuinely mind-blowing. The delicate nature of their movements and skills is something that I've never witnessed before, made even more impressive by the high definition screens, showing exactly what the team of surgeons were doing. Witnessing the moment the cornea was separated from the donor rim, in a procedure known as "trephining the corneal button" was a moment to remember. Like many people, I can’t say that watching an eye being separated into its component parts was something I’d feel entirely comfortable with but, after the initial shock of the high definition feed, the surgeons’ work is a thing of beauty. The intricate stitching on a transplant patient’s eye is possibly the most personal body art a person can ever have.

Unlike charity organisations that perform large quantities of procedures, the visits by the Flying Eye Hospital are a chance to find certain conditions which will be useful to local surgeons, doctors and nurses in a training capacity. While the patients receive excellent surgical care for their immediate situation, the training given to those in the area provides knowledge that can be used for years to come. Beyond the work onboard the aircraft, Orbis has long-term programmes running in regions all over the world.

The day after surgery, Diana and Rosa returned to the IRO centre and, despite tests showing that the cornea transplant had been a success, Diana was clearly upset and in some discomfort.

Thankfully, I was able to meet with them a few days later and it was heart-warming to see a much happier girl. Heading out to meet a friend for a meal, she laughed and joked the whole way with her mother. Once she had met up with her best friend Erika, it was a pleasure to see Diana become the fun-loving teenager she deserves to be. Childhood giggles about her new crush on one of the translators provided blushes and plenty of laughter. I hope that laughter will continue for many years to come.

The other case that I chose to follow was that of Obdulia, a sixty year old cataract patient whose sight had deteriorated so much in the last three years, she was now virtually housebound.

During a visit to her home, this quiet polite woman was clearly doing all she could to hide her condition but, when asked to read a calendar on the wall, she failed to read the largest five centimetre high font from around thirty centimetres away. Speaking to her husband, he talked of how her character had changed as her frustration and diminishing independence impacted on her life. Initially refusing to admit to the problem, the severity only became apparent when he pushed her to get an eye test, saying; “Obdulia didn’t say she couldn’t see, she kept it a secret. We had to ask her if she was having trouble seeing and she said yes. She had three sets of glass prescribed. Each time they lasted less and less time until they no longer worked.”

A series of injuries due to falls as she walked outside her home, had resulted in her leaving the house less and less until she was now at a point where she feared being away from the familiar layout she knew so well. A visit to the local food market demonstrated just how much difficulty she was now experiencing. Items of debris on the floor weren't sensed until her feet touched them and, watching her as she walked, I noticed that she often closed her eyes because it didn’t help having them open.

Unlike Diana's operation, Obdulia's surgery took place at the IRO centre, or Regional Ophthalmology Institute in Trujillo, Peru. This demonstrated the other aspect of Orbis's programmes, where they carry out surgery in local hospitals to ensure that the systems, conditions and staff are all working as they should be. Watching the patient clinics take place, it was clear that things that we take for granted in European hospitals can't be relied upon in countries such as Peru. During one visit, a power cut hit the area during surgery but thankfully the hospital generators kicked in as they should, allowing work to continue.

The day after surgery, Obdulia returned to the IRO centre for various check-ups and tests and the difference in her vision was astounding. Asked to read the letters on a visual acuity test, I found myself leaning forward to read the letters she’d successfully identified.

A few days after surgery, I visited her at her home and the difference was staggering. Her personality could shine through, and she smiled and laughed as we discussed the improvements that had occurred. She recalled being wheeled out of surgery and smiling as she saw me take her photo, as she hadn’t known what I’d looked like before. During our previous meeting, she had talked of how much she missed sewing and now she could thread a needle with cotton, a task she would have found virtually impossible just three days earlier. Walking through her neighbourhood, she spoke of the fences at the far end of the street, and the calendar which proved so hard to read from up close was now no problem from across the room. The difference to her enjoyment of life cannot be quantified.

I offer my huge thanks to Orbis for allowing me to document the important work they do, and for giving me such fantastic access to their facilities. The whole team offer such a warm welcome and they work with such a professional attitude, it's an inspiration.

Donations that will help to keep Orbis providing such important support for communities around the world can be made through this link.