With experts predicting that global blindness will triple by 2050, and the number of people requiring eyecare already outpacing the number of trained ophthalmologists, eyecare training has never been more vital. 

Traditional in-person ophthalmic training has been curtailed by the need for social distancing, forcing teaching institutions to turn toward innovation and technology to ensure eye health professionals can continue to acquire surgical and clinical skills. Increasing access to cutting-edge training technologies is therefore vital, especially for those living in low to middle income countries, where the prevalence of visual impairment is four times greater than in high income countries.

In swift response to the ‘new normal’, a week-long virtual symposium entitled ‘Unlocking the Power of Simulation: A Next Generation Solution to Training Ophthalmic Professionals’ took place from 12-16 October 2020. Organised by leading eyecare NGO Orbis, it brought together experts in ophthalmology, nursing and anaesthesia from around the world to discuss how simulation and technology can transform eyecare.   

Often involving simulation devices – like virtual reality, artificial eyes, and life-like manikins – simulation allows for complex surgical procedures to be broken down into smaller parts, giving eye care professionals the opportunity to practice each step as many times as they need to get it right, something that is not possible with an actual patient. This reduces the learning curve for difficult techniques and accelerates skill acquisition. Most importantly, it has the potential to transform lives and save the sight of thousands of people who need it the most.  

Throughout the week-long symposium, a range of exciting innovations were showcased, including a simulation using household food items; mini wet-labs; live surgery demonstrations for key conditions such as cataracts; the latest in technology such as artificial eyes and lectures on subjects ranging from ‘simulation on a budget’ to ‘best practice in simulation’.  

Dr James Whelan, Canadian Viteoretinal surgeon in Ghana 2019 © Geoff Oliver Bugbee.

Crucially, Orbis launched its Simulation Center Manual during the symposium, a key innovation which can improve eyecare in low and middle-income countries. Just as pilots learn to fly planes through simulation training before taking off from the runway, simulation training in ophthalmology allows eyecare teams to build their skills and confidence safely before progressing to real-life surgeries.   

Explaining the importance of simulation training, Dr Danny Haddad, Chief of Programs at Orbis International, said: “Simulation training is transforming how eye care professionals become masters of their field, and as we equip more institutions with the knowledge to leverage that technology, the ripple effects will be felt far and wide.
“The end goal for all ophthalmic training is a higher quality of care for patients, and simulation training open possibilities for achieving that goal at faster speed, lower cost and with greater results. It is truly a game-changer.”

Simulation training in Barbados © Orbis.

The Simulation Center Manual by Orbis aims to help hospitals and teaching institutions to run their own ophthalmic simulation centres and training programmes. This is significant as cutting-edge simulation technology is expensive, which has often kept them out of reach of eyecare professionals in low to middle income countries. But like many Orbis resources, the manual is available free of charge to ensure countries that need them the most can benefit.  

The free manual is available from Cybersight, Orbis’s telemedicine platform, and considers a range of budget constraints and training needs. This includes: recommendations on equipment, supplies and consumables to procure; structured curricula, schedules, training plans and learning objectives in a range of subspecialties and ophthalmic disciplines; assessment tools, quizzes and rubrics; debriefing tools for structured feedback; recommendations on management and staffing of a simulation centre; introduction to blended-learning, innovation and digital resources; a list of additional simulation training resources.   

Simulation training on board the Orbis Flying Eye Hospital © Geoff Oliver Bugbee.

Simulation training can benefit every member of the eyecare team – including doctors, nurses, and anaesthetists – and has been proven to decrease medical complications, improve the quality of patient care and increase cost savings for training hospitals and teams. Vitally, it helps training continue which could help thousands of people who may otherwise be left untreated under the pandemic.

Training providers can download the manual free of charge, by visiting

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