Using Cybersight to help diagnose and treat urgent cases during lockdown

May 2020

Orbis partner Dr. Khauv is a Cambodian ophthalmologist who has been using Cybersight for more than a decade, seeking consultations on nearly 200 patients. Thanks to the support of Orbis Volunteer Faculty Dr. Shaikh, he was able to diagnose and treat an urgent case, even in the midst of a pandemic.

A set of parents began to worry when they noticed their 10 year-old daughter wouldn’t stop rubbing her eye. They took her to see Dr. Phara Khauv, a local ophthalmologist who found an abnormality – the likely result of either a severe infection or retinoblastoma, a type of cancer affecting the eyes of children. Dr. Khauv feared that she faced a sight-threatening condition, or even worse, a life-threatening one.

Determined to make the right diagnosis on the complex case, he turned to a familiar resource: Orbis’s telemedicine platform, Cybersight. The platform’s teleconsulting feature allows ophthalmologists like Dr. Khauv to upload patient cases and receive advice from expert mentor doctors around the world.

“Since I work alone, Cybersight is my learning tool and my teacher as well. I grow a lot from it.”

Dr. Phara Khauv

Ophthalmologist

Dr. Khauv first became involved with Orbis in 2007, during a Flying Eye Hospital visit to Cambodia. There he met Volunteer Faculty member Dr. Daniel Neely and was selected the following year for a fellowship, sponsored by Orbis partner FedEx, to study with him in the United States.

“At that time, Dr. Khauv was one of only eight ophthalmologists in Cambodia,” says Dr. Neely. “Since then, he has become one of the most sought-after ophthalmologists in the country, even as more doctors have been trained.”

Over the years, Dr. Khauv has also become a power user of Cybersight, seeking consults on nearly 200 patient cases!

Doctors Khauv and Neely in Cambodia in 2007.

On the receiving end of the case involving his 10-year-old patient was Dr. Saad Shaikh, a retinal surgeon and professor of ophthalmology in Orlando, Florida.

“I was impressed with Dr. Khauv’s level of clinical expertise,” says Dr. Shaikh. “He seemed like a very sharp physician and was right on-task with this patient’s management.”

Working together, the two doctors were able to determine that the abnormality was caused by a thorn lodged in the girl’s eye. Dr. Khauv was able to safely remove it through surgery. “Her parents were very happy with the results,” he says.

Dr. Shaikh is a Cybersight power user in his own right, having served as a mentor on more than 200 consults over the past 14 years. In the early days, he worked alongside Cybersight founder Dr. Eugene Helveston. The two later became coauthors on a peer-reviewed article in the Journal of Telemedicine and Telecare, in which they looked at the positive impact of teleconsultation on retinal cases by analyzing 11 years’ worth of Cybersight data.

Dr. Shaikh

But there’s one thing that Dr. Shaikh makes clear – learning on Cybersight is a two-way street. He explains that, for ophthalmologists in developed countries, “you tend to narrow into certain cases that don’t expand the breath of your knowledge, but international cases force you to sometimes think differently and stay sharp with different methods of teaching.”

Dr. Shaikh often involves the residents and fellows he teaches in the process of advising on Cybersight cases as well, widening the impact of sharing his knowledge.

The case he helped Dr. Khauv with was submitted just as many communities around the globe were beginning to feel the effects of coronavirus. Now with many health care facilities around the world making the difficult decision to exclusively offer emergency care at this time, many ophthalmologists – including mentors like Dr. Shaikh and Dr. Neely – are only seeing patients with the most critical needs.

You tend to narrow into certain cases that don’t expand the breath of your knowledge, but international cases force you to sometimes think differently and stay sharp with different methods of teaching.

Dr. Saad Shaikh

Member of the Orbis Volunteer Faculty

As doctors reach out for consults via Cybersight, the second opinions they obtain can increase their ability to make the right call about the cases to prioritize during this time. In turn, mentor doctors are embracing the consultations as a way to continue to give back. And that’s not surprising, given the desire to serve that unites them.

“The doctor-patient relationship is a sort of sacred bond,” says Dr. Shaikh. “I think the act of helping any patient is a compassionate act. But in the sense that we are helping people who otherwise may not have had it, from that standpoint, it’s maybe even more rewarding.”

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