Diary: Trinidad visit by Alex Levin, MD

Trinidad Visit   

Alex Levin, MD, Chief, Pediatric Ophthalmology, Wills Eye Hospital, Philadelphia

Day 1: February 9, 2009

  • Morning clinic 0830-1300: 15 patients.  All very appropriate and complicated.  Pediatric cataracts, glaucoma and uveitis.  One severe retinoblastoma with likely orbital extension. Session attended by 2 staff doctors (including Program Director, Desiree Murray, MD), 1 Registrar, 3 residents. Residents presented cases very well. 
  • Lunch in hospital with Dr. Murray. Discussed above issues and planned teaching session.[AL1] 
  • 1430-1530:  Teaching session for residents, nurses, Program Director, and other personnel. Topic: Vision Testing in Children.

Day 2: February 10, 2009

  • OR: 0830 - 1300.  The main part of this was used for the RB enucleation (a procedure I do not do) but I was there to talk about case, teach medical students). Did two EUA’s (aphakia presumed congenital rubella but with bizarre retina that is not consistent with rubella, aniridia) with extensive resident teaching. No surgery needed. Last case cancelled for illness.  
  • Lunch in hospital with the 3 staff doctors
  • 1500-163:  Interactive retinoscopy teaching session/laboratory

Day 3: February 11, 2009

  • 0800-1400:  Mixture back and forth of patients in clinic and OR.  Did two cataracts.  EUA of child with severe ROP – no intervention possible. Today residents got chances in clinic and OR to do retinoscopy.
  • 1500-153:  Interactive session with residents on when to prescribe spectacles for children.
  • 1600-1900:  Trip to Caroni swamp
  • 1700-2200:  T&T Medical Society meeting.

Day 4: February 12, 2009

  • 0800-1300 OR:  EUA + incisional biopsy of unusual conjunctival lesion, EUA of infantile glaucoma likely due to trauma, EUA + cataract extraction of complicated cataract. Staff and residents present + medical students (who were at all OR sessions every day).
  • Lunch at hospital with 3 staff doctors.
  • 1400-1600: Visiting Professor lecture “Clinical Manifestations of Non-Accidental Eye Injuries”.  > 100 in attendance, mostly medical students.

Day 5: February 13, 2009

  • 0800-1100:  Clinic.  Saw approximately 5 patients including post-ops.  Much teaching to staff doctors, residents and medical students.
  • 1145-1230:  Teaching session for residents: strabismus examination


This is a public site with a budding ophthalmology residency program. It has the potential to be a major training site for the Caribbean. Excellent staff (in particular Drs. Murray and Seemongul-Dass). Would benefit from continued participation of visiting professors and attendance at annual review course (e.g. Wills Eye Hospital) in North America. VP’s could have role in identifying basic equipment and program needs/WEM.  I think it was very productive trip to a site with much potential and need.

Submitted February 14, 2009

Patrick Commiskey