Ophthalmology in the Canadian North

Résumé

... Early medical care was provided in the North by missionaries, Hudson's Bay traders, and surgeons on whalers or exploration ships. ... Today most Eskimos are within reach of a nursing station, whence a patient may be evacuated to one of six modern hospitals in the Canadian North. If specialist care is necessary, the patient is flown south to a university hospital. ... The question arose in the late 1960s whether a central eye hospital was needed in the north, and a decision was taken to survey ophthalmological needs. In 1970 and 1971, with Canadian Government sponsorship, three Canadian universities took part in a widespread survey, sending teams to examine whole populations of selected settlements. A total of 4,450 people were examined, McGill being responsible for the East Baffin Zone. ... No eye hospital was deemed necessary .... In September 1970 the first "service" trip was made to the Baffin Zone. Teams of ophthalmologists from the McGill Hospitals now visit regularly the twelve settlements in this Zone. ... On these tours a variety of eye problems is found. Snow-blindness ... jumps to the layman's mind when there is mention of eye problems in the North. ... while this condition is of extreme discomfort to the patient, it is transitory. ... More serious eye problems found in the North are, in order of increasing importance: trauma ...; scarred cornea due to old tuberculosis, which is now on the wane; glaucoma, the blinding disease; and myopia. The Eskimo is found to be congenitally susceptible to angle closure glaucoma .... The disease is found more commonly is Eskimo women than men, and is forty times more prevalent in Eskimo women than in women of other races. The majority of all eye patients flown to Montreal for medical or surgical treatment are sent because of this type of glaucoma. ... An important aspect of northern medical service must be education of the people. If, for instance, they learn to recognize early symptoms of glaucoma (usually pain and temporarily diminished vision) and seek immediate help, the settlement nurse may control an attack with drugs for a few weeks, in most cases, until the patient can be flown out for surgery. ... the ophthalmologist's principal activity in the North is the prescribing of glasses. The most astonishing evidence to come out of the Ophthalmological Survey was the "epidemic" of myopia in the young. Thirty to thirty-five per cent of all young people between the ages of 15 and 25 were found to be short-sighted and to need glasses, as opposed to nine per cent in those over 25. Perplexing questions present themselves: Why the young? What is different in their life style compared to that of their parents? Has a protective factor been lost to the younger generation, or a virulent factor introduced? What is the influence of schooling, of the change to a white man's diet? ... In 1967 an international symposium on circumpolar health-related problems was held at the University of Alaska under the joint auspices of the University and the Arctic Institute of North America. ... The second Symposium was held in June 1971 in the new, modern Medical School of the University of Oulu, Finland .... In July 1974 the third International Symposium on Circumpolar Health will be held at Yellowknife, N.W.T., and ophthalmologists will be among others to continue discussions on health problems peculiar to the far North.