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International Blindness Prevention Awardee

Clare E. Gilbert, MB, ChB, FRCOphth, MD, MSc

 Dr. Clare Gilbert
Professor Clare E. Gilbert qualified in Medicine at Bristol University and went straight into ophthalmology, partly because she knew that blindness was relatively common in developing countries and that ophthalmology was a transferable skill. After clinical training, and while working at the Institute of Ophthalmology with Professor David McLeod on an MD (equivalent to a PhD in the US) she had the opportunity to work on one of the first clinical trials of Mectizan® for the treatment of onchocerciasis in Sierra Leone. This reconfirmed her interest and desire to work in international eye health. Dr. Gilbert joined the International Centre for Eye Health (ICEH) in 1990, under the leadership of Professors Gordon Johnson and Allen Foster (AAO International Blindness Prevention Award in 2005) with a remit to study the epidemiology of blindness in children. In 1995, she obtained a Masters in epidemiology and became an advisor to Sightsavers International.

One of the first tasks on joining ICEH was to develop a classification system for the causes of blindness in children, which is now the World Health Organization standard. Data on over 32,000 blind children from over 40 countries is now available. This data has guided her research agenda and allowed blindness in children to be included as a VISION2020 priority. She has or is currently working with colleagues in the following areas in relation to blinding eye diseases of childhood, and it is enormously satisfying to see how research findings can be translated into policy and programs:

Childhood Cataract: A large national study in Bangladesh showed that cataracts were responsible for 31% of blindness in children. This led on to a national five year campaign supported by Sightsavers, ORBIS and the Fred Hollows Foundation, which resulted in the development of eight tertiary Child Eye Care Centres; over 32,000 blind children were identified across the country and over 24,500 cataract operations were performed on children, almost 10,000 of whom were bilaterally cataract blind.

Retinopathy of Prematurity: Data that Dr. Gilbert and colleagues collected showed that a “third epidemic” of blindness due to ROP is occurring in the middle income countries of Latin America and Eastern Europe, and in cities in the emerging economies in Asia. As a result of operational research and multiple workshops across Latin America and in other regions, programs for ROP are now in place in the majority of countries in Latin America and policies which make ROP screening mandatory are also in place in some countries. Programs and policies are also developing in India, China and in some Eastern European countries.

Other Areas of Research: Dr. Gilbert's other research in relation to children include a nationwide study of congenital eye anomalies in the United Kingdom; evaluation of low vision services for children in Asia; a trial of different interventions to promote spectacle wearing among secondary school children in Tanzania; and a PhD student from Malawi is comparing two different approaches to detecting children in the community who need eye care services.

At ICEH, Dr. Gilbert has also played a major role in two large national surveys of blindness and visual impairment among adults in Pakistan and Nigeria. Both have provided a wealth of data for planning, advocacy and policy. She is currently supervising a PhD student who is exploring eye disease in an HIV cohort in South Africa, and two further Nigerian PhD students are investigating different aspects of primary open angle glaucoma in adults in Nigeria.

As a member of staff at ICEH, she teaches Masters program and contributes to the production of the Community Eye Health Journal, which now has a circulation of 34,000 published four times time a year in five languages to over 180 countries. Being an advisor to Sightsavers keeps her rooted in the realities of eye care delivery in developing countries and the challenges faced by service providers and communities.

Dr. Gilbert received the Honorary Fellow West African College of Surgeons Award in 2004, the Outstanding Contribution Award from the International Agency for the Prevention of Blindness in 2001, the Pfizer Visiting Professor Award in 2010 and the International Blindness Prevention Award from the American Academy of Ophthalmology in 2011.