• One YO’s Quest to Change How Brazilian Parents See Congenital Cataracts

    Public service and ophthalmology are in cataract surgeon Bruna Ventura’s blood. But when she was faced with an ever-increasing demand for congenital cataract surgery in her community in Brazil, the young physician responded with an innovative video project to educate families.

    Dr. Ventura practices in Recife, an expansive city along the northeastern coast of Brazil where several generations of her family have practiced ophthalmology. Almost 30 years ago, several of her relatives founded the Altino Ventura Foundation to provide free ophthalmological care for the community’s low-income population.

    Altino Ventura Foundation

     • Serves the population of Recife, Brazil, the country's fifth largest metropolitan area
     • Founders: Altino and Lourdes Ventura; Ignácio and Auristela Cavalcanti; Marcelo and Liana Ventura; Ronald and Elani Cavalcanti
     • Website: www.fundacao-altinoventura.com.br

    The foundation also develops some of Brazil’s top physicians, offering a specialization course in ophthalmology, plus a residency course and a fellowship that Dr. Ventura herself completed. “Ever since, I’ve loved the entire process of providing care,” she said, “examining the children, performing the surgery and following up to make sure they are doing well.”

    Dr. Ventura quickly realized that part of successfully delivering quality pediatric care involved vital interaction with the children’s families. In addition to her work with the Altino Ventura Foundation, she also works at the HOPE Eye Hospital, just one of a few institutions in the entire northeastern region of Brazil that provides cataract surgery for children. Ophthalmologists like Dr. Ventura tackle an ever-present waiting list of up to 40 children.

    Compounding this demand for treatment, parents are often terrified by the diagnosis of congenital cataracts. “Case after case, I see how parents are totally surprised by the possibility of their children being born with cataracts,” said Dr. Ventura. “At the same time, they are very scared not knowing what the treatment options are.”

    Dr. Ventura with a young patient.
    Dr. Ventura with a young patient.

    She found that, in each case, meeting with families was of the utmost importance. After learning each step of the treatment, including their own role in improving their child’s prognosis, parents were more confident about the recovery.

    As important as they were, these meetings took time – and collectively reduced the number of waiting-list patients she could treat. So one year after residency, Dr. Ventura contemplated a more streamlined approach to this educational process. “I realized that I needed to find a more effective way to explain the nature of the disease and the treatment to patients’ families so that I could have more time in the operating room to help more children,” she said.

    She decided to develop an educational video that teaches families everything about congenital cataracts — especially the importance of a proper postoperative regimen with continued visual stimulation.

    During the consultation in which the ophthalmologist first confirms the diagnosis of congenital cataract, a patient’s family views the video. Parents and caregivers then have a chance to ask additional questions. They are also allowed to take home a copy of the video to show other family members and friends.

    This process focuses her conversation with the family. “The video isn’t going to serve as a substitute for the interaction between parent and physician,” Dr. Ventura noted. “The interaction is still going to exist, but in a more effective manner, since the doctor will be able to focus on answering any outstanding questions and providing other instructions specific to their case.”

    If the video serves as kind of partner in Dr. Ventura’s work with patients, the Pan-American Association of Ophthalmology (PAAO) was one of her partners in developing the video. Through the PAAO Curso de Liderazgo, whose participants meet jointly with those of the Academy’s Leadership Development Program, Dr. Ventura got invaluable training and fundraising help.

    Dr. Ventura with PAAO Curso colleagues and session faculty. Left to right: Nuno Miguel Tavares L. Gomes, MD; Sandra Larco Moncayo, MD; Dolores María Ribero Ayerza, MD; Gail Schmidt, Academy staff; Dr. Ventura; Helena Prior Filipe, MD; Marcello Novoa
    Dr. Ventura with PAAO Curso colleagues and session faculty. Left to right: Nuno Miguel Tavares L. Gomes, MD; Sandra Larco Moncayo, MD; Dolores María Ribero Ayerza, MD; Gail Schmidt, Academy staff; Dr. Ventura; Helena Prior Filipe, MD; Marcello Novoa Colombo Barboza, MD.

    “The leadership program has provided me with so many great ideas on how to raise funds for the project and how to negotiate the costs,” Dr. Ventura said. “The feedback of the participants has also been extremely helpful in determining just how I can rearrange my patient flow so that the entire video-in-practice process is more effective and less time consuming for both the patient and the doctor.”

    Perhaps most important of all, the Curso introduced her to Bruno M. Fontes, MD, PhD, a cataract and refractive surgeon based in Rio de Janeiro and a graduate himself of the Curso program. His mentorship was essential as their brainstorming sessions laid the foundation for her project’s success.

    Dr. Ventura will graduate from the Curso this October during the AAO 2014. Curso graduate and now faculty member Natalio J. Izquierdo, MD, who practices in Puerto Rico, said Dr. Ventura has blossomed into a true leader. “She’s not only become a pediatric cataract specialist that caters to both the rich and poor, but also an international leader and spokesperson for the preferred practice pattern of congenital cataract management.”

    Because of Dr. Ventura’s efforts, every parent whose child is diagnosed with congenital cataract at the Altino Ventura Foundation is now required to view the video. Soon, the video will be available on YouTube as well as the foundation’s Facebook page and website. Currently the video is only available in Portuguese, but Dr. Ventura also plans to release versions with Spanish and English subtitles — enabling her passion for patient care to travel the globe.

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    About the author: Mike Mott is a contributing writer for YO Info and a former assistant editor for EyeNet Magazine.