In this issue we highlight ‘Vision 2020: The Right to Sight' Programme set up between the World Health Organisation (WHO) and the International Agency for Preventable Blindness (IAPB) in 1999 to eliminate preventable blindness by 2020. The programme deals with treating trachoma, onchoceriasis, xerophthalmia and refractive errors together with cataracts. The main surgical challenge is cataract surgery which needs to increase from 12 million to 32 million cataract operations per annum, the majority of which are in Africa , China and India . The articles highlight some of the different approaches to teaching and training which are being used in order to achieve these laudable aims.

The ESCRS is supporting Vision: 2020 to which they have made a firm commitment as a participating Non-Governmental Organisation (NGO).

The issue of a patient's right to choose who performs their cataract surgery has taken an interesting twist in our region. As we have reported earlier in EuroTimes, the UK government has awarded a contract for cataract surgery to a visiting team of surgeons from South Africa who roam the country in their mobile operating theatre. The government have also stated that ‘patients must be given a choice of surgical provider after April 2004'. In the meantime, however, they are in the awkward position of having awarded the contract to the South African team without having sufficient numbers of patients who, when given the choice, would opt to have their surgery in the mobile theatres. To circumvent this problem, patients from our waiting lists have been sent direct to the mobile unit, without consultation or choice, with the UK government's argument being ‘we do not have to give patients choice before April 2004'!

This is another example of political interference in health care provision and once more I would ask our readers to please let us know of examples they have within their own health care services.

I have read a recent EuroTimes Prime Site article about unhappy LASIK patients. I've spoken to 200-300 patients with LASIK complications. Most of them are experiencing a combination of major depression, symptoms of traumatic stress (PTSD), and thoughts of suicidal ideation. Most patients aren't psychologically prepared for the problems they're experiencing. My experience in talking to patients suggests that most are not prepared for the comorbidity of symptoms. They are just never aware that if you have glare, you're likely to have halos, starbursting, blurry vision, etc., along with dry eye. Informed consent should prepare patients for the total existential situation in which they might find themselves. The patients need heroes to emerge from inside the refractive surgery industry. These heroes would reach out to the casualty community and say, if not explicitly then through their actions, "We're going to do our best to get everyone of you back to the lives you had. We're doctors and we're going to do our best to heal you...healing is what we do." Sincerely, Roger D. Davis, PhD Clinical Psychologist   Letters to the Editor are welcomed to: escrs@ agenda -comm.ie

CLIVE PECKAR