Armenian EyeCare Project responds to heightened needs in post-war Armenia

It has been nearly a year since Azerbaijan’s attack on Artsakh –– an ethnic enclave home to hundreds of thousands of Armenians –– and much has changed in that time. What began as an attack targeting innocent civilians in their homes, businesses, schools, churches and hospitals ultimately led to war as it propelled Armenia’s military to act. Over 5,000 Armenian soldiers were killed, countless more were wounded, and more than half of the civilian population of Artsakh has been displaced from their homes as they seek refuge in Armenia.

It has been a tragic year for Armenians in the region, but it has also been a time when Armenia’s dedicated community of supporters has risen to the occasion and offered a helping hand. Due to the immense support from dedicated donors as well as organizations like UCLA’s Operation Armenia, the Armenian EyeCare Project (AECP) has been able to meet the increased need for vision care in post-war Armenia through both emergency relief efforts following the attack and ongoing relief programs that continue to offer care for those who need it.

These efforts have included urgent treatment for wounded soldiers and civilians during and after the war through the launch of the AECP’s Vision Referral Program to most efficiently care for those injured and the expansion of the AECP’s Low Vision Center to offer aid to the increased number of Armenians with vision loss.

Emergency Relief Efforts

With resounding support from donors and unwavering commitment from its doctors and staff, the AECP was able to offer a coordinated response just days after the war began, utilizing its established infrastructure, equipped clinics and trained medical staff.

Dr. Asatur Hovsepyan, AECP’s chief surgeon, was among the first physicians to respond to the need for a skilled eye surgeon and volunteered to work in the makeshift military hospital in Artsakh. Working aboard the AECP’s Mobile Eye Hospital for nearly 20 years, Dr. Hovsepyan has gained extensive surgical experience that was invaluable on the frontlines. But even with these skills, he admitted that the injuries sustained in the recent war were severe and previously unseen due to new-age weapons, including cluster bombs, which cause terminal damage to the eyes. During his time in Artsakh, Dr. Hovsepyan saw up to 50 soldiers a day and treated injuries ranging from pieces of shrapnel in soldiers’ eyes to aluminum-like particles undetectable on X-ray to more severe cases where eyes were irreversibly damaged due to explosions and drone strikes.

“Doctors and patients were crammed in one room of the hospital, which was in a safe zone because the main hospital was being targeted by Azeri missiles,” Dr. Hovsepyan said. “At times, a team of doctors worked on one patient as many areas of the body needed care. Every doctor was doing their best to save as many lives as possible.”

AECP Chief Surgeon Dr. Asatur Hovsepyan performs eye surgery

In some cases, Dr. Hovsepyan had to perform emergency surgery using what basic equipment was available. Despite the conditions, surgeries went well and patients could then be transported to the Malayan Ophthalmological Center in Yerevan for follow-up care. There, the Center’s Trauma Department had become a military hospital and staff worked nonstop to ensure wounded soldiers received immediate attention.

Dr. Armine Gharakeshishyan, AECP Fellow and Head of the Neuro-Orbital Department at the Malayan Ophthalmological Center in Yerevan, examines a patient

Two AECP fellows, head of the neuro-orbital department Dr. Armine Gharakeshishyan and head of the trauma department Dr. Georgi Grigoryan helped provide urgent eye and face reconstruction for the injured soldiers. “We were working around the clock to provide immediate care to our soldiers as any delay could result in the need for a prosthesis at a later stage,” Dr. Gharakeshishyan said.

Ongoing Relief Efforts

In addition to treating immediate eye trauma, the AECP quickly realized that many soldiers wounded in the war would need long-term, follow-up care to recover their sight, including orbital implants and ongoing assistance at the AECP’s Low Vision Center. With this in mind, the AECP launched a Vision Referral Program, facilitating the highest quality eye care by connecting specialists in Armenia and abroad to discuss cases and offer the best treatment solutions. This effort has largely been made possible thanks to the generous support of UCLA’s Operation Armenia, which is a coordinated endeavor under the umbrella of The Promise Armenian Institute at UCLA and implemented through the advocacy of UCLA Health, to provide immediate medical disaster relief and long-term humanitarian aid and support to Artsakh and Armenia.

Launch of Vision Referral Program

As the need for vision care in Armenia increases due to injuries sustained by soldiers and civilians as a result of the war, the AECP has established a Vision Referral Program to effectively address this heightened demand. Blast burns, explosion debris and white phosphorus have been just some of the ways the wounded have been hurt and the majority of those affected have been Armenia’s soldiers, though some civilians have been injured too.

The AECP’s Vision Referral Program encourages vision needs to be addressed as efficiently as possible by accepting requests submitted by people and/or organizations on behalf of the injured person or by the injured person themselves. Through a broad referral process and the utilization of social media and other communication avenues to identify Armenians in need of care, the AECP can more promptly and efficiently provide the required treatment and rehabilitation for these injured Armenians.

The goal of the AECP’s Vision Referral Program is to facilitate the best possible eye care and treatment for individuals who have sustained optical injuries during the war by connecting them with appropriate specialists in Armenia for clinical evaluation (first-time assessment or second opinion) and determining their best treatment options. As such, the program will use its global network to enable remote/virtual, peer-to-peer consultation between an eye care specialist in Armenia and a counterpart in another country. These consultants will include individuals and organizations outside of Armenia such as AECP volunteer physicians, non-AECP-affiliated ocular experts, second opinion/consulting organizations and training and education organizations.

This Vision Referral Program will enhance the AECP’s treatment and rehabilitation capacities to offer the patient, individually or in combination, low vision aids (optical and non-optical devices, mobility and occupational training, etc.), ocular prosthetics and/or reoperation. The AECP encourages all individuals and/or organizations who know of an injured Armenian soldier or civilian in need of eye care to fill out a referral form.

Enhancement of Low Vision Center

Since last November, the AECP’s Low Vision Center in Yerevan has seen a dramatic increase in the number of patients with ocular damage from explosions and other injuries sustained during the war. Caused by heavy munition blasts, the ocular trauma is both dire and complex, often leaving patients with little to no vision at all. Those considered lucky to have avoided complete blindness need access to regular low vision services to maintain what remains of their sight.

As such, the AECP’s Low Vision Center, which was established in 2006 and is located in the Kanaker-Zeytun Medical Center in Yerevan, is undergoing major enhancements to continue meeting the growing needs of Armenia’s population, including soldiers and civilians wounded in the recent Artsakh War.

The AECP’s Low Vision Center has recently ramped up its services by obtaining additional equipment, including specialized optical and non-optical devices, to continue helping an increased number of patients. In addition to the updated equipment, in partnership with a group of Boston-based low vision professors, the AECP has also organized a series of online training sessions for local low vision specialists and occupational therapists to help them master new techniques in the field of low vision. These services and tools, such as vocational and life skills training, ensure that patients suffering from low vision continue to live productive lives despite their loss of sight.

The only clinic of its kind in the Caucasus, the Low Vision Center treats individuals who experience loss of sight that cannot be corrected with eyeglasses, contact lenses, medication or surgery. Low vision can hamper daily activities like reading and driving, but it is not the same as blindness, as there is still some vision in the eye that may be improved with the use of special devices and lifestyle aids. The Center works with patients who suffer from impaired sight and teaches them vocational and life skills like specialized computer programs for the visually impaired. This specialized low vision treatment opens a new world for the visually impaired, providing patients with a renewed hope to continue living a full and independent life.

The AECP’s Low Vision Center currently treats over 7,000 patients a year, but that number is expected to rise over the next few years as wounded soldiers with eye trauma require low vision services, prosthetic eye replacements and search for new possibilities to partially restore their sight.

“The Low Vision Center receives many patients who have been operated on in clinics across Armenia and require follow-up low vision treatment and services,” says Dr. Ani Gevorgyan, director of the AECP’s Low Vision Center. “We help all of our patients preserve the maximum possible vision depending on the complexity of each case.”

The AECP’s Low Vision Center is currently in need of additional equipment to prepare for a new influx of patients as more soldiers and civilians undergo post-war treatment and rehabilitation. This includes optical and non-optical devices such as telescopic glasses, magnifiers, writing guides and canes, as well as mobility and computer training related needs to ensure patients’ independence such as various voice programs, smartphones and computers. For more information on what equipment is needed for the Low Vision Center, please contact the AECP office at 949-933-4069, and they can provide a full list. Through donor support, this much-needed Center can be enhanced with the resources needed for the visually impaired in Armenia to thrive.

Additional Aid

Aside from the direct emergency and ongoing relief efforts put in place, the AECP has also received many requests for aid from various medical facilities in Armenia, so they too can address the urgent needs of wounded Armenians. Thanks to the organization’s efforts, hundreds of ophthalmic equipment, surgical supplies and eye implants have been donated to eye clinics across Armenia. The AECP also played a key role in coordinating donations of much-needed medical equipment outside of eye care, from supplies for abdominal surgeries to ear, nose, throat and dental tools to equipment for clinics both in Armenia and Artsakh.

Along with medical outreach, since the start of the war, the AECP has delivered several shipments of first aid medications, warm clothes and other necessities to soldiers and refugees. Women, children and the elderly displaced from Artsakh have also received food, clothes, blankets and more. Additionally, refugees have received eye exams aboard the AECP’s Mobile Eye Hospital and follow-up care like surgeries, laser treatment and eyeglasses when needed – all at no cost.

Continuation of Care

In addition to the relief efforts in direct response to the recent war, the AECP also continues its mission to make quality eye care accessible to every child and adult in Armenia. Despite the immense challenges of the past year, the organization was able to follow through with its plans for 2020 and open its fifth Regional Eye Center in Armenia, bringing eye care to thousands more Armenians in the region who otherwise would not have quick and easy access to this care. Located in the city of Yeghegnadzor in the Vayots Dzor province, the Vahakn Aglamishian AECP Regional Eye Center welcomed its first patients last fall.

The AECP was born out of crisis when, in 1992, Armenia’s healthcare system was initially overwhelmed with the wounded from the first Artsakh War. Decades after this first war, the AECP is standing beside Armenians once again in times of need. Through the dedication of its physicians and staff and with help from the organization’s faithful friends and supporters, the AECP has been able to keep its promise to Armenia and bring sight to Armenian eyes even during the most trying of times.