Trailblazer has preventable vision loss in his sights
A surge in the number of South Africans going blind through a little-known side-effect of diabetes is predicted by an ophthalmologist.
With diabetes on the rise from poor diets and sedentary lifestyles, it’s important that people realise it can lead to blindness, Dr Kgaogelo Legodi says, because by the time a person’s sight deteriorates, it’s generally too late to cure.
Legodi used to be Nelson Mandela’s eye specialist. Now he has set his sights on working to eradicate preventable blindness across Africa. Alerting people to the risk of diabetes is a great place to start.
"Blindness caused by diabetes is very, very common and if you have diabetes you need to see an ophthalmologist yearly," he says. "If you don’t do that you can have bleeding in your retina and once you’re not able to see very well, it’s usually too late and 90% of my patients come too late."
The disease causes diabetic retinopathy, where blood vessels in the retina bleed or leak fluid, distorting vision. It’s a leading cause of blindness among working-age adults, according to the National Eye Institute in the US.
Legodi’s grandmother went blind because of diabetes, and that influenced his career choice. "That’s the thing that made me say ‘wake up, there are some problems that people have and it’s very difficult to get help because they don’t know where to go’," he says.
"We ophthalmologists who are already there should make youngsters aware of this speciality. We have a backlog of cataract operations that need to be done and we need to treat other eye problems that are leading to avoidable blindness."
While opticians deal with refractive errors that require spectacles or contact lenses, ophthalmologists deal with anything that involves medicine or surgery, including infections or inflammations.
Black practitioners are a scarce breed and Legodi is a trailblazer. "We have about 410 ophthalmologists in SA and I don’t think more than 30 of us are black. We are still very few, I can even name all of us."
Figures from the British Journal of Ophthalmology in 2013 show that SA had six such specialists for every 1-million people.
Botswana had only two and Chad had two ophthalmologists for a population of 14-million people. The UK had 49 per million people and the US 59 per million.
Legodi works as a private practitioner in the Mediclinic Medforum in Pretoria and at the Advanced Soweto Eye Hospital, which he established two years ago with a partner.
It is the first specialist eye hospital in Soweto and was launched with backing from the healthcare company Advanced Health.
Legodi secured a bank loan for his investment in the hospital and contributes his skills. "It was a passion because there were no black-owned eye hospitals," he says.
Legodi hopes to get permission from the Department of Health to make the hospital a training centre so that more medical students can become eye specialists.
It’s is a difficult career choice, requiring six years of medical training, followed by two years of community service and another five years of speciality training.
Legodi qualified at the age of 29, after 13 years of training. But his studies still weren’t over. Each part of the eye has super-specialists, like retinal surgeons, corneal surgeons or glaucoma specialists. He is a retinal doctor and went to Germany for specialist training.
"When I was training, each and every corner of the speciality clinic including the toilet, had a picture of an eye on the wall. The eye is just a small little thing but it’s a mammoth task to learn," he says.
His knowledge has earned him global recognition. In 2013, he became the first black president of the Ophthalmology Society of SA and in 2015, he was elected vice-president of the International Council of Ophthalmology, the first African to hold that position.
He serves on the boards of the American Academy of Ophthalmology and is president elect of the African Ophthalmology Council. He’s also a member of specialist groups like the South African, African, Nigerian and European vitreo-retinal societies.
He recruited for a leadership programme run by the International Council of Ophthalmology several years ago. "I was in the right place at the right time, or maybe I talk too much when I’m with other people, but it all started when I was recognised by the president of the [council]," Legodi says. "He wanted some young ophthalmologists to be on the leadership programme, and I was one of them. That’s where I learned a lot about leadership and advocacy."
His high profile helped SA win the right to host the biennial World Ophthalmology Congress, to be held in Cape Town in 2020.
"As president of the Ophthalmology Society of SA I bid for the right to host the 2020 conference and we won. I’m very excited because this was my baby," he says.
"I’m looking for all ophthalmologists in the world to flock to Africa for the first time since it [the conference] started in 1845."
Legodi hopes 18,000 people will attend, including ministers of health and heads of state from across Africa, to open their eyes to problems like preventable blindness from cataracts, or glaucoma, which cannot be cured but can be treated to prolong the life of the eye.
"The conference will improve the skills in Africa because there will be presentations and workshops where specialists will teach new skills," he says.
"There will be machines doing cataract operations and other procedures for the eyes, and connections will be formed between African ophthalmologists and those from the rest of the world."