Lacrimal surgery at St John, Jerusalem.

Lacrimal surgery forms a prominent component of a general ophthalmic surgeon's workload at the St. John Ophthalmic Hospital, Jerusalem. The hospital caters for the Palestinian community of East Jerusalem, the West Bank and Gaza, the combined population totaling approximately 2.2 million. The area is under-developed economically and, in addition, the ongoing political conflict, the Intifada, makes the provision of health care difficult. Nonetheless the St. John Ophthalmic Hospital provides a level of surgical care which is notable for the fact that it is consistent and high. Advanced, obstructive lacrimal disease is endemic in the region; in 1993/94 256 operations were performed for lacrimal obstruction at the St John Ophthalmic Hospital. Lacrimal disease on the West Bank and Gaza Strip is the result of well defined causes which have not been previously documented. This paper proves that conventional lacrimal surgery is successful in relieving advanced lacrimal obstruction in the developing community.