I am looking for advice on how to handle a plexiform neurofibroma in a fairly classic NF1 patient.

The girl is complaining of ptosis and worsening vision in her right eye although she says that this eyelid has been abnormal essentially all of her life.

The mass is segmented on the palpebral conjunctival side.

 For doing standard Manual Small Incision cataract surgery, our standard instrument set is shown here.

The instruments that I use are the following:

1.  drape scissors

2.  Lid speculum

3.  .12 forcep

4.  Wescott scissors

5.  25 ga Cystitome

6.  3 blades - 15 degree, crescent, 3.0 keratome

7.  bipolar cautery

9.  27 ga cannula

10.  Irrigating Lens vectis

11.  Sinske hook

12.  Simcoe cannula

13.  Kelman forcep (IOL forcep)

Extra instruments that are peel packed or used occasionally are:

Needle driver

Vannas scissor

Utrada forcep

Iris Spatula

On the mission field, often you don't have the privilege of having BSS in 500 ml bottles.

We have found that a good alternative is to use Lactated Ringers with a mix of bicarb, epi and Vancomycin for cataract surgery.

            God watches over those who trust Him, and He was working overtime when it came to Komlavi Djikpo, a market vendor in Lomé, Togo.

            Catherine and Marty Schwebel, Chaplains onboard the Africa Mercy, were browsing through an artisan market with their sons when they met a very nice man, named Komlavi, who sold wooden sculptures. They liked him and his crafts so much that they referred all of their Mercy Ships friends to him for purchases!

            A few days later, some Mercy Ships crew members were out browsing the same artisan market when they began talking to Komlavi. He mentioned that he couldn’t see well out of his right eye. Alana Abernathy, a member of the eye team, took a look at Komlavi’s eye. She recalls, “I took him over into the shade where I could see into his pupil better. Sure enough, I saw one of those dense, white cataracts.” Seeing the cataract made Alana smile because she knew this was a problem that Mercy Ships could definitely solve. Alana wrote down the location of the eye care screening, and told Komlavi to come to the screening very soon.