LOCKPORT — Patients won’t be able to make an appointment with eye surgeon Vivian K. Fasula during the second half of January.

For the third consecutive year, the doctor will be in a remote part of Latin America, using her skills to help impoverished patients whose vision problems, ranging from crossed eyes to blindness, wouldn’t be treated otherwise.

Fasula and two opticians, Marsha and Arnold Edelman of Williamsville, will leave Jan. 16 for San Carlos, Nicaragua, on a two-week mission organized by Medical Ministry International.

The interdenominational Christian group puts together about 65 overseas medical, surgical, dental and eye missions each year, sending volunteer doctors and nurses to poor countries.

In the 2010 lineup are missions to the Dominican Republic, Malaysia, Jordan, Colombia, Ecuador, Peru, the Philippines and Guatemala — and that’s just the January schedule.

Nicaragua is the second-poorest country in the Western Hemisphere.

Fasula, a clinical assistant professor at the University at Buffalo Medical School who has been practicing in Lockport since 1984, will be in San Carlos for the second consecutive winter.

“I decided to go on a medical mission and researched some organizations and just picked it. It sounded like it was a well-organized group,” Fasula said. “I like the fact that it works with the [host country’s] government. And I’m a Roman Catholic; it’s part of our culture.”

Last year, after landing in Managua, the capital, the doctors were taken by military helicopter to San Carlos, which has a regional population of about 9,000. The 180-mile journey would have taken 12 hours using the challenging roads.

That means it’s a 12-hour slog through the rain forest to get from

San Carlos to the nearest ophthalmologist, in Managua.

The group will comprise 20 people at the start, but some will stay for only a week.

All the medical supplies are donated by manufacturers. Last year, armed Nicaraguan Army troops drove the materials to San Carlos.

“When we went to Mexico the year before, half of our [lens] implants were confiscated at customs. They were probably sold on the black market,” Fasula said. “That did put me off Mexico. They are so needful [in Nicaragua] that I don’t think there’s that much graft and extortion. That was so disappointing, to have all that stuff taken and at the end, we had to turn people away.”

Last year, Fasula, who lives in East Amherst, traveled with two surgical residents from the UB Medical School. She was so impressed with the surgical skill of one of them, Dr. Andrea M. Buccilli, that she hired Buccilli as a partner in her private practice. The third partner in the office is Dr. Charles J. Fetterman.

New cases, follow-ups

Besides helping new patients, many of whom will travel hours to the remote hospital in southern Nicaragua, she’ll visit last year’s patients.

Fasula will follow up on the cases of those she operated on to correct crossed eyes, those whose cataracts she removed and a boy whose sight she saved after a stick pierced his eye.

Being cross-eyed isn’t just a cosmetic problem; it can produce double vision and eventually blindness. “After a while, the brain just shuts that eye off,” Fasula said.

Fasula said that besides the impact on vision, being crosseyed is a serious social problem. People with strabismus, as the ailment is officially known, are abused so severely by other children that they often drop out of school — one boy she operated on had dropped out of school for three years — and the bias against them is such that they can’t get jobs or spouses, the ophthalmologist said.

“They won’t make eye contact with you,” Fasula said.

But crossed eyes isn’t the only eye problem she saw.

“There are a lot of cataracts. We ended up doing about 200 [last year],” she said. The hospital in San Carlos had decent lighting and anesthetic equipment, but no microscope, a must for sensitive eye operations.

“This poor little microscope we had, we packed it into a ski bag and took it along with us and assembled it there,” Fasula chuckled.

Reichert Inc. of Depew donated a machine for use in testing eye refractions to determine what strength of eyeglasses to give patients. Five thousand pairs of used glasses, mostly gathered by Lions and Rotary clubs, were distributed to the locals, who lined up for hours before the eye clinic opened at 6 a. m.

Eventually, tickets had to be given out for the clinic, as the doctors worked 14 or 15 hours a day.

Helping a blind girl see

Accommodations in San Carlos were “pretty basic,” she said. The cabin the doctors were given featured as house guests geckos, flying cockroaches and assorted other vermin. Also seen in the neighborhood were poisonous frogs, a 5-foot-long boa constrictor and, at least until the snake found them, two chickens. The boa left the neighborhood parrot alone, though.

The town is on the shore of Lake Nicaragua in the southern part of the country. It’s rather scenic, except for the world’s only species of freshwater sharks.

“One lady had the densest cataract I’ve ever seen in my life,” Fasula said. “Some of these people were totally blind with the cataracts.”

Most Americans with cataracts have them treated when their vision gets cloudy. In Nicaragua, some of the cataracts Fasula removed were so old that they had turned black. “In the 25 years I’ve been practicing, I’ve never seen anything like it,” she said.

One 14-year-old girl, Wendy, was blind because of her crosseyed condition and because of childhood surgery for congenital cataracts that wasn’t followed up with proper treatment. Her parents walked in with her from a town four hours away from San Carlos.

“She came into the clinic the last day that my residents were there with me,” Fasula remembered. “I had no assistants to help me the following week.”

But Fasula’s daughter Alex, a registered nurse, had made the trip and said she thought that she had seen enough operations that she could assist. She and her mother prayed with the girl at her request before the operation to try to calm her.

“She said, ‘I know that God will take care of me.’ She was so sweet,” Fasula remembered. “Everybody just fell in love with her. She stole everyone’s heart.”

Wendy’s eyes were repaired, and she was given glasses. “She can see for the first time in her life. It was like a miracle,” Fasula said. “This year when I come back, I’m going to have [lens] implants for her.”

A spirit of sharing

Marsha Edelman, who works in Fasula’s practice, is going for the first time. “It’s always been my dream to go to another country and help someone who can’t help themselves,” she said. “We have so much here in the United States, and I’d like to share that with other people.”

Arnold Edelman calls himself the longest-practicing optician in Buffalo. He’s 72 and has been working for 52 years. He’s now at the Ross Eye Institute in Buffalo.

“We’ve been talking about this for years, maybe 30 or 40 years. We thought someday we’d like to do it. That time is now,” Arnold said.

Thirteen-year-old Juan Antonio, who got a sharp stick in the eye while playing in a mountain village about five hours from San Carlos, was brought by horseback and by bus.

“The stick went all the way through the eye. It was a terrible, terrible injury,” Fasula said. “It took me three hours to sew this eye up because it was so severe. . . . He ended up doing very well, thank God.”

But the incident made Fasula even more reflective than usual. “When I came home, when I went to bed at night, I thought of him, and when I woke up in the morning, I thought of him. I kept saying, ‘What if we had not been there? What would have happened to this young man?’ And you start thinking, ‘Why was I so lucky to be born in this beautiful country that we live in? There but for the grace of God could have been one of my children.”

She’ll be bringing a lens implant for him next month.

Medical Ministry International, although a Christian group, isn’t too concerned about the religious background of its medical volunteers. The Edelmans are Jewish, and the two residents from UB who accompanied Fasula to Mexico in 2008 were Jewish and Hindu.

The volunteers must pay all their expenses. “It’s $975 per person; we don’t know what the airfare is,” Arnold Edelman said. Whatever the tickets cost, the doctors will have to pay. The total tab will probably be about $2,500 each.

Two other UB Medical School residents will go along next month, too.

“I think it’s nice to give them an idea that it’s not just about us,” Fasula said.