Who will save this boy from going blind?

By Austin Oduor

With schools closed and Christmas lights on, homes are beaming with life.

But Imran Juma, 11, has nothing to celebrate. He has been out of school for one year, and as his agemates gather to play, he can only stand and stare.

Imran hopes to be a doctor one day, but his present circumstances do not look very bright. His eyesight has grown weak, and has lost use of one eye.

Imran Juma’s life outlook has been pretty bleak since he lost use of his right eye following an infection. Inset, a technician displays a model of a human eye. [PHOTOS: AUSTIN ODUOR /COURTESY]

It started as a mere inflammation that was cleared by use of an eye-drop. But today, his eyes are swollen and itchy with moon-like patches.

All he wishes is for his grandmother, Zainabu Mohamed, to raise funds to facilitate an operation that medics call corneal transplant, and which could restore his sight.

When his mother, Fatuma Musungu, took him to the hospital only eye drops were provided, which reduced the redness but did not clear the infection.

Two months later, when the family secured an appointment with Loresho Eye Hospital senior ophthalmologist, Dr Jyotee Trivedy, his verdict was grim. "The eye is gone. There is no further treatment other than a corneal transplant," said the doctor.

But Imran’s story is one of the many in need of urgent attention. In fact, he should count himself lucky as he still has use of one eye. But it has been infected, too, and there is fear he could lose it as well.

The national blindness prevalence is estimated at about 0.7 per cent, or about 250, 000 persons.

Preventable Blindness

Of these, cataract accounts for over 43 per cent of the preventable blindness, while corneal disease contributes about 19 per cent, accounting for some 50, 000 cases. Over half of those suffering from corneal blindness are 30 years and below. This makes corneal infection the second cause of blindness in the country after cataracts, says Gerald Muriithi, an eye bank technician and counsellor at Lions Sight First Hospital.

Cornea is the clearest tissue of the eye that allows light in to enable focus and vision. Corneal opacity, Muriithi says, is the condition where the clarity of the cornea is affected, leading to cloudiness as light cannot penetrate. The cornea can become cloudy or due to injury or infection, which prevents light from passing into the eye resulting in loss of vision.

Corneal infection, Muriithi says, is also caused by rubbing one’s eye after a prolonged allergy. A scar forms and extends to reach cornea. Damage to cornea may also occur during an eye surgery.

Other causes of cornea infection include wrong medication, long use of contact lenses and ageing.

Murithi says school going children are likely to damage their corneas as they more predisposed to allergies such as dust. But at the age of 13, most allergies are outgrown.

However, patients with corneal opacity, like Juma, can have their sights restored by undergoing corneal grafting, a sight restoring operation whereby a healthy cornea is used to replace the impaired one, says Muriithi. Such corneas are harvested from the dead.

Unfortunately, Imran may not get his cornea transplanted soon. "There is not a single cornea left at Kanubhai Babla Lions Eye Bank, the country’s first and only eye bank in East and Central Africa," said Muriithi. He says this is due to Kenyan hospitals relying on corneas donated from hospitals abroad, mostly America.

Since 2007, when the eye bank was launched in Kenya, about 1000 corneal patients have been registered with the number rising daily and only 110 operations conducted, Muriithi added.

Surgical Facilities

But even with competent surgeons in Kenya and the availability of advanced surgical facilities, very few surgeries have been performed due to lack of corneas and the need is still rising, says Muriithi.

Corneal transplants rely solely on corneal donations, recovered from the dead. Since the establishment of the eye bank in Kenya, only 22 corneas have been donated in three years. All were by Kenyans of Asian origin.

Passing On

Corneas are harvested within six hours of someone passing on, so family consent has to be secured earlier.

Anybody can be a donor irrespective of age, sex or blood group, Muriithi said.

"If your heart goes out to the blind during your life time, let your corneas go out to them after your death. It is the most precious gift you can give them, pleads Muriithi.

As long as there are no cornea donations, many Kenyans like Imran are likely to lose sight as the eye bank will not be replenished without donations. The gift of sight is in your hands.

But with reports that medical students do not have adequate number of cadavars (bodies) to train in human anatomy indicates the reluctance that Kenyans display in donating after death.