From Kenya . for better vision
Olivia Moraa Ondimu, 16, came to L V Prasad Eye Institute, Hyderabad, on August 6, 2007, with a grave problem – she had been gradually losing her vision over the past three years. She had tried glasses and contact lenses back home in Kenya but nothing had really helped. She had advanced keratoconus (increased conical shape of the corneas) in both eyes with opacification of the cornea of the left eye. She badly needed a corneal transplant for her left eye. Olivia is a bright young girl and a diligent student. She had board examinations coming up the next year. How would she study if she could barely see? Olivia’s mother Stella works for the British High Commission in Nairobi, Kenya, as a press and public affairs officer. On a visit to India earlier in the year, Stella had heard about L V Prasad Eye Institute. Olivia’s ophthalmologist in Nairobi had sent a couple of young ophthalmologists from Kenya to train at the Institute. She referred Stella to LVPEI, who undertook the ‘safari’ to India in search of vision for her young daughter.
Olivia was examined here; a functional vision test revealed that she could see very little with both her eyes. With her very high-powered glasses (minus 21 diopters), she could at least see with her right eye. However, her left eye could not see beyond a two-feet distance. A specialized examination of the eye with a microscope revealed all the signs of advanced keratoconus, more severely in the left eye. Doctors at LVPEI tried to fit specialized contact lenses for both eyes. Olivia’s right eye achieved reasonably good vision with the lens. However, the cornea was so conical in the left eye that the contact lens could not be fitted. With no other medical option available, she was advised to undergo a corneal transplantation (penetrating keratoplasty) to correct the abnormal corneal shape and improve her vision. Surgeons at the Institute match the age of the corneal donor with that of the recipient as much as possible, in order to maximize the chances of success. Olivia had to wait for a few days till a good match was found; finally, she went into surgery on August 17, 2007.
After the surgery Olivia’s visual acuity in the operated left eye improved to 20/200 – about 25% of ‘normal’ vision. Her vision will improve gradually over a period of time. As part of the treatment, to protect the delicate layers of the grafted tissue, a bandage contact lens was placed on the eye, which would be removed by Stella’s ophthalmologist in Nairobi after a week. Stella was advised to send Olivia a few months later for a follow-up check. The patient care counselors explained to Olivia and Stella the need for taking good care of the eye along with regular use of prescribed medication, as post-operative care is crucial to the surgery’s success. Stella and Olivia were all smiles when they came to the Institute on a farewell visit. Olivia’s brother Brian was beaming. Olivia now plans to become an ophthalmologist; she is majoring in biology and chemistry. Stella was relieved that everything went well and was excited about returning to her husband and home in Nairobi. So the safari to India was well worth it after all!
“It just seemed that life would be much easier, postoperatively, so I decided to go for it,” says Kiran. With his consent, the surgeon performed deep lamellar keratoplasty in the right eye.
“When the bandage was removed the day after surgery, I could actually recognize the person sitting across from me! It was fabulous!” The excitement of that day can still be heard in his voice. In less than three months after surgery, Kiran was able to go back to work in the cardiology unit of his hospital, see OPD patients, and manage a near-normal work schedule.
“I’ve had to keep my ambitions in check and, suddenly, everything seemed possible again,” he says. As a student with failing vision, he often had to depend on what he remembered from lectures to write his exams, as he found reading too difficult. “I had adapted quite well, but there were still many things that had become impossible with the vision I had.” Not any more, though.
“The difference between my right and left eye was amazing — vision in the operated eye was really good, and I could tell in comparison my left eye was deteriorating.” Once the vision stabilizes in the operated eye, Kiran wants to undergo the same procedure in his left eye. Kiran had stopped working as he couldn’t read ECG strips but, a few weeks after surgery, he was able to resume work.