Wellness & Fitness

How Kenya can keep cornea blindness at bay

cornea

Dr Jyotee Trivedy, an opthamologist at Lions Eye Hospital, explains the transparent eye cornea during the interview. PHOTO | SARAH OOKO

On the grounds of Lions SightFirst Eye Hospital, about 11 kilometres from Nairobi, 15-year-old Ivy Kerubo was having an animated conversation with her dad Isaac Mokaya over something they were watching from a distance.

Although some people may take the sense of sight for granted, not so for this family.

“I watched my daughter’s vision deteriorate over the years. We noticed that her eyes had a problem when she was three. First doctors treated her for allergy. Then she was given specs. But the problem persisted and she could hardly see what was written on the blackboard in school,” reminisces Mr Mokaya.

Ivy was later diagnosed with an eye disease known as keratoconus. The condition adversely affects the cornea (transparent outermost part of the eye) while slowly making it to lose its round dome shape and become cone-shaped.

The cornea functions like a window that allows light to enter the eyes and enable seeing again. It contributes up to 75 per cent of the eye’s focusing power.

When the cornea is damaged, light entering the eye is blocked or distorted, thus compromising vision.

Dr Walter Ogony, an ophthalmologist at Kenyatta National Hospital (KNH), says that keratoconus causes a high degree of short-sightedness.

“Most of these patients can’t see far, making it hard for them to do normal life activities.”

The disease may be missed by some doctors, the doctor warns.

“My grades dropped in school. I was struggling so much to read and I still kept having headaches and very itchy eyes,” Ivy says.

Those affected by the disease usually spend so much on spectacles or contact lenses only to realise much later that the underlying problem was keratoconus.

This ‘silent’ eye disease is now the leading cause of cornea associated blindness in Kenya. But experts say it is largely preventable with early diagnosis and appropriate treatment.

Keratoconus in both children and adults is often associated with allergies, vigorous rubbing of eyes, hereditary factors such as Down syndrome and wearing of contact lenses for many years.

“But sometimes the cause is unknown. People just get keratoconus out of nowhere,” says Dr Jyotee Trivedy, an ophthalmologist at Lions SightFirst Eye Hospital.

WATCH: How to prevent Corneal Blindness

Other conditions that damage corneas in children include gonorrhoea passed to them as well as Vitamin A deficiency. Women attending antenatal clinics are usually screened for such infections and treated early.

During routine immunisation, young children are given Vitamin A supplements to prevent associated illnesses.

But adults can damage their corneas if they get viral infections, such as herpes or chickenpox, which often occur in those with low immunity.

People working on farms may also get fungal infections from plants or from the soil, Dr Ogony says.

Viral infections

“That’s why it’s important to always wear protective eye goggles while digging, weeding and harvesting. You can easily get them in local supermarkets. But most people don’t know this.”

Fungal eye infections are severe, and sometimes even after treatment, the affected eye may not be salvaged.

The viral and fungal infections cause so much pain and redness in the eye, leading to scarring or blurring of corneas.

“The earlier you get to hospital and receive the recommended treatment, the higher the chances that the eye will recover fully,” the doctor says.

Injury to the eyes through accidents or assaults may also destroy corneas.

Intense cornea damages are recommended for surgery, but scars left after healing obscures its transparent nature, leading to vision loss.

When detected early, diseases that can harm the cornea can be treated by antibiotics, anti-viral and anti-fungal medicines. For irreparable cases, doctors recommend transplant surgery to restore vision or reverse blindness.

“It’s this operation that finally rectified my eye sight. Now I function normally. I can read well and my performance in school is improving,” says Ivy whose surgery was done at Lions SightFirst Eye Hospital by Dr Trivedy, who says the replacement was donated.

Cornea transplants can also be done at KNH, Kikuyu Eye Hospital, Aga Khan, Sabatia Eye Unit and Lighthouse for Christ Eye Hospital.

These hospitals rely on cornea imports from countries such as the US, one of the factors that make costs prohibitive.

Donate corneas

Among other reasons, Kenya is yet to enact laws governing the harvesting of tissues from the dead and relies on those who agree that theirs can be used for transplants after death.

“Locally donated corneas are given at no cost. If more Kenyans did so, then the cost of transplants would drastically go down,” she notes.

A cornea transplant at Lions SightFirst Eye Hospital costs about Sh250,000, which figure Dr Trivedy says can drop to Sh60,000 if local donations are used. The hospital opened an eye bank in 2010.

Dr Trivedy explains that cultural and religious restrictions have hurt cornea donations in Kenya, where the bulk of donors are from the Kenyan Asian communities. In Asia, the practice is well embraced.

Corneas have to be harvested within six hours of death to be used in transplants, the doctor said.

“When you die, you no longer use your eyes. But through donation, you can help a child to get her vision back and see the world as you did. That’s a life you will have touched.”

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