Mildred Ngesa
22 September 2007
Nairobi — Hundreds of Kenyans with sight problems may soon get a respite when the region's first eye bank is set up.
Apart from saving people from going blind, the bank will also smash the myth that successful eye transplants cannot happen in the region.
Cornea transplants, a crucial correctional surgery aimed at restoring and saving sight, and of which hundreds are queuing in line to receive, will be readily available from the proposed bank.
But this project spearheaded by the Nairobi eye bank committee under the Ophthalmologist Society of East Africa (Osea) will only be realised if Kenyans donate their eyes.
In India, eye banks have now become common. In fact, most Kenyans with eye problems have to travel to India for the treatment at prohibitive cost.
Dr (Mrs) Prabha V. Choksey, a consultant ophthalmologist at Aga Khan Hospital, Nairobi, comes face to face with the problem on a regular basis.
A significant percentage of the patients she attends to - both children and adults - would easily have their sight saved or restored, if there was an operational Eye Bank in the country.
Lose sight
"It's sad to see many people lose their sight because of something that could easily be corrected by an eye donation. If Kenyans start donating their eyes, it would be of major help," she said.
A corneal transplant is the replacement of damaged or diseased tissues or organs with healthy ones. In a corneal transplant, the cloudy or warped cornea is replaced with a healthy one. If the new cornea heals without problems, there can be tremendous improvement in vision.
According to Osea, corneal blindness as a result of the malfunction of the cornea, accounts for at least 25 per cent of blindness in East Africa.
Since there is no eye bank in the region, donor tissues for these transplants have been coming especially from the United States and South Asia.
This desperation has led to hundreds either completely losing their sight, or having their conditions dangerously deteriorate as they wait on the queue for their time to find a cornea donor from overseas.
Ms Stella Ondimu, a mother whose daughter Olivia, 16, was diagnosed with a cornea deformity several years ago, was put on the waiting list at the Kikuyu Eye Clinic for about two years before seeking alternative treatment in India.
"We found people waiting on queue who had been there even longer than us but I was anxious because both my daughter's eyes had steadily lost vision... I had to act fast," says an elated Stella after her daughter's successful operation in Hyderabad last year.
It was on Dr Choksey's recommendation that Olivia was taken for the operation.
"It was necessary because by the time Olivia was brought to me, I realised that she was suffering from a condition known as severe keratoconus on both eyes. A cornea transplant was necessary to save her sight and were she to wait here on the queue for a donor, the situation would have been bad," Dr Choksey explained.
Patients waiting
According to Osea, a recent study evaluating the magnitude of treatable corneal problems in the region showed that more than 150 patients were on the waiting list of just two of the major charitable eye hospitals in the country.
Without its own eye bank, Osea warns, Kenya will continue to receive lower priority for receipt of corneal tissue, behind the transplant needs of those countries with eye banks. This means that the number of those blinded by corneal pathologies will continue to rise.
And the eye ailments threatening Kenyans are many.
Keratoconus is apparently a common ailment, which, if untreated, eventually leads to blindness. The condition is caused by severe allergic conjunctivitis.
Allergic conjunctivitis is caused by foreign bodies invading the eye, for example, dust, pollen, ultraviolet light, pets and too much chlorine, as found in swimming pools.
It occurs predominantly in children and young adults. It is also common in individuals who may suffer from eczema, asthma or hay fever.
Save situation
"About 20 per cent of the children I see at the Kenyatta National Hospital on a regular basis suffer from allergic conjunctivitis. Were we to have a vibrant eye bank, a lot of these cases would not have to be so severe. A simple but urgent corneal transplant would easily save the situation," said Dr Choksey.
The cornea is the front, outermost layer of the eye. Just as a window lets light into a room, the cornea leads light into the eye. It also focuses the light passing through it to make images clear and sharp.
According to India's LV Prasad Eye Institute brochures, corneal problems can happen to anyone at any age, sometimes due to disease, injury or infection when the cornea becomes cloudy and warped.
A damaged cornea, like a frosted or misshapen windowpane, distorts light as it enters the eye. This causes distortion in vision.
But the importance of having an eye bank notwithstanding, Dr Choksey, who has just received the Osea Award for Outstanding Eye Care in East Africa, said the problem was the stigma associated with eye donations or the donation of body parts in the region.
"Eye donation is the most sublime type of compassion. After one person donates his or her eyes, two blind people can see," she said.
If people were to commit their eyes for donations on their deaths, then it would ensure that an existing eye bank would flourish.
As the LV Prasad Eye Institute stipulates, the corneas are collected from human donors within hours of death. Stringent tests are done to ensure the safety of the person receiving the cornea. If all appears clear, then a person's sight is guaranteed on the death and kind donation of another.
As Dr Choksey explains, people are quick to seek kidney donations and blood transfusions, measures that also intend to restore the life of another, but become hesitant when it comes to dedicating other body parts.
If all goes well, the registration of the Nairobi Eye Bank, targeted to start operations in 2008, will soon be complete.
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