KARACHI: “I was shattered when the doctor disclosed that my newborn son had defective eyes and would never be able to see. He didn’t even offer me false hope that could give me the strength to bear this shock,” recalled Amber, a young mother, whose first child, Yaqub, was born in 2011 with congenital glaucoma in both eyes.

Since then, her family has been to numerous ophthalmologists and Yaqub has undergone various treatments that included two surgeries — one for the cataract and the other to reduce intraocular pressure inside his eyes.

These efforts did pay off to an extent and Yaqub, over four-and-a-half years of age now, can finally see in one eye.

“He can only see in his left eye and that, too, after bringing things, for instance a book, close to his eye. I am thankful to God for this miracle as I was told that he would never see,” she said.

Time has brought solace to the family but they still wonder why blindness struck their child.

“They say it might be our cousin marriage which led to the disease. However, there is no history of blindness in our family,” she said, still reluctant to accept reality.

Recently, Amber brought her son to the Pakistan Eye Bank Society (PEBS) hospital after she was given hope that a corneal transplant may further improve his eyesight.

PEBS was established in 1974 to provide quality eye care free of cost.

Yaqub was among four patients called in to the hospital on the day a pair of donated corneas from Sri Lanka was to be transplanted. The procedure involves careful assessment to judge the most suitable candidate, and only two are selected and given the corneal transplant in one eye each.

Yaqub’s waited hours which however, proved futile as the corneas were transplanted to two other patients.

Twenty-eight-year-old Sumaira Yasmeen, registered with the PEBS for corneal transplant for months, also had to leave, disappointed.

A resident of Landhi, Yasmeen has been blind for the past five years.

“I lost vision in the right eye after a stone injury. I can only sense slight light now,” she recounted, adding that she experienced no improvement in her vision despite receiving treatment by reputed doctors.

“It hurts me a lot when people look at me in a strange way. I spent my time doing household chores as I couldn’t even complete my schooling due to financial constraints.

“My mother supports me a lot but she is worried about my marriage prospects,” she said, while sharing how visual impairment has affected her life.

Waiting for a miracle is also 12-year-old Munib, another patient enlisted with PEBS for corneal transplant. Despite having a lens replacement surgery four years ago, he continued to have blurred vision and gradually completely lost the ability to see, following an injury.

100,000 corneal blinds

According to Dr Qazi Wasiq, senior ophthalmologist at the PEBS, corneal blindness contributes five per cent to the total burden of blindness in the country.

“It is estimated that there are 100,000 corneal blinds in Pakistan. These people, mostly belonging to the underprivileged sections of society, can have a perfectly normal life if their damaged corneas are replaced with healthy ones,” he explained.

So far this year, he said, 35 patients have registered with PEBS for corneal transplant.

There are many different conditions which can damage the structure and shape of the cornea leading to visual impairment and blindness. These include infectious, nutritional, inflammatory, inherited, and degenerative conditions.

“In addition, workers in developing countries are increasingly exposed to occupational injuries as safety protocols are often ignored. Minor injuries heal on their own but deeper injuries can cause scarring, resulting in a haze on the cornea that impairs vision,” he said.

Eye donation challenge

According to experts, unlike many countries including several Muslim ones where eye banks have been successfully developed and corneal blindness has significantly declined, Pakistan still remains far behind in generating its own corneas as the spirit of cadaveric eye donation is yet to be built-up in the country.

“Pakistan annually imports two to three dozen corneas; all are a gift from Sri Lanka. Locally, the few donations come from the Parsi community,” said Dr Wasiq.

The country has all the expertise and facilities to start cornea grafting on a wider scale and the only lacking is of public motivation and religious and culture misconceptions hampering the job, he added.

Sharing his observations, president of the Ophthalmological Society of Pakistan, Dr Idrees Adhi, said corneal diseases causing blindness were among the three common causes of blindness in the country and concerted effort was required to promote corneal donation.

“Given the fact that deceased organ donation is being successfully carried out in countries like Saudi Arabia and Iran shows that it has the approval of diverse religious schools of thought.

“Our religious scholars must come forward and clarify the issue to the common man in the media, and the trend set by Abdul Sattar Edhi Sahib on corneal donation should be a step towards encouraging cadaveric donation.”

Ophthalmologists of the country, he said, needed to work together to set up well-organised eye banks for the preservation of donated eyes, making teams to retrieve eyes, and maintaining registers for needy patients.

“All these efforts are in their infantile stage in Pakistan and ophthalmologists must play their role in organising corneal donations and eye banking,” he said.

Published in Dawn, August 17th, 2016