Ritayan Mukherjee

P. Sainath

Editor

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“I can’t see
anything in my left eye. The bright light hurts. It&#39;s painful. Very painful. I
am living in such a challenging situation because of this” says Pramila Naskar,
a homemaker from Bangaon town in West Bengal’s South 24 Parganas district.
Pramila, in her early forties, is speaking to us at a weekly cornea clinic in the
Regional Institute of Ophthalmology, Kolkata, where she has come down for
treatment.



I could
easily empathise with Pramila Naskar. The more so as loss of sight even in one
eye is a terrifying prospect for a photographer. I had a corneal ulcer in my
left eye in 2007 and was on the verge of going blind. I was living overseas at
the time and had to fly back to India for treatment. For one and a half months,
I endured a torturous rehabilitation procedure before regaining full vision.
And yet, a decade and a half after recovery, I still harbour a fear of going
blind. I keep visualising how agonising it must be for a photographer to lose
his sight. 



Globally, according
to the World Health Organisation (WHO) &quot;<a href="https://www.who.int/news-room/fact-sheets/detail/blindness-and-visual-impairment#:~:text=Key%20 eefacts,are%20refractive%20errors%20and%20cataracts">at least 2.2
billion people</a> have a near or distant vision
impairment. In at least 1 billion – or almost half – of these cases, vision
impairment could have been prevented or has yet to be addressed…”



The second most common cause of blindness
worldwide, behind cataracts, is corneal diseases. The epidemiology of corneal
blindness is complex and includes a wide range of inflammatory and viral eye
conditions that result in corneal scarring, which eventually causes functional
blindness. Additionally, the frequency of corneal disease varies from country to
country.

A 2018 study
in the International Journal of Medical Science and Clinical Invention
estimated that India had approximately 6.8 million people with less than
6/60 vision in at least one eye due to corneal diseases; of these, about a
million had a bilateral involvement. Normally, 6/60 vision means a person can see at 6
metres what someone with normal vision could see from 60 metres away.



The study also expected that number could touch
10.6 million by 2020 – but no clear updates appear to be available. 



A <a href="https://journals.lww.com/ijo/fulltext/2023/71090/corneal_blindness_and_eye_banking__current.7.aspx">review
article</a> in the Indian Journal of Opthalmology says “Corneal
blindness (CB) in India is 1.2 million, which is 0.36 per cent of total blindness;
about 25,000 to 30,000 people are added every year.” The Regional Institute of
Ophthalmology (RIO) was founded in Kolkata Medical College in 1978. RIO has
experienced considerable growth under the stewardship of Prof. Asim Kumar
Ghosh, the institute&#39;s current director. The RIO&#39;s cornea clinic, held just
once a week, sees over 150 patients on just that single day. 



This clinic,
run by Dr. Ashis Majumdar and his associates, helps those who are most in need.
Dr. Ashish told me, referring to my own case, “though you had developed a
corneal ulcer from a fake contact lens solution, the term ’corneal blindness’
describes a variety of eye conditions that alter the transparency of the
cornea, leading to scarring and blindness. The leading causes of corneal blindness
include infectious causes, i.e., due to bacteria, viruses, fungi, and protozoa.
The most common predisposing factors are trauma, contact lens usage, or the use
of steroid medications. The various other diseases included are trachoma, and dry
eye disease.”



Niranjan
Mandal, in his mid-forties, was standing quietly in a corner of the RIO’s
cornea clinic. He had black glasses on. “The cornea of my left eye was damaged,”
he told me. “The pain is gone. But vision is still blurred. Doctor said, it
can&#39;t be recovered fully. I work as a labourer in a construction company and if
I can&#39;t see properly in both eyes, it will be tough for me to continue in the
same profession.” 



While
talking to Niranjan, I heard another doctor gently scolding a patient, Sheikh
Zahangir, in his late thirties: “Why did you discontinue treatment even after I
told you not to. Now you are dropping in here after 2 months. I am sorry to
say, you will never get back your full vision in your right eye”.



The same concern echoes in the voice of Dr.
Ashish. He says “on many occasions we have noticed, the eye could have been
saved if the patient was brought in on time. Recovering from corneal damage is
a long and tedious process and discontinuation in treatment can lead to
blindness.”

But there
are intractable factors behind patients being irregular in their visits to the
RIO. Take Narayan Sanyal, in his late fifties, who told us, “I live in a far-away
place [Khanakul] in Hooghly district. For me it&#39;s better to go to a local
doctor [ a quack] for check-ups. I know that doctor is not worthy but what to
do? I ignore the pain and keep working. If I come here, it costs me roughly 400
rupees each time. I can&#39;t afford that”. 



Pushparani
Devi from Pathorprotima block of South 24 Parganas, faces similar
difficulties. She has lived in a slum with her two children for the past 10 years
and works as a domestic help. She said “I made the mistake of ignoring the
redness in my left eye. And I went for a check-up with a local doctor. Then it
became serious. I had to stop working. Then I came here [RIO]. Thanks to the
doctors here, after 3 months of regular check-ups, I got back my vision. Now I
need surgery [a corneal transplant] to ensure full vision. So, I am waiting for
my date.”



The
operation called a cornea transplant involves removing all or part of a damaged
cornea and replacing it with healthy donor tissue. The terms keratoplasty and
corneal graft are frequently used to describe corneal transplants. It can be
used to cure serious infections or damage, improve vision, and alleviate
discomfort. Dr. Ashish, performs around 4 to 16 corneal transplants in a month.
It&#39;s a critical procedure which takes 45 minutes to 3 hours. Dr. Ashish says
“the success rate after transplant is very high. And patients easily go back to
their work. The problem is something else. There’s a supply and demand gap which
affects us. Families should come forward with eye donations.”  There&#39;s a huge demand-<a href="https://www.thehindu.com/news/cities/Visakhapatnam/need-to-bridge-the-huge-gap-in-eye-donation-and-requirement-in-the-country-says-expert/article67235581.ece">supply gap</a>
in Bengal as well as in India.  



RIO Director
Dr. Asim Ghosh has this message to give: “Please note that most people do not
require corneal transplant. Please do not ignore initial symptoms. Please check
your local ophthalmologist first. So many patients come to us and we feel bad
when we see them come in at the very last moment and ask us to save the eye. As
doctors it hurts us to see this.” 



Also, says
Dr. Ghosh, “make sure you have a healthy lifestyle. Keep a check on the sugar
level. Diabetes makes our treatment for cornea &amp; other eye related
disorders more complex.” 



“Back in the hospital corridor I meet Avarani
Chatterjee, in her early sixties. She clearly looked joyful: “Hello, I don&#39;t
have to come here again. Doctor said my eyes are fine. Now I can spend time
with my granddaughter and see my favourite serial on TV.”

Corneal diseases are coming into sight

آنکھیں دکھاتی قرنیہ کی بیماریاں

దృష్టిలోకి వస్తోన్న శుక్లపటల వ్యాధులు

புலப்படும் விழி வெண்படல நோய்

ਕੋਰਨੀਆ ਦੀ ਬਿਮਾਰੀ ਦੀ ਦਸਤਕ

ଦୃଷ୍ଟିଶକ୍ତି ନଷ୍ଟ କରୁଛି କର୍ଣ୍ଣିଆ

കോർണിയ രോഗങ്ങൾ ദൃശ്യമാവുന്നു

ಬೆಳಕಿಗೆ ಬರುತ್ತಿವೆ ಕಾರ್ನಿಯಲ್‌ ಕಾಯಿಲೆಗಳು

बेतहाशा बढ़ रही हैं कॉर्निया की बीमारियां

કોર્નિયાના રોગો નજરે ચડી રહ્યા છે

बढ़त हवय कार्निया के बीमारी

कॉर्निया के बेमारी के उत्पात बढ़ रहल बा

পোহৰলৈ আহিব ধৰিছে কৰ্ণিয়াৰ ৰোগাক্ৰান্তৰ তথ্য

ক্রমশ নজরে আসছে কর্নিয়াজনিত রোগ

Kolkata

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Corneal diseases are coming into sight

Millions of people in India are impacted by corneal illnesses. After cataracts, it is the leading cause of blindness, caused by a multiplicity of factors including lens solutions, viruses, steroids and more

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