Wednesday, 11 December 2013

ROP Blind Baby from Bangladesh has Successful Surgery

This is the story of Baby TC who presented as a 3-month old preterm baby, born at 28 weeks gestation, with 1kg birth weight. She was born in Dhaka, Bangladesh; her parents hail from Bangalpara village in Kishorgonj district, Bangladesh. The hapless parents were shocked when they found their baby was having difficulty in her vision. She was diagnosed with ROP in both the eyes. ROP (Retinopathy of Prematurity) screening which should have been done immediately after birth was long overdue for the baby.

Retinopathy of prematurity (ROP) is a disease of the eye affecting prematurely born babies. The inside of the eye (the retina) is not fully developed in a premature baby due to the early birth. Abnormal blood vessels can develop in such a retina, which can cause bleeding inside the eye and even progress to retinal detachment. 

After visiting various hospitals in Dhaka, the baby was finally referred to LVPEI by Dr. Muhammad Moniruzzaman, vitreo-retinal surgeon from the National Institute of Ophthalmology and Hospital, Dhaka. By the time the patient was able to procure a visa and reach Hyderabad, she was seen to have developed considerable retinal detachment: Stage 4B- right eye, Stage 4A- left eye.

At LVPEI, under the leadership of Dr Subhadra Jalali, pars plana vitrectomy was successfully performed on the 2 August 2013. The difficult surgery lasted 3 hours for both the eyes. Pars plana vitrectomy is a general term for a group of operations accomplished in the deeper part of the eye, all of which involve removing some or all of the vitreous - the eye's clear internal jelly.


After surgery, the child has attained reasonable good vision according to the parents. She was later following up for care with Dr. Nazmunnesa and her team from the Islamia Hospital in Dhaka who had earlier undergone ROP training at LVPEI. LVPEI has over the years been treating patients and also nurturing surgeons from various developing nations, and the happiness in the parents’ eyes is testimony to the success of this approach.

Little Harshini overcomes strabismus

S Harshini of Machavaram town in Guntur district had strabismus (squint) right from birth. When the child was six months old, her parents took her to a doctor in their locality who recommended that they consult LVPEI but they delayed the consultation. 

But when the child was three years old, she developed difficulty due to the squint problem. Luckily for the parents, by that time LVPEI had opened a tertiary centre in Vijayawada. They immediately consulted the doctors at Tadigadapa. Dr Niranjan Pehere instilled courage in them and counseled them regarding the surgery. The surgery for strabismus was performed successfully. 


Post surgery, Mr Srinivasa Rao, Harshini's father, expressed happiness that Harshini is able to see normally having overcome the problem. He conveyed his gratitude to Dr Niranjan, his secretary Bhavani, and the rest of his team for helping his child and felt that the people of Vijayawada were very lucky to have such a good hospital in their vicinity.

Thursday, 21 November 2013

Who Stole Her Vision? Story about a pre-term survivor on The World Prematurity Day: Nov 17, 2013

 "She was born too soon" –seven weeks early and weighs 1.7 kgs - the first message to the parents who should have been celebrating the birth of their child.  Technology, medical science, care, and the hard work of medical professionals and social workers and NGO’s helped the pre-term and low birth-weight baby to survive!

Many premature babies die within few days of birth. But thanks to each of the above she lived for several reasons.  Maybe she was  given critical and basic care  in the first ‘Golden hour’ of birth, someone ensured that she was transferred to an appropriate Neonatal Intensive Care unit (NICU) or Special Newborn Care Unit (SNCU) where day and night the staff provided care in the incubators manufactured by companies who set standards of such equipments, where oxygen and warmth, nutrition and asepsis ensured her safe survival; the doctors used their skills that they attained during their training  years , nurses washed their hands to avoid infection, and fed her at timely intervals to improve the body weight. After 28 days the little baby was strong enough to be sent home, but with lots of counselling to parents about further care over the next few months.

In their efforts to ensure the pre-term baby’s survival, no one realised the risk factors associated with low weight pre-term babies. She was not born blind but then who stole her vision? Her vision was perfect for her age, the Retina was immature because in all babies it slowly matures in the mothers’ womb by 40 weeks, which is the expected date of delivery (EDD). Then what led to irreversible and needless blindness by the time she was three months old? What could be the plausible reasons? Was it the doctor’s lack of knowledge of Retinopathy of Prematurity (ROP) that needs to be checked and treated within 20-30 days of life? Or, the nurse who did not monitor the oxygen to low levels which can worsen ROP? Or the incubator suppliers and trained super-specialists who did not educate the untrained users that only blended oxygen should be supplied to preterm babies with strict control using pulse oxymeters? Or the Obstetricians who assisted in delivery administered preventive steroids to her high-risk pregnant mother or who gave oxygen at birth without checking with a pulse oxymeter whether it was required?  Or could it be the fault of the duty doctor who discharged her from the NICU and scribbled ROP on the discharge slip without explaining to the parents how critical it was to check the baby’s retina within 20-30 days of birth and who did not fix appointment with a trained eye specialist? Are the parents to be blamed for not following the doctor’s advice? Or the eye specialist without proper training failed to see ROP in her eyes as it was not in the syllabus? Or the Retina specialist who was on vacation did not arrange a back-up to cover ROP screening in their absence? 

ROP develops 2-3 weeks after birth due to prematurity and low weight and then worsens due to many factors but can be fully treated by lasers if detected by proper retinal examination before 30 days of birth.
If Retina check-up was done not later than 30 days, 90 per cent of her vision could be restored.  Every day, doctors stumble upon such cases where helpless parents visit hospitals with babies who are blind due to lack of proper screening for ROP.

On this World Prematurity Day, I hope everyone involved will talk about survival and vision. Let’s hope there are more people like Elizabeth Taylor and Bill Gates who took up HIV cause or Amitabh Bacchan to say “Tees Din Roshni Ke” like he said ‘Do Boond Zindagi Ke” to ensure rigorous ROP testing in all hospitals, maternity clinics, birthing suites, etc to restore the vision of babies who are at risk. 
                              
    Author: Subhadra Jalali, ROP surgeon in-charge of the Indian Twin Cities ROP screening (ITCROPS) program, on behalf of a blind ROP baby in India and in other growing economies. subhadra@lvpei.org

Sunday, 3 November 2013

Venkateswarlu Retains his Job Thanks to Help from CSE at LVPEI

J Venkateswarlu was a topper and a recipient of the National Merit Scholarship. A triple postgraduate and an MBA graduate, he was battling eye problems from age 10. He had always worn glasses and had undergone a keratectomy when in college to help stabilize his vision. Later in 1996, he underwent LASIK surgery in both his eyes, and his vision returned to normal. He had a cataract surgery in 2004 but in 2010 he was diagnosed with glaucoma. Deteriorating vision drove Venkateswarlu to visit several eye hospitals but to no avail. No one wanted to operate on him, because of his complex case history. That is when he came to LVPEI.


In June 2011, Dr G Chandra Sekhar, Head of Glaucoma Services, tested his eyes and sent him to LVPEI's in-house Centre for Sight Enhancement (CSE). At CSE, Mr Deepak Kumar Bagga and his team counseled him about a range of low vision assistive devices such as magnifiers and computer software MAGic, but Venkateswarlu was upset since he was not prepared to live with low vision! He had expected to have his vision restored to normalcy after going to LVPEI. As he was a finance manager, he worked with worksheets, numbers, Tally software, etc. But increasingly, he was unable to manage his office work and thought of quitting. Towards the end of June 2011, he visited CSE again, without an appointment, and requested the staff to explain some more about the use of assistive devices and the portable video magnifier - Olympia. After over an hour of patient explanation, Venkateswarlu decided to use the Olympia magnifier to aid him in his work along with MAGic software. His MD saw the devices and advised him not to worry about losing his job any more. A grateful Venkateswarlu says. "I would have lost my job if Dr GCS and Mr Deepak did not help me at the right time."


















Sarojini's Case of Fuchs' Endothelial Dystrophy (FED)

Mikkili Sarojini, 60, and her husband worked as daily labour in their village Kondepadu in Pathipadu mandal, Guntur district. Sarojini had Fuchs' endothelial dystrophy (FED), characterized by an asymmetrical, bilateral, slowly progressive edema of the cornea in elderly patients, more common in women than men. She was referred to LVPEI Hyderabad by the doctors in Guntur district and had undergone PK (Penetrating Keratoplasty) and corneal transplant along with cataract surgery in 2002. Post the surgery performed by
Dr Prashant Garg, Sarojini did well for five years. A graft rejection episode in 2007 necessitated a repeat corneal transplant.


In 2013, there was a problem of blurred vision in the same eye, diagnosed as failed graft and she underwent Descemets Stripping Endothelial Keratoplasty (DSEK) corneal transplant, carried out for patients with persistent corneal swelling and poor vision. With DSEK procedure, only one of the innermost layers of tissue, the endothelium, and its membrane, the Descemet's membrane, are stripped off the cornea and replaced with a layer of healthy inner lining of a donor tissue. A thin button of donor tissue with only the endothelial cell layer is inserted onto the back surface of the patient's cornea. Post the operation, eye drops were prescribed and the happy couple is now on its way back to their village. The significant improvement in Sarojini's eyes has become a story of hope for many inhabitants of nearby villages.

Friday, 4 October 2013

Samreen overcomes congenital glaucoma

Hailing from the Defence Colony in Kanpur, Samreen Naseem is a happy person today having surmounted the difficult problem of bilateral congenital glaucoma.Glaucoma (kaala motiain Hindi) is a condition where the fluid pressure inside the eye rises to such a level that it damages the delicate structures of the eye, especially the optic nerve.


She had first presented as Baby Bushra, a 18 days old child with bilateral congenital glaucoma, a genetic disorder and also Phthisis bulbi in the right eye. To address the problem of congenital glaucoma, trabeculectomy was performed on her left eye to relieve the intraocular pressure by removing part of the eye’s trabecular meshwork and adjacent structures. The Phthisis Bulbi affecting her right eye, on the other hand, is a shrunken, non-functional eye that results from severe eye disease, inflammation or injury. Dr Mandal operated upon her while she was under the care of the reputed ophthalmic surgeon Dr N N Sood at the All India Institute of Medical Sciences (AIIMS). 

Later on, while on a visit to Chennai, the parents had read about LVPEI in a news magazine and came to the institute with hope. After Dr Mandal took up the case, the situation has more or less stabilized and had not deteriorated any further.With trabeculectomy having been performed seven times on her left eye, her vision was restored to 20/200 in the left eye. Samreen is now a girl driven by ambition and the zest to enjoy life like any of her peers. She is all praise for Dr Mandal who she says is not only a very qualified doctor, but a great human being. 



Thanks to him, she never required special care and had been able to study like any other child by using eye drops to maintain the intra-ocular pressure in her eyes. She even managed to excel in her studies, securing 94% marks in her 12th standard. Equipped now with an M.B.A degree, she says she wants to either pursue her higher education and earn a PhD, or perhaps like to be involved in a business. 


Little Sennai from Eritrea overcomes Pseudo Peter's Anomaly

In August 2011 we were blessed with our second child Sennai. Though born very healthy, his mother soon noticed a strange looking spot in his left eye. On being taken to the only eye hospital in Eritrea, the doctors assured that the spot might clear out subsequently. However, when the child was 3 months old, he developed secondary glaucoma that caused acute pain which made him suffer continuously for two days. The doctors then prescribed certain eye drops to ease the IOP and relieve the child of the pain. 

At the eye hospital in Eritrea the doctors however, did not completely rule out retinoblastoma. It was a nightmare. For 30 days, I stopped working and started hunting for internet cafes to do a bit of research on the matter. We decided to look out for places outside Eritrea for treatment. However, leaving the country was a challenge as one needed special permission from the Ministry of Health.




Finally, when Sennai was 4 months old, we found ourselves in UAE Dubai and headed to City Hospital. On learning that there were no specialists in Pediatric Ophthalmology, we visited Moorefield’s Eye Hospital in Dubai Healthcare City where on further investigation, the two consultant doctors came to the conclusion that it was a Peters Anomaly. The hospital however quoted a cost of 60,000 Dirhams (a little more than 16,000 USD) for the surgery; with subsequent treatment to cost another 1000 USD. 

This cost was truly prohibitive and the doctors were also not conclusive with their diagnosis. But they ruled that it was certainly not a case of retinoblastoma. For me as a father, this was a great relief and worth all the trouble and expenses we had to bear to travel to expensive Dubai. Considering the cost and at the recommendation of family and friends and my own research, we headed to Hyderabad in India. We reached LVPEI on February 5, 2012. 

Once here, Dr Muralidhar, Dr Subhadra and another glaucoma specialist examined Sennai under Anesthesia. The diagnosis was Pseudo Peter's Anomaly, a rare condition that needed surgery. This was the worst nightmare a parent could go through. The decision to allow a sharp blade to cut the eyes of a 5 months old child is not easy. Only a parent who went through the same experience can understand it. At that point, everything becomes questionable. So as parents, we confronted the hospital with the bold question of why should we trust this doctor? We even asked them to convince us of the abilities and experience of the doctor who was designated to do the surgery. The personnel at LVPrasad were patient enough to explain everything to us, and to give us as much information as we needed regarding the experience, talent and reliability of the doctor who was designated to do the surgery.


Armed with such information, we spent a night without any sleep. A decision had to be made. The next morning (February 6, 2012), we agreed for the surgery. This led to the longest 3 hours of our lifetime. The last minute of the 3 hours is one of the moments I am most thankful to God. We finally got to see our son, with no pain, with his eye covered, but peaceful. To the surprise of the doctors, the child was very patient and very cooperative. In fact they said he did not even cry till he got sedated. Never did he cry or tried to remove the patch from his eye after the surgery. 



For me, this is the deed of God. God gives us challenges to overcome, but He also accompanies them with miracles. 

Three weeks, down the road, Sennai’s wound recovered without any complication. Two years after his surgery, Sennai came to Hyderabad on his third trip to India. In this visit, we are told that, the child is improving well. 

(As narrated by the patient's father Ambasager Mebrahtu)

Overcoming Ocular Albinism and Nystagmus

This is the story of B Yadagiri a client of the Centre for Sight Enhancement at LVPEI who overcame his handicap and is now gainfully placed as a senior technical officer with Bharat Dynamics Limited (BDL), a Ministry of Defense (MoD) organisation. 

B Yadagiri was born in 1983 to a lower middle class family. Soon after his birth, parents and relatives were in for a shock when they noticed the newborn's white body colour and hair. The little child also had his eyes and body shaking considerably. But somehow the boy survived and was soon admitted to primary school where the temple priest of the village taught in the Telugu medium. The priest observed little Yadagiri's difficulty in reading and writing and promptly reported this to his parents. 

This was in 1986-87 when there were no reputed private eye hospitals. The boy was taken to Sarojini Devi Eye Hospital where he was prescribed glasses, but the thickness and weight of the glasses was too much for the small child. The doctor also informed the parents that consecutive consanguinous marriages in the family could have been the reason for the condition of the child. When Yadagiri was in the 5th standard in 1995, a doctor from a private practice declared him to be unfit for higher studies and suggested his parents stop sending him to school and look for alternative options for his livelihood. 



Though disappointed to hear this, the boy’s father neither stopped his education nor did he discriminate him against his other siblings. This Yadagiri opines is one of important reasons for his success today. However, he found it increasingly difficult to read or write, and managed only with support from his Telugu teacher. Socially too he faced ridicule and teasing from other children who called him names (white haired boy, old man, etc) but he was never disappointed or discouraged. 

In 1997, a relative who had undergone surgery at LVPEI, recommended the institute to Yadagiri. At the Centre for Sight Enhancement (CSE)), he was surprised when Dr Vijaya Gothwal asked him to dye his hair. When he failed to do so the next day, she said that she would not examine him. So he returned to the hospital having dyed his hair. He was told that his was a case of Ocular Albinism and Nystagmus and it could not be cured as it was a genetic disorder. But the doctor and the patient did not give up hope; they tried the use of various techniques and low vision devices like magnifier, peaked cap (to avoid sunlight as he was also sensitive to heat) and full sleeved shirts to cover his hands, use of tinted glasses (which gave a lot of improvement), black ink pen, hand held magnifier, telescope, etc. 

Later, when Yadagiri joined a polytechnic course, the telescope proved very useful. He ended up scoring 91% and was the top scorer in his class. He went on to procure a government certificate for the physically handicapped that facilitated special privileges, and pursued his higher studies in engineering and is now gainfully employed with BDL. He confidently takes care of the documentation of various projects for his company, and can also drive a bike and a car. He has recently married Deepthi who is an electronics graduate.


Yadagiri expresses his gratitude to LVPEI and in particular to CSE and believes that all eye hospitals should have low vision centres to help their clients.

Tuesday, 3 September 2013

The Spirit of Eye Donation



Following is a narrative written by Toni Cervantes, a volunteer photographer who has worked closely with SightLife, LV Prasad and Ramayamma international Eye Bank. She has traveled extensively throughout India, photographing the noble work done by eye banks across the country. ln her travels, she has also spent considerable time with donor families, capturing their stories and the stories of their loved ones. Read through this story ("Bright Spirit") and spend a few minutes discussing how the work  carried out by eye donation counselors can not only allow others to see but can also help donor families through the grieving process.

Every parent's worst nightmare is to have to bury one of his or her own children. Beautiful 11-year old Gwonjan was on her way to a Pujah at the Hindu temple to receive a blessing from the Goddess Durga. On her way back home, she stopped at a friend's house before heading to her father's small shop in the neighborhood. She never made it.

A few hundred meters from the safe haven of her father's arms, Gwonjan cherry red bicycle with a pink floral basket hanging in front was hit from behind by an unknown driver who never stopped to claim responsibility for the crime. An upbeat and happy soul like her was well known in the neighborhood. Someone recognized her lifeless body and went running to get the father.

Satish accompanied his daughter to the emergency hospital hoping there was a chance for revival, but Gwonjan had died on the spot. His only wish was that she would speak just once - call out "Papa" – but she could not. She was already gone. His biggest regret is not hearing her voice one more time. After informing the family of the accident, Gwonjan's father went completely numb. From this moment on, he was on automatic pilot with only one thought in mind: against strong family and bureaucratic opposition, he was determined to donate the corneas of his beloved daughter.

It was around 8:00 in the evening when Gwonjan passed away, long past closing time for the legal and technical infrastructure and personnel to approve and endorse the cornea recovery. The father had no idea there was a time limit for donating healthy corneas. When he was informed that the integrity of the tissue is no longer viable for transplant after a few hours, he worked with more urgency. For a little girl who always wanted to do good in the world, her father would not be deterred from making sure that his daughter’s death would not be in vain.

First he had to convince the grieving mother, Rehke, and his other two daughters that this is what Gwonjan would have wanted. The mother, t4-year-old Ayushi and 8-year-old Twinkle were so overcome with grief they said, "No!" Eventually Satish was able to convince them that her death could be of some value; after all Gwonjan was always a god-fearing little girl and wanted so much to do something good in the world - please let this be it.

In the meantime, the manager at the local eye bank was startled awake by an urgent midnight phone call. The wheels were in motion and the clock was ticking. The police were reluctant to proceed, but Gwonjan's father was a self-motivated donor. He had seen the ad campaigns around town and remembered them well. He told the authorities Gwonjan was his daughter and they were in no position to tell him, "No!" He would not be denied. She was his and he had made the decision. lt was final.

The police reluctantly agreed. The next step was for the eye bank manager to coordinate with her staff in order to carry out the recovery. She needed to find a technician who was willing to crawl out of bed in the middle of the night to perform the recovery - and she needed to find one fast. With a blessing from the Goddess Durga, a technician was found. But Gwonjon's neck was so badly broken; the technician could not do the recovery and hold her head correctly at the same time. The father heroically stepped in and gently cradled his daughter's head in his hands one last time as he steadied her for the procedure.

The corneas were tested and they were superb. ln the morning two families were woken up by a life changing phone call. Two young children who had been waiting months for a suitable match were going to be the recipient of Gwonjan's corneas. By 3:00 of that afternoon (in April of 2O11), two successful PK surgeries were performed. Because of the tenacious mission waged by Gwonjan's father, these two kids would have a fighting chance at a normal life.

Satish still thinks of his darling daughter 24 hours a day. He cannot believe she is no more. The house is empty without her. Of the three daughters, Gwonjan was the naughty mischievous one who delighted everyone she met. Twinkle misses her favorite playmate. Ayushi misses the pranks Gwonjan used to play on her. When she entered the Horne she came in dancing, alerting everyone like a signal that she had arrived - her energy was that vibrant.

As the family related the story and their memories of their luminous sister and daughter, tears welled up in their eyes. Throats swelled and tightened from the overwhelming sorrow and disbelief that she is truly gone. That she passed so unexpectedly into the next world was impossible for the family to accept. Three days later, they went to the eye bank begging for the opportunity to meet the recipients, but the eye bank manager refused this request. She was able to convince the family of the legal and emotional ramifications if such a meeting were to take place. lt wasn't easy, but in time they understood the wisdom of maintaining the privacy of both families.

ln conclusion, Gwojan's family urges all people to be brave and courageous when they are faced with the difficult decision of whether or not to donate the corneas of their loved ones. That person is gone and cannot come back, but if his or her corneas are donated, then someone else will have the prospect of a new life. Her mother says, 'A donation is the gift of sight which can help light up the world," one person at a time.

If Gwonjan’s' family has but one wish for the recipients it would be that they embrace life with a passionate vivacity. They pray the beneficiaries carry in their Heart the bright spirit their beloved Gwonjan radiated to all those who crossed her path

Monday, 2 September 2013

MCEH trainee from Zanzibar, Tanzania



Fatma is the firstborn in a family of five. She was born in 1969 in Pemba in Zanzibar Island, Republic of Tanzania. Both her parents are associated with healthcare; her mother is a retired gynecologist and her father a nurse. She too joined the medical profession is currently employed with the Ministry of Health as a national eye care coordinator for the Zanzibar Islands and mid level eye care worker. She has trained as a cataract surgeon in Malawi and has a post graduate diploma in community eye health from the University of Cape Town.

Fatma has collaborated and coordinated, both locally and nationally in her country, on several eye camps, outreach screening and surgical programs. She is keenly involved in planning, clinical teaching, management, supervising and conducting staff training at Primary Health Care Units Centers. She is married and has a son.
Despite all her commitments and engagements, Fatma seized the opportunity to fulfill her dream of obtaining a Masters’ in Community Eye Health (MCEH) when she chanced upon the LVPEI/UNSW program. She promptly applied for it and was selected.

At LVPEI, she soon felt so much at home that she didn’t miss Zanzibar much. The excitement of an impressive work environment and the sizeable exposure contributed immensely to her skills and knowledge. Thanks to the training, she has upgraded her capability in areas such as community assessment, planning, project management, epidemiology, biostatics and research. She is so enthused with the experience that she plans to continue with her studies and pursue a PhD. 

 

Inspired by the LVPEI model, she has plans to make suitable changes to the eye care program she works with back home in Tanzania. She is also eager to continue communicating with LVPEI in different ways in terms of sharing experiences, case studies, research, etc., and plans to send more students to the institute.

Tira, the eye bank trainee from Mizoram

 

T Lalhriattira or in short Tira is from Aizawl, Mizoram. Having completed his B SC in Physics, he found work as an ophthalmic assistant at the eye bank at the Civil Hospital in Aizawl. He has now been sent to LVPEI to train for 3 months as an eye bank technician at the Ramayamma International Eye Bank.

Now two months into his training at LVPEI, he is highly appreciative of the quality of training provided and is particularly impressed with the immense practical orientation he is getting. In his words, “Even after 10 years, I will not be able to forget what I learned here at LVPEI!” 

Thanks to the practical hands-on training imparted by eye banking staff, he says that he has gained so much knowledge and experience in two months that he is confident of applying it right away; if he were to return to Aizawl now, he thinks he could handle assignments with ease. What that would entail for an eye bank technician would be to screen the donor, retrieve the corneas from the deceased, processing of corneas, evaluation of the corneas and distribution of suitable corneas to the needy surgeons. This would also include ensuring quality until the cornea is transplanted along with taking care of laboratory and equipment maintenance, instrument cleaning and sterilization and proper documentation of the donor corneas.

He also had the opportunity to work with eye donation counselors trained by LVPEI. The counselors spend time at the multispecialty hospitals, approaches bereaved families and motivate them to make an eye donation. This forms part of the HCRP (Hospital Cornea Retrieval Program) which is the first of its kind started by LVPEI way back in 1990.

Tira looks forward to coming back again for the one week refresher training. After completing his training, he aspires to work for the people of Mizoram in particular, and India at large. He is a soccer enthusiast just like most of his other peers from the North East; but quite unlike many other digitally inclined, keypad-happy youngsters, he enjoys reading good old books and has even enrolled for a B.A to fulfill his passion!

Dr. Joseph Nezgoda completes short term clinical rotation


 


Dr Joseph Nezgoda says that with his fellowship training having completed, he will have two personal goals being very effectively fulfilled. Firstly, he will be able to understand and perform the nuances of Small Incisional Cataract Surgery (SICS) that he believes is the most cost-effective treatment for cataract extraction. Secondly, he will also be able to pursue his main area of interest of vitreoretinal disease thanks to the exposure to the retina service at LVPEI. 

He feels that LVPEI offers good learning opportunities in retina care. The diversity and numbers of India’s population provides a host of trauma and uveitis cases that can only further his education. He has seen many cases of Macular Telangiectasia (MacTel), VKH, Behcet’s disease, FEVR, Retinoblastoma, among other rare conditions, and found it exciting that LVPEI’s research includes Idiopathic Juxtafoveal Macular Telangiectasia (MacTel), a blinding condition of the retina. 

He also had the opportunity to work with eye donation counselors trained by LVPEI. The counselors spend time at the multispecialty hospitals, approach bereaved families and motivate them to make an eye donation. This forms part of the HCRP (Hospital Cornea Retrieval Program) which is the first of its kind started by LVPEI way back in 1990.




Tran Minh Anh was born and brought up in Hanoi, the capital city of Vietnam. The opportune moment for her to be associated with the world of Optometry presented itself when the two organizations of Eye Care Foundation and Brien Holden Vision Institute in collaboration with the Vietnam National Institute of Ophthalmology were scouting for avenues to establish and develop Optometry in Vietnam. Tran Minh Anh seized the opportunity by enrolling for a course in optometry, securing a sponsorship for a 4 year program. This was how she came to L V Prasad Eye Institute and the Bausch and Lomb School of Optometry (BLSO).

With interests in travelling and reading books, Tran Minh was particularly fond of Chemistry and Biology right from her school days. Tran Minh had travelled to a few countries before coming to India, having chosen the country for its strength in imparting both theoretical and clinical skills. She says she is fond of Hyderabad for its beauty and feels that India, with its diversity of cultures, provides a very fascinating environment. Though she finds the food spicy and oily, she has come to cope with it. Being the fourth year of her stay at BLSO and LVPEI, she recalls how the past 4 years were memorable.

She found the classes held in BLSO very interesting and inspiring. She has a special word of praise for the BLSO principal and faculty who are always helpful and supportive. She also recalls how during her internship, she could herself clinically examine patients. She also recalls how she and her mates at BLSO had chanced upon 'Reflektionz', a two-day intercollegiate festival at the Sankara College of Optometry, Bangalore, on the occasion of World Optometry Day. The festival included more than 20 competitions; and there were 8-9 colleges from South India attending it.

  
 

Tran Minh Anh – fondly called Miao by her mates - won awards in various categories such as debate, pick and speak, art from waste and face painting categories. To top it all she even won a special prize for winning the highest number of prizes in the festival. This was something special both for Tran Minh and BLSO. She became noted on campus as the Vietnamese student who had come all the way to study Optometry in India and was now winning awards for BLSO, beating students from other institutes! Tran Minh Anh hopes to become an Optometry practitioner in Contact Lens and Pediatrics. She is also ambitious of becoming a good teacher to inspire the minds of aspiring Optometrists.

Penetrating Keratoplasty (PK) surgery for Kanakappa

This is the story of Kotha Kanakappa who hails from Avangapur in Narayanpet mandal of Mahabubnagar district of Andhra Pradesh. Unfortunately for him, at the age of 55, he developed vision problem in both his eyes and was confined to his house. He was even unable to attend to his daily chores.

As he was carrying on in this difficult condition, after about a year, his son came to know of an eye camp at Kaverammapeta. On being taken there, Dr. Mallikarjun referred him to L V Prasad Eye Institute. At LVPEI, Dr. Somasheila Murthy performed Penetrating Keratoplasty (PK) surgery on Kanakappa, once in the left eye, and two times in the right eye.

Penetrating Keratoplasty (PK) refers to the replacement of the host cornea with a donor cornea. It is used with success in patients with decreased visual acuity secondary to corneal opacity, in the treatment of corneal thinning or perforation, for the removal of non responding infectious foci and for the relief of pain. Penetrating Keratoplasty (PK) may be combined with cataract surgery, secondary intraocular lens implantation, glaucoma surgery and retinal surgery.


Post surgery, Kanakappa’s condition has improved significantly, and he is able to carry out his activities effectively. He says he goes to his field, goes to the nearby hotel for a cup of tea and is able to carry out his daily activities and is again self dependent. He is full of gratitude for Dr. Somasheila Murthy and LVPEI. He says LVPEI has brought back "light into his life".

Vitrectomy Restores Vision for Sai Keertana

The story is regarding a young girl Sai Keertana from Kakinada in East Godavari District of Andhra Pradesh. Doctors who saw her said that they had little hope in restoring her eyesight as she had developmental defects in both the eyes right from birth. The parents, both of whom were working people, were very distraught with this.

However, on the advise of well wishers and the medical fraternity in Kakinada, they came to LVPEI Hyderabad where Dr Raja Narayanan “created hope, gave assurance and showed the result” in the words of Sai Keertana’s happy mother Mrs Usha Rani. In February 2012, Vitrectomy was performed in the left eye. Vitrectomy is the surgical removal of the vitreous gel from the middle of the eye which is done in cases of retinal detachment. In March 2013, surgery was performed for cataract and an IOL (Intra ocular lens) was implanted. Post surgery, there was significant improvement.





Sai Keertana is now in the seventh standard and with the use of aids like the telescope and stand magnifier provided by the CSE (Centre for Sight Enhancement) at LVPEI, she is able to carry on with her studies. She has come out of the situation in which she had to depend on her mother to read out to her. Though she had a post operative problem of developing cataract, it was also attended to by Dr Pravin Krishna.

Sai Keertana, who is 14 years old, has been under treatment for the last one and a half years. With follow up treatment along with regular check-up every two months, her condition has improved significantly. Back to normal life she is now eagerly pursuing carnatic music apart from her regular studies. With this intervention, not only Sai Keertana, but the entire family has been helped out of the emotional trauma.