Wednesday, 3 April 2013

IAS after Chemical Burns in Both Eyes

Shyam Gautam Sharma accidently injured his eyes in 1998 when the poorly packaged pouch of ‘chuna’ (slaked lime or calcium hydroxide) he was playfully squeezing, squirted directly into his eyes.

‘Chuna’ is an ingredient that, along with other condiments, is smeared on betel leaves and chewed together as ‘paan’ or betel quid. An ugly fallout of this thriving social practice of chewing ‘paan’ is that the ‘chuna’ gets to be sold in cheap, easy to carry plastic pouches that are potentially hazardous to children who can accidentally puncture them, causing ocular chemical burn injuries to their eyes as in the case of Shyam Sharma, requiring urgent emergency intervention.

The Grade 4 chemical injury in the 6 year old Shyam progressed to total limbal stem cell deficiency. Between July 2000 and July 2009, he cumulatively underwent 11 limbal stem cell transplantation surgeries, either direct or cultivated from either his father or mother (where the stem cells from his parents’ eyes were cultivated in the laboratory and transplanted onto his eyes), and also 3 corneal transplants in both eyes. Each of the procedures led to a transient clearing of his visual axis for a period of 1-3 months after which it failed.

He finally underwent Boston Keratoprosthesis implantation, and now, 15 years later, Shyam enjoys 20/20 vision. The 21 year old has successfully completed his Bachelors through all of this, and studies for 14 hours a day as part of his focused preparation for his civil services examination. He dreams of starting an NGO for underprivileged students with vision problems, and draws inspiration from his visits to LVPEI and his treating surgeon Dr Virender Sangwan.

Patient: Shyam Gautam Sharma, seen by Dr Virender Sangwan

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