Saturday, 14 February 2015

Corneal transplant for severe vitamin A deficiency due to hepatitis A

Yaramala Varakumari was a happy 4 year old until she had Hepatitis A, a highly contagious liver infection contracted from contaminated food or water. There is no specific treatment for hepatitis A and recovery is slow. During convalescence, children are prone to nutritional deficiencies that deplete the Vitamin A stored in the liver. 

Little Vara showed these symptoms - her stomach had bloated, her legs showed muscle wasting and she could no longer go to school or walk around and play outside the hut. Her hearing diminished and her black eyes changed colour to a crimson red. Soon the parts inside her right eye came out through the gaping hole where the cornea had melted. The vitamin A deficiency was triggered on receiving inadequate medical care for her hepatitis A that had resulted in onset of acute Keratomalacia (corneal melting) and its disastrous sequelae. 

When the local doctor in Guntur could not help, her parents rushed her to LVPEI in Hyderabad.

Dr Muralidhar Ramappa, a specialist in pediatric corneal diseases, took utmost care to replenish the child's Vitamin A reserves before performing a corneal transplantation on her left eye. With vision restored in her left eye. Vara is independent again after nearly 2 years. She can now move about in her hut and can easily go out to the toilet even after dark. Her mother Mariamma is much relieved, hugging and kissing her precious daughter, and not at all mindful about borrowing money and foregoing her daily wages as farm labour to travel 7 times from Mallavollu village to Hyderabad. She is very grateful for the free of cost treatment her daughter receives at LVPEI.

Ladakhi student's steroid-induced glaucoma

Mohammad Husain, 20, the 7th child of a labourer from Baroo town of Kargil district in Jammu and Kashmir, was slowly losing his vision. He had been to a local doctor for some drops to treat his eye irritation but the temporary relief soon gave way to partial blindness. With his 12th standard examinations looming large, he visited an eye screening program being conducted at the Lamdon clinic, Director, Centre for Ocular Regeneration at LVPEI. 

Clinical Associate Uday Adepalli and Research Optometrist Veerendranath Pesala found that Husain suffered from glaucoma, induced by the use of topical steroids prescribed by the Kargil physicians. The team also found that a majority of the schoolchildren in Ladakh suffered from some kind of irritation in their eyes, just like Husain, typical of the dryness associated with high altitudes. Steroid induced glaucoma typically has no symptoms and is caused by the unmindful use of over-the-counter eye drops. They arranged for Husain to immediately travel to LVPEI Hyderabad by air, with his uncle accompanying him, to be treated by Dr Sirisha Senthil, Head of Glaucoma Care who performed two surgeries to ensure that Husain returned to Ladakh just in time to write his school examinations.