Discovering Gold In Glaucoma

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By Richard Olumide Oyefeso 

The eyes are the window into a man’s soul. They are also our door into humanity. But what happens when sight is lost or impaired? Disaster happens as anguish replaces vision. Worry, desperation and misery engulfs the soul. But it need not be so, if only we could nip things in the bud and pay more attention to caring for our eyes just as much we care for what goes into our mouth.

According to eye care experts, the common ocular diseases worldwide are cataract, glaucoma, conjunctivitis, corneal ulcers, uveitis, refractive errors, pterygium. Other eye diseases include trachoma, onchocerciasis, xerophthalmia and ocular malignancies.

The pattern of ocular diseases varyin different parts of the world, influenced by racial, geographic, socioeconomic and cultural factors. For many folks in sub-Sahara Africa, the possibility of losing their sight is a real prospect. Already contending with the perils of underdevelopment and poverty, the continent is unfortunately the worst hit by the myriad of eye ailments and diseases.

Studies have shown that several conditions, namely, cataract, refractive errors/low vision, trachoma, onchocerciasis, and vitamin A deficiency/other causes of childhood blindness were indicatively responsible for 75% of all blindness worldwide. Thankfully, these are treatable and preventable causes of blindness.

A recent personal experience revealed the depth of ocular morbidity and the pent-up demand for eye care services in Nigeria. I was reflecting recently about my incredible good fortune to have discovered that I had Glaucoma before it was too late. The fact that I could have easily lost my vision is truly humbling, and I shiver to think of what the full ramifications of that could have been for my life.

I also recall coming to terms with the reality that many are walking the streets all over the country, totally oblivious that their sight was leaving them. Statistically, over 10 million Nigerian are literally living in partial or total darkness, and Nigeria particularly belongs to the league of nations with an alarmingly high prevalence of ocular diseases and blindness.

 As at 2013 it was estimated that there were 64.3 million people aged 40–80 years with glaucoma worldwide, projected to increase to 76.0 million by the year 2020 and 111.8 million in 2040.

Open-angle glaucoma (OAG) is the most prevalent type of glaucoma in Africa and a leading cause of blindness and visual impairment. The glaucoma-specific blindness prevalence in Nigeria among those aged 40 years and above is one of the highest ever reported and glaucoma is the second-leading cause of blindness after cataract. An estimated 1.2 million adults in Nigeria had glaucoma in 2012.

These are truly troubling facts. Browsing through the Asian Pacific Journal of Tropical Disease, I also recently stumbled on a report of a study authored by Ms. Catherine U. Ukponmwan of the University of Benin Teaching Hospital in Benin City (incidentally my alma mater).

The report, “Pattern of ocular morbidity in Nigeria” tracked the case records of 7, 220 consecutive patients seen at the university’s eye clinic between July 2004 and June 2008.

The report states that: “Glaucoma which was seen in 11.9 percent of patients in this study has been reported to be the second most common cause of blindness or visual impairment worldwide. It is the leading cause of irreversible blindness in West Africa and it has been estimated that 20 percent of people older than age 40 in West Africa may be at risk from the disease. Glaucoma was the commonest cause of blindness in the study by Mahmoud et al., and the second cause of blindness in Nigeria. It was also found to be a common disease in other studies from Nigeria and Nepal.”

This sour reality made me turn to the Canadian physician caring for me and innocently we broached the possibility of a medical mission to Nigeria. The physician and her husband(Dr. RajvinderPabla and AJ Khroud), both eye care professionals at the Regal Eye Care clinic in Orangeville, Ontario, Canada showed an amazing interest to travel to Nigeria for this reason.

 Obviously aware of the numerous negative narratives about Africa and Nigerians, they never expressed any fears about coming to Nigeria. As I took a picture of them on their arrival at the Murtala Mohammed International airport in Lagos, a few weeks ago, following their 17-hour journey, I could not help but be moved by their generosity and benevolence.

These folks have no ties whatsoever to our country and they spent their own money, left their businesses and their family to come here. They were also impressively gracious and humble in disposition. They had ignored all the unbridled, exaggerated fears and misinformation surrounding our nation. They were told by many that a trip to Nigeria was dangerous.

During their week-long philanthropic stint in Lagos, they held several eye clinics in indoors and out-door locations across the city, tending to over 200 cases as they teamed up with Nigerian eye care professionals for this noble cause. I am glad that together we brought miles and renewed vision to many faces.

We provided free comprehensive eye exams and vision screening, tested ocular pressures, diagnosed ocular anomalies, gave out free prescription glasses and referred many for further treatment.

It was gladdening to see them blend so well and share their expertise with we locals under the auspices of “4 Breath 4 Life”, a charitable organization comprising of professionals of Nigerian ancestry based in North America.

 Previous tours of duty by “4 Breath 4 Life” has seen these Diaspora-based Nigerian medical experts extend pro-bono services in Ogun, Oyo and Ondo states, working with local healthcare authorities on reducing maternal and child care mortality in the rural corners of these states.

This 2017 tour of duty for “4 Breath 4 Life” left all medical experts involved with a particularly pleasing sense of achievement notwithstanding the obvious lacuna between the pent-up demands for eye care services and the availability of affordable eye care services and specialists.

 The opportunity to raise awareness and bring solutions to eye diseases and preserve sight has a peculiar joy attached to it. The joy and gratitude from the participants was special and so touching. We hope to garner resources from all possible areas to render more of this services in the future.

Indeed, the milk of human kindness continues to give us snapshots of humanity at its best. It also sometimes brings the painful realization following the words of a great man that the worst thing than blindness is to fail to see with our eyes.

At the end of the day, the ultimate proof of our love and wisdom remains our ability to transcend our preoccupation with self to an embracement of selflessness and ‘other-centeredness’. As I reflect on this peculiar experience, I realize that discovered “Gold in Glaucoma”!

As we continue to seek for more golden moments of selfless contributions to society, we must also continue to call for policy-based and pragmatic interventions for ocular diseases management in Africa’s most populous nation. One day, as we keep on expanding the sphere of selfless service to humanity, we might just succeed in confining glaucoma to the annals of Nigeria’s medical history.

-Oyefeso is a Fellow, American Academy of Pediatrics and Founder, 4 Breath 4 Life.