My battle with a near loss of eyesight

Anderson Gitonga, 44, has low vision due to a condition known as keratoconus and has undergone a cornea graft.

My struggle with low vision began as a young boy but it was diagnosed a decade after I started having sight problems.

I struggled in a regular school because the blackboard was blurry and copying classwork into my school books was humiliating. My academic performance was affected and recognising people and objects became a challenge.

Most of my friends and family described me as a ‘nose-reader’ because I had to bring exercise books close to my eyes to read. But this method of reading was frustrating.

My parents sought medical advice and I was diagnosed with a disease that had already severely damaged my cornea called keratoconous and was advised to enroll in a special school.

The disease causes visual distortions due to a curved cornea that deflects light as it enters the eye thus affecting the quality of images.

I was enrolled at St Lucy’s School for the Blind at ten years old and later Thika School for the Blind for secondary school, and then Kenyatta University for my both my undergraduate and graduate studies.

After the diagnosis, I was given and a new pair of glasses with very high ‘power’ of about 16 and 17 in each eye.

My vision improved and so did my academic performance. However over the years, my vision became poorer necessitating the need for a cornea graft in my left eye in 1996 and another in the right one in 2012.

I have also undergone a lens implant where an artificial lens customized to my eye was fitted and I am now able to run my affairs as the chief executive at the United Disability Persons of Kenya very well. I am also a husband and father of three wonderful girls.

Keratoconous is a progressive disease that needs frequent medical check-ups and an honest discussion with your eye specialist on the strength of your vision. I have adopted some personal habits to conserve what remains of my vision such as keeping away from direct sunlight and minimizing my time in front of either a computer or the television.

Over the years, I have also modified my diet to include foods rich in Vitamin A and protein. I look forward to a time when Kenyans begin to list themselves as cornea donors in the event of their death in order to help persons with vision problems.

Expert's opinion: Effect of curved cornea is near sightedness

According to consultant eye specialist Daniel Mundia, research shows that the primary cause for keratoconous is the weakening of the cornea leading to thinning, which causes it to bulge and be further damaged. When this happens, an individual may need a cornea transplant. The cornea is the transparent cover of the eye that functions like a window to control and focuses the entry of light. In a cornea transplant, surgery is performed to remove all or part of a damaged cornea and replace it with healthy donor tissue.

“The disease commonly runs in families although other causes include overexposure to ultra-violet light, which includes direct sunlight, eye rubbing and allergic eye conditions. Down syndrome, poorly fitting contact lenses and chronic eye irritation may also cause damage to the cornea,” notes Mundia.

In diagnosing the condition, Mundia says that the curvature and thickness of the cornea is measured.

“The more curved the cornea, the higher the likelihood of having keratoconus, and the thinner the cornea the higher the likelihood of the disease,” Mundia notes, adding that the availability of newer and more advanced methods involve machines that check for all these parameters much quicker.

The initial effect of a curved cornea is short sightedness but Mundia warns that over time it leads to distortion of images causing the patient to have very poor vision.

“The continued bulging may also lead to internal tearing of the cornea, which causes sudden swelling and whitening of the cornea leading to pain, severe loss of vision and even though the swelling will go away, it could leave a dense central white scar that may render the eye blind,” Mundia warns.

For treatment, the first approach is to prescribe spectacles to correct the poor vision but with time rigid contact lenses become necessary. Cornea transplants are usually at the tail end of treatment.

There is another form of treatment called collagen cross-linking, Mundia says. In collagen cross-linking, Vitamin B2 is added to the corneal tissue using ultraviolet light to strengthen it and prevent further deterioration.

In Kenya, corneal transplantation is available at the PCEA Kikuyu Eye Unit, Lions Sight First hospital in Loresho, Aga Khan University Hospital, Nairobi and Tenwek Mission Hospital.

“The cost of corneal transplant is still high and unavailable to most needy cases as the tissues have to be imported from the US. It would help very much if we had cornea banks locally,” Mundia says.