Why little girl's eye won't be 'fixed' soon

Blessings Chebe began experiencing eye allergies at three years old and upon joining school had difficulties reading. Light also affected her eyesight, something teachers noticed and informed her parents to seek medical attention.

Her mother, Claire Yego, was given drugs to control the allergy, but the situation worsened and Blessings was forced to stay out of PP2 classes as she could not read or see the blackboard or identify people even at close range.

Blessings was later diagnosed with damaged corneas at the Kitale County Referral Hospital. But not even eye glasses could solve her problems and a cornea transplant was scheduled at the Moi Teaching and Referral Hospital in Eldoret.

"I never knew about cornea transplant and I was disturbed that my daughter would be given an organ from a dead person," says Yego, whose daughter stayed out of school for four months as they waited for a donated cornea.

"There is a big challenge in getting corneas and we fortunately got one and her left eye was operated on. She responded immediately and could finally see me," says Yego.

Blessings resumed school in protective eye glasses coupled with regular check-ups as she waited for another cornea for her right eye.

But come July 2020, Blessings removed her protective eye glasses and a classmate touched her eye and the resulting infection got her admitted to hospital for two months.

The eye healed with a scar forcing her to undergo another cornea transplant and while waiting, "Blessings could not see tiny objects and can only identify bright colours and big writings," says Yego, adding that since it was around Covid-19 pandemic, there was a shortage of donated corneas.

It has been over a year and Blessings has not resumed school. "I am devastated because Blessings is now 11 and has been deprived of her education," laments Yego.

Corneal disease is considered one of the leading causes of visual impairment and blindness in developing countries.

In 2013, District Health Information System Statistics, placed corneal disease the fourth common eye condition after cataract, refractive error, and conjunctivitis.

Common indications for corneal transplant in Kenya are keratoconus, corneal scarring, bullous keratopathy, and corneal dystrophies.

According to Dr Fredrick Korir, a cornea surgeon at Lighthouse for Christ Eye Centre, Mombasa, about 75,000 Kenyans are in need of a cornea transplant. However, only 1,000 patients have been seen by a doctor and are in line to get cornea tissues for a transplant.

He says that currently Kenya has only one eye bank at Lions First Eye Hospital, a private institution in Nairobi that was only able to harvest 70 corneas from 35 persons from the Asian community in 2021.

Dr Korir says most people are not aware they can donate their corneas and currently about 85 per cent of corneas are imported from the United States where people are open to organ donations.

Over-dependence on imported cornea has caused a backlog in hospitals, leading to prohibitive transplant costs, wit charges range from Sh250,000-Sh450,000 depending on the supplying eye bank.

Dr Korir says the Covid-19 pandemic saw a drastic drop in the number of cornea tissues harvested besides a shortage of "Optisol GS solution that preserves corneas and the containers that store them".

Dr Korir says cost of a cornea transplant would go down by almost 400 per cent if the tissues were harvested in the country.

He says corneas should be used within two weeks after harvest as sometimes they expire at the port due to logistical challenges.

"The clearing process at the port takes from hours to days. Sometimes those handling the process have very little knowledge on human tissues thus don't understand the urgency. The pharmacy and poisons board should seek special consideration for such," says Dr Korir.

With only one eye bank, the few hospitals that perform corneal transplants include Lions First Eye Hospital, City Eye Hospital, PCEA Kikuyu Hospital, Moi Teaching and Referral Hospital, Agarwal Eye Hospital, Tenwek Mission Hospital, Lighthouse for Christ Eye Centre, Kisii Eye Hospital and Eye and U Eye Centre.

There are more than 12 surgeons in these nine hospitals.