RAM’s Cornea Graft – An Oversight that could have made Ram blind

On our return from Bangkok and in the flight to KLIA, Ram had complained of pain in her right eye, the one with the cornea graft. We reached home at about 2.00am early Friday morning 24th. December 2004. At 8.00 am we went straight to THONEH as Ram had complained of throbbing pains in her eye since getting up from sleep.

At the Hospital, although there was no scheduled clinic that day, Dr. Veera Ramani was available to see her. One look at her eyes she decided to detain her in hospital and do an intensive and intrusive treatment to the eye. What happened? She exclaimed. You have been doing very well and now it is really bad. There is an ulcer on the cornea and its spreading, she said. The whole cornea can be damaged in a day or two and you will be blind!!.

Apparently dust had gone into the eye and had caused an infection of the new cornea which had turned into an ulcer that’s spreading fast. The doctor gave her two injections directly at the eye and prescribed eye drops to be administered every 15 minutes. That’s the reason she detained and confined Ram to the hospital ward for treatment and to avoid further infection. We decided to take a single room in the ward and I stayed with her throughout. I called Tessa. She came later in the afternoon after going home to fetch some essential stuff, change of clothing, reading materials and my laptop.

Ram’s eye was red all over. The treatment to it continued every 15 minutes with three different types of eye drops until Saturday, Christmas day, when the doctor evaluated the eye and said that the spread of ulcer had been arrested and it was beginning to reduce in size. Treatment, however, need to be continued and on Sunday the frequency was reduced to hourly.

On Monday, 27th December, 2004 (the day after the tsunami incident) the doctor said that the ulcer on the eye had reduced considerably but treatment continued 2 hourly for the next few days. Ram was allowed to go home on Wednesday 29th but has to come in on Thursday for follow up checks. Two types of eye drops were prescribed to be administered every four hours and we religiously followed the instructions. She was to observe all the precautions set after she had the operation previously. So I had to perform most of the household chores as previously done while Ram took care not to exert herself too much. We went back to the hospital on Thursday as appointed. The doctor reduced the frequency to every six hourly and asked her to come back on Monday 3rd. On that day her eye has recovered almost fully but to be sure, the doctor continued with the two types of eye drops to be administered six hourly and set for another appointment the next Monday, 10th January 2005.

Monday 10th January came. We went to the hospital early. The doctor said that the eye had recovered fully and that Ram should continue to take extra care and not expose herself unnecessarily. She should take all precautions possible and avoid infections. Her next appointment was set at one month interval. Shaffik bought for her one of that fancy safety glass that cover the eyes almost completely and yet look fashionable.

Now that the eye is recovering well we tried to get answers to the many questions we had on why this could have happened. Apparently, the new cornea, not being directly connected to the other parts of the eye (there are no blood vessels connection as in other body part transplants or grafts), obtains its nourishment from the film of liquid around it. With foreign body(es) lodged into the cornea like dusts and other impurities, and other living organisms coming along with the foreign bodies eg. dust mites and the likes,infection will take place, and the cornea being weaker, with minimal nourishments, will succumb to the attacks by these foreign organisms. This was what we believed happened to Ram's eye. So, we have to also remember that it will not only be protecting the eye from airbone infections but also from waterborne infections. She has to also be very careful when she uses water to wash her face and eyes. We are aware that this recent incident could have been due to our carelessness in protecting the eye when we were in Bangkok. We thought the most likely occassion that she caught the infection and had dust in her eyes was either when we took the tuk-tuk ride or when we walked along the busy streets of Bangkok at night, when there was an occassion Ram took off her eye-glasses as the street was rather dark and she could not see where she was going using the glasses that had colour shades on it. This was an expensive lesson to us. We will have to be more careful in the future.

We thank Almighty Allah for answering our prayers and for the protection and guidance throughout this ordeal. We are thankful that Ram recovered and did not lose her eyesight, vision being one of our most important senses. We hope we can soon proceed with further treatment of the eye as advised by the specialists from ‘Orbis’ the Flying Eye Hospital, mentioned in my previous write up

MKI Ramblings Unlimited
Petaling Jaya