The gift of sight

Sight. Sound. Taste. Smell. Touch. The Five Senses. There is no doubt about the most important of them all. Sight. The ability to see. Take that away and only the darkness remains. It is devastatingly difficult to cope with the modern world without the ability to see. Forty five million people around the world are blind and nearly 300 million others are visually impaired up to some extent. There is no other disability quite like blindness. Some are born blind, others lose their sight much later.

However, not all hope is lost. Blindness is preventable and even reversible in some instances. Many diseases which lead to blindness, such as glaucoma, can be prevented and treated if detected early and some blind people can be given the gift of sight by the simple procedure of corneal grafting. In fact, in up to 80 percent of cases, blindness can easily be prevented. A number of eye banks were opened in Sri Lanka recently for this purpose. Nevertheless, there seems to be a shortage of corneas. This is an unfortunate situation, because Sri Lanka was once famed for its cornea exports to all parts of the world. Hundreds of people around the world literally see through Sri Lankan eyes thanks to the pioneering efforts of personalities like Dr. Hudson Silva and the Eye Donation Society.

The Colombo National Eye Hospital has appealed to the public to get registered to donate cornea (eyes). There is a shortage of cornea in the Colombo National Eye Hospital and over 500 patients are in the waiting list to obtain corneas, a Health Ministry spokesman has said.

The spokesman said the number of patients who need cornea transplants rises daily but the Eye Hospital receives corneas only through the Colombo National Hospital. The nearest relatives of persons who die at the Colombo National Hospital can donate the deceaseds' cornea to the Eye Hospital. The eye hospital is now in the process of implementing the same strategy in other State hospitals to remedy this situation. Anyone can get registered at the Colombo National Eye Hospital to donate their corneas after death.

This is a timely move which will address the future needs for corneas here and abroad, in conjunction with the expansion of the new state-of-the-art Eye Bank in Colombo. However, most people do not know about this initiative and the message must be spread far and wide. There should be more awareness among the people about the acute need for corneas in the country.

There should also be greater awareness about the causes of blindness. Blindness is not something that happens only to 'others' - it can happen to virtually anyone either by accident or disease. Even a seemingly fit and healthy person could have a condition which could lead to permanent blindness.

One of the leading causes of blindness here and overseas is glaucoma, the 'Silent Thief of Sight'. According to statistics around 5 million people worldwide are currently living with blindness due to the Glaucoma and this number is expected to rise by the year 2020 to 11.2 million.

Appropriately, there should be a greater focus on this condition, arising mainly as a result of chronic diabetes, during this Glaucoma Week from March 6-12. Only cataracts (which can, of course, be surgically corrected) surpass glaucoma as the leading cause of blindness. To its credit, the Colombo National Eye Hospital has launched a series of programmes to educate the people throughout the island on Glaucoma in collaboration with vision 2020 secretariat and the Sight Savers International to coincide with the Glaucoma Week. Macular degeneration is another cause of blindness, which is less well known. Although prevention is still the best answer, technological advancements will one day make blindness history. Bionic vision, as seen in some popular TV serials, is rapidly becoming a possibility.

Just the other day, I read a report about an Israeli company which will provide an advanced bionic vision device to help millions of blind people see the world.

Herzilya-based Nano Retina is developing a prototype medical device, that "if all goes well" could be an answer to the prayers of people worldwide who suffer from impaired eyesight and blindness due to age-related macular degeneration (AMD), diabetes, retinopathy, retinitis pigmentosa, and related illnesses. The heart of the system is a wi-fi - powered chip about the size of a child's fingernail that is attached over the damaged retina within the eyeball. The 30-minute operation would be a relatively simple surgical procedure, similar to a cataract procedure, in which a five millimetre incision is made in the sclera, and the device slid inside and glued to the retina, according to the company.

The device, which the firm calls Bio-Retina, is powered via a small battery mounted in a normal-looking pair of eyeglasses that broadcasts an under-one-milliwatt WiFi signal.

Bio-Retina then uses the power to operate like a digital camera's image recording chip: light naturally entering through the pupil falls on the chip, which then sends a 24x24 black and white pixel image via a series of nano-scale electrodes enmeshed within the optic nerve to the brain. Later versions are aiming for 72x72 resolution, according to the firm, with enough resolution to read a large-font book, watch television or engage in similar activities - essentially giving the blind and near blind back their vision. The firm has already demonstrated proof of concept, and Gefen said "we're working on a prototype to show the image end-to-end," and hope to start clinical trials on humans by 2013.

Meanwhile, the world's most advanced artificial retina has been approved for use in new patients in Europe. The Argus II, developed by Lawrence Livermore National Laboratory and marketed by Second Sight is on sale in the EU but still awaiting FDA approval in the US. With the Argus II, blind patients use an external camera to pick up video that is wirelessly transmitted to an electrode array surgically implanted in the eye. While full vision is not restored, the 60+ electrodes allow for some distinction of outlines and other basic shapes. Definitely an improvement over blindness. Thus there is hope for blind people around the world. Perhaps by 2050 full colour, full resolution artificial vision integrated with the optic nerve could be a possibility. Well, it could even be better than natural vision, in fact. But if you already have sight, it is the most precious gift that you have received from nature. Taking good care of your eyes will protect this gift. Have your eyes tested as regularly as recommended by your optometrist (usually every two years especially if you are over 40). This will help avoid any complications and even blindness, later. And when you finally call it a day, make sure that someone else will see the world through your precious eyes.