A Telemedicine Innovation Is Preventing Blindness in Babies
Monday, December 14, 2015
Every sighted child that is born premature and weighs less than two kg faces a risk of lifetime blindness: a chilling fact that is known to few outside the select community of paediatric retinal surgeons. All that is needed to stop the blindness is screening and a specialised laser operation. But there is next to no awareness on that.
It is a problem that has fascinated Dr Anand Vinekar, 40, to the point of obsession. Anand, as he prefers to be called, has spent the last seven years, night and day, screening, monitoring, operating, teaching, training, spreading awareness and saving the eyes of premature children in district hospitals of Karnataka. “It doesn’t matter what else you write about our programme, our organisation or about me. The only message that needs to be conveyed is: every child born premature and with low birth weight has to be screened for RoP within 30 days of birth. It just has to be done,” Anand told ET Magazine.
RoP is an eye problem called retinopathy of prematurity. When a child is born premature, the blood vessels in her eyes are not grown fully, up to the retina at the back of the eye.
The retina is the light-sensitive layer of tissue at the back of the inner eye, which acts like the film in a camera and is essential for vision. In stage one of the disease, a thin screen-like white barrier comes up in the back of the eye, covering the retina. As the stages progress, this barrier grows thicker, preventing the blood vessel from growing to reach the retina. After the fourth and the fifth stage, the back of the eye is gone, with no chance of vision recovery.
Intervention through focussed laser beams has to happen at stage three. The doctors have just 48 hours to do it to prevent blindness. The child remains conscious through the approximately hourlong operation in which lasers are focussed on the area behind the barrier. The beams remove toxins and ensure the barrier falls, so that the blood vessels can reach their full growth in the retina. Lack of such intervention has a heartrending result. The child is unable to focus its vision on the parent or anyone. By the third month, the eyeball is rolling around and the child can’t see. Even if the parents spend all that they have, move heaven and earth to help their child, nothing can be done.
The problem is so complex that most parents don’t even understand what it is. Many, particularly uneducated, povertyand malnutrition-struck people for whom Anand does his work for free, think that he may be making it up. “It is perfectly understandable as there is no visible problem in the initial stages. The women tell me, ‘our mothers-in-law say the child’s eyes are perfectly fine, what are you talking about?’ It is very difficult to convince them that we need to screen, monitor and do surgical intervention through lasers on the newborn’s eyes,” Anand said. Often, even after the screening, monitoring and operation that has saved the child’s vision, parents don’t know what it is that Anand has fixed and go away without realising the gravity of the task he has performed.