World Prematurity Day: Dr. Ashi Khurana, Vice-Chairman, C.L. Gupta Eye Institute on preventing blindness in premature babies

An eye condition that is all but invisible to parents, pediatricians and the community can silently rob premature and low-weight infants of their sight. The condition must be treated early or the infant can go blind, not as a baby, but years later as a child. The condition is called Retinopathy of Prematurity (ROP), and in 2016, it became all too visible to eye doctors at C. L. Gupta Eye Institute.

Dr. Khurana remembers a doctor coming to her and being “very concerned as they found that a lot of children were coming in and had gone blind due to ROP.” It was a major problem that no other organization was addressing. ROP can be treated but it requires screening, diagnosis and urgent treatment that can include injections and laser eye surgery.

However, there was no widespread public health initiative to address ROP. Dr. Khurana and her team saw the shadow that blindness from ROP caused on children, their families, the health care system and society. Though a small number of babies develop ROP and lose their sight, “there is a huge impact on the life of that child and their family because someone, often the mother, becomes the caregiver.” There is a direct impact on the mental, physical and financial resources in a family, she says. Later treatment is also often complex, intensive and has poor outcomes. “It is very frustrating as a doctor,” says Dr. Khurana, “when there is not much you can do for a condition that could have been prevented.”

Conditions impacting premature infants, such as ROP, are on the rise

Premature births are a global issue. The World Health Organization data from 2020 estimates that 13.4 million babies, or one in 10, were born premature.

India has the highest prevalence of premature births in the world. Data from the Lancet found that three million premature babies were born in India in 2020.

The emergence of local NICUs has greatly increased the survival rate of premature infants. This has led to a shift from survival to quality of life by addressing the complications of prematurity. “ROP is a modern disease as more babies survive due to high quality NICUs,” Dr. Khurana says.

Conditions of Premature Infants on the Rise

To address the growing need and fill the gap in service, Dr. Khurana and her team launched an ROP screening program in Moradabad, Uttar Pradesh, India. Initially it was a pilot and then it expanded to include a partnership with Operation Eyesight Universal and was called the Retinopathy of Prematurity Eradication Project.  

On a mission to raise awareness and start screening for ROP

At that time, Dr. Khurana remembers that C. L. Gupta Eye Institute was not getting a lot of referrals from pediatricians to screen the eyes of premature infants for ROP. She knew that they needed to start an awareness campaign to educate doctors and pediatricians about ROP and the need to screen. “It should just happen, like a vaccine,” Dr. Khurana says.

The team started knocking on doors and going into NICUs to talk to not only doctors but also NICU managers and nurses, who are often the ones responsible for requesting ROP screenings.

Screening requires specialists and equipment often found in an eye hospital. As premature infants cannot travel and spend their first few weeks in emerging NICUs, the screening needs to take place there. However, many of the infants are fighting for their lives. “They have a lot of complications and there is a lot of priorities for doctors and stress for families,” Dr. Khurana says. “And then with all that, this issue of blindness comes up.”

There are also a limited number of eye doctors, and it can be challenging for them to travel to multiple NICUs to screen premature infants “who may or may not have an eye problem.”

An ambitious screening goal

The initial goal was to screen 500 children “which was huge,” Dr, Khurana says. To achieve this they sent optometrists to screen premature infants for ROP regularly at 40 local NICUs. Infants with ROP were referred to C. L. Gupta Eye Institute for urgent treatment.

In the first phase, the team screened 464 premature infants and saved 50 children from blindness. “It has been very satisfying for our doctors,” Dr. Khurana says.

In addition to raising awareness among medical staff, Dr. Khurana’s team started to educate the community as well. Not all parents are able to understand why screening and treatment are needed. There can be literacy and poverty issues that need to be addressed and at times, parents may deny treatment. Gender can be a factor as can birth order, if there are many children in the family.

People who can pay do, those who can pay part of the cost contribute what they can and those who cannot pay are supported by Operation Eyesight Universal. In this way, “everyone receives care and treatment.”

The second phase of the project launched on July 16, 2024, expanding beyond Moradabad to Sambhal, Bijnor, Amroha, Rampur and Baduan. Reaching these semi-urban areas was possible due to a mobile van with the required equipment, made possible through the Rotary Foundation, for onsite screening and treatment in rural and underserved areas, a tele-ophthalmology platform that allows experts to provide remote consultations, diagnoses, and treatment recommendations, an expanded network of neo-natal intensive care units in the five new regions and continued medical education to raise awareness of ROP, capacity and skills of NICU staff in the additional districts.

In December 2024, the Retinopathy of Prematurity Eradication Project ends. Services will be maintained with C. L. Gupta Eye Institute, a non-profit, covering costs for those who cannot pay, and working with NICUs.

ROP is a modern disease that requires resources

ROP is being studied and the ROP Society of India is looking at the impact of the condition on the country. As more NICUs emerge and more premature infants survive, ROP is appearing more frequently.   

Now, Dr. Khurana and her team are working to raise awareness of ROP in the community, among parents and with medical professionals. What is needed is more resources, public health support and training for doctors.  

For now, her team is small but dedicated. “It is satisfying for us to make a difference in the lives of these children and families,” she says.  

For the premature infants and their families in and around Moradabad, there is hope of a bright future. 

See how this this project works in the video Born Too Soon: Retinopathy of Prematurity Project, Moradabad, India.

Read about how this project transformed the life of Baby Aarsh and his family.

The post Preventing blindness in premature babies with Dr. Ashi Khurana appeared first on Operation Eyesight.

Aly Bandali, our President & CEO, met her at one of our boreholes, where she was fetching water for her family, carrying her grandchild on her back in a large scarf.

She told Aly her story. She had lost her sight in both eyes due to cataract. When we came to her village to drill a borehole and create access to eye care, a community health worker met her and referred her to the hospital for sight-restoring surgery. But Musokwe was too afraid to go through with it.

Of course, the community health worker didn’t give up. She counselled Musokwe day after day, encouraging her to go for surgery and explaining to her how the process would work. At last, Musokwe agreed to the treatment.

And thanks to the support of incredible people like YOU, she has her sight back!

When Aly asked her if she was happy to be able to see her grandchild’s face, she was moved to tears of joy. She nodded, barely able to reply through her tears. She’s so grateful to be able to watch her beautiful grandchild grow up!

This heartwarming moment was captured on video. You can watch it on Aly’s Instagram account.

We’re so grateful to people like you for helping people like Musokwe and her community every day!

Thanks to your generous gifts, there are now boreholes serving communities in Zambia with safe and clean water, which helps prevent the spread of trachoma, a blinding eye disease.

Even more – because of you, people living in villages like Musokwe’s have access to eye care treatment like cataract surgeries. Thank you!

There are still so many people like Musokwe who need your help. Please give the gift of sight today – For All The World To See!

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Can you imagine what it would be like to be a young man in a remote village, watching your parents struggle to bring food to the table, and realizing that you’re losing your sight?

And imagine what it would be like to be a mother living in poverty and watching your son go blind?

When Shivsagar started to lose his sight as a child, his mother didn’t have any other option but to take him to a healer in the village. Their village did not have a healthcare centre, and Shivsagar’s mother couldn’t afford the bus fare to the nearest hospital, let alone the expensive sight-saving treatments. Besides, taking Shivsagar to the hospital would cost her a day’s work and cost her family a day’s meal. So, she did all she could – placing all her hopes on the village healer and praying for her son’s remaining sight.

Sadly, the folk healer’s medicines had no effect. Shivsagar’s mother helplessly watched her son’s world go dark around him. He became alienated and eventually he was forced to drop out of school.

In many communities in India, men are expected to look after their parents when they grow old. However, instead of growing up to become a breadwinner for the family, Shivsagar depended more and more on his mother for his daily needs. But one day everything changed!

Years after Shivsagar lost his sight, his sister got married and moved to the city of Bangalore with her husband.

Operation Eyesight established a vision centre in Bangalore and Jyoti, one of our community health workers, went door-to-door in the area screening households for their eye health. As luck would have it, Jyoti met Shivsagar’s sister. When Jyoti heard about Shivsagar, she urged his sister to bring him to Bangalore.

So 20-year-old Shivsagar travelled 700 kilometers to his sister’s place in Bangalore and met with Jyoti. Jyoti referred him to the vision centre and the hospital, where the doctors identified the damage to his cornea and offered a cornea transplantation surgery at an affordable, subsidized cost of less than 100 Canadian dollars.

Cornea transplants need eye donors. After being referred for the surgery, Shivsagar returned to his village and waited for a donor. The long-awaited call came a year later!

Two weeks after the surgery, he could see his surroundings again, and his sight would keep improving for the next three months.

Shivsagar is at his sister’s recovering from his surgery, ready to head home to take on his new life. Once he returns to his village, he hopes to find a job to support his mother.

It’s a new beginning! Not just for Shivsagar, but also for his mom. Now she can rest easy knowing that her son can provide for their little family, and she knows that his future is bright and full of hope – all thanks to the support of incredible people like you!

Thank you so much for your incredible gifts that are helping to restore sight and hope for people like Shivsagar! There are still thousands like him who need your help. Please consider donating today and give the gift of sight to more people in need – For All The World To See!

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38-year-old Evelyn lives in Muziyo village, about 35 kilometers south of Zambia’s Sinazongwe District. What started as itching and irritation of the eyelids turned into severe, burning pain. Before long, Evelyn couldn’t even blink without feeling intense pain, and she started to lose some of her vision.

“It was very painful for me to open my eyes, and bright sunlight only made it worse,” she explains sadly. She didn’t know what was causing her so much pain, and she feared she would lose her sight completely.

It was a very difficult time in Evelyn’s life. She couldn’t walk without someone to guide her, and she could barely open her eyes.  Sadly, Evelyn’s condition  continued on like that for five long months.

Lucky for Evelyn, an outreach screening camp organized by Operation Eyesight was held in her village.

Evelyn attended the camp, where she was screened and diagnosed with trachoma, a bacterial eye infection that causes permanent blindness if left untreated.

Evelyn was referred for trachoma surgery at the Maamba General Hospital. Finally, her suffering came to an end.

Today, Evelyn can open her eyes without experiencing any pain, and her remaining vision has been preserved.

Trachoma affects women and children most, as children will touch their faces with dirty hands, and mothers will develop the infection through contact with their kids. Unfortunately, women don’t usually access eye care services with the same frequency as men. In many cultures, women’s health isn’t seen as a priority, and other barriers, such as low income or distance to a health centre, prevent women from seeking help. But thanks to you, Evelyn and the other women of Muziyo received the care they needed!

“I’m really so grateful for all the help I received,” Evelyn says smiling. She’s happy that her treatment was provided free of cost, all thanks to our generous donors!

There are still millions of women like Evelyn who need your help. Make a donation today and give the gift of sight!

The post You’re bringing precious eye care to the women of Zambia! appeared first on Operation Eyesight.