Toughest Case: Mr Ken Nischal, head of clinical and academic ophthalmology, Great Ormond Street Hospital

I'm an ophthalmologist specially trained in paediatrics at Great Ormond Street Hospital. The eye is separated into components and I'm an anterior segment specialist, which is basically the front of the eye.

When I returned from my specialist training in Toronto Hospital for Sick Children in 1998, I began to develop a service based at Great Ormond Street for very young children born with problems in their corneas.

Some children are born with corneas that are opaque, meaning they can't see. I was interested in these rare conditions and to try and help these children.

A three-month-old boy was referred to me because one eye had total opacity of the cornea, so you couldn't see any of the coloured part of the eye, and the other eye was similar, but a little bit bigger because he also had glaucoma.

In children under the age of four, if the pressure in the eye goes up higher than it should be – greater than 21mm of mercury – then the eye expands like a balloon, so his right eye was a little bigger than his left eye and we didn't know what was going on behind the opacity.

The first thing we did was a normal ultrasound and we found that the left eye had a total retinal detachment, which means that the retina had not formed properly and was completely off, so there was no chance of any vision in that eye. There's nothing that can be done when a baby's born with that sort of condition.

So I had a three-month-old baby who had only one eye with which he could potentially see. At the time, he would react to light but that was all, and the cornea was opaque. If I operated and did a corneal transplant, which is a high-risk procedure, and he lost the eye from an infection, or the cornea was rejected, there was a chance that this child would lose the vision that he had, but if we did nothing, there was a chance that he would lose that vision anyway.

It was a tough decision. We decided with the parents that we would go ahead and operate, and the next problem was that there was a real shortage of corneal transplant material. It was just after it was discovered that Liverpool pathologists had been saving body parts and organs from the post mortems of children. There was a huge public outcry and, as a consequence, organ donor rates had radically dropped throughout the UK.

When you operate on an infant, you need corneal material that is under the age of 21, so you need someone to have passed away under this age and for their family to have agreed to donate the eyes. Due to the shortage, we did a bit of PR work with our hospital to try and raise awareness that there were babies that needed these corneal transplants.

Luckily for this young boy, we managed to get material from a three-year-old child who had sadly passed away. The parents had read the piece in one of the newspapers and had come forward and said that they'd like to donate one eye specifically for this child.

So we did the corneal transplant and he's five years old now and he can see with one eye. He still comes to see me for check ups. He actually has some developmental issues which are due to his brain not being quite normal, so giving him sight has been hugely beneficial. If you give a child enough vision to be able to recognise objects, their global development is much better.



www.eyedoc.org.uk

Suggested Topics
Life and Style
ebookNow available in paperback
ebooks
ebookPart of The Independent’s new eBook series The Great Composers
  • Get to the point
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Ashdown Group: Trainee Consultant - Surrey/ South West London

    £22000 per annum + pension,bonus,career progression: Ashdown Group: An establi...

    Ashdown Group: Trainee Consultant - Surrey / South West London

    £22000 per annum + pension,bonus,career progression: Ashdown Group: An establi...

    Ashdown Group: Recruitment Consultant / Account Manager - Surrey / SW London

    £40000 per annum + realistic targets: Ashdown Group: A thriving recruitment co...

    Ashdown Group: Part-time Payroll Officer - Yorkshire - Professional Services

    £25000 per annum: Ashdown Group: A successful professional services firm is lo...

    Day In a Page

    Fishing for votes with Nigel Farage: The Ukip leader shows how he can work an audience as he casts his line to the disaffected of Grimsby

    Fishing is on Nigel Farage's mind

    Ukip leader casts a line to the disaffected
    Who is bombing whom in the Middle East? It's amazing they don't all hit each other

    Who is bombing whom in the Middle East?

    Robert Fisk untangles the countries and factions
    China's influence on fashion: At the top of the game both creatively and commercially

    China's influence on fashion

    At the top of the game both creatively and commercially
    Lord O’Donnell: Former cabinet secretary on the election and life away from the levers of power

    The man known as GOD has a reputation for getting the job done

    Lord O'Donnell's three principles of rule
    Rainbow shades: It's all bright on the night

    Rainbow shades

    It's all bright on the night
    'It was first time I had ever tasted chocolate. I kept a piece, and when Amsterdam was liberated, I gave it to the first Allied soldier I saw'

    Bread from heaven

    Dutch survivors thank RAF for World War II drop that saved millions
    Britain will be 'run for the wealthy and powerful' if Tories retain power - Labour

    How 'the Axe' helped Labour

    UK will be 'run for the wealthy and powerful' if Tories retain power
    Rare and exclusive video shows the horrific price paid by activists for challenging the rule of jihadist extremists in Syria

    The price to be paid for challenging the rule of extremists

    A revolution now 'consuming its own children'
    Welcome to the world of Megagames

    Welcome to the world of Megagames

    300 players take part in Watch the Skies! board game in London
    'Nymphomaniac' actress reveals what it was really like to star in one of the most explicit films ever

    Charlotte Gainsbourg on 'Nymphomaniac'

    Starring in one of the most explicit films ever
    Robert Fisk in Abu Dhabi: The Emirates' out-of-sight migrant workers helping to build the dream projects of its rulers

    Robert Fisk in Abu Dhabi

    The Emirates' out-of-sight migrant workers helping to build the dream projects of its rulers
    Vince Cable interview: Charging fees for employment tribunals was 'a very bad move'

    Vince Cable exclusive interview

    Charging fees for employment tribunals was 'a very bad move'
    Iwan Rheon interview: Game of Thrones star returns to his Welsh roots to record debut album

    Iwan Rheon is returning to his Welsh roots

    Rheon is best known for his role as the Bastard of Bolton. It's gruelling playing a sadistic torturer, he tells Craig McLean, but it hasn't stopped him recording an album of Welsh psychedelia
    Morne Hardenberg interview: Cameraman for BBC's upcoming show Shark on filming the ocean's most dangerous predator

    It's time for my close-up

    Meet the man who films great whites for a living
    Increasing numbers of homeless people in America keep their mobile phones on the streets

    Homeless people keep mobile phones

    A homeless person with a smartphone is a common sight in the US. And that's creating a network where the 'hobo' community can share information - and fight stigma - like never before