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
ebookA delicious collection of 50 meaty main courses
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

    Recruitment Genius: Ecommerce Manager

    £45000 - £55000 per annum: Recruitment Genius: An opportunity is available to ...

    Recruitment Genius: Customer Service / Administrator - Spanish Speaking

    £16000 - £17000 per annum: Recruitment Genius: This world leading specialist i...

    Recruitment Genius: Regional Support Manager

    Negotiable: Recruitment Genius: This role's responsibility also include operat...

    Recruitment Genius: Field Engineer - Northern Home Counties

    £27000 - £28000 per annum: Recruitment Genius: Their revenue and profit have g...

    Day In a Page

    Greece debt crisis: What happened to democracy when it’s a case of 'Vote Yes or else'?

    'The economic collapse has happened. What is at risk now is democracy...'

    If it doesn’t work in Europe, how is it supposed to work in India or the Middle East, asks Robert Fisk
    The science of swearing: What lies behind the use of four-letter words?

    The science of swearing

    What lies behind the use of four-letter words?
    The Real Stories of Migrant Britain: Clive fled from Zimbabwe - now it won't have him back

    The Real Stories of Migrant Britain

    Clive fled from Zimbabwe - now it won’t have him back
    Africa on the menu: Three foodie friends want to popularise dishes from the continent

    Africa on the menu

    Three foodie friends want to popularise dishes from the hot new continent
    Donna Karan is stepping down after 30 years - so who will fill the DKNY creator's boots?

    Who will fill Donna Karan's boots?

    The designer is stepping down as Chief Designer of DKNY after 30 years. Alexander Fury looks back at the career of 'America's Chanel'
    10 best statement lightbulbs

    10 best statement lightbulbs

    Dare to bare with some out-of-the-ordinary illumination
    Wimbledon 2015: Heather Watson - 'I had Serena's poster on my wall – now I'm playing her'

    Heather Watson: 'I had Serena's poster on my wall – now I'm playing her'

    Briton pumped up for dream meeting with world No 1
    Wimbledon 2015: Nick Bollettieri - It's time for big John Isner to produce the goods to go with his thumping serve

    Nick Bollettieri's Wimbledon Files

    It's time for big John Isner to produce the goods to go with his thumping serve
    Dustin Brown: Who is the tennis player who knocked Rafael Nadal out of Wimbeldon 2015?

    Dustin Brown

    Who is the German player that knocked Nadal out of Wimbeldon 2015?
    Ashes 2015: Damien Martyn - 'England are fired up again, just like in 2005...'

    Damien Martyn: 'England are fired up again, just like in 2005...'

    Australian veteran of that Ashes series, believes the hosts' may become unstoppable if they win the first Test
    Tour de France 2015: Twins Simon and Adam Yates have a mountain to climb during Tour of duty

    Twins have a mountain to climb during Tour of duty

    Yates brothers will target the steepest sections in bid to win a stage in France
    John Palmer: 'Goldfinger' of British crime was murdered, say police

    Murder of the Brink’s-MAT mastermind

    'Goldfinger' of British crime's life ended in a blaze of bullets, say police
    Forget little green men - aliens will look like humans, says Cambridge University evolution expert

    Forget little green men

    Leading evolutionary biologist says aliens will look like humans
    The Real Stories of Migrant Britain: An Algerian scientist adjusts to life working in a kebab shop

    The Real Stories of Migrant Britain

    An Algerian scientist struggles to adjust to her new life working in a Scottish kebab shop
    Bodyworlds museum: Dr Gunther von Hagens has battled legal threats, Parkinson's disease, and the threat of bankruptcy

    Dying dream of Doctor Death

    Dr Gunther von Hagens has battled legal threats, Parkinson's disease, and the threat of bankruptcy