I was invited to speak at the forum of the United for Vision Club a few days ago. I had decided to speak on “Innovations in Eye Care,” as a follow up to my previous article, “A glimpse into the future – The year 2022.” However, I had no other choice but to step it down to allow an old lady who was burning to tell her story.
“My name is Banes. I just turned 68 a few weeks ago,” she said. My thoughts ran riot. She looked more like an 86-year old! So, I thought I didn’t hear her clearly. I wasn’t alone!! Someone in the audience interrupted her and asked, “Ma’am, did you say 86?” I was worried how she would take it! Twenty odd years added to her age! That was quite unfeeling, impolite, rude and undiplomatic.
I quickly interjected to save the day by asking loudly. “Have you ever heard the adage, ‘Never ask a lady for her age’?” Some audacious young man refused to take the hint and asked, “Why shouldn’t I ask a lady for her age?”
Actually, up to that moment, I had never given it a thought. I just accepted the old saying! And as a medical doctor, a person’s age is very important to make a diagnosis and establish treatment. Nonetheless, I ventured a reply to turn the attention from the obliging lady, “Yes, for the same reason men would not want to reveal to ladies their salaries, a woman would not want to reveal her age!” Everyone laughed heartily.
Ms Banes, continued her story, smiling and undeterred by the comments. “I am 68 years, two months and eight days old! About 20 years ago, on a bright Sunday afternoon, I suddenly found that my view of the television was blurry. This had happened several times in the past four weeks, but on this particular Sunday, it was a lot more.
I also discovered that I saw better with my reading glasses. The following day, I went to see my eye doctor to complain about the frequent fluctuations in my vision.
“The first question he asked me was, ‘Do you suffer from Diabetes?’ ‘Certainly, no!” I answered. To my knowledge, no one in my family ever had diabetes.’ He took out a laboratory form and ticked ‘FBS’ and ‘HbA1c’. “What is FBS? I asked?” “Fasting Blood Sugar,” he replied and added, HbA1c is glycosylated haemoglobin.”
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“Not waiting for me to ask the next obvious question, he added, ‘HbA1c is a measure of the amount of glycosylated haemoglobin in your blood. This will help me determine your average blood glucose level for the last two to three months and how well you fared if indeed you have diabetes.’
“When I brought the results to him the following day, they were abnormal. You are lucky to be alive. You could have gone into coma and knocking at the door of heaven if help did not come soon after. Within a few weeks of starting treatment, my blood sugar was controlled and, true to the doctor’s words, the blurry vision had disappeared and I didn’t need a change of glasses any more. ‘People with diabetes,’ he said, ‘shouldn’t get new glasses until their blood sugar levels have been under good control for at least two months’.
“But I did go into coma several times! I was a bad patient. I neither kept my appointments nor used my medications regularly. My doctor had warned me about the consequences of untreated or badly treated diabetes. My first encounter was the blurry vision. He had told me I could develop cataract at a much earlier age than most people and as the condition progressed, diabetic retinopathy.
“When you see spots or dark strings floating in your vision; or your judgement of colours becoming impaired or there are dark or empty areas appearing in your vision, the journey to loss of vision might have begun. The more scary ones are the sudden, painless loss of vision due to bleeding within the eye and the development of glaucoma – two potentially blinding conditions – double jeopardy!
“Ladies and gentlemen, despite the advance warnings, like a dog set to get lost in the woods, I refused to listen to the whistle calling my attention to danger. So at 50, I had surgery in both eyes for cataract. My hitherto visual impairment improved tremendously. The doctor and his patient were equally excited. At 58, I started seeing dark areas in my field of vision.
“Then suddenly, I lost vision in my right eye from bleeding into the eye. A few weeks later, disaster strucks, the vision in my left eye just disappeared! The doctor said it was caused by occlusion of the vessel taking blood out of the eye – ‘Central retinal vein occlusion with severe proliferative retinopathy.’
“Pardon me if I am selfish. I deliberately hijacked your lecture for two reasons. I wanted people to learn from my experience. Secondly, I am for all practical purposes, blind! Your last article gave me hope. I’d like to confirm if it is true that with modern technology, people like me have hope of recovering some vision.”
“Ms Banes, it is certainly true. A combination of artificial intelligence and telemedicine, supported by the goodwill of concerned and generous Nigerians will help our ophthalmologists reach out to the remotest villages to screen and prevent blindness caused by diabetes mellitus. A not-for-profit Centre for Eye Health and Retina Care is opening very soon to provide this service in Oyo State.
“At the next opportunity, I promise to talk more about prevention of blindness due to diabetes,” I told her. Her face brightened up. She is definitely looking more like 68 now, I thought.
and then