White eyes, red eyes, brown eyes and sweet potatoes

As the little boy was led into my office something unusual caught my attention. He had severe excoriations (like bruises) all over his face, especially around his eyes which were firmly shut. He refused to open them. The more I cajoled him, the more unfriendly he became. So I tried a trick that usually worked. I let the examination chair go up and down several times while he was seated on it. He opened his eyes briefly to see what was happening.

I had already positioned my hand in a vantage position and quickly instilled some “magic” eye drops into one eye and then the other in quick succession. The eye drops would, within a short time, remove the severe discomfort and give him the confidence to open his eyes. He protested vehemently but I ignored him to chat with his mother.

“Why have you brought him?” I asked. She told me he had had a long standing history of severe itching and how he would rub his eyes until the skin of the lids became sore. The eyes would stick together in the morning and unable to open them, he would scream for help. Once in a while, stringy worm-like discharge would come out of his eyes.

Just as she finished talking, we both noticed her little boy had opened his eyes and was trying to work out how the chair was able to move up and down. I joined in the activity for some seconds and then diverted his attention to my pen torch so I could have a quick look at his eyes without touching them because I knew he wouldn’t allow me.

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I saw marked brownish discolouration of the conjunctiva in both eyes and the transparent part of the eye – the cornea – had already started taking a bashing. I could see evidence of repeated damage and healing owing to constant vigorous rubbing of the eyes, worsened by the indiscriminate use of corrosive and dangerous medications.

The diagnosis is severe allergic conjunctivitis with sight-threatening complications. It is also called ocular asthma and like asthma, there is no cure. All we try to do is to control the allergic reactions with medications – topical and oral.

It is not unusual for children to become severely visually impaired as a result of the complications of the treatment rather than of the disease itself.

Allergies are hypersensitive immune responses to substances that enter the body, either through food or air such as pollen dust or to substances in the environment which come in contact with the body.

Certain foods such as milk and milk products, eggs, fish and crayfish are frequently associated with allergies. In theory, if the cause of the allergy can be identified and removed, the allergy would disappear without treatment.

Unfortunately, this is not always possible for two main reasons. First, people with allergies often react to more than one allergen. Secondly and perhaps more importantly, how do you separate the sufferer from allergens in the air around him such as pollen dust?

I was in the middle of this conversation when my wife called, asking what I would like to have for lunch. “Today is Thursday, sweet potatoes and beans, of course,” I answered. Momentarily, I had forgotten the presence of my little friend and his mum. I was jolted back into their presence by her question, “Doctor, do you recommend sweet potatoes for my son?”

I was taken aback by the question. I didn’t realise she was listening but all the same delighted that she had asked. “Sweet potatoes are one of nature’s unsurpassed sources of beta carotene which is of great importance for the eyes. Alone, it can meet about 90 per cent of all the Vitamin A needs of the body.

They also help to lower the potential health risk posed by heavy metals and oxygen radicals. However, to enjoy the full beta-carotene benefits in the sweet potato-containing meals, it must be prepared with a little fat. Unless prepared by boiling or steaming some of the nutritional benefits from the sweet potatoes may not be achievable.

I looked all over the little boy; I could see that with a little more attention to his diet and personal hygiene he would have responded better to the ravages of the ocular allergy and the integrity of his eyes would have been better preserved.

As both mother and son filed past me to get out of my office, I noticed that the mother’s eyes were red. I knew she was just starting an infection – conjunctivitis. While she would respond to appropriate antibiotics, her son would not. Hers is due to a bacterial infection and his to allergy. The normal eye is white.