Italian researchers have demonstrated the long term effectiveness of using stem cells to cure corneal blindness. From 1998 to 2006 the team, headed by Graziella Pellegrini at the University of Modena, performed 125 stem cell procedures on 112 patients, all who had lost partial or complete vision due to chemical or thermal burns. Stem cells were taken from the limbus in the patient’s own eye, cultured, and then grafted back on the eye. As recently published in the New England Journal of Medicine, the grafts had a success rate of 76.6% – leading to restored or improved vision. Better still, the positive results have lasted – one patient has been followed for more than 10 years and still has healthy vision. That’s remarkable. This work represents a real group of people who have already had their lives radically changed through stem cell treatments. More patients all around the world may see benefits from this technique soon.

Using grafts of stem cells to treat corneal blindness isn’t a new idea. Pellegrini and collaborators like Michele De Luca, were pioneering different versions of the technique back in 1997. We’ve seen related approaches to restoring damaged corneas, most notably in New South Whales. This report in NEJM, however, has something that few (if any) have presented before: a relatively large sample set that shows positive results verified over the long-term. Ten years for a successful stem cell transplant? Outside of bone marrow grafts, almost no one has that kind of follow-up history for stem cells. It’s a great sign that what Pellegrini and colleagues are doing is a viable long term cure for corneal blindness.

These before and after pictures are astounding. The top example required no further surgery to correct vision, but the others need keratoplasty.Notice the small notations in the right picture that indicate how long after treatment the images were taken. The arrows in the last row highlight that blood vessels no longer intrude onto the cornea.

The NEJM article also describes an important development in being able to predict the success of a stem cell treatment. Many of the patients in the study had mild to severe limbal damage, limiting the amount of healthy stem cells that could be harvested and cultured. Pellegrini’s team monitored levels of p63 transcription factor in the stem cells they harvested from patients. When the number of ‘p63-bright’ cells was greater than 3%, the success rate of the eventual transplant ended up around 78%. When it was less than 3%, the outcome was successful only 11% of the time. This work demonstrates that very little of the limbus need remain healthy for the stem cell transplant to still work. Using p63 levels as a metric could allow doctors to present patients with a better idea if a corneal stem cell transplant would be successful. It also hints that p63 transcription factor could be augmented or controlled in some way to improve stem cell therapies of this kind.

Amidst all the success in this recent report, we must also face some serious limitations of the work. First, these stem cell treatments were only used for corneal blindness. Not only that, but a very specific cause of corneal blindness – burns. Chemical and thermal burns can cause a wide variety of injuries to the eye, but often leave all parts of the inner eye and optic nerve functioning. Some patients retain some form of (very limited) vision. Also, because of the nature of the causes of these injuries, more than 78% of the 112 patients were men. While thousands lose their vision to chemical accidents every year, there’s a huge number of people with vision problems related to other corneal damage, retinal damage, and nerve damage that are unlikely to benefit from this technique in stem cell transplantation.

It’s also important to note that while the study followed one patient for more than 10 years, the average follow-up was closer to three years (with large variation). That’s still pretty good, but it’s not the same as saying that all 112 patients were tracked for a decade. As always, smaller data sets mean data has to be taken with a grain of salt.

Finally, I should point out that the term ‘positive results’ covers a wide range of changes in vision. A few went from seeing nothing to having restored vision. Some patients went from only being able to see the vague outline of fingers to actually being able to read and determine fine shapes. Others saw more modest improvements, and 24% failed to benefit. These changes didn’t happen overnight; they often took many weeks or more than a year to develop. About half of patients needed keratoplasty (reshaping of the cornea) to correct their vision, though that is a relatively simple procedure these days. Bottom line, it wasn’t like these patients got an injection of their own stem cells and could miraculously see the next day. Stem cells taken directly from their eyes had to be cultured and then grafted onto the cornea, and there was a sustained period of follow-up and further medical care before doctors or patients knew how successful (if at all) the procedure would be.

Still, these results are real world examples of how stem cells are already treating a loss of vision. Pellegrini and her colleagues may be able to adapt their technique to treat other (more common) forms of corneal blindness with the same impressive outcomes. Their confirmation of the importance of p63 transcription factor could also prove helpful in the wider field of regenerative medicine. This work is another victory for stem cells and another step towards being able to regenerate or regrow every part of the human body. I’m deeply impressed.

[image credits: Rama et al NEJM 2010]
[source: Rama et al NEJM 2010]

Seva supporter, Michael Buckley was in Cambodia recently and kindly offered to journey to Battambang, in the far west of the country, to see and photograph Seva’s eye care programs there.

During the genocide, Cambodia’s health care system was devastated and the country was left with just one ophthalmologist. Now Cambodia has 9 ophthalmologists serving a population of 14 million and Seva has helped train over half of them.

There are about 168,000 Cambodians who are blind — and, as is true in nearly all poor, developing countries, 80% of this blindness is due to preventable or treatable conditions such as cataract. The backlog of cataract blind is estimated to be 90,000 people and there are a further 20,000 who go blind from cataract each and every year.

View Michael’s Flickr slideshow which gives a glimpse of the incredible work being done by the team in Cambodia.

Cataract, the clouding of the lens of the eye, occurs with age. Blindness due to cataract occurs with poverty.

In Canada, almost no one becomes blind from cataract. Cataract is diagnosed early when impairment is minimal, and treated surgically, almost always restoring near-normal sight.

In low-income countries, almost everyone with cataract becomes blind. Cataract is diagnosed late when impairment is severe. When possible, cataract surgery occurs, almost always restoring near normal vision.

This teenage girl from Nepal is blind from mature bilateral cataracts. Photo from Seva Canada.

The difference between cataract in high and low income countries is not the condition or its treatment. All populations develop cataract with age. All countries offer similar high quality cataract surgery. Therefore, the difference is timing.

In Canada, cataract surgical services catch people up-stream as they age, before they become blind. In low-income countries, cataract surgical services work down-stream in the deep accumulated pool of older cataract blind.

The problem in most low-income countries is that they developed their cataract surgical service after their population aged beyond 50 years, and 5-10% of them became blind. Their cataract surgical services face this accumulated mass of cases. Meanwhile, the population ages and more and more cases pour in.

In most low income countries, there are five times as many in the pool of blind people needing surgery as the number of people who become blind every year. Even with a large investment in cataract surgical services it takes a decade or more to deal with the backlog, while meeting annual incoming needs.

Seva programs are situated where the backlog is greatest and services are least. As a result, their cataract surgical services require substantial expansion, far beyond those expected by people living in a high income country such as Canada, where cataract blindness is seldom, if ever, found.

Ken Bassett MD PhD is the Program Director for Seva Canada and Director of the BC Centre for Epidemiologic and International Ophthalmology.

This young Indian woman is blind from cataracts. Photo by Dr. Martin Spencer for Seva Canada

Here is the same Indian woman after having her sight restored in one eye through cataract surgery. Photo by Dr. Martin Spencer for Seva Canada

Source: New York- Presbyterian

A physician at New York-Presbyterian/Columbia University Medical Center, using an experimental electronic retinal implant has been able to partially restore the sight of a woman previously blinded by retinitis pigmentosa. The woman is able to see light and make out figures for the first time in 20 years, explained lead researcher Lucian V. Del Priore, MD, PhD, an Attending Surgeon at New York-Presbyterian Hospital and a Professor in the Department of Ophthalmology at Columbia University College of Physicians and Surgeons.

The retinal implant is currently being investigated for the treatment of retinitis pigmentosa, a progressive disease that causes degeneration of photoreceptor cells in the outer layer of the retina. The inner layers of photoreceptor cells still function in patients with retinitis pigmentosa so the implant is used to bypass these damaged cells to reach the healthy ones.

How the Device Works

The device works as a three-part system. The first part is an external video camera that is mounted on a pair of eyeglasses worn by the patient. That image is processed and then a signal is transmitted wirelessly to the second part of the system – a microprocessor implanted on the outside of the eye under the lid that translates the information into a series of electrical pulses.

Those electrical pulses are then sent to the third part: a tiny patch containing 60 electrodes that is attached to the retina. The electrical stimulation from the electrodes causes retinal nerves to transmit a message through the optic nerve to the brain. The brain then interprets the electrical stimulation into light and dark spots that form an image. The images seen are rudimentary. However, for a patient who has had no vision initially, the level of vision afforded by this device can represent a remarkable improvement, Dr. Del Priore said.

The device works best with high contrast images (eg, a white object on a black background or vice versa) and at night, when there is high contrast between lighted objects and the dark background. The patient who received the device five months ago at NewYork-Presbyterian Hospital/Columbia University Medical Center is now able to see large letters on a computer monitor and she also describes being able to see street and traffic lights as well as light coming in through the window of her front door. Her vision continues to improve, Dr. Del Priore said.

Learning to use the implant properly requires a major commitment on the part of the patient, as it takes several years of rehabilitation to learn how to use the device and interpret the patterns that the patient sees. This part of the visual training involves using direct electrical stimulation of the retina; successful interpretation of the image by the patient requires that she participate in one day per week of visual training in a laboratory and then practice the techniques learned at home. The visual training includes, for example, asking the patient to find shapes on a computer screen and point to them, allowing the patient to relearn eye-hand coordination.

The surgery required to implant the device took approximately 5 or 6 hours with the patient under general anesthesia. While the patient treated by Dr. Del Priore and colleagues did not experience any serious side effects, he said that there are surgical complications that can result from surgery of that length, such as infection, low eye pressure, and movement of the device after surgery.

Currently, the device is only being investigated for use in the treatment of retinitis pigmentosa. Dr. Del Priore said that patients with conditions like macular degeneration would not benefit markedly from the current generation of the implant device, as the additional vision gained from the device is not worth the risk of surgery and length of rehabilitation the patients would have to undergo. Dr. Del Priore believes that the technology will continue to improve and offer a higher image resolution in the future. “At that point, we will have more experience and it is likely that use of multi-electrode arrays will likely expand to other eye diseases,” he said.

Faculty Contributing to this Article:

Lucian V. Del Priore, MD, PhD, is an Attending Surgeon at NewYork-Presbyterian Hospital and a Professor in the Department of Ophthalmology at Columbia University College of Physicians and Surgeons.

Congratulations to the Canadian blind skier, Viviane Forest, for her second medal of the Paralympics at home in Whistler. Ms. Forest, who only started seriously skiing three years ago, followed her guide Lindsay Debou down the steep pitch of Creekside, winning bronze in the visually impaired giant slalom event.

Ms. Forest, 30, has only about 5 per cent vision. She sees blurry vague shapes, having been born with albinism and retinitis pigmentosa.

The visual problems particularly associated with albinism arise from a poorly developed retina due to the lack of melanin.

Where Seva works in Tanzania there are many children and adults with albinism who suffer from serious visual problems. Many children with albinism are placed by their families in blind schools, not just because they need visual aids, but for safety reasons, because their lives are threatened because of a series of brutal attacks against those with albinism.

The following slide show of photographs by Dutch photographer, David de Wit, gives a glimpse of some of the eye care programs that Seva Canada supports in Tanzania and elsewhere in eastern Africa through our partner, the Kilimanjaro Centre for Community Ophthalmology in Moshi.

Many of David’s photos were taken in blind schools and annexes and show some of the vision aids that can be used to help children manage in school, such as glasses, large print materials, angled reading stands, hand-held devices such as magnifiers and monoculars (like a little telescope).

Other images were taken at the outreach camps held by KCCO to treat a variety of eye conditions including refractive error, eye infections, eye injuries and to find and transport patients who need cataract surgery.

Thank you, David, for these wonderful photographs!

A donor who once suffered from a blinding corneal ulcer sent me the following video link.

Here’s the news article about it:

Stem cell breakthrough restores sight to sufferers of corneal disease
27  May 2009

In a world-first breakthrough,  medical researchers have used stem cells cultured on a simple contact lens to restore sight to sufferers of blinding corneal disease.

Sight was significantly improved within weeks of the procedure, which is simple, inexpensive and requires a minimal hospital stay.

The research team from UNSW’s School of Medical Sciences harvested stem cells from patients’ own eyes to rehabilitate the damaged cornea. The stem cells were cultured on a common therapeutic contact lens which was then placed onto the damaged cornea for 10 days, during which the cells were able to re-colonise the damaged eye surface.

While the novel procedure was used to rehabilitate damaged corneas, the researchers say it offers hope to people with a range of blinding eye conditions and could have applications in other organs.

A paper detailing the breakthrough appears in the high-impact journal Transplantation this week.

The trial was conducted on three patients; two with extensive corneal damage resulting from multiple surgeries to remove ocular melanomas, and one with the genetic eye condition aniridia. Other causes of cornea damage can include chemical or thermal burns, bacterial infection and chemotherapy.

“The procedure is totally simple and cheap,” said lead author of the study, UNSW’s Dr Nick Di Girolamo. “Unlike other techniques, it requires no foreign human or animal products, only the patient’s own serum, and is completely non-invasive.

“There’s no suturing, there is no major operation: all that’s involved is harvesting a minute amount – less than a millimeter – of tissue from the ocular surface,” Dr Di Girolamo said.

“If you’re going to be treating these sorts of diseases in third world countries all you need is the surgeon and a lab for cell culture. You don’t need any fancy equipment.”

Because the procedure uses the patient’s own stem cells harvested from their eye, it is ideal for sufferers of unilateral eye disease. However, it also works in patients who have had both eyes damaged, Dr Di Girolamo said.

“One of our patients had aniridia, a congenital condition affecting both eyes. In that case, instead of taking the stem cells from the other cornea, we took them from another part of the eye altogether – the conjunctiva – which also harbours stem cells.

“The stem cells were able to change from the conjunctival phenotype to a corneal phenotype after we put them onto the cornea. That’s the beauty of stem cells,” Dr Di Girolamo said.

The therapeutic contact lens used in the trial was of a type commonly used worldwide after ocular surface surgery. However, of the several brands on the market, only one was suitable for growing the stem cells.

“We don’t know why. It’s probably to do with the components the manufacturers have used in that particular lens,” Dr Di Girolamo said.

The researchers are hopeful the technique can be adapted for use in other parts of the eye, such as the retina, and even in other organs. “If we can do this procedure in the eye, I don’t see why it wouldn’t work in other major organs such as the skin, which behaves in a very similar way to the cornea,” Dr Di Girolamo said.

Source: The Medical News

By Penny Lyons
Executive Director, Seva Canada

November 20^th

Thirty six elderly Tanzanians sit under the shade of a Poinciana tree in Ndatu village.  All are from the same village in the district of Arumeru, about an hour from Moshi.  They know each other well so the air is a filled with the sounds of laughter and conversation.

I have come to this village with a team from KCCO.  There are 4 of us:  Herieth Mganga, KCCO’s new gender and blindness coordinator, Fred the driver who doubles as the visual acuity tester in the field,  Dr. Amadou Bio from Benin,  who is training to be an ophthalmologist, and myself.

Fred at the Kilimanjaro Centre for Community Ophthalmology in Tanzania

All 36 of these people have agreed to participate in a study (there will be 150 participants in total from 4 different villages) to determine the effect that correcting presbyopia (or age related far-sightedness) has in their daily life.  Do reading glasses make an elderly Tanzanian’s life easier?  Most are illiterate but if they can now pick the stones from the rice, thread a needle and take thorns from their fingers will this significantly improve their quality of life?

A patient has her eyes examined in Tanzania

There is very little refractive error in Africa and most of these people have distance vision that someone 40 years their junior would envy.  The flip side of that great distance vision is that many of the 36 have difficulty seeing things that are close so “reading” glasses (even though most do not read) are provided to them free of charge.  While doing the vision testing, four cases of cataract were diagnosed and referred on to hospital for treatment and a few infections were treated.

Each person who received reading glasses will be visited in their homes in three months to determine what difference, if any, the reading glasses had on their daily life.

Heriath Mganga, KCCO’s new gender and blindness coordinator, working with women in rural Tanzania

At this point you might be asking yourself if this study is important, or even relevant, to the elimination of preventable and treatable blindness.  It is because it illustrates the cornerstone of all of Seva and our partner’s work; together we create programs that are based on evidence.  Evidence tells us a problem exists, it tells us the extent of the problem and it tells us what should be done to correct that problem.

With evidence, we can spend our donor’s dollars effectively and get the maximum benefit – whether we are studying presbyopia, childhood blindness, the incidence of cataract in a population or the barriers people face when trying to access treatment.

Adults with poor vision are at increased risk of early death according to a recent study from the Westmead Millenium Institute in Sydney, Australia, published in the Archives of Ophthalmology.

Researchers found that in a group of adults between 49 and 74, those with noncorrectable vision problems were 35% more likely to die than people with unimpaired vision.

Michael J. Karpa and colleagues analyzed data from the Blue Mountains Eye Study, in which 3,654 Australians over the age of 49 were examined between 1992 and 1994, with follow-up exams at five and ten years. Patients were considered to have noncorrectable visual impairment if they presented with vision worse than 20/40 in the better eye after subjective refraction. The researchers compared these eye health data with Australian mortality records. They found that 13 years after the study started, 1,273 of the participants had died, and that those with vision problems were more likely to die.

Finding showed that difficulty walking, which is often a result of vision problems, is the most significant risk factor. According to the researchers, people who have difficulty walking may be less likely to visit a doctor regularly (for an exam or to get prescriptions for important medications filled). They also may have a poorer diet, be less likely to exercise, be socially isolated, and be less likely to seek urgent help. Previous studies found that people were also prone to other factors that can raise mortality risk, such as unintentional injury, depression, increased risk of falls, and cardiovascular disease.

If adults in the developed world risk early death from poor vision and blindness, in the developing world the risks are higher. Here at Seva we receive terrible stories and photos of blind adults and blind children who have suffered terrible accidents and endured harsh lives because of their vision impairment.

The good news is that for 80% of the world’s blind, there is a solution in sight — their vision loss is either treatable or preventable.

Visit www.seva.ca for more information.

Source: medpagetoday

Today The Province ran a lengthy article on Seva Canada’s sight programs. Our thanks to Elaine O’Connor for the following great story:

On Saturday, the Globe and Mail published a two-page feature “A Clear Vision for Better Health” about cataract surgery on Vancouver Island.

Line of blind women patients going for cataract surgery in India

The article was about streamlining the surgical process by following the Toyota Production System to make cataract surgery faster and cheaper and to save our health care dollars. Using this model, Royal Jubilee Hospital has increased its cataract surgical rate from 2,800 in 2003 to 3,900 surgeries in 2008.

Here at Seva we know all about CSR — cataract surgical rates. Our mission is to create high-volume, high-quality, low-cost, sustainable eye care programs in the developing world. The gold standard for efficient cataract surgery is our partner in India — Aravind Eye Care System.

A line of women cataract patients in India

With Seva’s help and with funding from CIDA, the Canadian International Development Agency, Aravind has become the most productive eye care centre in the world in terms of surgical volume and number of patients treated. In 2008, Aravind’s network of 5 hospitals saw over 2.7 million patients and performed over 300,000 surgeries (over 200,000 of them cataract surgeries). A cataract surgery can be performed in about 5 minutes.

It’s a good enough model for Professor Yunus, the economist and Nobel Prize winner, who is using some of his funds to build a network of eye hospitals in Bangladesh. Teams of eye specialists from Bangladesh are now being trained at Aravind.

So move over Toyota! You’re fine for cars, but if Canadians are looking for a health care revolution in eye care, they should look at Seva’s partner in India.

Imagine if you were blind from cataracts and lived in a village deep in the Himalayan region of Tibet. The world has gone dark. You can no longer see faces of loved ones. You have no way to cook or feed yourself. There are no seeing eye dogs, beeping crosswalks, or eye surgeons to help you.

Tibetan landscape. Photo courtesy of Gary Hahn

In Tibet’s under-served mountainous region, seeing an eye doctor would have likely meant a multi-day trek to Lhasa. It would cost you many months salary pay to have cataracts removed. For too many, this means a mother, father, grandparent, or even child could not have cataracts removed and would remain blind.

Since the beginning, Seva has already tried to help the most vulnerable and has reached out to remote areas where there is no care. Now, in Tibet, people needing eye care but who have no way to travel to get it, can take Seva’s new bus on the Roof of the World!

Seva's new bus in Tibet which transports blind people to and from hospital

This bus will travel to remote mountain villages, picking up blind patients and transporting them, free of charge, to a hospital in the city of Lhasa staffed by local Seva trained eye surgeons. There they will have cataracts removed and their vision restored! And after they have had their sight checked and all their post-operative care, they will be transported back to their villages. A magic bus!

Thanks to Seva’s generous donors like you, this bus will help us better reach the underserved and restore sight.

The following is a special post by Laura Spencer, a Seva volunteer:

I have been privileged to work with Seva projects in Guatemala that have been developed by amazing Seva staff. The highlight so far has been Seva’s three-day eye care outreach excursion to isolated villages, reaching indigenous Guatemalans who had never received eye care services before!

Seva eye camps - a joyful thing to witness

The three-day eye camp was funded and organized by Seva, with community development links made between the eye hospital – Vincent Pescadore in the northern region of Guatemala – and the community health promoters in various villages.

A crew of six Guatemalan eye clinic workers from Vincent Pescadore and I made the journey into the hot jungles of Guatemala’s mountainous central region. We ventured off with supplies of glasses, instruments and charts. After a four-hour drive, we arrived in Coban, the nearest town.

Outside of Coban, we transported ourselves and the supplies into a pick-up truck along with some local villagers. We made the slow, bumpy ride along the uneven, rocky road through mountains of corn and coffee fields to the community of Chilten.

The road was long, with a broken down van on the way holding us up. The difficulty in reaching the community was a testament to the difficulty the people have in reaching services on their own. Many of them had trekked even further from Chilten, from surrounding villages even deeper in the mountains.

Hundreds of people lining up to be seen at the 3-day Seva eye camp in the remote village of Chilten, Guatemala. Photo by Laura Spencer

An hour and a half later, we arrived! Over 500 people were waiting in line to receive eye care. Excitement was in the air! The eye camp was set up in a school and the children were given the day off. As a result, they were either getting their eyes checked or running around adding to the excitement!

The organizing staff quickly set up six stations for smooth service delivery. They included an area for registration, for a visual acuity exam, a consultation with the optometrist, a meeting room for cataract patients, and another location for dispensing eye glasses.

A Guatemalan ophthalmologist examines patients at the Seva eye camp in the mountainous central region of Guatemala. Photo by Laura Spencer

For patients in need of cataract surgeries, transportation to Vincent Pescadore, food, and accommodation were free of charge. Those in need of glasses were provided with them at low cost or free of charge. It is such an amazing opportunity for these people and it was priceless for me to see the people’s faces as they went through the emotions of being offered free surgery and eye care.

Seva was one of the supporters, having developed the community link between the health promoters and the hospital Vincent Pescadore. The local volunteers were an integral part of the process, acting as translators for the hundreds of indigenous people who could not speak Spanish, but the Mayan language Quechi.

The first day was a great success! Thirty cataract patients were driven the 5 hours and back with free food, board and surgeries fully paid for by Seva and partners.

Cataract patients at the Seva eye camp in Guatemala being given free transportation to the hospital for surgery. Photo by Laura Spencer

My personal contribution has been conducting research for my MA on why so few rural women are taking advantage of free surgeries, as is also the case in most developing countries. With the help from volunteers with translating, I surveyed or interviewed over 80 women over the course of the weekend, collecting information regarding the barriers to service for themselves and with regard to the women in need of eye care who were not present. I also enjoyed the company of the local children who were running around the school and waiting for me to finish interviewing their mothers and grandmothers!

Interviewing Guatemalan women at the eye camp with support from a young friend!

The second and third day we drove a few hours more to another village, meeting the needs of the other surrounding communities. More free surgeries and eye care services were delivered and received.

Just before leaving the last eye camp, a truckload of the first patients from two days before arrived. They were returning from the northern clinic where their surgeries were conducted by Guatemalan surgeons. Their post-operative eyes were healing behind their large, protective sunglasses. Accompanied by the community volunteers, they made their way home, with new hope for survival, with the ability to contribute to their family again and with an increased quality of life.

The first cataract patients returning from hospital after their sight-restoring surgeries. Photo by Laura Spencer

The six of us made the four-hour trip back to the northern eye clinic which is located in the largest, poorest and most secluded province of Guatemala, El Peten. Once we arrived, the patients from the same day and the others from the day before were either waiting for their surgery or waiting a day to have a post-operative examination. Whether through translation or directly in Spanish, the patients shared their fears and excited anticipation of their restored vision.

I will remember well many of the patients. In particular, I will remember one man who said to me, “Vision is the most important thing. Without it, all is painful.” Another patient, an older woman in traditional dress, will remain in my memory because of her smile. She smiled throughout the whole experience, which is unusual for the culture (but she would not smile for the camera, more common for the culture!). I was honoured to see her through the whole process: from the line-up for services, the waiting room for cataract care, on the bus up to the northern clinic, before, during and after surgery, at meals in the hospital and finally to see her off as she got on the minivan back to her village.

One of 500 Guatemala patients who received eye care at the 3-day eye camp. Photo by Laura Spencer

Thank you to all the donors, sponsors and Seva staff for making this eye camp a success!

In February, I wrote about a little girl in Madagascar with such severe and unusual myopia (nearsightedness) that there was no help available to her in her own country.

This morning we received these photos of 8-year-old Andoniaina (Ando for short) wearing her new glasses specially made for her in Canada.

Ando wearing her new glasses

Ando lives on a small island in the Mozambique Channel, off the southwest coast of Madagascar. To seek help, she and her father travelled one hour by speedboat to Tulear on the mainland, then drove 1,000 kilometres to the capital of Antananarivo to get her eyes examined. They were eventually referred to a hospital in Antsirabe, 170 km south of the capital for a second opinion. That’s where Dr. Henry Nkumbe, Seva’s partner in Madagascar, saw the little girl and asked Seva Canada for help.

Seva then called on longterm supporter and optometrist, Dr. Larry Louie, for his expertise. Together Dr. Louie and his colleague Wayne Trieu of I-Lab Optical in Edmonton created a very special pair of glasses. The glasses were then hand-delivered to Madagascar in time for Christmas by a representative of Sherritt International Corporation, a Canadian resources company.

“Something like this is not usually done and isn’t readily available. That’s what made it challenging,” said Dr. Louie. The typical eyeglass prescription is 2.00 to -3.00 points, but Ando has a prescription of -27.00 points for her right eye and -23.50 points for her left eye. This means that, without glasses, Ando can’t see much beyond the tip of her nose. Ando was essentially blind and would not have been able to see the faces of her family.

Andoniaina and her family

To keep the glasses from becoming too thick and thus brushing against her eyelashes, Dr. Louie and optician Wayne Trieu used special myodisc lenses with two bi-concave lenses on the front and back of each lens. Another challenge was getting a frame that was strong and durable and that would last a long time.

Andoniaina’s story and the way in which Canadians in three provinces came together to help her was featured in the Edmonton Journal and on Global news.

Andoniaina at school with her new glasses

On behalf of Andoniaina, her family and our partner in Madagascar, Seva Canada would like to thank everyone who helped change this young girl’s life by giving her the gift of sight.

Andoniainia in her classroom off the coast of Madagascar

Seva Canada Board Member, Susan Erdmann, writes:

Prior to my leaving for Nepal in March, I gave my presentation on the Tibetan surgical eye camps to a class of 11 year olds (5th graders) at Mitchell Elementary in Richmond, BC. It was wonderful how well they responded to the visuals and story around eye camps and what it is like to lose sight from cataracts. The students asked lots of questions and were very engaged. When I left, I gave them each a Seva Gift of Sight catalogue and told them that everyone can make a difference and help restore sight.

I left quite pleased that they had responded so well. But what surprised and thrilled me far more was an email from the teacher, Miss Anita Lau, on my return from Nepal, telling me that the children had some money to give to Seva and asking me to return to the school to receive it. On Friday May 22nd, I returned to Mitchell Elementary and in front of the entire school, students from the class presented me with a cheque for $361.83.

Students from Mitchell Elementary School present Susan Erdmann of Seva Canada with a cheque for $361.83

How did they do it? They told me that, having decided to raise some money for Seva and under the teacher’s guidance, they brainstormed what they wanted to do and how they would do it. With their Seva brochures, they visited each classroom and told the other students about Seva and that what they were going to do raise some money to give people their sight back. They were going to hold a bake sale. They made posters to advertise, baked the goodies themselves and held the sale. They sold out and raised enough money to help restore the sight of 7 people.

But much more happened than being able to give Seva some money for the sight programs. These children learned many life lessons about what individuals can collectively achieve – how to work as a group for a common and worthwhile cause, the payoff of working towards a goal through personal effort, the satisfaction of giving to a wonderful cause and helping others in need, and the sheer joy of giving. They were so proud of themselves – as they should be.

The teacher, Miss Lau empowered and guided these young students, allowing them to discover for themselves what might be possible. I applaud Miss Lau and her students for a job well done. These students will have this experience for the rest of their lives, growing up with an expanded view of the world and how they can effect positive change in it.

Susan presents the cheque to the Seva Canada Executive

A huge thank you from Seva!

On April 28, the award-winning Canadian musician, Terry Kelly, performed a fundraising concert for Seva at the Ottawa school of Seva’s longtime supporter, Alistair Butt. Terry had been impressed with Alistair’s “Eyeballs for Eyesight campaign” and offered to do a charity concert for Alistair, telling Alistair he could give the money to whatever charity he liked. Alistair picked Seva, which Terry fully supported. Both Alistair and Terry know first hand about vision loss. When Alistair was younger, he had severe sight problems and had to wear a patch for 10 years. Terry Kelly is blind.

The event raised $1,231 for Seva Canada’s sight restoration and blindness prevention programs in the developing world. $1000 was donated by Terry Kelly and Alistair raised $231 through the sale of chocolate eyeballs. Every child who attended contributed a toonie.

Alistair Butt and Terry Kelly

Terry was a double silver medalist at the 1979 Canadian Track Championships, a member of the Canadian Track Team that competed in the 1980 Paralympics, and distinguished himself as the third blind person in the world to run the mile in under five minutes.

This Newfoundland native has been making music since his childhood years. He has recorded six full-length recordings, was nominated for four Canadian Country Music Awards and a JUNO, and has received seven East Coast Music Awards.

Seva is deeply grateful to both Alistair and Terry for their generosity and compassion and for giving the gift of sight to people in the developing world.