Feature: Restoring a sight: The fight against Corneal Blindness in Ethiopia

By Molla Mitiku @MollaAyenew

Addis Abeba – Across Ethiopia, the pervasive shadow of corneal blindness stretches far and wide, engulfing countless individuals and communities. This devastating condition doesn’t just extinguish sight; it snuffs out independence, opportunities, and the vital connections that weave communities together. Though the exact number remains elusive due to a lack of recent national data, experts estimate that hundreds of thousands of Ethiopians navigate the daily challenges of this debilitating condition.

A study conducted a decade ago revealed a grim reality of over 300,000 individuals in Ethiopia grappling with corneal blindness. According to Mulugeta Demisse (MD), a corneal surgeon specialist at Addis Ababa University, it is one of the leading causes of vision impairment alongside cataracts and trachoma. Yet, the critical lack of accurate data hampers the fight against this disease. 

“Without reliable data on the prevalence of corneal blindness,” Dr. Mulugeta explains, “it is impossible to implement effective interventions and allocate resources efficiently.”

However, despite the challenge, a glimmer of hope persists as tireless efforts and unwavering commitment of governmental and non-governmental organizations as well as concerned individuals are helping victims regain their sights. According to Dr. Mulugeta, the Eye Bank of Ethiopia in collaboration with dedicated hospitals has facilitated over 2,177 corneal transplants between 2013 and 2022, not only restoring sight, but also rekindling lost dreams and empowering individuals to re-engage with the world around them.

Tariku Hussien, 23, was among those Ethiopians who regained their sight by corneal transplantation. “I had lost interest in life,” he told Addis Standard, describing the despair that shrouded his world when he lost his sight at a mere seven years old. 

“Stricken with a debilitating eye condition that veiled my vision and jeopardized my future, I refused to yield and courageously underwent corneal transplantation surgery in 2020, a defining moment that not only restored my sight but also re-ignited a burning passion within me,” he conveyed.  

Following receiving the corneal transplant, a new chapter unfolded. He continued his education, earned his first degree and found employment as an inspector at the Ethio-Djibouti railway service.

Wegayehu Fetene’s story also resonates with a spirit of unwavering resilience. At the tender age of four, his childhood was tragically plunged into an unending night when diagnosed with corneal blindness. Yet, in 2008, a glimmer of hope pierced through years of darkness. A life-changing corneal transplant restored sight to his one eye. “This precious gift,” he confided, “ignited a passion for knowledge and determination to overcome any obstacle.”

However, fate dealt another blow when a second transplant failed in 2014. Despite this setback, Wegayehu’s spirit remained unshaken. He pursued his education, and at present he is a second-year student at Teferi Mekonnen Technical college.

Eden Teferi (MD), self-employed and resident of Addis Abeba, understands the sting of corneal blindness firsthand. Despite her vision impairment, she persevered through her school years and managed to obtain her degree in Medicine. Her zest to have her sight restored, culminated in a life-changing corneal transplant in 2022. “Throughout my school and university life, I had been suffering from the severe pain of the keratoconus,” she told Addis Standard, speaking of her profound gratitude for her donor and surgeon. 

Eden’s story, along with the stories of Tariku and Wegayehu, serves as a testament to the transformative power of transplantation.  Alongside two other individuals who shared similar experiences, they created the Ethiopian National Cornea Transplant Recipients and Volunteers Association, an organization that, through its holistic approach, extends far beyond medical intervention, offering comfort, guidance, and practical assistance to individuals and families affected by corneal blindness.

Despite valiant efforts to combat corneal blindness, a stark reality persists: the demand for corneas far outweighs the supply. Sister Liya Tikabo, a senior department head at EBE, eloquently captures this ongoing struggle: “Over the past two decades, we’ve distributed over 3,200 corneas, with 200 to 300 distributed annually. There is an immense gap that remains a resource-intensive battle.” 

Reluctance among potential donors, limited financial resources, and a critical shortage of professionals are key challenges hindering progress, according to Liya. “With only 11 cornea transplant ophthalmologists in the country, this scarcity stands as a formidable obstacle,” she emphasized.

Dr. Mulugeta, ophthalmologist, however, shed light on how rigid bureaucracies, acting as knotted fences, can delay decisive action, hamstringing healthcare institutions’ ability to swiftly assist those grappling with corneal blindness.

The most profound consequence, of course, is the partial or complete loss of sight, impacting everything from reading and working to navigating everyday life. Reliance on others grows, while autonomy shrinks, casting a long shadow over self-sufficiency.

“The psychological burden of this darkness can be crushing, leading to anxiety, depression, and a diminished quality of life. Sadly, this devastating condition is also a major global public health issue, disproportionately affecting developing countries where access to quality healthcare is a scarce commodity,” Dr. Mulugeta underscored. 

The Resolutions

According to Eden (MD), overcoming these stark challenges requires a multifaceted approach. Strengthening the EBE’s autonomy and streamlining regulations can empower it to act with greater agility. Building robust infrastructure, including cold chain storage and efficient transportation networks, will expand the bank’s reach and ensure vital supplies to those who need them most.

Investing in education and training programs can create a pipeline of skilled eye care professionals, building a sustainable workforce for the future. And finally, targeted fundraising and resource allocation can ensure the EBE has the financial muscle to acquire the equipment and technologies it needs to win the fight against corneal blindness.

Mulugeta on his behalf argued that by tackling these challenges head-on, Ethiopia can transform this darkness into hope. We can restore sight, empower individuals, and reweave the threads that bind communities together. According to Mulugeta, one crucial thread is clear, streamlined regulations. In partnership with government agencies, the EBE must navigate bureaucratic hurdles to ensure the efficient use of donated corneas – each a precious gift capable of illuminating a life

“Encouraging pledges of corneal donations will become the needle and thread that stitches together the future of sight for many,” Mulugeta aptly emphasizes, adding that  “another critical thread is a skilled workforce and fostering partnerships with academic institutions which is key to boost comprehensive training programs and scholarships to empower new generations of ophthalmologists, technicians, and healthcare professionals”.  He also advises for collaborative funding efforts, where public and private hands intertwine with grants and individual donations.

By stitching together these critical threads of research, outreach, regulation, public awareness, workforce development, and financial stability we can unlock full potential in fighting corneal blindness, he emphasized. AS