Prof. Dr. Ruit

God of Sight

By Team TDO

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Born on September 4, 1954, Dr. Sanduk Ruit became one of the eye surgeons from Nepal who made the whole country proud through his low-cost cataract surgeries. Dr. Ruit was born in the remote mountainous village Olangchung gola that lies in Taplejung district of Nepal. Some years of his schooling was spent in St Robert's School in Darjeeling and later he completed his School Leaving Certificate from Siddhartha Vanasthali School in Kathmandu, Nepal. Later he went to India for further studies and completed his MBBS from King George's Medical College, Lucknow and then higher studies at AIIMS, Delhi. He had his research studies in the Netherlands, Australia, and the United States.

 

During his work in Australia, in 1986, Ruit and Fred Hollows developed a strategy for using inexpensive intraocular lenses to bring small-incision cataract surgery to the developing world. Yet, the lenses still remained expensive for many cataract patients. Ruit along with Fred Hollows founded Tilganga Institute of Ophthalmology in 1994. Then came the turning point in the life of Dr. Ruit. In 1995, Ruit developed a new intraocular lens that could be produced far more cheaply as low as 5 USD. As he has restored the eyesight of more than 130,000 people, mostly poor, he is referred to as ‘God of Sight’. Many of his surgeries are taken to the remotest mountains where people are too poor and fragile to travel to his clinic in Kathmandu. He pioneered a stitch-free surgical technique known as ‘Ruitectomy’ that let many blind people see. Recipient of numerous awards and honors like Ramon Magsaysay Award, Order of Australia, Padma Shri among others, Dr. Ruit is not only inspiration to Nepali people but also to the entire world population.

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Glaucoma

Glaucoma notoriously called the “silent sight robber” is the second leading cause for blindness in the world, right after cataract. It can damage your optic nerve, which supplies visual information to your brain from your eyes. Glaucoma is mostly the result of high intraocular pressure (IOP) inside your eyes. The blindness caused by glaucoma is irreversible. However, if diagnosed early, the vision loss can be slowed down or even prevented with medicine, laser and/or surgery. Here is everything you need to know to about glaucoma.

Causes:

In our eye, there is a small chamber called the anterior chamber. Clear liquid flows in and out of this chamber to nourish and bathe the surrounding tissues. Glaucoma causes obstruction and this fluid drains very slowly. As a result, accumulation of fluid occurs and the pressure increases in abnormal amount leading to the optic nerve damage.

Normal eye pressure ranges from 10 to 21 millimetres of mercury (mm HG), if it goes beyond this point there is a higher chance of eye damages. Eye injury, heredity, ageing, issues with blood circulation, sugar and blood pressure imbalance, etc. might lead to glaucoma. But the reason behind the increase in IOP is not always known. The following might be some causes of glaucoma:

  • Poor blood flow/optic damage

  • Old age.

  • Conditions like diabetes or hypothyroid

  • Eye surgery

  • Myopia (nearsightedness)

  • drops containing corticosteroids.


Symptoms:

There are five different types of glaucoma. The two common types are open-angle glaucoma and angle-closure glaucoma. Open-angle glaucoma, which accounts for 90% of all the glaucoma is caused by the slow clogging of the drainage canals. In this condition, there is a wide and open angle between the iris and cornea. It develops slowly, has no major signs and symptoms and may go unnoticed for a long period of time.​

Angle-closure glaucoma, on the other hand, is a less common form of glaucoma and is caused by blocked drainage canals, which rises the IOP suddenly. Its signs and symptoms are noticeable and demand immediate medical assistance. Get help from your doctor if your symptoms include any of the following:

  • Severe eye pain

  • Nausea

  • Vomiting

  • Redness in eye

  • Abrupt vision disturbances

  • Sighting of colour rings around lights

  • Sudden blurred vision

 

Diagnosis:

Your ophthalmologist will perform a range of eye test and examinations to diagnose it. They will among others, ask for your detailed medical history, measure your IOP, check the thickness of your cornea, take photographs of your optic nerves.


Prevention:

There is no particular way to stay away from glaucoma, but early detection and a routine visit to the doctor can help in controlling it and loss of vision can be prevented. Older people above 40 years, diabetes patients, and other people with its risk are recommended to have their eyes tested every year or two.


Treatment:

Though the loss of vision due to glaucoma cannot be reverted back, it can be treated and prevented if detected early. The treatment involves eye drops, lasers, and surgery. Your ophthalmologist may start with medicines like eye drops and pills. Using these drops regularly may prevent your IOP from rising. Your doctors may also suggest surgery to make a drainage path for fluid or eliminate the tissues that causes increased fluid.

However, the treatment for angle-closure glaucoma is different. As it is a medical emergency, the eye pressure needs to be calmed down quickly. Laser treatment might be needed, where a small hole is made in your iris for allowing the fluid movement.


Glaucoma in Nepal:

A study published in 2010 showed that glaucoma is one of the leading causes of blindness in Nepal. In 1981, 3.2% of the country’s population had glaucoma, which reached 5.9% in 2012. As such, glaucoma remains a dangerous threat to our eyesight and it is increasing.

Due to the lack of awareness about glaucoma and poverty, people avoid their regular eye examinations. As a result, the diagnosis of glaucoma is done at the later stage and the risk for the loss of vision becomes high.

The people with diabetes have 3-5 times more chance of glaucoma in comparison to people without diabetes. Similarly, high blood pressure also increases the chance of glaucoma by 2.7 times. Regular examination of the eye will help your ophthalmologist detect the disease early and suggest measures to slow it down or even prevent the loss of vision. Schedule an appointment with your doctor regularly and get immediate help when in doubt.