Emanuel Kabuubi

Emanuel Kabuubi sits quietly on his mother’s lap as his big sister, Margaret, is examined by an ORBIS pediatric ophthalmology specialist. It’s been a long day for Emanuel. He looks tired, his eyes half-closed and his head tilted back against his mother’s chest.

Emanuel’s mother brought the toddler with her because at age 2, he was too young to leave at home.

But as Margaret’s examination progresses, circumstances take a peculiar turn. Margaret’s eye condition is termed inoperable, but Emanuel, who just happens to be sitting in the patient screening room by chance, is diagnosed with a serious eye condition of his own and scheduled for surgery.

Sleep look hides disabling ptosis

Dr. David Laws

“During Margaret’s examination, I noticed the little boy had bilateral ptosis," said ORBIS volunteer ophthalmologist David Laws. "When his head was in a normal position, his eyelids were obstructing his vision in both eyes. The lids were beginning to block the pupil, stuck at 'half-mast' and forcing the little boy to thrust his head back in order to see." 

The condition can lead to amblyopia — lazy eye — a situation in which the eyes fail to learn how to see properly.

Emanuel, Dr. Laws noted, may look sleepy, but no amount of napping would revive those sagging lids. As for the warm and cozy way Emanuel snuggled against his mother’s chest? Snuggling like that, he noted, allows Emanuel to tilt his head back far enough to see. Educating parents as to the signs and symptoms of eye disease, such as droopy lids, is a major challenge in developing countries.

“Because Emanuel’s eyelid muscles won’t hold his eyelids open, he has spent his entire life with his head titled back at a sharp angle so he can see out from under his lowered eyelids,” Dr. Laws explained.  “Emanuel is an ideal teaching case because ptosis is a common problem here, but many doctors don’t know how to treat it.”

Surgery successful for patient and trainees

The following day, Emanuel arrives at the Flying Eye Hospital for his surgery. Dr. Laws demonstrates to his Ugandan counterparts a simple procedure that they have rarely attempted — a Levator sling, which lifts Emanuel’s eyelids.

Emanuel and his mother outside the Flying Eye  Hospital

Dr. Laws operates on one eyelid, then Ugandan ophthalmologist Hilda Tibayungwa operates on the other. Dr. Rose Mutumba, another Ugandan trainee, watches the surgery broadcast live to the classroom in the front of the plane. Not only is Emanuel's eyesight saved, but the transfer of skills taking place means that ophthalmologists in Uganda will feel confident treating ptosis on their own.

“It’s such a privilege to come out and work with ORBIS,” Dr. Laws said. “You are exposed to foreign cultures, and the doctors in the places you go are highly intelligent, hard working, competent people doing a fantastic job with limited resources. Helping the individuals you come across is so worthwhile. We realize we cannot solve all of Uganda’s eye problems. But because our work is primarily teaching, our work is an investment in the future.”

Dr. Mutumba is thrilled with her training.

“I picked an interest in pediatric ophthalmology because I realized we were doing so little in the country for the children,” Dr. Mutumba said. “For those of us who saw Emanuel’s surgery, the result was very dramatic. It is very simple, and we will be able to do the technique. It was nice to see someone so skilled perform the surgery. It helped me to upgrade my skills and give me confidence.”

You can help

With your support, even more doctors in developing countries can learn blindness prevention techniques and surgical repair. Advanced training in pediatric ophthalmology will allow other children like Emanuel to grow up healthy and happy, their eyesight intact. Blindness in Africa can be treated. Please give today so that others may see.