A vice for which others pay the price

A first standard student, Chirag has stopped attending school. Nor does he go out very often to play. Snuggling up to his father in the hospital bed of M N J Institute of Ophthalmology at the New Civil Hospital here, he fiddles with the protective glasses that set him apart from other kids. “I do not like to wear these glasses,” he says.

Another victim is 12-year-old Bharat J Thakore from Bajakhont ni Val village in Balasinore taluka of Kheda district. Playing near his uncle’s house one day, he found a lime tube. “I held it close to my face and pressed it. Lime shot up and went into my left eye,” he says. Bharat has lost total sight in the eye.

Chirag and Bharat’s only fault was that their relatives love to chew tobacco. “When a child playfully presses the sachet, it bursts because it contains air,” explains Dr Bhartiben Lavingia, Director, M N J Institute of Ophthalmology. “We receive about three to four cases every week, and some 150 in a year,” says Dr Lavingia, adding that many victims are children employed for delivering lime pouches to customers. Children of paanwallahs also figure among the victims, she says.

“When lime touches the cornea, it burns it and makes it opaque. If the burn is of the third or fourth degree, it can cause blindness,” says Dr Lavingia, who thinks that only awareness among tobacco-chewers can save the children.

C H Nagri Municipal Eye Hospital superintendent Dr Ushaben Vyas also says that this is a very common type of eye injury. Vyas’s colleague Dr Kirtiben Modasia, who heads the cornea clinic at the hospital, says this is a serious problem. “Lime is an alkaline substance and injury caused by it is more serious than that caused by an acidic substance. Damage caused by an acidic substance gradually reduces, but that caused by an alkaline substance like lime gradually increases in severity,” says Dr Modasia.

Lime penetrates the cornea tissue. “At first, the injury may not seem so serious. But it slowly increases,” she says. The lime also damages the white of the eye (called sclera) where blood vessels are located, shutting off blood supply, she says.

That is why a case of lime injury is very difficult to treat. “In a lime injury case, even a cornea transplant does not work because no blood supply is available. The transplanted cornea will soon die,” explains Dr Modasia, who says that in 90 per cent of the cases the child loses sight.

Another ophthalmologist Dr Surendra Patel also explains the difficulty of treating a lime injury case. “Acid just clots protein, but does not penetrate the cornea. In an injury caused by acid, the damage is maximum at the time of the incident and then recovery starts. But a strong alkali like lime penetrates cornea layers and causes damage that increases day by day. Outcome of an alkaline-caused eye injury is very difficult to predict,” he says.