Restoration of Severely Impaired Eyesight in an Adolescent with Down Syndrome and Bilateral Cataract in South Asia
A 16-year-old South Asian male with DS from Saharsa, India, grew up as the beloved son of a landless laborer and a housewife. Only 3 months before presentation, his parents realized that there might be an impairment of vision contributing to the general cognitive difficulties of the adolescent. Despite the relatively modest road distance of about 130 km, the Sagarmatha Choudhary Eye Hospital in Lahan, Nepal, is hard to reach for the villagers of the region; nevertheless, its reputation in the area is remarkable. The patient's parents knew about the facility and managed to overcome major difficulties (the journey took 16 h by train and bus and stressed the economic means of the parents to their very limits) to bring their son to Lahan for treatment. The adolescent was diagnosed with cataract in both eyes (fulfilling all clinical criteria [] in the absence of the opportunity for genetic testing) and underwent surgery (phacoemulsification and implantation of a posterior chamber lens) in both eyes on 2 consecutive days (February 20 and 21, 2013, respectively). Surgery was successful from a macroscopic point of view (fig. , fig. ), and the patient responded to visual stimuli (e.g. movement of hands) that had eluded him prior to surgery. The adolescent had not been able to contribute to domestic chores at all previous to surgery, but might be able to do so in the future due to the apparent improvement in eyesight.