The reception hall was overflowing, yet as I looked at my desk, there were just about ten case files. There must be a few patients accompanied by two or more persons, I surmised.

By the time I browsed through the files, I knew why every available seat had been taken up leaving many without seats standing in the corridor and in the door way.

A child suddenly started to cry and two others joined. The uncoordinated music was deafening and irritating.  “May I see all the children first?” I said, seizing the opportunity to give preference to the little ones.

The first to come in was a week old baby. With her were four adults whom I presume were the parents and grandparents. Otherwise healthy looking, the baby’s eyes were missing from the socket. A tiny knob, the vestiges of an eye stood in its place.Sadly, nothing for can be done for anophthalmia. That meant she would remain blind for life.

The second was a 1-year old child. He struggled with his mother to get his freedom. “Kindly let him get down and stand on his feet,” I begged. His mother obliged. As his feet touched the ground, he took some steps and crashed into the chair opposite him, fell down and got up to repeat exactly the same thing. “He walks into objects. He can’t see and that is why we have brought him,” his mother said crestfallen. I picked up the little one from the floor and while playing with him completed the first part of my examination.

“He has congenital cataract in both eyes,” I told his parents. I noticed a look of bewilderment on their faces and could therefore anticipate their next question. “Aren’t cataracts supposed to come in old age?” echoed both simultaneously.

“Most cataract patients are above the age of 50years. But we do have some children born with cataract or developing it soon after birth,” I replied. Lowering my voice for effect, I added, “Cataract may develop in anyone, young or old, after trauma to the eye.” Examination of his eyes showed there was hope of visual recovery following surgery.

The third and fourth children drew tears from my eyes. One, a two year old had a glow deep inside the eye. Have you seen a cat’s eye at night? The glow made the eye look just like that. And that’s why we call it the cat’s eye reflex. It is a sign that there’s cancer (retinoblastoma) inside the eye! This is the early stage.

The fourth child, a 4year old, told the story of what could happen to an eye with cat’s eye reflex if left unattended for a long time. The parents had taken him from one hospital to another and were told exactly the same thing that the eye had to be removed. They ran from pillar to post for two years until the growth had broken the confines of the eyeball and orbit. It was a pathetic sight! In front of me was a child in severe pain and a face disfigured by a smelly fungating mass of cancer.

What sins have all these children committed to deserve such a cruel fate? None! They are a manifestation of how things can go wrong in the body. A new human baby starts from one cell from the father and one from the mother. The union gives rise toone new embryo which divides over and over again until a critical mass of cells is reached. Then the cells begin to differentiate into various tissues and organs.

Anything that interferes with the embryo in the early stage may lead to absence of an organ. If it happens at a later stage it may cause abnormality of the organ. A severe abnormality of a crucial organ necessary for survival will result in death of the foetus inside the womb and an abortion. Damage can happen to the growing foetus especially in the first three months of life in the womb from radiation, food or drugs ingested by the mother and from maternal infections.

Modern developments have smiled on babies with congenital eye problems. Cataract can be tackled easily. We can deal with retinoblastoma without having to remove the eye but we cannot make a baby without an eye see.

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