Peculiar eye disease toll 40, half lose sight

KATHMANDU, Oct 12: Seasonal Hyperacute Panuveitis (SHAPU) has affected 40 persons in the past few weeks taking away eyesight of almost half of them.

Records at the Tilganga Institute of Ophthalmology show that an encouraging 18 patients have seen improvement in their eyesight but the others have lost their eyesight. "Most of the cases come at an advanced stage with blinding condition. Still, we have been able to improve sight of almost 50 percent. Two patients are also likely to recover in the next few days," said Dr Anu Manandhar, uveitis specialist at Tilganga. [break]

Nepal Eye Hospital, Tripureshwar, has also reported four to five cases of SHAPU this season. "We referred two to three cases to Tilganga and treated others here," said Medical Director at the hospital Dr Aditya Prasad Rizal.

Opthalmologists say this peculiar eye infection unique to Nepal is reported every two years (odd year in Gregorian calendar and even year in Nepali calendar) in between September and December and infects only one eye, mostly the right eye.

This disease which is like conjunctivitis but without sticky secretion is very dangerous. It can be treated through antibiotics and antivirals, depending upon the type of infection, in the initial stages but needs surgery in the later stages and can lead to blindness if not operated within 48 hours.

Eyesight gradually becomes weaker after infection, patients have difficulty in even opening the eyes in light, and a white spot develops in the black part of the eye due to accumulation of pus which has to be removed surgically to save the infected eye.

"The fluid used to show bacteria previously but in 2005 and 2007 we also found viruses. This year we have found bacteria in 10 cases," Dr Manandhar said.

While six SHAPU patients had come to Tilganga in 2005 and 18 in 2007, this year the number has already gone up to 40 since the first case was seen on August 23. Dr Manandhar said the frequency of patients has gone down in October after a peak in September, as in the previous years, and he expected the cases to go down further.

Most of the infected patients this year are children with the youngest being a 11-month-old. Though the cause of the disease is yet to be confirmed, doctors believe the white tussock moth is responsible and children get infected after playing with the moth.

"We have found hairs in eyes of patients who have come even after Dashain. A patient even said that an unidentified insect got into the eye," Dr Manandhar explained.

The nocturnal moth, which does not fly, and can only crawl, can be seen around bright lights and with the festival of Deepawali coming up children should be prevented from playing with them.

SHAPU Facts