Anecdotes of an Ophthalmologist ~ Ruchir Mehta

“Sir, I want to get rid of my eye number”, said the young woman as she sat on the patient’s chair in my clinic. Her attendant, a young bespectacled man, took the other seat. I am a practising ophthalmologist and often people come to our clinic for refractive procedures (laser based procedures to remove glass power). So, this was nothing out of the ordinary for me. The patient was 23 years old. Her surname indicated that she belonged to a certain warrior community in Gujarat. The sindoor on her forehead pointed to the fact that she was married. “What is the power of your glasses?” I asked. “I have never worn glasses”, she replied. This surprised me a little. I checked her glass power with an autorefractor. She had -6 dioptres power in both eyes. She had high myopia (she was near-sighted). I checked her uncorrected visual acuity and it was 3/60 in both eyes. That means to see an object that a normal person can see clearly from a distance of 60 meters, she would have to come as close as 3 meters to the object! According to WHO, she was legally blind. I put the lenses with power -6.00 dioptres in the trial frame and asked her to wear it. Her vision was improving to 6/12. Although not optimal, it was 10 times better than what her vision was without glasses. “How long have you been married?” I asked the patient. “2 months”, my patient responded. Generally, this power must have been slowly building up since her childhood and she never paid any attention to the fact that she could not see as clearly as her siblings and her friends or she simply chose to hide it. Possibly, she had spent her entire childhood, teens and young adulthood LEGALLY BLIND!

Another girl, engaged to be married, came with a similar demand to be spectacle free. The girl was 19 years old and like the other lady had never worn any glasses. She too belonged to one of the warrior communities of Gujarat. On examination she had high myopia along with high astigmatism (cylinder) in both eyes. Further investigations showed she had keratoconus (abnormal cone shaped bulging of the cornea) in both eyes with abnormally thin corneas. We clearly explained to her that this would require particularly different management including special contact lenses, corneal strengthening procedures and in severe cases corneal transplantation. We categorically stated that normal refractive procedures were out of question for her. The parents clearly did not want to hear that and looked quite disconcerted.

Yet another newly married girl from this warrior community came to us with sudden loss of vision in one eye. On examination we noted she had high minus power in both her eyes due to which both her retinae (light sensitive, back portion of the eye) were weak and she had retinal detachment in one eye leading to the loss of vision. All her life she had avoided seeing an ophthalmologist for the fear of being prescribed spectacles.  

Over the past 4 years that I have been practising in Jamnagar, Gujarat, I have come across multiple cases of young women belonging to this community coming to get a refractive procedure done almost immediately post wedding/ engagement. Quite often it is the girls’ family members who accompany the girl and not the boys’. Almost all of them come up with the same story: “I had spectacles 2 to 3 years before marriage and then I had no spectacles as my refractive error got corrected on its own and now after marriage I have difficulty seeing distant objects again.” This is the story they use on the in-laws. We, as ophthalmologists, know that this is highly unlikely. Such high myopia once gained cannot magically disappear and then tragically reappear. The unsuspecting in-laws fall for this story and herein lies the scam.

She sacrifices her vision because she and her family know that they would never be able to marry her to a particular strata of society if she had spectacles. And if you think I am exaggerating, I have a few patients who were sent back to their maternal homes as soon as the boys’ families found out that the girls had spectacles.

A bespectacled woman is frowned upon, especially, when it involves marrying one. This is quite prevalent in this warrior community in Gujarat. The stigma against the women with spectacles which is borne by the elders is passed on to their sons and grand-sons. Spectacles are considered to be a physical deficiency, also a bespectacled woman is not considered beautiful and hence she is not accepted as a daughter-in-law by the more affluent families of the community. The woman shuns her spectacles as soon as she reaches the legal age for marriage and accepts blindness. In some cases, like the ones I described above, the girl-child is never taken to the ophthalmologist for the fear that she might have spectacles.

It is an enormous burden for the girl to carry as her family almost thrusts upon her the responsibility to carry out this elaborate scheme to scam the unsuspecting suitors due to the stigma that the society attaches to something as frivolous as a pair of spectacles. Having been put in this predicament, the girl in many instances has to spend a significant portion of her life ‘legally blind’. A change from within the society, especially from the women in the grooms’ families, is the only way to fight this atrocity.