Mahmoud and Mustafa Twam, Ramallah, August 2011

Mahmoud and Mustafa Twam are brothers aged 12 and 16.  Both still at school, they live with their parents, a third brother and two sisters in Ramallah.  Mr Twam is a 38 year old driver and 36 year old Mrs Twam is a housewife; they are not related. 

Both Mahmoud and Mustafa have been known to The St John Eye Hospital Group since their infancy.  The eldest, Mustafa, suffers from Vernal Catarrh and  Keratoconus.  12 year old Mahmoud also suffers from Vernal Catarrh. 

*Mahmoud and Mustafa

Vernal catarrh, or vernal conjunctivitis, is a chronic, bilateral conjunctival inflammation with photophobia and intense itching that occurs during warm weather.  The conjunctiva is the delicate membrane lining the eyelids and covering the eyeball. 

Often associated with asthma and eczema, the condition usually begins pre-puberty and requires long-term medical care.  It is more common in boys than in girls and is usually treated with topical sodium cromoglycate drops. 

Keratoconus is a degenerative disorder of the eye in which structural changes within the cornea cause it to thin and change to a more conical shape than its normal gradual curve.

It can cause a substantial distortion of vision, with multiple images, streaking and sensitivity to light all often reported by the patient. It is typically diagnosed in the patient's adolescent years and attains its most severe state in the twenties and thirties.

As a result of their conditions Mahmoud must wear glasses, both suffer from pain and Itching, and Mustafa has to use cold compresses to sooth his eyes.  They are unable to play with other children when it is warm and their schoolwork suffers. 

Mahmoud and Mustafa will need to use eye drops for most of their lives and will require regular medical observation.  Coming from Ramallah, this is problematic as their parents must ensure they have the correct permits to allow the boys to come to Jerusalem, where they attend our Outpatients Department.  

However, the family’s diligence in caring for the brothers and bringing them to the St John Eye Hospital has resulted in stable allergic activity and is allowing the boys the hope of a normal life. 

Mahmoud and Mustafa told us that they very much appreciate the efforts of our Jerusalem staff and send a big thank you to all.