Mrs Khadra Marawa, Tamoon near Jenin, May 2012
58 year old Mrs Khadra Marawa is a widow from the village of Tamoon near Jenin in the very north of the West Bank.
She does not work and lives alone in her family’s old home, consisting of one room, plus a kitchen and a bathroom. To live, she depends on the Palestinian Authority’s Ministry of Social Affairs (MoSA) assistance, which allows her 750 ILS – £121.00 or $196.00 – every three months.
As well as struggling with heart disease, Mrs Marawa suffers from intraocular pressure (IOP) and glaucoma in both eyes. She has been a patient at the St John Eye Hospital in Jerusalem since 2003.
A higher than normal IOP can be dangerous because the condition can damage the optic nerve – which connects the eye to the brain – leading to decreased peripheral vision, the loss of the nerve tissue and the diagnosis of glaucoma.
Glaucoma is usually, but not always, associated with elevated IOP. It is now considered a disease of the optic nerve, or optic neuropathy. Vision loss due to glaucoma usually occurs in both eyes, and is thus termed bilateral. However, one eye may develop glaucoma quicker than the other. If the glaucoma is not diagnosed and treated, it may progress to loss of central vision and blindness.
When Mrs Marawa presented at our Jerusalem Hospital in May 2012, she was also discovered to be suffering from cataracts and the decision was made to perform combined phacoemulsification and trabeculectomy surgery.
Trabeculectomy is a surgical procedure used in the treatment of glaucoma to relieve IOP by removing part of the eye's trabecular meshwork - the area of tissue located around the base of the cornea responsible for draining the aqueous humor – or clear fluid – from the eyeball. It is the most common glaucoma surgery and permits increased drainage of fluid from within the eye.
Phacoemulsification with Intraocular Lens (IOL) Implantation involves removal of the lens fibres, which form the nucleus and cortex of the cataract, by first emulsifying them with an ultrasonic handpiece, and then replacing them with an IOL, or small plastic lens.
Recent studies support claims that the combined procedure can be as effective, if not more so, than two separate surgeries and that postoperative complication rates and IOP are both lower when cataract surgery is combined with trabeculectomy.
Mrs Marawa’s condition had meant that she was finding it difficult to cope on her own and that she was facing the very real threat of blindness. Post-surgery, the threat to her vision is now greatly reduced and Mrs Marawa is once again able to look after herself at home.
Further, as our Social Worker was able to see that Mrs Marawa was in no position to pay for her treatment, SJEHG covered the expense of her surgery using our Patient Relief Fund.
Upon leaving, Mrs Marawa was most grateful to all at the Jerusalem Hospital for their care and concern and thanked the hospital for her exemption.
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