This may sound inconceivable but a scientist having his roots embedded in old part of Jammu city has done miracle in United Kingdom (UK) by discovering a previously undetected layer in the cornea, the clear window at the front of the human eye. Academic professor Harminder Singh Dua, working as head of the Division of Ophthalmology and Visual Sciences, University of Nottingham whose father, paternal uncles and aunts were all born and brought up in Tanga Wali Gali, Kachi Chawni, Jammu discovered sixth layer in the cornea which has now been named after him as “Dua’s Layer”. His father Inder Singh Dua after his retirement from Indian Air Force (IAF) as Air Commodore had settled in his ancestral house at Kachi Chawni from where he moved to stay in Delhi for some time and then with his children in London. Harminder’s grandfather S Tek Singh had raised his children very humbly in Kachi Chawni and imparted them quality education during 1930s in the same ancestral house where his cousin brothers still live and are keeping the family legacy intact.
The discovery of Dua’s Layer is likely to empower Ophthalmologists with more knowledge about the human eye which in turn will help surgeons take suitable measures during operations. Earlier the human cornea which is the clear protective lens on the front of the eye through which light enters the eye was believed to be composed of just five layers. These five layers from front to back were known to scientists as corneal epithelium, Bowman’s layer, the corneal stroma, Descemet’s membrane and the corneal endothelium.
Now with the discovery of sixth layer to be known as Dua’s Layer located at the back of the cornea between the corneal stroma and Descemet’s membrane, new vistas have been opened for the surgeons to carry out operations and save human eyes. The new layer has been termed as just 15 microns thick. This discovery is going to create miracles in the medical history and help patients with corneal disorders. In Harminder Dua’s own words published in science journals, “This is a major discovery that will mean that ophthalmology textbooks will literally need to be re-written. Having identified this new and distinct layer deep in the tissue of the cornea, we can now exploit its presence to make operations much safer and simpler for patients. From a clinical perspective, there are many diseases that affect the back of the cornea which clinicians across the world are already beginning to relate to the presence, absence or tear in this layer.”
Earlier Dr. Harminder Singh Dua completed his MBBS from Nagpur where his father was posted. After his graduation, he was sponsored by the Rotary Club of Nagpur to travel as a member of a Group Study Exchange (GSE) team to Pennsylvania, USA way back in 1981. During his days in India, he had conducted numerous free diagnostic eye clinics through Rotary and other nongovernmental organizations. Dua himself had performed thousands of free operations on poor patients who had cataracts and glaucoma. It was only this year that he was chosen by The Rotary Foundation Trustees as the recipient of Rotary Foundation Global Alumni Service to Humanity Award.
Mrs Sangeet Kaur Dua his aunt who still lives in Kachi Chawni remembers days when she along with her later husband Dr S S Dua and entire Dua family had gone to Nagpur to attend Harminder’s wedding. “Harminder had always remained a soft spoken, introvert yet intelligent boy who excelled in studies. His parents, especially mother Kulwant Kaur Dua was very much concerned about her children’s studies and made sure that he got best and quality education”, she recalls. “Harminder has made us proud by discovering Dua’s Layer. This is going to make Duas a proud family of a world renowned scientist who has contributed in a big way in medical field. Though he lives miles away and family ties have been fogged with the death of his parents and my husband, yet he continues to belong to our blood. I am proud of my nephew. I still have cherished memories of Harminder staying in his ancestral house at Kachi House and teaching my children how to solve Rubik’s Cube, which he was quite good at, “Sangeet Kaur added.
Dua, who is chair and professor of ophthalmology at the University of Nottingham, Queen’s Medical Centre, has treated patients around the globe in the United Kingdom, India, and the United States and is renowned as an authority on corneal disorders and performs advanced surgeries. His new discovery is going to change the way the doctors treat their patients. The entire cornea is around 550 microns thick or 0.5mm. It is believed that cornea hardly withstands one and a half to two bars of pressure thus making the surgeries very tough.
Once the surgeons are able to understand the location of Dua’s Layer it would help them conduct operations more finely. Diseases of the cornea including acute hydrops, Descematocele and pre-Descemet’s dystrophies will be treated much more effectively with the detection of Dua’s Layer. This would also help surgeons improve outcomes for patients undergoing corneal grafts and transplants. According to science journal, the scientists proved the existence of the layer by simulating human corneal transplants and grafts on eyes donated for research purposes to eye banks located in Bristol and Manchester.
During this surgery, tiny bubbles of air were injected into the cornea to gently separate the different layers. The scientists then subjected the separated layers to electron microscopy, allowing them to study them at many thousand times their actual size. Understanding the properties and location of the new Dua’s layer could help surgeons to better identify where in the cornea these bubbles are occurring and take appropriate measures during the operation.
If they are able to inject a bubble next to the Dua’s layer, its strength means that it is less prone to tearing, meaning a better outcome for the patient. The scientists now believe that corneal hydrops, a bulging of the cornea caused by fluid build up that occurs in patients with keratoconus (conical deformity of the cornea), is caused by a tear in the Dua layer, through which water from inside the eye rushes in and causes waterlogging, the science journal published.
Harminder Singh Dua, MBBS, DO, DO (Lond), MS, MNAMS, FRCS, FRCOphth., FEBO, MD, PhD., was earlier associate professor at the Thomas Jefferson University, Philadelphia, USA when he was invited to chair in Nottingham in April 1994.
He still holds or has held many positions on various national and international councils, board of governors and advisory panels including the Royal College of Ophthalmologists as one of the vice presidents and chairman of education, Oxford Ophthalmological Congress, the Iris Fund, Fight for Sight, Medical Research Council (UK), Sight Savers International, International Ocular Surface Society, and the Eye Research Institute (Philadelphia).
He edits the British Journal of Ophthalmology and is also president of EuCornea, the European society of Cornea and Ocular surface disease specialists. He is also president of the European Association for Vision and Eye Research (EVER) Foundation (EVERf) and past president of EVER.
He has over a 200 research publications, 20 published letters, and 14 book chapters to his credit. Harminder Singh Dua has also received Oxford Ophthalmological Congress Founders’ Cup, the Ian Fraser prize, the Julia Duane Scholarship, Spencer Walker Prize, and 18 eponymous lectures including the Duke Elder Lecture at the Royal College of Ophthalmologists annual congress in 2005.
His recent awards include the achievement award for distinguished services, by the American Academy of Ophthalmology (October 2010); the His Royal Highness Prince Abdulaziz Al Saud Prevention of Blindness Shield and lecture (awarded on 27 February 2011 in Riyadh, Saudi Arabia) and the Gold medal lecture by the Ophthalmological society of South Africa (awarded on 25 March 2011). On 13 November 2010, the Times newspaper, UK, published in its Saturday magazine a roll of Britain’s top doctors. Professor Dua was one of five ophthalmologists named in this list.
Discovery of Dua’s Layer while is a matter of proud for Harminder himself, his siblings, wife and children he continues to be torchbearer of Dua family, son of the soil, an ideal and an icon who has made Jammu proud by his breakthrough in the history of medical sciences.
(The writer is a freelance journalist and an engineer by profession)