KnowTheGlow (KTG) recently had the honor of connecting with Dr. Ranju Kharel Sitaula, a leading uveitis specialist and Associate Professor of Ophthalmology at the BP Koirala Lions Center for Ophthalmic Studies in Nepal. Dr Sitaula, currently pursuing her PhD on SHAPU at the University of Padua in Italy, has dedicated her career to addressing one of Nepal’s most devastating childhood eye diseases, Seasonal HyperAcute PanUveitis (SHAPU).
SHAPU is a rare and aggressive eye condition that strikes primarily children; 72% of those affected are underage, and can cause irreversible blindness within just a few days. Most cases occur in Nepal’s tourist-heavy Pokhara region, typically surfacing in the post-monsoon months of August and September. The disease presents with sudden redness, a white glow in the pupil, rapid vision loss within 48–72 hours, and often leads to a shrunken, blind eye (phthisis). Red eye with white glow is the characteristic feature of SHAPU, which differentiates it from white eye with white glow of a retinoblastoma child. Tragically, the condition affects only one eye and is painless, allowing many cases to go unnoticed until it is too late.
Dr. Sitaula shared with KTG’s Co-Founder Megan Webber and Director of Global Outreach Helene Dameris her deep commitment to tackling SHAPU. Inspired by her mentor, Dr. Madan Upadhyay, the first to note SHAPU in 1975, Dr. Sitaula has worked tirelessly since 2016 to unravel the disease’s mysteries. After partnering with WHO Nepal in 2017 and conducting extensive community-based studies, her team identified the female white moth as the primary risk factor. The tiny hairs cushioning the moth’s eggs appear to trigger the disease following the rainy season, when moth populations surge.
Beyond research, Dr. Sitaula has led vital awareness and training efforts. With the support from Epidemiology and Disease Control Division (EDCD), Ministry of Health and Population, Nepal government and grant support from organizations such as SURGO UK, her team has educated over 5,500 students, 300 teachers, 500 community health workers, and families. Female Community Health Workers, local health workers, trained to be the first responders, go door to door during outbreaks, sharing knowledge through pamphlets, videos, and radio messages. Despite the challenges of the COVID-19 pandemic, which delayed critical lab analyses and saw SHAPU cases triple due to moth population explosions, Dr. Sitaula has persevered. Today, the Nepalese government has begun formal data collection, a crucial step in tracking and controlling SHAPU through early warning and reporting system of Nepal.
Dr. Sitaula’s collaboration with KTG reflects a shared mission: ensuring no child needlessly loses vision to preventable diseases. She continues to advocate for early detection, knowing that if SHAPU is caught within its first 48 hours, vision can sometimes be saved. As Nepal braces for the next expected outbreak in 2025, Dr. Sitaula’s tireless work gives hope to thousands of children and families.
Together, KTG and Dr. Sitaula aim to bring global attention to SHAPU and support efforts to finally solve this medical mystery, turning a dream into reality for Nepal’s children.
