Ayad al-Sirowiy, the 13-year-old Iraqi boy who came to America last week with a burned face and big hopes, hit a major setback yesterday.
While being examined for a possible cornea transplant, Ayad learned not only that his right eye, which was visibly injured by an American cluster bomb, was damaged beyond repair, but also that his left eye had tiny bomb fragments in it and might require emergency surgery to save his sight.
Ayad can still go on with laser treatments to remove disfiguring scars on his face, but his eyes are in much worse shape than doctors expected.
"Things are not good," said Joe Tom Easley, a retired law professor who is serving as Ayad's sponsor.
Mr. Easley worked for more than a year to bring Ayad from southern Iraq to the United States for medical treatment after he read that Ayad had been badly burned and blinded in one eye by an American cluster bomb. The injury led to relentless teasing, with other children in Ayad's village, including his own 6-year-old sister, calling him Mr. Gunpowder because of the blue-black shrapnel pieces embedded in his face.
American Army doctors examined Ayad within months after he was hurt in April 2003 but failed to detect the rising pressure in his right eye. The pressure was caused by bomb fragments that scarred his eyeball and left thick, milky scar tissue over his cornea, which trapped an abnormal amount of fluid inside his eye.
Esen Akpek, a cornea surgeon at the Wilmer Eye Institute at Johns Hopkins in Baltimore, examined Ayad yesterday and said that if he had been given eyedrops soon after the injury, the pressure would not have built and destroyed his optic nerve.
"It's frustrating," Dr. Akpek said. "The doctors over there could have saved this eye."
Dr. Akpek said there was now a chance Ayad could become totally blind, because his left eye, which was thought to be unscathed, has a piece of shrapnel embedded in the retina.
When Dr. Akpek broke the double dose of bad news to Ayad and his father, Ali, who has accompanied him on his trip, the two started sobbing.
"It was horrible," Dr. Akpek said.
Mr. Easley said he felt heartsick too.
"Sometimes there's just nothing that can be done," Mr. Easley said.
Mr. Easley worked closely with a high-ranking official in the Defense Department to win permission for Ayad and his father to come to the United States. He also lined up an impressive roster of eye surgeons and dermatologists to treat Ayad at no cost.
On Wednesday, Ayad and his father arrived in New York with stunned smiles on their faces. On Friday, Ayad began laser surgery at a clinic in Washington to remove the map of pinprick scars across his face. The surgery went well, and he is scheduled to have more next week. Doctors are also fitting him with special contact lenses to conceal the scars on his eye.
"At least he'll look better," Mr. Easley said. "At his age, that means a lot."
Ayad was so ashamed of his scars that he quit school. On the rare occasions he leaves home, he twists a scarf around his face and never takes off his wraparound sunglasses.
His father, a struggling date farmer, was as angry as he was disappointed yesterday.
His hopes had been steadily building for the past year since Mr. Easley reached out to him.
Now he wants to go back to Iraq.
"Let me take my son home," Mr. Sirowiy said. "And if it's O.K., I want to leave now."