KYIV, Ukraine (AP) — Mykola Kasiuk’s world plunged into near-total darkness when a land mine exploded on the battlefield with Russian troops.
The Ukrainian soldier lost an eye. He clings to hope that one day he will see with the other because he can still discern faint traces of light.
After two years and numerous operations, Kasiuk placed that hope with a visiting team of U.S. surgeons.
Kasiuk crossed himself as he lay on a hospital bed before a recent surgery in Kyiv, praying for one thing:
“I want to be able to see my children again.”
Surgeons treat wounded soldiers while teaching Ukrainian doctors
Russia’s war in Ukraine has left soldiers and civilians with devastating eye and facial injuries. But specialists who can repair the damage are scarce. Before the 2022 invasion, ophthalmic expertise in many Ukrainian hospitals rarely extended beyond basic procedures such as cataract surgery.
The U.S. surgeons treat complex cases while training Ukrainian doctors in oculoplastic surgery, from rebuilding damaged eye sockets to fitting artificial eyes.
Local doctors had told Kasiuk that his vision was lost and recommended removing his remaining eye.
But he refused.
“No, I won’t let them,” he told his wife. “This is my last hope.”
A soldier learns bit by bit to live without sight
Kasiuk trained as a military cook, not an infantryman. Still, he was handed a rifle and sent into some of the fiercest fighting in eastern Ukraine.
His last visual memories are consumed by the war’s brutality in the Donetsk region: fellow soldiers killed, houses reduced to rubble, dogs wandering through ruins.
He could hear Russian soldiers’ voices nearby. The smell of death, he said, was everywhere.
Kasiuk was walking with fellow soldiers on April 16, 2024, when he stepped onto something and fell. His commanders later told his wife, Tetyana, that he stepped on the mine. He was placed in an evacuation vehicle that came under fire. Almost everyone in the vehicle was killed.
At a hospital, Tetyana saw a swollen man covered in shrapnel wounds, his face wrapped in bandages, his teeth shattered.
“This is not my husband,” she told a hospital attendant.
Then she noticed the tattoos on his hands. They were his.
Doctors removed one eye after shrapnel pierced it and they feared infection. They operated on the other but suspected its optic nerve was damaged. Kasiuk moved between hospitals, undergoing repeated operations with little improvement.
He has slowly learned to live without sight. He uses an old mobile phone to make calls and listen to the news, and recently learned to style his own hair. When Tetyana switches on a lamp, he tells her the faint light he sees grows brighter.
A surgery is performed under threat of Russian attacks
On surgery day, a nurse helped him into scrubs and wheeled him toward the operating room. He prayed aloud the entire way and asked her anxious questions about the procedure and if it would actually work.
The nurse told him not to worry, that he would be beautiful.
The surgeons were in Kyiv as part of Vision for Ukraine, a medical mission organized by the Christian Medical Association of Ukraine. They would not know the extent of the damage until they opened Kasiuk’s eye socket.
Stuart Seiff, an oculoplastic surgeon from San Francisco, was cautious about the prognosis. The immediate goal was to reconstruct Kasiuk’s socket and eyelids, restore his appearance and give him back some sense of normality.
“The socket on the right is very contracted,” Seiff said.
To rebuild its lining, surgeons may use tissue from inside the mouth or behind the ear, or a freeze-dried amniotic membrane that promotes healing and limits scarring. When sight cannot be restored, they can fit an artificial eye.
That was the outcome for Artem Deresh, a wounded soldier whose prosthetic eye, meticulously hand-painted in a Kyiv laboratory, looks almost real. “I don’t want to stand out from the crowd. I also don’t want to make people uncomfortable,” Deresh said.
Seiff began Kasiuk’s surgery under the constant threat of Russian attacks. There was an air-raid alert, which can halt procedures for hours. When the alert lifted, applause broke out across the ward as staff rushed to resume surgery. But during the hours-long operation, a major strike in central Kyiv hit the National Sciences Building, sending plumes of smoke into the air. Hours later, a strike hit another medical facility in the city.
A wife nervously waits for news
Tetyana waited at home in Chernivtsi in western Ukraine, knowing that what doctors found could shape her family’s future.
The Mykola she knew before the war is gone, she said. He had worked in factories to support them, and they raised three children together.
“He lives in his own little world now,” Tetyana said.
Kasiuk lives with near-constant pain. His days and nights have blurred: sometimes he sleeps through the day and stays awake all night.
The daughters he cannot see are moving ahead toward bright futures.
His eldest is studying psychology. His middle child is pursuing art, and her paintings have won awards.
The youngest daughter, now in sixth grade, remembers a different father — one who could see, play with his children and take them on trips.
His altered state has traumatized them, his wife said.
Tetyana tries to shield him from worries she fears he cannot bear. She spends her time fighting for his treatment, chasing disability paperwork and trying to hold the family together.
She is exhausted.
“Sometimes I wish someone would understand that I get tired, too,” she said.
A glimmer of hope, but no guarantees
What surgeons found was better than they had hoped.
They restored movement in Kasiuk’s eye and used skin grafted from behind his ear to help the eyelid protect it, opening the possibility of a corneal transplant.
“He has a fantastic result at this point, absolutely fantastic,” Seiff said.
Whether Kasiuk will see again is uncertain. Doctors believe scarring on the cornea, the eye’s transparent front surface, may be clouding his vision. They do not know yet how much damage lies deeper inside the eye, or whether it can still send visual signals to the brain.
Much depends on how Kasiuk heals. Scar tissue from the surgery can cloud the cornea again. Seiff called that the central challenge. Even with medication, Seiff said, “It’s the big enemy. We try to control it, but there’s only so much you can do.”
Doctors will monitor Kasiuk for up to six months before considering another intervention, including stem cells to support a corneal transplant or an artificial cornea.
Kasiuk remains optimistic.
“I remember what the world looked like: the sun, the blue sky, the clouds,” he said. “I hope I’ll be able to see this beautiful world again, even if only a little.”