Eye Surgery - A Childhood Injury Left Untreated Had to Be Fixed a Good 20 Years Later to Save Eyesight with Surgery Which Included Penetrative Keratoplasty

Childhood injuries can terribly go wrong if left untreated. This is what a patient who visited our hospital for eye treatment experienced firsthand. He was some 7 years of age when he had an injury on his right eye which he had left untreated until recently; he would have gone blind in his right eye if not for the treatment he had at India and in our hospital.

The ophthalmologist’s investigations of his right eye revealed that his posterior segment appeared normal and the ophthalmologist could clearly rule out endophthalmitis and atropic bulbus. The only factor that needed some keen assessment was the amount of amblyopia he had, and the treatment would be decided strongly based on this factor.

Further, from the reports presented, it was not clear to the ophthalmologist as to the amount of corneal opacity that was present in the affected eye. The ophthalmologist had no options but to request the patient to fly down to India for further evaluation and appropriate treatment. The ophthalmologist was in no position to give an estimate to the cost of treatment since everything was dependent upon his evaluation of the patient in person.

When the patient finally arrived at India he presented himself with total loss of vision in his right eye. The injury that he had left untreated for some 20 years had now developed into total corneal opacity with vascularization. The treating ophthalmologist gave a clinical diagnosis of  adherent leucomo. The ophthalmologist observed that the left eye was functioning quite normally. The ophthalmologist also suggested that the patient undergo a B-Scan and also an OCT.

These tests revealed that the posterior segment of his right eye was perfectly normal, but the anterior segment could not be made out. As previously observed from the reports the patient had previously presented, the new reports too confirmed that Endophthalmitis and atrophic bulbus could be ruled out.

The new reports helped the ophthalmologist to arrive at a treatment plan. The treatment plan that was decided was a combined eye surgery. The eye surgery planned was cataract extraction and penetrative keratoplasty and also ocular implantation with guarded prognosis.

But, these procedures had to wait for almost 15 days since the eye bank was yet to make ready the required cornea. But eventually the wait paid off and the promised cornea arrived. The patient was scheduled for operation the very next day. The eye surgery was to be conducted under general anesthesia.

The ophthalmologist was keen at operating the patient very early in the morning; sometime past 5.30 am.

The eye surgery that was done included ciliary staphylomectomy. Pupilloplasty was conducted and the anterior chamber was formed. Rubeosis iridis was noticed in the patient. The cornea was removed and replaced. All the procedures were carried out under general anesthesia.

The patient was advised rest for almost 10 days. The checkup by the ophthalmologist post 10 days of the surgery revealed that there was no rejection of the graft, and the corneal button had a normal appearance. The anterior chamber was clear with a mild hyphema.

The patient had to leave the country and hence he was prescribed oral steroids and the course would last for 3 weeks.

The patient is now doing quite well and his eyesight has been successfully restored.