A case from this morning.

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Dr. Sobol is a Board Certified Ophthalmologist practicing in Uniontown Pennsylvania.

He provides medical and surgical care for eye disease and evaluates people for disorders of the visual system.

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Tuesday, October 2, 2007

A case from this morning.

Did a triple-procedure this morning for a long-term challenging case. It began with a severe contact-lens related corneal ulcer. Corneal scraping didn't grow anything.

Here's how it healed over the next few months:

Eventually it went for penetrating keratoplasty, with a good result and 20/30 uncorrected vision.

Unfortunately, the patient then was shot in the right eye with a pellet from a pellet-gun and there was almost circumferential wound dehiscence. I took him to the OR for exploration and to re-suture his graft. Here he is, months later, after removing most of those sutures.

The pellet is still lodged in his inferior orbit. The oculoplastics specialist didn't want to remove it. So he got another graft after the inflammation cleared.

Then this cornea rejected a few months later and he developed a dense traumatic cataract. He wasn't able to go through surgery for personal reasons for a year and today I replaced the graft, severed the synechiae, and removed the cataract. I also covered the cornea with amnion as he might have some epithelial-healing issues following his conjunctival re-arrangement during his open-globe exploration.

alsobol at 9:29 AM | | | Permalink