Question
Hi,
My son had a pen stabbed in his eye,about 8 years ago,he is now 15,he has a cataract growing now but very slowly,if he was to have an operation to remove it, what are the chances of him going blind in that eye.
The doctors at the royal Melbourne Eye and Ear Hospital,said it was not like a normal cataract that it was more involved to remove it. If you could give me your opinion i would really appreciate it.
Thanking you
Answer
Thanks for your Question
Your Question was not that informative for me but here are some explanations and outcomes.
Traumatic cataract, itself can be treated by phaco surgery with IOL implantation which can be either in the posterior chamber(the regular site for IOL implantation), in the Sulcus in case of posterior capsule of the cataract is ruptured but can hold an IOL and also can be implanted in the anterior chamber.
If the other ocular structures are intact and not involved in the trauma, the visual outcome of this surgery with IOL implant in any of these sites is great.
Here are some possibilities of trauma that involve other ocular structures:
1- Corneal scar either small which can cause high astigmatism degree or large corneal scar which sometimes requires corneal graft.
2- Adhesions between the cataract and the iris. Can be treated by phaco but it can be a hard surgery.
3- Angle recession glaucoma. Lesions to the drainage system of the aqueous humor, which can cause increase in intraocular pressure. Chronic untreated high intraocular pressure can cause atrophy of the optic nerve which can cause complete loss of vision.
4- Retinal detachment. Sometimes trauma can cause detachment of the retina. It can be diagnosed at the time of the trauma and should be treated within few days after surgery. Any delay in treatment can have bad visual prognosis.
5- Choroidal rupture. This condition unfortunately can't be treated and if it occurs over the fovea (the area of the center vision) the visual prognosis can be bad. If it occurs outside the fovea area, it can be asymptomatic.
6- Amblyopia. Cataract at young age, such as 8 years old can be complicated by amblyopia in which the brain will recognize this eye as a lazy eye. There are some studies that amblyopia can be treated in some patients older than 10 years old.
As I said, if there is only traumatic cataract without lesions to other ocular structures, the visual outcome of cataract surgery removal with intraocular lens implantation is great.
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