Child small laceration/iritis Part Two- Questions

[sashasmom]

1)  Do we need a 2nd opinion from a pediatric ophthalmologist re: her condition & how she should be followed?  At 10 wks the ophthalmologist dilated her & said all looks fine.  Her ophthalmologist wants to see her as needed or in 6 months.

2)  Ophthalmologist noted very mild lens opacification recently - too mild to call a cataract.  She saw it without dilation in the injured eye, then she saw it in the other eye with dilation.  The injured eye is a little more opacified & she said maybe the bilateral opacification was there before and the injury worsened it in that eye.  She said it isn't anything to worry about.  Any thoughts?

3)  2 of 3 docs say she should never in her life wear contacts due to her injury.  I saw a study about contact lens causing very mild corneal abrasions but that it isn't a problem.  Is this why they said this?  What is usually recommended?  

4)  2 of 3 docs say a steroid at the time of injury would/could have decreased the scar size.  Any opinion?

5)  Whether or not it was deemed necessary for the abrasion, wouldn't she have been given a steroid for iritis?

Thanks for any opinions you might share!

[John C Hagan III, MD, FACS]

1. If you've seen a cornea specialist that should cover it. stay in touch with him/her.
2.Then I wouldn't worry
3. If two of the people that have examined her say no contacts than I would go with that
4. Scars are more a function of depth of injury than steroid use
5. Iritis is usually treated with a topical steroid
JCH MD

[sashasmom]

Thank you for taking the time to respond.  Your answers were very helpful.

[John C Hagan III, MD, FACS]

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[Sandy Feldman, MD, MS]

Dear sashasmom,

I would recommend that you seek the care of an eyeMD with whom you and your daughter feel comfortable.  She should be evaluated to determine whether progression of the lens is occurring.  Due to the iritis, a drop to reduce the inflammation was needed. I cannot comment on why the doctors feel that she should not wear contact lenses. Perhaps, you could ask them further.  Steroids can sometimes, reduce the size of the corneal scar but by no means are they totally curative. Scarring will depend upon the injury, depth, etc.  Please take one step at a time and speak with your eyeMD about your daughter’s condition.

Dr. Feldman

Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California

[sashasmom]

Thank you for your suggestions.  They are very helpful.