High Velocity Blunt Trauma to Right Eye

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Good afternoon,

I had an accident involving a small plastic ball that hit me just below the right eye at an extremely high velocity two weeks ago today... My face is healed and the scar from the stitches is pretty small which is all great, but my vision is still terrible.  I had a CT scan done at the ER where I had the laceration closed, and there was a very small fracture in the lower orbit, probably right where the ball hit, that did not require treatment. I was told that I had traumatic iritis in the right eye, and that I should see an ophthalmologist within 3 days (the accident happened on a Friday evening, so Monday was the next business day).

So three days later, I saw an optometrist (because it was a federal holiday and I could not find any available ophthalmologist), and he prescribed predisone drops and told me that although my vision was blurry, it would heal up well and that luckily I had no bleeding behind the eye.

Yesterday, I attended an appointment with an ophthalmologist because my vision was not improving, my right pupil is giant and the pilocarpine drops I was prescribed were only helping temporarily, and I did not want to wait an additional day for my second followup with the optometrist.  Well, it turns out that I have a torn retina, angle recession (graded as III in the top three quadrants and IV in the lower), and possible macular scarring, in addition to the traumatic iritis.  I am scheduled to see a retina specialist on Wednesday morning, which was the soonest appointment I could get.  The ophthalmologist found RPE clumbs, intraretinal hemes, and worst of all a hypopigmented area in the center.  The Amsler grid is skewed for me above the center dot, and it is in the form of micropsia (the edges of the boxes seem to collapse into one another in a few lines).  It is the ophthalmologist's suspicion that the hypopigmented area is the reason for this, and since hypopigmentation normally indicates atrophy, I will at the very least not regain this part of my vision.

Since my appointment is not until Wednesday, I wanted to see if there is anything I can do in the meantime to help maintain or if possible even improve the blurry vision that I have remaining.  I also wanted to see if there is anything I can do to keep any further atrophy from occurring if possible... Like eye exercises of some sort?

I am a 23 year old woman, and I do wear glasses with a fairly light prescription (I usually only wear them at night, while driving, or when I need to be able to read from a moderate distance).  Luckily, my left eye is still doing well-- but any advice/information for me regarding my right eye is greatly appreciated. Thank you in advance!

[John C Hagan III, MD, FACS, FAAO]

There is no exercise that will help you eye. The best thing is use the drops as directed (pilocarpine is usually contraindicated in iritis or retina damage so I'm assuming you are not using it; if so call your ophthalmologist to clarify.  Protect you "good eye" (uninjured) from disease or injury. You may need to wear glasses even if non prescription as "safety" glasses to prevent another injury.

These injuries are impossible to predict and it likely will be 3-6 months before your final recovery is known. This injured eye is at increased risk of traumatic glaucoma, retinal detachment, cataract and macular scarring/atrophy.

JCH MD

[clearweave]

Prednisolone***

[clearweave]

I forgot to mention:

The ophthalmologist said the best thing I can do is to continue the predisone drops, so I am still on those 3 times per day.