Severe Eye Problems

I had an eye injury 25 years ago with shrapnel from the helium cylinder piercing through my cornea damaging the lens of my right eye due to which the damaged lens was removed. After 10 yrs I started experiencing high IOP and my eyes became extremely photophobic. The cornea also started becoming cloudy. The Doctor advised Betoptic and Betagan to keep the pressure low but it was not too much help. Luckily an ad hoc solution was discovered and I started using soft contact bandage lens. In Nov 1999 to find a permanent solution to the problem I underwent Keratoplasty. For six months or so it was all good but then I started experiencing high IOP again which developed into glaucoma. Due to very high eye pressure Xalatan was prescribed by the doctor but to no effect.Trab was performed by the surgeon to release the pressure which developed a cist in the upper portion of my cornea. Ultimately in July 2000 cyclo cryoplasty was performed which helped reduce the pressure significantly. However after that calcification of the cornea started occurring which became very thick and finally these were scrapped off by Laser in 2004. These calcium deposits just keeps recurring even post Amniotic Membrane transplant in 2006. On top I developed retinal detachment. Now the condition is that I am unable to detect any vision from my right eye. Soft or cosmetic lens both do not suit me at all even different diameters have been tried. There is a lot of pain especially when pieces of calcium scratch my cornea when I blink and I also have very high photosensitivity. Please advise me if there are any options/hope to just bring back some level of comfort perhaps by a special type of lens. I will be extremely grateful for a response.

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

Your eye sounds like it has no visual potential so pain relief is primary goal and seconday goal is cosmetic acceptance. Ask your surgeon about pulling a Gunderson Flap across the cornea for pain relief.

Other options include injection the optic nerve with long acting pain anesthetic (such as 100 proof ethanol). However this often leave the eyelid paralysed and the lid shut.

JCH MD