removing an eye

Hello, we took our daughter back to her Dr. Wednesday where he discovered she has veins in her cornea and coming thru the scar tissue.  At that point he perscriped a medicine to help dialate her pupils and a numbing drop.  Her left eye is really hurting her, a lot, the Dr. said to give it a week, but if her eye continues to hurt her like it is now should I wait?

Also if it is decided to remove her left eye is this form of surgury done as out patient or what?  Will they fit her for a "new" eye then?  By the way she also has depletional hypoglocemia, will this effect the possible surgery?

Cheryl

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

Sorry, your description of her problem is not always due to one thing. It most closely resembles neovacular glaucoma. I would call the answering service if she is in severe pain and get some pain medication and make arrangements for her to be seen on Saturday or Monday.

There is something worse than a blind eye and that's a blind painful eye. There are alternatives to removing a blind painful including cryopexy, endolaser cyclotomy, absolute alcohol injection behind the eye.

Removal of the eye is usually done as an outpatient and a round sphere roughly the size of the eye is put in the orbit where the eye was and the eye muscles and Tenon's fascia and conjunctiva sewed over the sphere. A "conformer" is used over this to save a place for an artifical eye (prosthesis). In perhaps 4-6 weeks after surgery the patient goes to an ocularist to fashions an artifical eye.

JCH III MD

[dynastarrt]

I think he called it neovacular glaucoma.  Is that a form or is it related to congentital glaucoma?  He did mention alcohol injection but I am not sure if it was absolute or not.  Would this be better than removing the eye?  Would her eye still be light sensitive?  I know he planned on contacting a surgeon next week to discuss what should be done.  Also he was going to contact our daughters glaucoma specialist.  By the way our daughter also has sinus fluid on her brain could the two be related?  Or would they be two separate issues?

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

Congenital glaucoma is totally different that NV glaucoma. CG is very rare, NVG is not all that unusual. The only alcohol that is used is absolute (200 proof ethanol). Most NVG are not light sensitive but the eye has intractable pain.

If you have a glaucoma specialist available in your community ask for a referral ASAP. There is some recent studies to indicate that injecting VEGF inhibitors (normally used to treat wet macular degeneration [Avastin, Lucentis] ) into the eye can dramatically help NVG.

JCH III MD