Post-Corneal Repair: Addressing Vision Issues and Emotional Support

Corneal suture healing?

Hello Doctor: I would like to ask about a patient who sustained an eye injury from being struck by a ball, resulting in a corneal rupture that was sutured at the upper edge, not centrally on the pupil.
Currently, two months post-surgery, the best-corrected visual acuity is 1.0, but there is still some astigmatism, and lights appear crescent-shaped.

(1) Is it possible to correct this with rigid gas permeable contact lenses?
(2) The patient also has post-operative traumatic mydriasis and is currently relying on topical miotics.
Is there any potential for recovery? What are the side effects of miotics?
(3) The patient began experiencing floaters and flashes of light two weeks post-surgery.
A retinal examination showed no significant issues, only some dark spots.
What could be causing the floaters and flashes? Is there a possibility for them to decrease or disappear?
(4) The emotional distress following the injury has been significant.
Are there any psychological counseling teams or support groups for eye injury patients in the country that could provide assistance?

irenee, 20~29 year old female. Ask Date: 2013/08/15

Dr. Wang Yuwei reply Ophthalmology

You are fortunate that the corneal center was not affected, allowing you to maintain good corrected vision.
Whether hard contact lenses are suitable for you should be determined based on the extent of wound healing and the health of the corneal epithelium.
Mydriatic agents may cause a slight decrease in intraocular pressure, which is generally acceptable for patients; however, traumatic mydriasis may be difficult to recover from.
Floaters and flashes are caused by degeneration of the vitreous body and peripheral retina, with impacts being a contributing factor.
Supplementing with lutein may help reduce them, but they will not completely disappear.
If your ophthalmologist cannot alleviate your anxiety, you may ask them to recommend an appropriate mental health counseling team nearby.
Wishing you a speedy recovery.

Reply Date: 2013/08/15

More Info

Hello, thank you for your inquiry regarding your post-corneal repair situation. It’s understandable to have concerns after experiencing an eye injury, especially when it affects your vision and emotional well-being. Let’s address your questions one by one.

1. Hard Contact Lenses for Astigmatism: Yes, hard contact lenses, particularly rigid gas permeable (RGP) lenses, can be effective in correcting astigmatism. They can provide a more stable tear film and can help reshape the cornea, which may improve your vision further. However, the suitability of hard lenses depends on the specific characteristics of your cornea after the repair. It’s essential to consult your eye care professional to determine if you are a good candidate for hard lenses and to ensure they fit properly.

2. Recovery from Traumatic Mydriasis: Traumatic mydriasis, or dilation of the pupil due to injury, can sometimes improve over time. The use of pilocarpine (a common miotic agent) can help constrict the pupil, but it may also have side effects such as blurred vision, headaches, and brow ache. It’s important to discuss these side effects with your doctor and to monitor your symptoms closely. Recovery potential varies from person to person, and ongoing evaluation by your ophthalmologist is crucial.

3. Floaters and Flashes: The appearance of floaters and flashes of light after an eye injury can be concerning. These symptoms are often related to changes in the vitreous gel inside the eye, which can occur after trauma. While the presence of floaters is usually benign, they can be bothersome. In many cases, floaters may diminish over time, but they may not completely disappear. Regular follow-up with your eye doctor is essential to monitor any changes and to ensure that there are no complications, such as retinal detachment.

4. Emotional Support and Counseling: It’s completely normal to feel emotional distress after an eye injury, and seeking support is a positive step. In many countries, there are organizations and support groups specifically for individuals with vision impairments or eye injuries. These groups can provide emotional support, resources, and connections with others who have had similar experiences. In the U.S., organizations like the American Foundation for the Blind or local chapters of the National Federation of the Blind may offer resources. Additionally, consider reaching out to mental health professionals who specialize in trauma or chronic health conditions, as they can provide tailored support.

In summary, your concerns are valid, and it’s important to maintain open communication with your healthcare providers regarding your vision and emotional health. Regular follow-ups and a supportive network can significantly aid in your recovery process. Don’t hesitate to seek help, whether it’s for your vision or emotional well-being. You are not alone in this journey, and there are resources available to assist you.

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