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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11096
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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She poked her r eye and has a scar right in her vision path

Resolved Question:

My 24 year old daughter had an eye injury 20 years ago. She poked her r eye and has a scar right in her vision path with a very small traumatic cateract. It has never changed size. Within a few years it was found that she needed to wear glasses (nearsighted) However, it was recommended that only the "good" eye be corrected. Reason being that the injured eye cannot be corrected at all. So for 16+ years she has worn glasses(seldomly) but contacts on a daily basis. She only wears 1 contact - in the "good" eye.
She has been getting headaches lately. Could it be a result of strain on the one eye? Should she at least try to set some vision out of the injured eye? Her eyesight is pretty bad - leaving her legally blind in the one eye. We have stayed with the same optomologist since the beginning. He maintains that the "bad" eye be left alone stating nothing can be done. Now she is questioning if she should get another opinion. I am interested in your opinion and if there may be another specialist we should be contacting.
Submitted: 5 years ago.
Category: Eye
Expert:  Dr. Rick replied 5 years ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

If she had a severe injury to her right eye when she was 4 years old which caused a scar to form and a cataract it is possible that the reason your daughters ophthalmologist is saying that nothing can be done to improve the vision in her right eye is because she is suffering from dense amblyopia in addition to any vision loss the corneal scar and cataract may be causing.

Dr. Rick :

The corneal scar and the cataract can, in the majority of cases be treated but, at this point, nothing can be done to improve the amblyopia.

Dr. Rick :

If you have been happy with this ophthalmologist for almost 20 years, I am sure that he has considered all the possible options to improve your daughters vision.

Customer:

Do you think her just wearing a contact in the good eye, having her only see out of one eye is causing strain and possibly her recent headaches?

Dr. Rick :

It is, in my opinion, unlikely that your daughters headaches are due to the strain of using her only good eye. I do agree that she should try to get as much vision out of the right eye within reason.

Dr. Rick :

I would have her examined by an internal medicine doc and see what he can find out about the headaches. If needed you could also take her to a neurologist.

Dr. Rick :

Do you think her current ophthalmologist has been doing a good job fitting her with the correct glasses/contacts?

Customer:

If you had a similar patient, would you try to put a contact in the r eye ? If you patient wanted to try would you go along with it? OR do you think it is not worth even trying

Dr. Rick :

No. I don't think I would risk the use of a contact lens in an eye with very little visual potential. Also, depending on the size of the corneal scar, it may be very difficult if not impossible to get a contact lens to fit correctly.

Dr. Rick :

Have you ever discussed treating the corneal scar and cataract to see if her vision would improve enough to be worth the surgical risks?

Dr. Rick :

If the patient wanted to try I would review the risks/expected benefits of all treatment options with her and see what, realistically, could be accomplished.

Dr. Rick :

Does this make sense to you?

Customer:

I guess he has fitted her correctly. She has played sports over the years and is a college graduate - allot of reading/computer work and has not really complained much at all until recently when she has a job staring at a computer for hours. The last time we discussed surgury we were told that a cornea transplant is the only thing and most people that are candidates hope to get the kind of vision in that eye that she already has. I guess I kind of believed that in 20 years since the injury that medical advances would have something to offer her by now.

Customer:

Thanks - everything you have said does make sense. It is time for her annual exam and I was wondering if we should pick another doctor for another opinion.

Dr. Rick :

There have been a lot of advances in the treatment of corneal scars since her injury, however, I agree with the doc you talked to -- if it seems that her vision is already as good as could be expected after surgery, what is the point of taking all the risk for no gain?

Dr. Rick :

It never hurts, however, to talk to a subspecialist such as a Cornea expert. She may, however, tell you the same thing your long-time ophthalmologist has told you....

Dr. Rick :

It sure wouldn't hurt to have her annual exam done by a corneal expert...they do regular eye exams too :)

Customer:

Thank you for your time. Maybe a Cornea specialist is an option.

Dr. Rick :

My pleasure. Best of luck to you and your daughter.

Dr. Rick :

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Expert:  Dr. Rick replied 5 years ago.
Let me know if there are there any other concerns or issues you would like to discuss on this topic.
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