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Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3204
Experience:  Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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Hello, Someone punched my brother in the eye and he had a ruptured

Customer Question

Hello, Someone punched my brother in the eye and he had a ruptured globe. Years ago my brother had a cornea transplant in that eye and that made the damage worse now. Can anything be done about this? Can a ruptured globe specialist be able to help my brother?
Submitted: 1 year ago.
Category: Eye
Expert:  Dr. Dan B. replied 1 year ago.

Dr. Dan B. :

Hello and thanks for your question. Can you tell me what you mean by the cornea transplant "made the damage worse"? Do you know what his vision was prior to surgery?

Dr. Dan B. :

Any other problems like a traumatic cataract? Retinal detachment?

Customer:

The Dr told me that since my brother had a cornea transplant years ago, that made this damage worse now. He didn't have a traumatic cataract. I don't know if something happened to his retina now too

Dr. Dan B. :

Hmmm... Thanks for that additional information. It's difficult to imagine how a corneal transplant would've made the open-globe injury worse. Open-globe injuries, though, come in all sorts of different severities, degrees, anatomical locations and complications. I imagine that if he required a corneal transplant, it was likely because there was significant scarring from the rupture and subsequent sutures, that useful vision wasn't possible. In this case, only a corneal transplant would make useful vision possible.

Dr. Dan B. :

It's also possible that he may have developed glaucoma after a corneal transplant--this is not uncommon. But in his case, the trauma to the eye, alone, can predispose and lead to glaucoma so I couldn't say that the corneal transplant would necessarily be entirely to blame.

Customer:

The Dr told me he reattached the cornea. He never had glaucoma. he had many eye exams

Dr. Dan B. :

Okay. It's possible that if the cornea ruptured at its base, then re-attaching may have caused significant amounts of astigmatism, causing his vision to be poor even in glasses. If this were the case and a corneal transplant was done in hopes of lessening astigmatism, then I could see where he may have ended up no better, and maybe even worse. However...

Dr. Dan B. :

Without specific information regarding how his eye is worse because of a corneal transplant, everything I can offer is merely supposition.

Customer:

but do you think anything can be done if the future to help improve his sight? Would a new cornea transplant help?

Dr. Dan B. :

It's certainly possible--if the corneal transplant did not take, and perhaps there is scarring or opacification of the transplant, then yes, ostensibly a new corneal transplant may help. If he has not been seeing one, then I would recommend that he start seeing a corneal specialist who would be able to answer that question definitively--unfortunately, not being able to examine him, I can't say for sure.

Customer:

I understand. I live in NY and he originally had the transplant done at Manhattan Eye and Ear. that is a very good hospital. I will take him back there after he recovers. Do you think that a ruptured globe specialist would also be able to help?

Dr. Dan B. :

Well, unfortunately there really isn't such thing as a ruptured globe specialist; any ophthalmologist can close a ruptured globe. Retina surgeons tend to be the closest thing we'd have to a ruptured globe specialist, though many of them don't tend to pay much attention to the ultimate vision and how to modulate for the best vision post-operatively after the initial closure is done. I think the cornea guys at Manhattan Eye and Ear would probably be the best bet.

Customer:

Ok, Dr, thank you very much for all your advice. I really appreciate it. Have a good evening now.

Dr. Dan B. :

My pleasure.


Your feedback is important to me and will help me improve my encounter with future customers. Please rate your encounter with me by providing positive feedback (by pressing the smiley face); any bonus you may feel prompted to provide would be welcomed and is appreciated. If you feel like your concerns are not resolved or you have a problem or issue with anything I have said or haven’t said, please don’t issue a negative feedback rating—My goal is your satisfaction and I would rather work together to solve your concerns, until you are satisfied, than have you leave our encounter unhappy and unsatisfied.


 


My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor. Thanks for your inquiry!

Customer:

bye now

Dr. Dan B. :

Good bye and good luck to him.

Customer:

thanks again. bye now

Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3204
Experience: Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
Dr. Dan B. and other Eye Specialists are ready to help you
Customer: replied 1 year ago.


Hello,


I just found out that my brother's retina was detached too. Is there such a thing as a retinal transplant?

Customer: replied 1 year ago.
Relist: Other.
I am satisfied with the answer I received. I just found out more information about my brother's eye condition. He has a detached retina. I want to know if there is such a thing as a retina transplant?
Expert:  Dr. Rick replied 1 year ago.
It seems that Dr. Dan is not online at this time. I will be happy to assist you. My Hi. I'm Dr. Rick and I have two decades of ophthalmology experience.

Hi. I'm Dr. Rick and I have two decades of ophthalmology experience. I'm online and happy to answer your question today.

I am a retina surgeon. Thank you for that extra information.

There is no such thing as a "retina transplant" but a retina detachment can be surgically repaired....that is what I have been doing for over two decades now....

Do you know the particulars of your brothers retina detachment? If you could provide more information I could give you some idea of what your brother can expect in the coming weeks and months.


Dr. Rick, MD FACS

By the way, Manhattan Eye & Ear is a very good place for eye care. I personally know a number of the surgeons there.....

Let me know how I can help.
Customer: replied 1 year ago.


Hello,


My brother was punched in the eye this past Saturday. His cornea transplant that he had done years ago came out. The Dr told me he reattached that. The Dr told me that he had a ruptured globe and that his retina was detached.My brother can only see light now. He told me that he saw a yellow light and a blue light when it was flashed in front of his eye. Is that a good sign? Also, would my brother have to have his retina attached as soon as possible or does this have to be done after the swelling from the surgery he already had goes down? My brother had his cornea transplant at Manhattan Eye and Ear and I would want to take him back there for the retina surgery.

Expert:  Dr. Rick replied 1 year ago.
Thank you for that extra information.

It sounds like your brother has a very, very serous eye injury. Seeing the yellow and blue light is not a good sign or a bad sign. It just means that his retina and optic nerve is not completely dead.

He needs his retina fixed as soon as his eye will allow the surgery. The retina surgeon will have to be able to see through your brothers cornea and lens to do the repair and this may require heroic measures at this point.

There is no need to travel back to NYC if it would be difficult for him to do so. Any good retina/cornea surgeon can do a good job for your brother.

Of course, if it is not difficult to get to New York, by all means, go back to ME&E.

I do want you to understand however that, from what you have told me so far, your brothers chance of regaining useful vision out of this eye is very small....

Does this make sense to you?

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS
Customer: replied 1 year ago.


Hello Again,


 


I read about retina surgery being done with the use of stem cells. Do you know anything about this?

Expert:  Dr. Rick replied 1 year ago.
yes. I sure do. And this is a very exciting breakthrough. Also, the use of an implantable "retina" computer chip has show amazing results in a couple of patients treated at Wills Eye Center.

These two (very early and limited) technologies will not, unfortunately, help your brother with what he is going though.

At this time I think your brother should expect the worst and hope for the best when it comes to future vision with this severely injured eye.

I realize that this was not the answer you were hoping to hear but it would be unfair to you and unprofessional of me were I provide you with anything less than truthful and honest information.

Surely, you prefer that I tell the truth rather than what you wish to hear. Because it reflects very poorly on me unless you press one of the top three feedback choices, keep this in mind when rating my answer and please do not punish me for being honest. I understand that this may not be easy to hear, and I empathize.

Even though my answer was not quite what you were hoping for, please understand that my priority was to provide you with the most honest information. With that in consideration, I hope that you found my answer useful. Please click the excellent feedback button so that I can receive credit for my efforts.
Customer: replied 1 year ago.


Dr,


I understand that you have to be truthful with the answers that you give me. I just have one more question. In the future, do you think that some kind of stem cell surgery would be able to help my brother?

Expert:  Dr. Rick replied 1 year ago.
No. I'm very sorry to say, but it will not be advanced enough in time to restore vision to your brothers eye.

Right now, the excellent care he is getting is his best hope for saving his sight in that eye.

Please give my best to your brother.

Dr. Rick

I'm available anytime you, your brother or anyone in you family have any more questions or concerns. I am happy to help in anyway I can.
Customer: replied 1 year ago.


Hello Again Dr,


 


I know that the retina stem cell surgery isn't advanced enough now to be able to help my brother, but if does become advanced in the far distant future, would it be able to help my brother then?

Customer: replied 1 year ago.
Relist: Other.
I am satisfied with the answer I received. I just have another question
Expert:  Dr. Rick replied 1 year ago.
Good Morning,

I do not think it will be able to help your brother as, even stem cells, will not be able to grow an entire, new, working retina.

Do you have any other questions?

If not then....

Don't forget to mash the positive feedback button for me...the one labeled "excellent" is the most fun to push by far ;)


It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.

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Dr. Dan B.
Dr. Dan B.
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Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology