Penetrating Corneal Injury: An Alternate Perspective

Introduction. One third of all vision loss in the first decade of life is secondary to trauma. Case Presentation. Surgery began 5 hours after a 6 year old female ruptured her right globe with a pair of scissors. The full thickness corneal, lenticular and scleral lacerations were treated by surgical repair of the cornea and sclera and patched overnight. Deviation From the Expected. This case will be presented from an alternate perspective; the parent. An innovative technique was utilized to increase compliance. Discussion. The next day the patch is removed and treatment with medication is initiated. Drop installation every two hours creates a traumatic situation for a 6 year old. Lens removal by pars plana vitrectomy and posterior capsulotomy was performed two and one half weeks later. The patient’s acuity was light perception with projection. The medications were tapered. The management incorporated protective eyewear, modifications to her school routines and training of the school nurse. Two months after the initial injury, all sutures were removed. Counseling began since the patient was experiencing night mares and despair about permanent blindness. The girl was eventually fit with a Silicone hydrogel which is inserted and removed independently. Conclusions. Techniques developed for compliance and management of this young child with a serious condition can be useful to other practitioners assisting families in similar situations. Presently, acuity maintained at 20/60 with contact lens and glasses. The patient has developed an 8 diopter exophoria resulting in an increased use of occlusion therapy. Grants. No funding source.