Additionally, significant corneal astigmatism may require the patient to wear glasses or contact lenses to achieve her best possible visual acuity. Given the severity of the cataract, vision will likely improve but will be limited I would not expect it to return to the pretrauma baseline. Other tools to determine visual potential include a red saturation test, laser interferometry, and potential acuity meter testing. An APD was detected, likely indicating traumatic damage to either the optic nerve or retina. B-scan ultrasound did not show any vitreous opacity, masses, or retinal detachment that would preclude her from seeing well. The first step is to determine if surgery will improve this patient’s vision. What factors must be taken into consideration in this case, and how would you proceed? The patient asks if surgery can improve her vision. A-scan ultrasound showed an axial length of 21.7 mm in the left eye. Optical biometry could not accurately measure the axial length of the left eye. No phacodonesis is evident, but mild hemorrhage is present on the lens capsule (Figures 1–4).įigure 4. A traumatic cataract is visible with irregular striations in the anterior lens capsule. The iris is irregular and peaked from tissue incarcerated in the nasal limbal laceration. The cornea is clear, and the anterior chamber has rare cells. In the left eye, there is moderate conjunctival injection and a nasal limbal wound closed by multiple nylon sutures, several of which have exposed ends. Slit-lamp examination of the right eye is normal. An afferent pupillary defect (APD) and irregular pupil are evident in the left eye. Upon presentation, BCVA is 20/20 in the patient’s right eye and barely hand motions in her left. She was monitored closely by both anterior segment and retina specialists after the repair but recovered little vision. At the hospital, she was diagnosed with a ruptured globe and taken to the OR for treatment of a primary rupture. She noticed an immediate reduction in vision in the injured eye and was taken directly to the emergency department by ambulance. The patient states that she was attacked in a bar and struck in her left eye with an unknown object. Managing Employees With Diverse Personalities and InterestsĬommunicating Effectively With Employees With Varied Personalitiesįrequently Asked Questions About Small Incision Lenticule ExtractionĪ 54-year-old woman presents approximately 6 weeks after blunt trauma to her left eye. Turning a Poor Practice Culture Into a Positive One Initiatives to Promote a Healthy Work Environment in Your Practice Use ‘Contagious Fun’ to Develop a Great Company Culture

Why Cultivating Positive Company Culture is Important Screening for Corneal Conditions Before Refractive Cataract Surgery Identifying Patients Who Should Not Receive a Premium Lens Traumatic Cataract With an Irregular Pupil Evolving Surgical Techniques With Laser Cataract Surgery

Irregular pupil shape dog