Editor’s Note: Welcome to “Eye Catching: Let's Chat,” a blog series featuring contributions from members of the ophthalmic community. These blogs are an opportunity for ophthalmic bloggers to engage with readers with about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The series continues with this blog by Mark Packer, MD, FACS, CPI. The views expressed in these blogs are those of their respective contributors and do not represent the views of Ophthalmology Times or UBM Advanstar.
Fred was a private pilot in his mid-50s who had an unusual right eye, an equally unusual complication during surgery and, in the end, a completely satisfactory result.
Fred’s left eye was relatively normal, with just a little farsightedness and astigmatism, + 0.50 + 0.25 X 180, with 20/15 best-corrected visual acuity (BCVA).
His right eye was highly myopic and also had significant astigmatism, - 9.25 + 4.75 X 63. Nevertheless, he had a surprisingly good BCVA of 20/30+. Corneal topography showed some mild irregularity.
He had virtually no nuclear opalescence, just normal age-related yellowing.
He had been treated for amblyopia as a child, but most of his life he had just ignored the eye. There were times when he tried to correct the vision with a contact lens, but he did not find wearing a lens comfortable because he had a facial palsy on the same side as his odd eye.
In his case, an idiopathic Bell’s palsy had persisted for many years, accompanied by intermittent symptoms of exposure keratopathy, usually during dry, cold, or windy weather. Slit lamp exam showed 1 mm to 2 mm lagophthalmos, and just a few dots of punctate staining inferiorly on the cornea. He had a decent Bell’s reflex, and only occasionally used artificial tears or gels.
Fred had no trouble getting a private pilot’s license. Apparently FAA standards for general aviation are not as strict as one might think.
Fred had come to see me to find out if I could make the vision in this eye “normal.” By “normal,” he meant like his other eye had been when he was 25. In other words, he’d like to be able to see clearly at distance and near and “everywhere in between” without glasses.
Fred was also a close friend of one of my employees. Fred’s wife and my employee shared a lot through their church. My employee had encouraged Fred to come see me. Personal relationships like that always create a bit more pressure for a great result.
So, I was pursuing a quest for perfect vision with freedom from eyeglasses in the face of high myopia and astigmatism, dry eye due to facial palsy, and perpetual updates on his surgical outcome.