Understanding societal pressures on patients

ByUday Devgan, MD

This patient is a young man in his 20s with his whole life ahead of him. In an unfortunate car accident, he suffered a ruptured globe from a glass shard that lodged inside his vitreous cavity.

After a repair of the inferior corneoscleral laceration, he had a pars plana vitrectomy to remove the glass foreign body and repair his retina. He ended up with a macular scar, a disfigured pupil and a significant degree of exotropia.

While this trauma has negatively affected the patient’s vision, a bigger problem in his eyes is the disfigurement and social pressures that come from having such an odd appearance in his eyes. At his young age, it is difficult for him to be socially outgoing when the initial impression that he casts is one of having a strange eye.

Traumatic iris damage and exotropia after a ruptured globe injury

Sometimes, as physicians, it’s important for us to remember that there is a person and a personality attached to those eyes. By fixing his ocular problems, straightening the eye and surgical correcting his pupil shape, we can not only improve his vision, but we can also restore his appearance. We all just want to be normal and fit into society. The patient’s ocular reconstruction is the first step in giving him that wish.

I performed strabismus surgery and pupilloplasty this morning for this young man and I’ll keep you updated on his postop results and his satisfaction with being a normal 20-something-year-old young man.