After 55 years, surgery restores sight

After being hit in the eye by a stone, a detached retina left a man blind in his right eye. Despite surgery to remove a cataract when the man was 23, which temporarily restored light perception, the patient was completely blind in that eye. Doctors at The New York Eye and Ear Infirmary have reported a case, published in BioMed Central's open access Journal of Medical Case Reports, describing how this patient had functional vision restored 55 years after the childhood accident which left him blind.

Whilst it is unusual for a retina to become detached, common causes include head injury, myopia or diabetes. If a retina remains detached for a prolonged period of time, degenerative changes mean that it is often impossible to restore sight even if the retina is reattached. When the patient arrived at the hospital, complaining of pain, he was found to have total hyphema, neovascular glaucoma, high intraocular pressure and a detached retina. Doctors first treated the pressure to relieve his pain.

Once his eye pressure had stabilized they treated the neovascular glaucoma using monoclonal antibody therapy and found that against all odds the patient regained light perception. Encouraged by these results the doctors decided to try and reattach the retina. After surgery the man recovered his eyesight to such an extent that he could count fingers at a distance of five meters.

A year later the patient required further retinal surgery because scars inside his eye were forcing parts of the retina to become detached again. However this second surgery was also successful. Dr Olusola Olawoye said, "To the best of our knowledge this is the first report of visual recovery in a patient with long-standing traumatic retinal detachment. This is not only a great result for our patient but has implications for restoring eyesight in other patients, especially in the context of stem cell research into retinal progenitor cells which may be able to be transplanted into diseased retinas to restore vision."

1. Visual recovery in a patient with total hyphema, neovascular glaucoma, long-standing retinal detachment and no light perception vision: a case report
Olusola Olawoye, Christopher C Teng, Uri Shabto, Jeffrey M Liebmann, Francis A L'Esperance and Robert Ritch
Journal of Medical Case Reports (in press)

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2. Journal of Medical Case Reports is an international, peer-reviewed online journal, publishing original research related to case reporting. Articles include, but are not limited to, N of 1 trials, meta-analyses of published case reports, research addressing the use of case reports and the prevalence or importance of case reporting in the medical literature and retrospective studies that include case-specific information (age, sex and ethnicity) for all patients.

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