June 15, 2016
Helping Patients Heal Faster While Maintaining Their Vision
published on June 15, 2016 by
A 58-year-old, wheelchair-bound female with a history of a CVA and unspecified neurologic disorder presented in my office complaining of severe blurry vision, severe pain, burning and a constant foreign body sensation of the left eye.
Her ocular history was significant for dense amblyopia in the right eye with a best corrected visual acuity of 20/400 and mild amblyopia of the left eye with a best corrected visual acuity of 20/60. She had been treated prior in the right eye with Prokera® Slim when she presented initially months prior with similar symptoms in the right eye due to severe dry eye, secondary to an extremely low blink rate and lagophthalmos related to her neurologic disorder. Her signs and symptoms dramatically improved in the right eye. However, she did not feel comfortable placing Prokera Slim in the left eye as she didn’t feel she would be able to safely go about her daily life with her left eye occluded and only 20/400 vision in her right eye.
On a more recent visit, the patient was informed of the new option of Prokera Clear for the left eye, allowing her to safely function in her day-to-day life without occluding her 20/60 vision in the left eye. Prokera Clear is a new device that has the Prokera Slim profile and a 6mm Clearview aperture to allow for vision during the treatment period. On examination she presented with an extremely low blink rate, lagophthalmos, and dense diffuse confluent punctate epithelial erosions in the left eye. She complained of severe discomfort and severe blurred vision with a visual acuity of 20/100 in the left eye.
Prokera Clear was placed without complications in the left eye and remained in place for one full week. Upon reexamination after removal of the Prokera Clear there was minimal fine scattered SPK, with a visual acuity of 20/60. The patient stated the eye was free of pain, without any burning or foreign body sensation. Given her ongoing neurologic issues, her surface will be reinforced with regular lubricants and we will repeat Prokera Clear as needed while we observe her ocular surface closely.
Daniel C. Brocks, M.D. is a board certified comprehensive ophthalmologist with a specialization in the medical and surgical treatment of the cornea. He is in practice at Hudson Valley Eye Surgeons in Fishkill, NY where he founded The Dry Eye Center, and is also Director, Department of Ophthalmology at Vassar Brothers Medical Center.