Ethical Considerations for Performing Intraocular Surgery on Eyes with No Light Perception

Anderson, Rachel; Caplan, Arthur L.; Schuman, Joel S.

doi:10.1016/j.ophtha.2018.09.026

Cited by 4 publications

(1 citation statement)

References 15 publications

(15 reference statements)

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“…Given that our patient had full light projection and no relative afferent pupil defect in this eye, there was potential for visual improvement despite the main objective of the surgery being to improve cosmesis. Nevertheless, the ethical considerations when operating on an eye with guarded visual prognosis due to traumatic injury need to be considered by the surgeon, 11 with proper informed consent being obtained. The surgeon should be guided by the principles of patient autonomy, beneficence and non-maleficence.…”

Section: Discussionmentioning

confidence: 99%

Intraocular foreign body and traumatic cataract removal 65 years after penetrating trauma

Wong

Assia

2020

European Journal of Ophthalmology

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We report a case of successful intraocular foreign body/traumatic cataract removal and anterior segment reconstruction surgery of a patient’s eye that suffered penetrating injury 65 years earlier. Surgery was not recommended by ophthalmologists that she had earlier consulted. The patient opted for surgery to improve cosmesis due to leukocoria, but the level of regained vision exceeded expectations of both the patient and the surgeon. This case adds further evidence that the duration of occlusion time has no effect on visual potential in patients out of amblyogenic age. The ethical considerations of operating on such an eye with poor prognosis after traumatic injury are also discussed. To our knowledge, our patient has the longest reported duration (65 years) between the time of injury and successful surgery with good outcome.

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Section: Discussionmentioning

confidence: 99%

Intraocular foreign body and traumatic cataract removal 65 years after penetrating trauma

Wong

Assia

2020

European Journal of Ophthalmology

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Re: Anderson et al.: Ethical considerations for performing intraocular surgery on eyes with no light perception (Ophthalmology. 2019;126:10-12)

Weinlander

2019

Ophthalmology

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also had other serious and complex underlying conditions. Additionally, although Dr Kuo reminds us of the importance of reducing employee presenteeism, or the practice of coming to work despite infectious illness, it was not the cause of the adenovirus outbreak at our hospital. In our outbreak, the index case was a patient, not an employee. The first employee case was identified significantly later. As previously shared, the epidemic curve (Fig 1 in the original article) detailed the number of cases identified by day of detection. 1 Affected staff members were promptly identified and furloughed, actions that, along with core infection control measures, were successful in preventing any secondary transmission between patients. As our report addressed, our hospital's most important finding was that handheld ophthalmologic equipment that had no direct patient contact was the unexpected source of this organism and served as a reservoir for silent transmission to patients. This discovery was significant because the vast majority of published outbreaks of adenovirus implicated sick providers or contaminated equipment or solutions that directly touch the ocular surface of a patient. This novel finding, coupled with the fact that experienced ophthalmologists had been performing retinopathy of prematurity rounds at our institution for decades without an analogous incident, made this an important investigation to share more broadly with others. It is our hope that future health care providers might now have a more complex database from which to deduce solutions to unconventional sources of outbreaks.

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Primary Repair of Ruptured Globe on No Light Perception Eyes and the Role of Vitreoretinal Surgery

Mahmoud,

Govindaraju

2024

Ophthalmology Retina

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Ethical Considerations for Performing Intraocular Surgery on Eyes with No Light Perception

Cited by 4 publications

References 15 publications

Intraocular foreign body and traumatic cataract removal 65 years after penetrating trauma

Intraocular foreign body and traumatic cataract removal 65 years after penetrating trauma

Re: Anderson et al.: Ethical considerations for performing intraocular surgery on eyes with no light perception (Ophthalmology. 2019;126:10-12)

Primary Repair of Ruptured Globe on No Light Perception Eyes and the Role of Vitreoretinal Surgery

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