Seeing Dramatic Results After a Frightening Eye Injury
When one of his eyes was severely injured, Leo Druliner’s parents were worried that, due to the trauma, their toddler might never regain his vision in that eye. But a team of Mayo Clinic specialists went to work to repair the damage, and now Leo’s on the road to a successful recovery.
It’s
one of a parent’s greatest fears — getting a call from day care that your child
has been hurt. That’s what happened to Leo Druliner’s parents in January.
Leo’s mother, Brooke, was at work at Mayo Clinic’s Rochester campus, where she performs colorectal cancer research, when the day care facility Leo attended called to tell her he hurt his eye following a fall.
“When
I got there, it was apparent that the injury was more extreme,” Brooke
says. “The material of Leo’s left eye appeared to be coming out. I would
learn later that this was because his eye had ruptured.”
Swift, skilled care
Brooke immediately took her 16-month-old toddler to Mayo Clinic’s Department of Emergency Medicine, where Jenny Wang, M.D., an ophthalmologic surgery resident, evaluated Leo. She told Brooke and Brooke’s husband, Aaron, that their son would need emergency surgery.
“The
white of the eye had a lot of bleeding under the surface. It looked like the
eye had a full-thickness laceration,” Dr. Wang says. “I could sense
how traumatic this was for his parents.”
Dr.
Wang performed surgery to repair the ruptured globe in Leo’s eye alongside Mayo
Clinic ophthalmologist and cornea surgeon Sanjay Patel, M.D.
“He was lucky with the location of the injury. It was at the edge of the cornea and toward the front of the eye,” Dr. Patel says. “Lacerations toward the back of the eye can be more vision-threatening because they’re often associated with retinal detachment.”
“Dr. Patel explained everything he saw in the surgery to us and told us he was very pleased with the way he was able to stabilize Leo’s eye.”
Brooke Druliner
Fortunately, Leo’s retina was still attached, and doctors stitched the wound closed. Although the surgery was successful, it was uncertain how much vision Leo would recover in the eye.
“Dr. Patel explained everything he saw
in the surgery to us and told us he was very pleased with the way he was able
to stabilize Leo’s eye. He also told us that his eye wouldn’t look the same.
His pupil would be misshapen because of the loss of iris tissue due to the
injury,” Brooke says, “And the most difficult news of all was that the chances that Leo would regain his full
vision in that eye remained guarded.”
Leo’s
vision was in jeopardy due, in part, to his young age, according to Erick
Bothun, M.D.,
Leo’s pediatric ophthalmologist at Mayo Clinic. “Our brain develops vision
in the first few years of life, and anything that hinders the function of one
eye can disrupt the brain development of the visual acuity and eye alignment,”
Dr. Bothun says.
Promising results
Three weeks later, Leo had a
second surgery that allowed his care team to better study the eye after it had
healed from the first repair. Dr. Bothun removed several of the sutures from the
first surgery and confirmed Leo’s retina was still attached. But while
examining the eye during surgery, Dr. Bothun discovered some of the layers of
the retina were torn, which could signal a potential
problem with future retinal function.
Dr. Bothun referred the Druliners to Mayo
Clinic retina specialist Timothy Olsen, M.D. At the end of February, Dr. Olsen
performed a third surgery
on Leo’s eye. The procedure, called an irridoplasty, changed the shape of the pupil
to make it more oblong, rather than keyhole-shaped, as it had been as a result
of the injury.
Dr.
Olsen also removed the remaining
sutures from Leo’s
eye. It was during this surgery that Dr. Olsen finally was able to see Leo’s
retina well and confirm that there had been trauma to the back of Leo’s eye,
close to his optic nerve. But no further surgery would be required.
Retinal detachment, cataracts and glaucoma are among the complications that can result from this type of severe eye injury. But overall, Leo’s outlook looks promising, according to Dr. Bothun. “It’s a strikingly positive thing for Leo’s life that, to this point, that he has not developed more severe complications,” Dr. Bothun says. “This is a positive predictor that his chances will be lower in developing them over time.”
Exciting progress
Once
Leo’s surgeries were behind him, the focus of his treatment shifted. “After you repair the eye from an injury
like this, the goal then becomes restoration of vision development,” Dr.
Bothun says. “This is a true partnership with the family to maximize their
child’s visual potential after such a concerning injury.”
Dr.
Bothun explained that for Leo to have a chance at seeing out of his left eye, Brooke
and Aaron would have to help Leo reestablish the brain connection and vision development.
To do that, Leo would wear a patch over his uninjured eye, forcing him to see
out of the injured one.
“If
this left eye isn’t made to see, Leo’s brain will shut off development of
vision on that side,” Dr. Bothun explains. “That’s why we work on
making the brain use the injured eye to give it the potential for which we hope.
Once you get the vision established, that’s the baseline vision one should
enjoy throughout adult life.”
“The team of specialists that’s been involved in Leo’s care has been mind-blowing. I attribute his healing and ability to see out of his injured eye to all of them.”
Brooke Druliner
“We
came home on a Friday and put the patch on the good eye. Within an hour of
wearing it, Leo began to see out of his left eye,” Brooke says. “I
handed him a ball and he said, ‘Ball.’ We were so overjoyed that he could see. From
that first hour, the change in his vision was exponential.”
At
first, Leo wore the patch whenever he was awake. In just one month, he was
seeing so well out of his left eye, he was able to take the patch off in the
evenings. Although Leo continues to require ongoing follow-up care, Brooke and
Aaron are thrilled with the progress he’s made so far.
“His
healing has been amazing. Dr. Bothun has been fantastic in terms of guiding us
on what we needed to do. He recognized how hard this was for us and really empathized
with what we were going through,” Brooke says. “The team of
specialists that’s been involved in Leo’s care has been mind-blowing. I
attribute his healing and ability to see out of his injured eye to all of them.”
HELPFUL LINKS
- Read more about eye injuries and tips to protect your vision.
- Take a look inside your eyes.
- Learn about Mayo Clinic’s Department of Ophthalmology.
- Explore Mayo Clinic Children’s Center.
- Request an appointment.