Surgery could reverse blindness after brain injury

Patients left blind after traumatic brain injuries can have their vision fully restored through common surgery, scientists claim. 
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Even if the operation doesn't occur until several months after the accident, it results in 20/20 vision for most people. The procedure, called a vitrectomy, works by removing the vitreous gel that sits between the eye's lens and retina, and replacing it with saline solution. Researchers from Washington University School of Medicine in St Louis, the Kresge Eye Institute at Wayne State University in Detroit, and the L.V Prasad Eye Institute in India, studied patients who developed haemorrhaging in the eye related to brain injuries suffered in motor vehicle accidents. Before surgery, some patients could barely detect a hand waved in front of their faces. But a few months later, the majority had perfect vision. The researchers divided patients into two groups: those who had the operation within three months of the haemorrhaging; and those who had surgery after the designated time period.  Within one month of surgery, the average was 20/40. A few months later, almost all patients had 20/20 vision. 'These patients often have other issues related to brain injury, and we can't work on the eye until a patient has stabilized,' said Dr Rajendra S. Apte at Washington University School of Medicine.

The surgery

During the procedure, the vitreous humour will be removed from the vitreous body of your eye and replaced with saline solution. 'It was important to learn how long we could wait to operate without having a negative effect on vision.  'In the majority of cases, it appears vision can be restored, even if the surgery is done several months after a traumatic brain injury.' Accident victims and patients who experience brain aneurysms can develop bleeding in the back of the eye. This is serious because it causes vision loss and indicates that a patient's life may be in danger. When patients suffer from brain bleeds, the risk for mortality is around 10 per cent, experts believe. However, if there is haemorrhaging in the brain and the eye, mortality rates can be as high as 40-45 per cent. The researchers analysed results from 20 patients who had surgery for Terson syndrome - bleeding in the back of the eye due to haemorrhaging elsewhere inside of the head. But because many develop haemorrhaging in both eyes, the scientists were able to examine the effects of surgery in a total of 28 eyes.  'In most situations where trauma causes bleeding in the brain that then leads to secondary bleeding in the eye, it seems likely that many patients will recover good vision after surgery, even if a few months pass before the operation,' Dr Apte said.  

What is a vitrectomy?

A vitrectomy is a surgical procedure to remove the vitreous humour in your eye, along with any floating debris, and replace it with a saline (salty) solution. A vitrectomy may be recommended as a possible treatment option if you have floaters -small shapes that some people see floating in their field of vision - that don't improve over time, or if they significantly affect your vision.  However, vitrectomies are rarely carried out due to risks associated with eye surgery, and the procedure may not be available on the NHS. Before having a vitrectomy, your eye will be numbed with a local anaesthetic. 

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