A Surprising Recovery from a Severe Eye Injury
New York Eye and Ear Infirmary of Mount Sinai patient describes his experience with the NYEE Ocular Trauma Service
When John McKnight, MD, slipped on his deck, hit his left eye on the screen door handle then had to struggle to stand, he knew he could have a significant problem. But it wasn’t until he made his way to the bathroom and saw his pupil fixed and dilated and the eye leaking vitreous fluid, that he realized the possible extent of the injury.
“I knew at that point I’d ruptured the globe, which was just a horrible feeling,” remembers the 45-year-old internist who lives in Brooklyn. “That was probably the worst moment of my life, when I realized I’d severely damaged my eye.”
As McKnight drove into Manhattan with his wife for care, he paged the ophthalmologist on call at the hospital where he worked. “He said to go immediately to New York Eye and Ear,” McKnight remembers of his colleague’s advice. “Given his experience with eye trauma, he felt it was the best choice.”
McKnight arrived at the New York Eye and Ear Infirmary of Mount Sinai (NYEE) 24-hour waiting room close to midnight, and within 15 minutes was being examined by residents who suspected the globe was ruptured and contacted the attending physician on call. Early the following morning, McKnight underwent surgery to repair the tear in the eye, and was told the tear covered approximately 30 percent of the entire globe, or as he terms it, “an enormous gash in the eyeball.”
Although this initial surgery to repair the tear was a success, McKnight knew he would have to undergo more procedures in the hope of restoring vision, and he needed to find the best physician to do them. When he contacted the ophthalmologist in his practice for a recommendation, he was told, “The person you have to see is Dr. Ronald Gentile; he is the top retinal eye trauma surgeon in NYC.”
McKnight and his wife went to the appointment together, and following a thorough examination, Dr. Gentile, Professor of Ophthalmology, Icahn School of Medicine at Mount Sinai and Chief, Ocular Trauma Service at NYEE, shared his assessment of the injury and his three goals for recovery: To save the eye, to restore some vision in the eye, and for both eyes to be symmetric.
“I was shocked that getting some vision back was a best case scenario,” McKnight remembers. “I wasn’t prepared that I might not see out of the eye, and I certainly wasn’t prepared that I could lose the eye.” However, Dr. Gentile felt the eye could be saved and outlined the next surgery that would be necessary for McKnight’s recovery.
Approximately ten days later, after the inflammation had lessened, Dr. Gentile performed a retinal laser treatment that also involved removing the vitreous gel inside the eye and temporarily replacing it with silicone, as well as fitting a plastic belt around the eye to help stabilize the retina. As it turned out, because of the extent of the trauma, the retina had already started to detach by the time of the procedure.
“That first surgery Dr. Gentile performed was a marathon—nearly a six-hour surgery that required a very, very high level of expertise,” McKnight says. “And it went very well. The retina was stabilized by the laser treatment, and the other parts of the surgery went well also.”
Three months later, Dr. Gentile removed the silicone gel and performed additional laser treatment to fix the retina to the back of the eye and further reduce the risk of detachment. He also removed a small traumatic cataract that had formed. “That surgery was quite successful,” McKnight says. “The retina has been completely stable without any further detachment and so it was an amazing success.”
As a result of this series of procedures and with the use of contact lenses, McKnight’s recovery has exceeded his expectations, achieving 20/40 vision in his left eye. “When I first wore a contact lens and could see out of the injured eye was an incredible moment … it was a miracle,” McKnight remembers. “It feels like the injury is behind me at this point. Certainly I’ll always be at a higher risk of retinal detachment so I need to be checked every six months. But beyond that I’m really amazed with the outcome.”
And McKnight is grateful to the hospital and staff, and in particular to the specialist who restored his sight. “My impression of NYEE is that it’s the highest caliber of care and service,” he says. “Dr. Gentile has been an incredible physician—not only his technical abilities, but his support throughout this experience... He’s really a vision saver.”