BIRMINGHAM, AL — Yitzhak Schilit thought the argument was over. The 16-year old Israeli turned away from his classmate and never saw the physics textbook hurled at him. The book, ironically titled In the Blink of an Eye, struck Yitzhak squarely in the left eye. The eye ruptured, a severe ocular injury. In the blink of an eye, Yitzhak’s vision in his left eye was gone.
Ophthalmologists in Israel treated Yitzhak and stabilized his eye, but told him he would never regain its use. They recommended it be removed. But Yitzhak and his parents were not willing to give up so easily. They were prepared to investigate any remote chance that he could regain vision in that eye.
A family friend, a retinal specialist in Baltimore, told them there were eye surgeons in Birmingham who have had remarkable success in repairing major ocular trauma. That information led to a relative in Israel who knew a UAB (University of Alabama at Birmingham) researcher. He directed the family to Robert Morris, M.D., a UAB associate professor of ophthalmology.
Morris, who is president of the International Society for Ocular Trauma, is a pioneer in the treatment of severe ocular trauma, along with colleagues Douglas Witherspoon, M.D., and Robert Phillips, M.D. Using new techniques they have developed and instruments they helped design, Morris and colleagues have previously enabled patients to regain sight in eyes that other physicians thought were lost. Their patients include Emily Lyons, blinded when Eric Rudolph blew up a Birmingham abortion clinic in 1998; Ellen Bomer, a victim of the 1998 terrorist attack on the American embassy in Nairobi; and Oren Almog, another young Israeli, whose eyes were damaged in a 2003 terror bombing at a Haifa restaurant.
Yitzhak’s mother reached Morris, who urged them to come as soon as possible for exploratory surgery at the Callahan Eye Foundation Hospital at UAB.
“There is no test following eye trauma that can definitively determine whether vision is irretrievably lost,” Morris said. “But with new surgical techniques, we now have the ability to explore the back of the eye following trauma and see the extent of the injury. In many cases, we find that the optic nerve is still viable and the retina, although perhaps damaged, is repairable. Fortunately, that was the case with Yitzhak.”
During three hours of surgery at UAB on March 21, Morris found that Yitzhak’s retina had been pulled away from the back of the eye by the force of the rupture but it was still connected at the optic nerve, which was undamaged. There was healthy, appropriate blood supply to the retina and the cornea had suffered only modest damage. During surgery, Morris called Yitzhak’s parents, Shoshanna and Moshe, to tell them he was encouraged by the exploration and went back to work to save Yitzhak’s eye.
He cleaned out accumulated blood and debris tissue from the eye, smoothed and reattached the retina, lasered its edges and restored proper pressure to the eye. In another irony, the surgery took place on the same day that other surgeons had planned to remove Yitzhak’s left eye.
The next day Yitzhak, his parents, Morris and nursing staff met in an exam room. Morris removed a patch protecting Yitzhak’s eye. Yitzhak now could reliably see light each time it was shined into the eye, which was all Morris expected at this early stage. Within a week, as the eye healed, Yitzhak could identify large letters with the injured eye. It will be up to three months before Yitzhak will know for sure how much vision he will regain. Vision in the injured eye will never be what it was prior to the injury, but Morris believes Yitzhak will have functional vision.
“Many physicians in the U.S. and elsewhere are pessimistic about saving an eye after serious trauma,” Morris said. “But we’ve shown that with recent advances in technology and technique, we can save many eyes that previously were justifiably removed. We are saving eyes with functional vision, so that bilaterally injured people can see to move about and handle activities of daily living, and people with a single injured eye can salvage the eye in reserve. In young men such as Yitzhak, that is especially important.”
Morris and colleagues are spreading the message that badly damaged eyes can now often be saved. The technology exists, but the awareness lags, he said. And while it will take longer than the blink of an eye to build that awareness around the world, Morris, Witherspoon and colleagues are persevering — one eye at a time.
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