03:12pm Wednesday 13 December 2017

Multidisciplinary team restores child's vision after eye laceration caused by a toy

“My husband immediately held a towel to her face to not only stop the bleeding but because he didn’t want us to see how badly she was hurt,” says Elvira Loera. “Our first thoughts were, ‘we have to get her to Loyola.”

Once at the Loyola trauma center in Maywood, Sophia was quickly assessed and the team immediately called in Charles Bouchard, MD, MA, chair of the Department of Ophthalmology. “Loyola is a level 1 trauma center which means our patients have access 24/7 to medical specialists to care for the most severe and complex cases,” says Dr. Bouchard. “Sophia’s cut was very deep and it was possible that she would lose her eye. After counseling the parents as to the severity, I took her to the operating room, scrubbed in and set about to save as much of her eye as possible.” Dr. Bouchard stopped the bleeding and repaired the corneal laceration.

After the initial surgery to close the laceration, the ophthalmology team and her family were cautiously optimistic that with ongoing care she would be able to keep her eye. But because of the extent of her injury, Sophia would have ongoing challenges during the healing process. 

“During examination, the inside back of her eye could not be seen due to hemorrhage in the back of the eye caused by the initial intense trauma,” says retina specialist Felipe deAlba, MD. Dr. deAlba is associate professor and director of the Retina Service at Loyola University Chicago Stritch School of Medicine

Sophia underwent a second surgery by Dr. Bouchard and James McDonnell, MD, pediatric ophthalmologist, to remove the cataract and to place an intraocular lens. The lens is located near the front of the eye behind the iris and focuses images. 

“Because Sophia was so young at the time of the injury, her brain was still developing. The eye plays a crucial role in that development process and we needed to be sensitive and also proactive to foster that growth,” says Dr. McDonnell, professor and Director of Pediatric Ophthalmology and Adult Ocular Realignment at Loyola University Chicago Stritch School of Medicine. Dr. McDonnell sees Sophia on an ongoing basis to coordinate her eye care as she matures. 

Peter Russo, OD, director of the Optometry Services, specializes in contact lenses and general eye care. He fit her with a rigid gas-permeable contact lens to help correct her vision and address the irregular astigmatism due to the trauma. She also was prescribed bifocal glasses. “Teaching Sophia’s parents how to put a hard contact lens into the eye of their 3-year-old was a challenge, but the whole family was willing to do whatever it took to make sure Sophia did not suffer any vision deficiency,” says Dr. Russo, a professor at Loyola University Chicago Stritch School of Medicine. “With both devices, Sophia has almost 20/20 vision in her damaged eye, thanks to the surgery and corrective measures.”

Ophthalmology is not only a highly detailed field of medicine but also that has 10 subspecialties with their own fellowships. “The eye is valuable and complex,” says Dr. Bouchard.  “As an academic medical center, Loyola invests heavily in covering all 10  subspecialties so patients receive the best care at one convenient location. A team of five of us in our department cared for Sophia to restore her vision.” 

Sophia’s electronic medical record helped the team of five coordinate care in real time. “The ophthalmology department is very close physically, as we work in the same clinic, and professionally as we all talk to each other and confer on patient care,” says Dr. McDonnell. “We respect each other’s specialties in eye care and appreciate the value we all bring. Sophia’s miraculous recovery is a testament to the entire Loyola eye department.”    

To strengthen the weak eye, Dr. McDonnell is guiding Sophia through a patching regimen and is seeing her for regular office visits. “The dominant eye is covered allowing the brain to focus on strengthening the vision in her injured eye,” he says. 

Sophia is now in second grade and still has regular eye appointments at Loyola. “Sophia is a normal girl. She goes to school, plays soccer, takes dancing lessons and does everything appropriate to her age,” says her mother. “Through the entire process, she has always been easy-going and positive, which is a true blessing given the complexity of her care routine.” Dr. McDonnell agrees, saying, “I know that Sophia is at the center of her parents’ world and I am honored to be trusted with her care.”    

The Department of Ophthalmology offers a complete range of comprehensive and subspecialty eye care. All Loyola ophthalmology physicians are board certified with  subspecialty fellowship training. Together with Loyola optometrists, the ophthalmologists offer comprehensive diagnostic services and personalized treatment for adults and children. As a tertiary care facility, the ophthalmology department uses the most current, state-of-the-art equipment and procedures. Loyola’s ophthalmology team also has a long history of international service, providing free eye care to some of the world’s most underserved communities.   

Loyola University Health System (LUHS) is a member of Trinity Health. Based in the western suburbs of Chicago, LUHS is a quaternary care system with a 61-acre main medical center campus, the 36-acre Gottlieb Memorial Hospital campus and more than 30 primary and specialty care facilities in Cook, Will and DuPage counties. The medical center campus is conveniently located in Maywood, 13 miles west of the Chicago Loop and 8 miles east of Oak Brook, Ill. The heart of the medical center campus is a 559-licensed-bed hospital that houses a Level 1 Trauma Center, a Burn Center and the Ronald McDonald® Children’s Hospital of Loyola University Medical Center. Also on campus are the Cardinal Bernardin Cancer Center, Loyola Outpatient Center, Center for Heart & Vascular Medicine and Loyola Oral Health Center as well as the LUC Stritch School of Medicine, the LUC Marcella Niehoff School of Nursing and the Loyola Center for Fitness. Loyola’s Gottlieb campus in Melrose Park includes the 255-licensed-bed community hospital, the Professional Office Building housing 150 private practice clinics, the Adult Day Care, the Gottlieb Center for Fitness, Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park.


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