Ask an Eye M.D. Answer Archive

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Question:
I had an acoustical neuroma brain tumor 30 years ago, with damage to the 5th facial nerve. Over the years, despite precautions, I have developed a severe corneal scar on my left eye due to improper closing of the eyelid and lack of tears. I have almost no vision in that eye, which otherwise is functional aside from the badly scarred lens. I have been told that a corneal transplant is not an option. Is that correct? Are there any other options?

Answer:
Without examining you, I cannot answer your questions for certain, in part because the information is confusing. The fifth cranial nerve is the trigeminal nerve. The seventh cranial nerve is the facial nerve. Sometimes with surgery for an acoustic neuroma, the fifth nerve is paralyzed, and sometimes both the fifth and seventh nerves are paralyzed. I suspect that at least the fifth nerve is damaged. However, I also suspect that you have been examined and had an opinion provided to you about your options. Such conditions as you describe often leave the cornea completely numb and eventually scarred as you describe. The prognosis for a corneal transplant in such cases is extremely guarded. That means that while the procedure could be performed, your eye could develop significant complications or even be lost completely because of the surgery. Most corneal surgeons would refuse to do the operation. It might help you to have a second opinion by another corneal specialist, but I suspect that what you have been told is correct.

Answered by: Ivan Schwab, MD Dr. Ivan Schwab

Categories: Eye Conditions, Eye Surgery

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Answered: Mar 06, 2013

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