cornea scar

[REMDenver]

I suffered a bad case of shingles on my face last year.  I was left with post-herpetic neuralgia and am on several medications to treat the pain.  I developed a sore eye and was told by the optometrist that it was iritis.  This recurred twice and I am now on lotemax once a day to prevent the iritis from coming back.  The problem is that I now have some corneal scaring that has left me with double-vision and cloudy sight.  The ophthalmologist told me that a transplant is the only solution but that he is reluctant to perform surgery as my chances are 50% that my vision would be worse.  He says that a chance of success is doubtful because my optic nerves were damaged.  As a musician I am unable to read music with the double-vision and my livelihood is being affected.  I also have HIV but am undetectable and healthy.  Is there anything that can help?

[Doreen Fazio, M.D.]

Corneal transplantation after herpetic eye disease is challenging because the cornea is neurotrophic (lacking nerve supply and sensation), and so it might not heal properly.  Ask your cornea specialist if a gas permeable contact lens or a scleral lens would help your vision by treating the irregular astigmatism.  If you have monocular diplopia (double vision in the involved eye only), the contact lens might help.  If you have binocular diplopia (double vision with both eyes open, but which goes away with EITHER eye closed), then this is an eye muscle problem, for which you should see a strabismus specialist.

[REMDenver]

Thank you for your response.  I did try the contact and unfortunately it did not clear up my double vision.  My ophthalmologist basically gave me the same answer regarding the prospects of a transplant healing.  I asked him about the possibility of laser but even though the scar is not deep it is diffuse and there would be no way to treat it with a laser. I guess I am to live with this condition from now on.