Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: THURSDAY, March 15, 1990 TAG: 9003162158
SECTION: NEIGHBORS PAGE: S-1 EDITION: SOUTH
SOURCE: YOLETTE NICHOLSON STAFF WRITER
DATELINE: LENGTH: Long
"It was all pretty much a shadow world already," Nagy said. "I was way beyond legally blind. I was just functioning because I was used to functioning. Obviously, I couldn't drive or read."
Two years ago, Nagy, a Roanoke resident, was referred to Dr. Frank B. Thompson, an ophthalmologist in California with a surgical procedure called scleral reinforcement. A year and three operations later, Nagy could see.
Nagy suffered from severe degenerative myopia, a condition that affects about 3 percent of nearsighted people. It is the seventh most common cause of blindness in the United States.
Myopia is an elongation of the eyeball that diffuses the focusing power of the eye. In most people, this elongation is minimal. It may only progress over a 10-year period and then stop. In severe degenerative myopia, the eyeball never stops stretching.
"As the eye begins to get longer and larger, the tissues that make up the eye get thinner, just as if you blow up a balloon. The more air you put in it, the thinner the walls of the balloon get," Thompson said.
"[The retina] begins to develop what we call a staphyloma on the back of the eye, which is like an extra bulge," he said. "[The retina] begins to deteriorate, and if that is allowed to progress, then the person can go from normal sight to . . . blindness."
Thompson's scleral reinforcement procedure stops that extra bulge from getting any larger.
Although the procedure has an almost 90 percent success rate, the surgery is not very popular. Only a handful of doctors around the world perform the surgery, and many others have never even heard of it.
Thompson said that most optometrists and ophthalmologists don't know about the procedure because not much has been published on the subject.
"I've been one of the few people writing very much about it and unless you write about a procedure, unfortunately, people aren't always aware of it," Thompson said. "But I'm in practice, too, so I only have a certain amount of time to write," he said.
Unfortunately, because so many doctors are unaware of the surgery, patients afflicted with the disease often don't know that there is a cure.
"I think a lot of doctors see these patients and tell them nothing can be done," Thompson said. "These patients get discouraged, stop seeing their ophthalmologists and end up following their optometrists trying to get stronger glasses.
"I think if more optometrists and ophthalmologists thought of the procedure when they saw a patient in this category, there would be a lot more of these operations done," he said.
In fact, it was an article by Thompson in Ophthalmic Surgery magazine that caught the eye of Nagy's ophthalmologist, Dr. Ann Sowers.
"I read about it in a medical journal and I contacted Dr. Thompson to see if he would take [Nagy] as a patient," Sowers said.
Sowers gave Nagy the article to think about.
"Of course I told her I've got to do it; I have no choice," Nagy said. Her eyesight at the time was so poor that she needed 20-diopter lenses. A diopter is a measurement of the refractive power of a lens. Most myopics never need more than four-diopter lenses.
Nagy flew to California in 1988 to consult with Thompson and underwent surgery on both of her eyes that December. Six months later, she returned for a cataract-removal operation.
"It was very uncomfortable but it wasn't painful," Nagy said of the scleral reinforcement surgery. "My eye muscles were very sore."
The surgery, which took about an hour, consisted of placing a strip of sclera - the white part of the eye - from an eye donor behind Nagy's eye to keep the eyeball from getting any longer.
"It's a fairly lengthy operation in terms of going in back of the eye, taking all the tissues down and going under all the muscles," Thompson said.
The surgery cost between $2,500 and $3,000 per eye and included several months of pre- and postoperative care. The amount is comparable with other types of eye surgery and is covered under most medical-insurance plans.
Nagy's surgery was a success, according to Thompson. The operation managed to stabilize Nagy's worsening eyesight and has even improved her vision, although it is not designed for that purpose.
"It's not an operation that's designed to improve vision although sometimes it does on younger patients. It's primarily designed to prevent them from losing the sight they already have in both eyes," Thompson said.
"[Nagy's] vision at this point is not real good, despite the fact that she's had the scleral reinforcement surgery," Thompson said. "But it's a lot better than before she had this done. Unfortunately, she had had a considerable loss of vision and a considerable amount of deterioration before I saw her.
"She's a super-nice lady and I wish I'd been able to get at her 10 years before I did," Thompson said. "If I had, I think I would have had a better chance at maintaining a lot more of her vision for the rest of her life."
Nagy will probably never be able to see perfectly without help, but she said the surgery was definitely worth it.
"I can see," she said. "With the right glasses, I'll be able to see 20/20."
by CNB