Is it possible to perform replacement surgery of the lens etc. in a patient with ocular albinism and nystagmus? If so, who can do this and can I get patient referals?
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Answered by Richard E. Gans, M. D. (xx102@ofcn.org)
The simple answer to your question is "yes." Cataract extraction with lens implantation can be performed on an individual with albinism and nystagmus. The surgery would be no different from conventional cataract surgery and could be performed by any ophthalmologist.
The more complex question has to do with whether the vision would improve as a result of cataract surgery. The answer to this is that it might not.
Ocular albinism refers to a condition where the body lacks the cells necessary to produce melanin, the pigment-producing cells. There are three types of ocular albinism:
1. Tyrosinase-negative oculocutaneous albinism
2. Tyrosinase-positive oculocutaneous albinism
3. Ocular albinism
In all three conditions, vision may be severely impaired, although the first two types tend to have the most difficulties. Decreased vision relates to several factors, the most important of which is that there is macular hypoplasia. In other words, the center of the retina fails to develop properly. (The exception to this is female carriers of the ocular albinism trait who may have the potential for normal vision.)
In addition, severe light sensitivity stems from the inability of the non-pigmented iris to block excess light entering the eye. The sensory deprivation from the poorly formed retina leads to the nystagmus -- the abnormal eye movements.
When a cataract complicates the underlying visual difficulties from albinism, vision can worsen. Removing the cataract can potentially bring the vision back to its condition prior to cataract formation, but it cannot correct the visual problems that are inherent to the albinism condition.
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Copyright, 1994. Richard E. Gans, M.D.
A RICHARD E. GANS, M.D. 11
A A OFCN Primary Sysop, The Eye Clinic 111
AAAAA xx102@ofcn.org 11
A A A C A D E M Y O N E 1111
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