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Fireworks
By Kristen Mulvihill
Scheie Vision Annual Report 2019

On July 4, 2018, Robert George was celebrating the Fourth of July just as he did every other year: lighting off fireworks with family and friends. As he was enjoying the display, a firework was launched about 30 feet from where he was standing. 

“The next thing I remember, I was holding my eye and blood was streaming down my shirt,” Robert recalled. “It didn’t hurt at first, but I knew something was wrong.” The firework had struck his left eye, causing him to immediately lose vision.

As the pain intensified, Robert was rushed to the emergency room at Penn Presbyterian Medical Center, where he was seen by a team of ophthalmologists from the Scheie Eye Institute. 

On route to the hospital, Robert remembers thinking, “Alright, I can get used to only seeing with one eye, I’ll just have to figure it out.” Luckily for Robert, he did not have to adjust to blindness in his left eye; his team of doctors at Scheie acted quickly to save his vision.  

As a result of the accident, he suffered extensive injuries to his left eye and lost most of his iris. The blast also burned the skin around his eye and damaged his lens, which caused a cataract to form.

When he was first examined, Robert was unable to read the eye chart with his affected eye, and was only able to count fingers held merely one foot in front of him.

Due to the blunt trauma inflicted by the firework blast, Robert severely injured his cornea and sclera (the white outer layer of the eye), and underwent a ruptured globe repair on the morning of July 5th to mend the damage. During this surgery, performed by the Attending Physician, Michael Sulewski, Sr., MD, with assistance from Michael Sulewski, Jr., MD, and Drew Scoles, MD, PhD, a third and second year resident at the time, the skin lacerations surrounding Robert’s left eye were also repaired.

After the first operation, Robert’s vision was still limited, and he could only see light in his left eye. Adriane Santa Croce, Director of Echography, performed serial ultrasound examinations on his eye and diagnosed a complex retinal detachment, which required additional surgery. 

On July 26, Robert underwent a vitrectomy, performed by Benjamin Kim, MD, Assistant Professor of Ophthalmology, with assistance from Robert Carroll, MD, a retina fellow at the time. During this procedure, Drs. Kim and Carroll removed the cataract in Robert’s eye, which left him aphakic, or without a lens. A significant amount of blood was in the eye from the original trauma, which was also removed. Next, they repaired the retinal detachment and placed a gas bubble in the affected eye so the retina would remain attached as it healed.

Understanding the gravity of his injuries and operations, Robert knew he was in the best possible care at Scheie. “My doctors were awesome,” he said. “They explained everything and told me exactly what was going on. They were just phenomenal.” 

Robert endured a long and draining recovery. During the initial period after the retinal detachment surgery, Robert had to lay face down whenever possible to ensure the eye healed properly.

“When I slept, I used a pillow with a hole in the center so I could lay face down. When I wanted to watch TV, I watched on an iPad that I kept below me,” Robert explained. “I didn’t even look people in the eyes when holding conversations.” In the weeks following his surgeries, he stayed home from work and required frequent post-operative visits.

Despite the severity of his injuries and the demanding recovery process that followed, struggling to keep his vision was not the most difficult of Robert’s health battles. 

“I’ve been electrocuted, I was crushed by a seven-ton roller and almost lost my leg, I was hit by a drunk driver, which rolled my truck down a mountain,” Robert said. “The recovery after this accident is probably the easiest one I’ve been through. Having my friends and family around – especially my wife and two kids – really helped, and my boss, Kevin Rabe, went above and beyond to get me and my family through this.”

With the support of his family, friends, coworkers, and team of doctors, Robert’s vision began to dramatically improve. After his eye healed, Robert received careful aphakic refraction and was evaluated and fitted for an aphakic contact lens by Regina Altemus, OD, an optometrist at Scheie. This custom lens will eliminate the remaining blurriness in his left eye and further improve his vision to 20/30.

“The result of this case is miraculous, as many of these kinds of devastating eye injuries end up with very poor vision or even loss of the eye,” Dr. Sulewski said. “Robert was able to achieve 20/30 visual acuity after several very complex surgeries and then visual rehabilitation with our top flight contact lens service.”

“When we first see injuries of this nature, the prognosis is always guarded. Retinal detachments related to severe trauma can be complex surgical cases,” Dr. Kim explained. “We had a wonderful group of surgeons that took care of Mr. George, and it really was a team effort by our department, from the time of the initial evaluation by Dr. Scoles to the final fitting of the contact lens by Dr. Altemus.”

Amidst all of the obstacles that continue to pose challenges to his health, Robert has yet to lose hope or succumb to his battles. “I’ve been dealt a full house of cards as far as I’m concerned, but you have to get up and keep going,” Robert said. “You can’t take anything for granted and you can’t give up.”

 

Robert's eye after fireworks accident

(Top) Robert's eye right after the fireworks accident. 

Robert's eye after recovering from his two surgeries

(Bottom) Robert's eye after recovering from his two surgeries.

Are you a patient interested in telling your story in a future issue of Scheie Vision? If so, call 215.662.9892 or email kristen.mulvihill@pennmedicine.upenn.edu. We would love to hear from you! 

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