At The Bedside: Seeing 20/20 becomes possible again for patient with help from UTHealth Houston and Robert Cizik Eye Clinic optometrist

More than a decade after undergoing radial keratotomy surgery in 1990 to correct her myopia, or nearsightedness, Shubhra Ghosh noticed she was beginning to strain her eyes to see.

Radial keratotomy, a precursor to Lasik surgery, involved making multiple cuts across the cornea to correct vision to 20/20. For Ghosh, who had worn glasses since she was a child, it seemed like a good option.

But as patients have aged in the decades since their surgeries, they discovered a drawback: the surgery made the cornea extremely unstable, and vision could deteriorate over time.

“The goal of the surgery was to flatten the cornea and correct the myopia,” said Stephanie Handal, OD, optometrist with the Ruiz Department of Ophthalmology and Visual Science in McGovern Medical School at UTHealth Houston, who sees patients at the Robert Cizik Eye Clinic. “The problem is that, with time, patients’ vision can shift too much, and they can become dependent on glasses again.”

Ghosh was prescribed glasses in 2004 to correct her vision. She then progressed to contact lenses, which are specially made to fit over the top of cornea and actually rest on the sclera, the white part of the eye.

“I tried several versions of lenses over the years, and they did well,” Ghosh said. “But last year when I went back, they didn’t improve my vision. I couldn’t see as clearly. That’s when I saw Dr. Handal, and it was the best thing that could have happened.”

Handal said Ghosh had more cuts on her corneas than usual, which in turn made them more unstable. The key, she said, was finding the right fit of contact lenses, which replace the function of the cornea.

“There is an art to fitting them, and from visit to visit, the cornea can change, so you need to know how much to tweak them,” Handal said. “I also noted that she had cataracts, and that was impacting her vision. Correcting the cataracts could give her a clear window, and then we could find a lens to focus that clear window and make her cornea stable again.”

“Dr. Handal took exceptional care of me,” Ghosh said. “She is not only highly knowledgeable, but also remarkably thorough and patient. In complex cases like mine, that level of attention truly makes all the difference.”

Ghosh underwent cataract surgery in one eye in January with Ahmad Kheirkhah, MD, associate professor of ophthalmology and visual science at McGovern Medical School and ophthalmologist at Robert Cizik Eye Clinic. She underwent surgery for the second eye the first week of April.

“Thanks to Dr. Kheirkhah’s expertise, he was able to successfully implant intraocular lenses that now allow me to see clearly — even without glasses. It was unbelievable. I have not seen that clearly in decades,” Ghosh said.

Ghosh called her treatment “a life-changer.”

“My vision has drastically improved. Before, when I was driving, I could see but I didn’t have the same confidence,” she said. “Now I have no trouble venturing out at night. It has just made my whole day so much easier. We rely on our eyesight every waking moment, often taking clear vision for granted. In my case, Dr. Handal and Dr. Kheirkhah helped make that a reality — and I’m incredibly grateful.”