Is There A Surgery For Ocular Albinism?

Ocular albinism is a rare disorder consisting of abnormality in melanin synthesis which can occur due to the genetic defect of the gene coding for the responsible enzyme or defect in the pathway of melanin synthesis. There are a variety of functional disabilities that can occur with ocular albinism ranging from strabismus or squint to trans illumination and foveal defects.

Since there is a medical abnormality in the melanin synthesis, the surgical modality has a limited scope in the treatment of ocular albinism. Not much of the surgical treatment is available for ocular albinism and there has been only limited research on this field. Even medical treatment is also not very reliable for the respective treatment. But the functional defects created along with ocular albinism can be treated surgically and in fact very successfully also such as visual acuity defects, retinal defects, optic nerve defects, extraocular eye defects etc. When there is no surgical treatment available even for the functional disability, then only the palliative treatment can be given like using glasses etc.⁽¹⁾

If there is a coloring defect of iris then it can be surgically corrected by filling ink in the iris but there has been limited research in this area. The success of this surgery is not yet fully explored. Instead of correcting colored lenses can be used to provide the color artificially to the eyes. If there is a defect of visual acuity in ocular albinism then it can be corrected with the help of a Lasik surgery (laser-assisted in situ keratomileusis) or Smile surgery (small incision lenticule extraction) both of which have a highly successful rate. These surgeries can be used both for myopia as well as hypermetropia that is nearsightedness as well as farsightedness.

Sometimes ocular albinism can also be associated with squint also known as strabismus for which surgery can be done based on the principle of resection and recession. It involves the tightening of one side of the eye muscle known as resection or loosening of the other side of the extraocular muscle known as a recession. Also, the prism glasses can be used to cover the squinting defect of the eye.⁽¹⁾

Ocular albinism can also be associated rarely with retinal defects. This can be corrected by laser operations like laser photocoagulation, Pan retinal photocoagulation, etc. Diode lasers having a wavelength of 1093 nm can be used for such purposes. The excimer laser is also used in a few cases depending upon the understanding of the surgeon about the requirement of the patient. If there is a severe deficiency of the pigment in the retinal pigment epithelium of the eye then cryopexy is a good choice of treatment for retinal coagulation which is performed with the help of a cryoprobe. It is not useful in cases of posterior retinal coagulation because the cryoprobe is not available to go to the posterior retinal surface. In the severe cases of retinal defects, pars plana vitrectomy (partial vitrectomy) could also be needed.⁽¹⁾

Conclusion

Ocular albinism being a genetic defect that is only hereditary in nature and there is a medical abnormality of melanin synthesis, there is not much medical or even surgical treatment available for this condition. Even after so many advances in the field of ophthalmology, this area widely lacks the research required for effective treatment. The functional defects arising due to the genetic deficiencies in the eye in association with ocular albinism as well as other syndromes like chediak higashi syndrome etc. can be effectively corrected with the help of various surgeries like that for visual acuity, squint, retinal defects, optic nerve and optic Cup defects etc.

The good part about the ocular albinism is that usually, it is a structural defect only with no functional limitations whatsoever in the eye. People are living with this condition for the whole life without having any problems.

References:

https://emedicine.medscape.com/article/1216066-overview

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Is There A Surgery For Ocular Albinism?