Following the injury, Hung underwent surgery to close the eyeball, but vision in his left eye could not be restored. Associate Professor Doctor Nguyen Xuan Hiep, Director of the High-Tech Eye Center at Tam Anh General Hospital, diagnosed Hung's left eye with a dense corneal scar, severe intraocular damage, and eyeball atrophy – common consequences of a ruptured eyeball, severely limiting the potential for vision recovery. Although the eyeball was preserved after surgery, the corneal surface remained unstable, easily rubbing against the eyelid, causing persistent irritation that could progress to corneal ulcers, recurrent inflammation, chronic pain, and aesthetic concerns.

Associate Professor Hiep assessed that the patient's cornea had developed extensive scarring, with very limited potential for surface restoration; therefore, conjunctival flap surgery was the optimal method.

Doctors perform surgery on a patient. *Photo: Tam Anh General Hospital*

Doctors used the patient's own healthy conjunctival tissue to cover the severely damaged corneal area, thereby creating a stable eyeball surface and reducing friction with the eyelid. After the surgical site stabilized, a thin prosthetic eye was fitted to address aesthetic concerns.

According to Associate Professor Hiep, the surgery was challenging due to the patient's history of severe ruptured eyeball, which resulted in complex surface structural changes. The cornea had extensive scarring, intraocular structures were difficult to observe, and the remaining healthy tissue was limited. Doctors had to carefully select the position and method of conjunctival mobilization to stabilize the eyeball surface while minimizing the risk of complications.

Post-surgery, Hung no longer experienced eye pain, was discharged the same day, and was advised to avoid rubbing his eyes and activities that irritate the eye surface, use medication, and attend follow-up appointments as scheduled.

Associate Professor Hiep recommends that individuals with a history of severe eye trauma undergo regular check-ups and not be complacent about symptoms, to ensure timely intervention and limit long-term complications. For post-traumatic ocular surface disorders, mild cases can be treated medically with lubricants, artificial tears, or monitored. When damage progresses, with extensive corneal scarring, an unstable eyeball surface, or chronic corneal ulcers, surgery is required. Even if emergency eyeball preservation surgery is successful, the eye's structure rarely returns to normal after a ruptured eyeball. Patients may suffer chronic complications such as corneal scarring causing persistent irritation, dry eyes, dull pain, or eyeball atrophy.

Ly Nguyen

*Patient's name has been changed