Low Vision Assessment and Management of a Leukemia Patient Undergoing Chemotherapy: Everybody Deserves Good Functional Vision

Abstract

Background: Acute myeloid leukemia (AML) is a malignant disorder of the hematopoietic stem cells characterized by abnormal proliferation of myeloid blast cells in the bone marrow and blood, preventing them from further differentiating into the specialized cells of the bone marrow and thus causing pancytopenia. Consequently, AML can affect various tissues and organs (liver, skin, central nervous system), including the eye and orbit. Ophthalmic manifestations of leukemia are more frequent with acute than chronic leukemia. It can affect all intraocular structures.
Methods: We present a 17 year old male student with AML, who developed severe painless progressive reduction of vision. Visual acuity (VA) was found to be Hand Movement (HM) in both eyes. Patient’s ocular B-scan showed every other ocular structure to be normal except the retina and vitreous. They showed some areas of tumor deposit and some atrophic areas. Patient was counseled on reason for reduction in vision and referred to the optometry clinic for expert management. Patient was referred to Low Vision unit for low vision assessment as there was no improvement after refraction.
Results: There was a great improvement from HM to 6/5 after assessment, training and prescription of low vision aids.
Conclusions: Hope was restored when low vision aids were prescribed. Everybody deserves functional vision notwithstanding life expectancy as long there’s life.