No True. Such Permit. Very Assassins. Wow. (naamah_darling) wrote in little_details,
No True. Such Permit. Very Assassins. Wow.

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Surgically-Induced Blindness

I guess I'll pony up the second blindness-related question of the day.

I have a character who is about to be rendered totally blind via surgery. Won't this be fun for him!

They are going to sever the optic nerve before it enters the skull and splits at the chiasm.

1) What procedure would they use for this?

Contrary to what I thought at first, going in through the natural eye opening itself seems to not really be an option; from what I'm looking at, it's probable he'd be given a lateral orbitotomy (squick-safe, diagrams only, see fig. 5 for the procedure I think is right), meaning they'd cut a hole in the rim of the eyesocket, go into the bowl of the orbit through the hole, cut the nerve, and then put the bone back and close it up, leaving muscles intact. However, most orbitotomies are performed to remove tumors, so they need that extra room for extraction, which is not necessary here.

I'd like the procedure to be as minimally invasive as possible while still preserving eye muscle control. Is there any other way to do this without cutting bone? All I need is a name. What procedure do I start researching?

Insight? Thoughts? Help? Please don't make me call an eye doctor and ask creepy questions!

2) Tech level is about on a par with the very best and most brilliant late 19th-century/early 20th century medicine, which means no vinyl sutures to hold the bone in place. Would they screw it back in, wire it, or what?

3) What would the aftereffects of a surgery like this be like? Bandaging, pain level, bruising, recovery time? Long-term effects?

4) Am I correct in assuming that he will not have pupillary response, as that's a function of the optic nerve, but will retain the ability to move his eyes, which is a function of the oculomotor nerve?

5) What am I not thinking of?

I am completely grossed out by my own question, and so sorry I've basically doomed myself to seeing grody pictures of eyeballs, but damn, I need to know where the guy's scars are going to be!
Tags: ~blindness, ~medicine: injuries (misc), ~medicine: injuries: eye injuries, ~medicine: ophthalmology & optometry

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