No Problems Foreseen for Leonard’s Eye

Fans flinched as much as Sugar Ray Leonard himself when Roberto Duran landed a right-handed punch on Leonard’s left eye late in the 11th round of their fight in Las Vegas last week.

That was the eye, the famous left eye; the eye that would, it was thought in 1982, end his career. Duran sliced its lid, 20 stitches worth, and the blood poured out. He later put another 30 stitches worth of damage in the right eyebrow with a head butt. Leonard still won, decisively.

But it was the left eye, from which the retina had detatched while Leonard was training for the Roger Stafford fight, that caused all the excitement. That was the one that had surgery to reattach the paper-thin layer of light sensitive nerve cells to the inside of the eye ball. The one that fans and observers feared would plunge Leonard into darkness.

Was the money to be made in the ring worth the risk of going blind? The debate has simmered ever since he came out of retirement in 1984.

But to his eye doctor, ophthalmologist Ronald G. Michels of The Retina Center at St. Joseph’s Hospital in Baltimore, it’s old news. Why even bother bringing it up again?

Ever since performing the reattachment operation seven years ago, Michels has chanted his mantra: The eye is OK; Sugar Ray Leonard has no more risk of a second retinal detachment than any other boxer walking into the blunt force of a punch.

Other eye experts agree.

“We know that once the retina is successfully reattached, the risk (of a subsequent detachment) is the same as the other eye,” said Serge de Bustros, a physician and acting director of the vitro-retinal surgical service at Johns Hopkins University’s Wilmer Eye Institute. “He has the same risk as any other boxer.”

“I would agree with that in general,” said Carl Kupfer, a physician and head of the National Eye Institute in Bethesda. But, he cautioned, it is difficult to determine whether a boxer such as Leonard who suffered a detached retina had some predisposition to eye damage or whether it was just a random blow that shook loose the retina.

Despite the stitches to close eyes and lip after his last fight, Leonard “has experienced no vision problems, no symptoms,” Michael Trainer, Leonard’s longtime friend and attorney, said in an interview earlier this week.

Leonard had been scheduled for a complete postfight eye exam this week, but because of the stitches, the full exam has been postponed until next week.

“We wanted the cut to heal first before we had him examined,” he said. “The pressure (applied to the eye during the exam) would hurt.”

The stitches came out Wednesday.

Part of the standard exam used by Michels involves putting the fighter on his back and applying pressure on each eye to reveal any tears or holes in the retinas, especially their front edges, which are not readily visible without poking and prodding.

“I expect him to be okay,” Michels said.. “I don’t expect Ray Leonard to ever have any serious eye problems unless he got a very severe, direct blow, which he has not had yet.”

Even for boxers slower than Leonard, that is unlikely.

“The eye has an enormous amount of protection around it,” Michels said, such as the bones that protect the recessed eye balls. “It is hard to get a blow directly on the eye itself. But it can be done. Most boxers feel that if they have an eye injury, it is from thumbing.”

These days Leonard will only fight with thumbless gloves.

If such a blow does land, the quarter-sized retina suffers from the shock waves. The gloved fist compresses the eye, flattening the fluid-filled ball, forcing the sides to bulge. Inside a fibrous jelly-like material called the vitreous humor pulls the edge of the retina, creating a tear or a hole in the sheet of nerve cells.

Fluid begins to leak through the tear, separating the retina’s nerve cells away from supporting cells that provide nutrients and blood. Once separated, the nerve cells begin to die and vision is lost.

The hole in the retina can be closed by damaging the underlying cells with surgery, with cold probes or with lasers. Any of these will cause the body to form a scar.

During Leonard’s surgery Michels reinforced the edge of the repaired retina with a piece of silicon that would help it from tearing free again.

That should do it, said Hopkins’s de Bustros: “If the scar seals the tear, it is unlikely to tear again.”

Six months after the May 1982 surgery, Leonard retired. When he came out of retirement two years later, sports columnists argued whether he was risking blindness in exchange for the millions earned with each bout.

“I’d never risk my eyesight,” Leonard said in an interview in 1984. “But the doctors have told me that my (left) eye is like anyone else’s now. I want to retire when I want to do it, not when some injury dictates it.”

Although most surgeons agree that the Leonard’s risk are the same as for any other boxer, they are not zero.

Ophthalmologists David J. Smith and Bert R. Estlow of the Wills Eye Hospital in Philadelphia examined 166 professional boxers seeking a license in New Jersey from February 1982 to July 1986. Thirty-four had eye damage; five had multiple problems. The most common damage was cataract formation, a clouding of the lens.

Twenty-three fighters had some degree of cataract formation. Only two had retinal detachment, although four had tears or holes in the retina.

One remarkable finding was that two of the boxers were legally blind (20-200 vision) in one eye due to severe near-sightedness or a lazy eye. One of the boxers fought 20 pro fights with this condition. (His won-lost record was not included in the study.)

Smith, during a 1986 conference, said if it was up to him he would prohibit any boxer from fighting if he had “a history of cataract or retinal detachment surgery.”

Not everyone agrees. Said Trainer: “Our position is that if he is at no greater risk, then why shouldn’t he be permitted to fight.”