A steak knife had pierced his right eye, cutting his cornea, slicing his lens and causing his retina to detach from some of its blood supply. Milky fluid oozed from the laceration.

Perez, of Green Bay, was visiting family in Mexico that frightening day this spring. Doctors there stitched up the outside of Jandel's eye.

Later, University of Wisconsin Hospital surgeons repaired the inside of his eye. The wiggly toddler eventually should have up to 20-60 vision in the damaged eye, doctors said.

"I never imagined he would even be able to keep his eye," said Perez, 26, a mother of three.

Not long ago, doctors likely would have removed Jandel's eye, said Dr. Michael Altaweel, a University of Wisconsin Hospital retina and trauma specialist who operated on the boy.

But new technologies — including lasers, magnets, better surgical instruments and oils and gases that act like casts allowing eyes to heal — are giving sight to eye trauma patients who previously would have gone blind, Altaweel said.

"Our ability to rehabilitate the eye and return usable vision is much better today," he said.

Both hands, both feet

Americans, mostly men under age 30, sustain about 2.4 million eye injuries each year, according to the United States Eye Injury Registry.

Doctors at UW Hospital have treated a range of traumatic eye injuries: factory workers who accidentally shoot shards of metal into their eyes, kids struck by BB gun shots or paintball pellets, older adults who fall and hit their eyes on bathtubs or bedposts.

Most of the injuries could be prevented with safety goggles or better lighting, Altaweel said.

Many of the repairs require a series of surgeries, and the procedures demand that the doctors have considerable dexterity.

Altaweel uses both hands and both feet in the operating room. One foot controls his microscope. The other foot guides his surgical instruments. One hand holds the instruments. The other hand holds a light.

He uses lasers to reattach retinas, magnets to get rid of metal and forceps to remove scar tissue. He fills eyes with silicone oil or perfluoropropane gas to keep retinas in place while they heal.

The layers of damaged cells he peels off from the inside of injured eyes are several times thinner than a human hair. The stitches he must sew are nearly as thin.

All of this is done in one of the most delicate and noticeable parts of the body, an area that bleeds easily.

"The eye is kind of a small and confined space," Altaweel said. "It requires finesse."

Nail gun accident

Patients appreciate the skill.

David Fiedler was putting roof trusses together at a house in Janesville when he lifted a nail gun to a metal plate and pressed the trigger.

The nail ricocheted back and stabbed the construction worker's right eye so forcefully the nail went through the other side of the eye.

Altaweel, who was working at a UW Health clinic in Janesville that day, stitched up the outside of Fiedler's eye at the clinic. Then he brought Fiedler to UW Hospital, where he removed his damaged lens and repaired his torn retina. A few months later, he implanted an artificial lens.

Fiedler, an avid hunter, figured he'd never have the depth perception to shoot a deer again. But while his peripheral vision is limited in the injured eye, his sight in that eye, with glasses, is 20-25.

He killed a deer last year, the first one since his eye injury in 2002. "I was very happy about that," he said.

The 29-year-old from Beloit has traded construction work for a warehouse job, but not long ago he used a nail gun to help his brothers remodel their parents' basement. He kept his face far away from the tool.

"I am a little more cautious now when using a nail gun," he said.

Hit by a soccer ball

Kendra Loch is careful now, too, when she plays soccer.

Loch, a senior at Memorial High School who will be a captain of the soccer team this spring, was playing against West High School in May 2007 when a soccer ball hit her left eye.

"It was gray spots all over," said Loch, now 17, who also lost some of her central vision because the impact of the ball tore a hole in her retina.

After Altaweel operated, Loch had to keep her head down for 10 days so her gas bubble "cast" would stay in place. Soon after that she was back to soccer, but with goggles.

Loch still sees some spots, but her vision in the injured eye is back to 20-30. "It's definitely much clearer than before," she said.

Jandel and the knife

It's too early to know how well Jandel Perez will be able to see.

After the steak knife somehow landed in his eye in April, he had surgery at American Family Children's Hospital in August. Altaweel suctioned the milky fluid, removed the severed lens and used a laser to put the retina back into place — "like spot welding," said the doctor, who also filled the boy's eye with silicone oil.

Last month, Jandel returned for another surgery. Altaweel removed the oil and saw that the retina had healed. Dr. Sarah Nehls placed a cornea from a donor on his eye.

Later, Jandel will get an implanted lens or special glasses or contacts, Altaweel said. The boy will wear a patch on his good eye for a while to force his damaged eye to work.

Within a few months, he'll likely have up to 20-60 vision in the eye, good enough for daytime driving, Altaweel said.

That sounds pretty good to Jandel's mother, Maricela.

"I'm just so happy that he can keep his eye and be able to see," she said.