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Cataract surgery post retinal detachment
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Cataract surgery post retinal detachment

I had a detached retina 7 months ago which caused my eye to develop a small cataract. Since then my eye sight has gotten worse. I emailed by retina surgeon and asked her to see me. She wrote back and said she would not see me unless an ophthalmologist said there was a problem with the retina and the cataract wasn't the culprit. The ophthalmologist said it was most likely from the cataract. In the meantime, I have been given a new prescription for glasses (my last pair only lasted 4 months). My concerns are as follows:

1. What if it isn't the cataract and the regular ophthalmologist is missing something?
2. How soon after retina surgery is it safe to do cataract surgery?
3. Should the cataract surgeon be someone who has done several surgeries on post-retina surgery patients? (I have been told "cataract surgery is cataract surgery" no matter the eye problems). The retina doctor has no concern regarding this as she says "it isn't her area" and she doesn't have an opinion as to who should do the surgery.
4. I really want a second opinion on my eyes from a retina specialist. However, since I have an HMO and the retina surgeon refuses to refer me, how do I go about this? The ophthalmologist in the HMO won't go against the retina doctor and send me for another opinion

These are the only two eyes I have. I am only 51 years old and could live another 30 years or so. I don't think it is unreasonable, to want a second opinion regarding my lattice degeneration in the other eye, especially since the retina surgeon has flip flopped between lasering the eye and not lasering the eye. And because of my current worsening of sight, I'd like a second opinion in my RD eye as well.
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12 Comments Post a Comment
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203589_tn?1267478770
I doubt that an ophthalmologist who performed a dilated eye exam would miss anything significant. Most likely your worsening vision is indeed being caused by the cataract. Talk with your ophthalmologist and tell him/her about your worsening vision and how it's impacting you daily activities (ie unable to drive at night, light sensitivity, etc). This should make your doctor aware of your difficulties and need for surgery.

If your doctor sees no retinal problems than proceed with the cataract surgery. Most general ophthalmologists are refractive surgeons.

Not all cataract surgery is the same as different people have different eye conditions and surgery may pose great risks such as for those with types of uveitis or glaucoma.

If you want another opinion go to your primary care provider and ask him/her to refer you to another ophthalmologist or you can go to www.aao.org to find a doctor near you.
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233488_tn?1310696703
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Avatar_m_tn
Thanks for the response. The ophthalmologist is aware of my worsening vision. I just want some guidance as to who is the best person to remove a cataract from someone with a RD experience. I have read on the NIH Web site that it should be someone experienced with RD patients. And I go back to "why is it so difficult to get a second opinion from a retina specialist?" I belong to an online group for RD patients and I am the only one who is not followed by a retina specialist. I am only 7 months out and some of these people had surgeries years ago. Also, I do think a regular ophthalmologist is capable of missing something something that a trained retina specialist would not. I have heard many horror stories about this very thing. When a doctor says (which was said to me) "I don't think it is your retina" you don't feel very secure in the diagnosis. Again, thank you for taking the time to respond.
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Avatar_n_tn
Your eyes are more important than money.  Get a copy of all your records and go see the best retinal specialist that you can find and pay for the consultation yourself.  Many of us have had to do just that.  Don't let an insurance company dictate the health of your eyes.
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233488_tn?1310696703
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233488_tn?1310696703
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Avatar_m_tn
Thank you for your comments. That was part of the problem. I was willing to pay out of pocket but couldn't get a retina specialist to see me without a referral. However, a friends cousin just referred me to some retina docs at Stanford and I have an appointment! What a tangled medical web we have! Thanks again.
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233488_tn?1310696703
It you think medical care is convoluted and tangled now-----wait till the government takes it over and the US starts to resembel the national health services of UK and Canada that so many have expressed their dissatisfaction with here on these eye forums.

JCH MD
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Avatar_m_tn
Yes, I see what we have to look forward to and feel that I have experienced it within my own HMO which we pay $650.00 a month for to add me to my husband's policy! For that amount of money, I could have seen several outside retina specialists by now. Thank goodness for friends with connections. And thank you for hosting this community.
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Avatar_f_tn
Oh! I so feel your pain. 3 weeks ago, I started experiencing flashes and floaters ... since I've already had retinal tears and surgery on one eye, I immediately called the doc. My opthmalogist and medical dr sent me to the ER. During that visit, the doc shined the light in my eye (the one the doc looks down your throat with ...) in my eye, said he saw nothing, and suggested I come back if I was still having problems. (FRUSTRATING!) The on-call opthmalogist (who happened to be my doc since I was 13 --20+years -- refused to come in since the ER doc saw nothing.

When I got home, I remembered the name of my retinal surgeon, called them. The nice on-call doc said to come in the next morning first thing.

Then I got to deal with the receptionist who was REFUSING to let me be seen since I did not have a referral. I tried to explain that I had seen the ER, talked to this retina doc last night, and that I was not going to go to my opthmalogist just to be sent back in 30 minutes. I was then told (nastily) "you do NOT need to give me any attitude, we WON'T see you." I then told her to call the police since I wasn't leaving. Finally, the doc came out and addressed the problem, explaining to his receptionist that he had ASKED me to come in.

I am now recovering from a buckle and vitrectomy. Guess I did need to be seen ...

Short story -- Don't be rude (I wasn't) but insist on being seen if you have known symptoms. I wasn't even asking for my insurance to cover this (they did however). Explain your symptoms. Usually if you can get past the receptionist, they will look at you.
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740516_tn?1360946086
Lets see if this d..comp is working ok today and I  finally can write you...
As a can see we have many things in common, RD appart
1- Lack of money . As a brazilian I know a lot about Public Health Service chaos - my first surgery was taken in a private clinic that,by the way, I couldnt afford . Family paid after I had been sent back home from the hospital I supposed to get help in a city nearby . At this moment I'm back to our SUS service- thats the name thing has here , means Unified Health Service and a lot worried in coming,going and arriving on time for my appointments- its almost impossible follows a schedule facing big cities traffic.
2- Abandoned by doctors . Thats how I feel at this moment - and my surgery was two months after yours - completed 5 months day 9.
At the very beguinning there was a time when I had 4 at the same time :
1- The first oftalmo, private
2-The sec oftalmo , public - to give me those referalls
3-Third one- recomended by the first when I couldnt get help at the place. Private, did the surgery in his clinic but his business is cataracts so
4-Cames the next, the retina especialist.Did my VPPR OK, but was never much "affective " so to speak. Must be happy now after sending me for a another public hospital,were I'm suppose to get rid of the oil and take the cataracts off together
Keep mailing two of them- the ones I have the direction but ...
Now in a University Hospital, my problem is recognize WHO  
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740516_tn?1360946086
Sorry,page problems
The problem is recognizing WHO is a doctor in the middle of that crowd reunited in the appointment room :-)

Hope I can keep counting with my American doct,at least ;-) as well as with some good friends here and outside here.
If theres something I do learned is that RD is a pretty democratic stuff...
Good luck for you all
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