Retinal Detachment - can I ignore and do nothing?

I lost vision in my right eye 30 years ago in an accident (I am 45 now). A cataract was performed 26 years ago. Due to damage to macula, the surgeon declared I will not get back my vision.

I have been living like this for a long time and everything is fine. Now, since 6 months I have had classic symptoms of RD - flashes of light, wisps of smoke etc. and recently a curtain too. I have visited eye surgeons several times during the past few months. Currently, I need to decide whether to go for a surgery (buckling, vitrectomy) or not.

Considering the fact that, anyway, I have no vision, should I get a surgery done at all? What will be the risk if I don't  act now? The surgeon mentioned possible blood vessel growth behind the retina and membranes forming and causing eye pain, redness etc necessitating surgery in future .

Surgeries come with possible side effects and other problems. What would be the effects of ignoring the RD?

Can I go for laser retinoplexy alone?

[John C Hagan III, MD, FACS, FAAO]

I cannot answer those questions. Only an exam of your eye can tell. You will need to get this from the surgeons.
JCH MD

[avna31]

Hi Dr Hagan

I am consulting with a surgeon. I understand that if left untreated, membranes and blood vessels will grow on and behind retina, Due to lack of use, the eyeball may shrink, become misshaped and require a surgery later anyway.

So the conclusion is, even if there is no vision RD cannot be left untreated

I am posting this info so that other readers may benefit. Appreciate if you have comments

[John C Hagan III, MD, FACS, FAAO]

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[avna31]

I have heeded the doctor's advice and underwent retinal surgery. RD, Laser done, Vitrectomy with Silicone Oil replacement (due to blood clots in VH),  Scleral buckling has been done.

This was two and half months ago. The eye has healed fully. Unfortunately, there is still eyelid swelling and hence droopy eyelid and watering. My surgeon has tried a few change in medicines but not much improvement.

He is now travelling and will be back next week. Are there any suggestions?

Is there anything I can do to speedup healing? My wife is attending to me 100% enforcing doctor's directions (rest, medication, food etc etc).

The only odd thing I notice is my resting pulse normally around 60 now hovers around 90-110.

I had a full clinical test - blood , urinalysis etc turned up 100% OK. (except for slightly elevated triglycerides)

Appreciate any suggestions

[John C Hagan III, MD, FACS, FAAO]

1. Be sure that the retina MD has checked for exposed sutures. One of our best posters JodieJ had an irritated eye for a long time and was due to over-looked suture sticking up and once it was removed the pain/irritation stopped.
2. Ask the retina MD to refer you to a oculoplastic surgeon about the droopy eyelid. Chances are they will have you wait 4-6 months post op before considering any surgical elevation.
3. A resting heart rate that high is abnormal and you should work through that with your family MD likely with a referral to a cardiologist.

JCH MD

[avna31]

Thank you, Dr Hagan

The cause of all the distress has been narrowed down to very high IOP due to the silicone oil (reconfirmed at another larger hospital)

The solutions seems to be to remove the Silicon oil after completing 3 months. Both surgeons agree on this. So I am opting for this. Seems the high IOP is causing inflammation etc. Temporarily I am on Combigan and the redness has disappeared.

Reg, high pulse, I believe it is caused by one of the tablets, the dosage of which has been reduced and my pulse is dropping towards normal.

[John C Hagan III, MD, FACS, FAAO]

best of luck. JCH MD