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Eye Care (Expert Forum)
Retinal detachment during the labour
Answered by
Michael J Kutryb, MD - Ophthalmology, Cataract Surgery, glaucoma, Laser Vision Correct
Kutryb Eye Institute - Titusville
Our Ask A Doctor Ophthalmology Forum is where you can post your question and receive a personal answer from physicians affiliated with the American Academy of Ophthalmology.
Retinal detachment during the labour
by cbr125r, Jul 22, 2009 02:01PM
Hello,
I am 22 years old and I live in U.K. I've been shortsighted since my childhood. I had retinal detachment and my first surgery on the right eye when I was 19 years old. I had 'a scleral buckle without drainage of fliud in March 2006' for my first surgery. However, after one year I noticed that vision on the right eye is worse and as doctor confirmed that there is 'a futher break with persistent leakage which was not identified at the initial operation' I needed one more surgery. However, after few weeks retina of the right eye detached again, so doctors decided to fill it with oil to keep the retina of my eye attached. I havent had any more surgeries after then as my ophthalmologist explained that nothing worse can happen when oil is in the eye and they will remove it when it is safe to do that. After last appointment they told me that there is cataract on that eye now and probably it developed in the last six months as this is when they saw me last time.
So current situation: about -7.50 shortsighted on the left eye (I haven't had surgeries and any problems with this one except shortsightedness) and I can only see white fog on my right eye because of cataract and oil inside it (by the way, scleral buckle hasn't been removed and its still there too).
I am 22 years old and I live in U.K. I've been shortsighted since my childhood. I had retinal detachment and my first surgery on the right eye when I was 19 years old. I had 'a scleral buckle without drainage of fliud in March 2006' for my first surgery. However, after one year I noticed that vision on the right eye is worse and as doctor confirmed that there is 'a futher break with persistent leakage which was not identified at the initial operation' I needed one more surgery. However, after few weeks retina of the right eye detached again, so doctors decided to fill it with oil to keep the retina of my eye attached. I havent had any more surgeries after then as my ophthalmologist explained that nothing worse can happen when oil is in the eye and they will remove it when it is safe to do that. After last appointment they told me that there is cataract on that eye now and probably it developed in the last six months as this is when they saw me last time.
So current situation: about -7.50 shortsighted on the left eye (I haven't had surgeries and any problems with this one except shortsightedness) and I can only see white fog on my right eye because of cataract and oil inside it (by the way, scleral buckle hasn't been removed and its still there too).
Doctor's Answer
by Michael J Kutryb, MD, Jul 25, 2009 01:55PM
, Jul 25, 2009 01:55PM
Just throwing in my two cents. My research so far has been unable to find an article showing an increases risk of retinal detachment with vaginal childbirth vs c-section. If you think about it you often cough and gag after c-section so that would cause strain. Until you or someone else can find the support in the medical literature, it seems at present at least, that regular labor and delivery might be the option your national health plan with provide. Keep researching.
MJK MD
MJK MD
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They checked my left eye and apart of shortsightedness its alright. However, I dont know why, I dont trust them. My mother said when she had me she had to push really hard and her eyes after delivery were so red and capillaries of both eyes are visible since then. I understand I should trust what doctors say, but Ive only got one eye now and if anything happens to it that means Im blind. So, if Im not going to have more than two children in my life, why should I risk?
I read some articles about this and it doesn't look that it was proven and doctors know what the truth is.
So what is your opinion about this? What would you do if you were me? It doesn't look I have choice as they didn't give me a choice, they just said I don't need it and only patients with certain health conditions get c-section. Ill see consultants next week again, so maybe I could persuade them.
I wrote on this forum maybe two years or year ago and I asked DR John C Hagan III, MD, FACS - Ophthalmology what is probability of the left eye detachment and his answer was 'Your risk of a RD in the other eye is probably about 2-6%. You can do nothing to change that so see an Eye MD at least every 6-12 months and go in immediately if you have flashes, floaters or loss of field of vision.' Would normal labour increase that percentage figure?
Due to your problems, I am guessing you are highly myopic (> -6D) in which case your eye is not alright. If this is the case and you have already had an RD in one eye, you are right to insist on a c-section. Increases in IOP during the severe valsalva actions that you will be undertaking during delivery are very dangerous to your eyes and have the potential to cause worsening of your myopia at the minimum....and might easily lead to an RD. I dont think this is a stretch. In fact, there are patients on this forum who have had c-sections just because of their myopia.
Oh and with this degree of myopia, Dr Hagan's numbers are wrong. A highly myopic eye has a 5% chance of developing an RD in one eye (vs 0.3% in general population) . The risk of then developing one in the fellow eye is much, much higher due to your myopia. In non myopes with one RD, the risk of an RD in the fellow eye is around 15 - 20%. I would put your risk much higher than that. Throw in extreme IOP spikes during delivery and, well, you have a problem. This is very dangerous situation for you but you have come to the right place!
Were you born prematurely by any chance?
I would recommend that you seek the care of an eyeMD specializing in retina and discuss this issue with him/ her. It would be wise to confirm that your good eye does not have retinal tears that might predispose to retinal detachments. If anything was observed on dilated funduscopic examination, they might recommend a laser treatment.
Dr. Feldman
Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California