Retinal detachment questions

[miriam__0]

Posted by miriam on August 08, 1999 at 11:49:13
     Flying overseas, I had a vitreous hemorrhage (like a black spider in my left eye).  A few minutes later, all I could see was a layer of moving "grease" (presumably the vitreous fluid)with specks of black "sand" (blood).  Did the hemorrhage occur because of a retinal tear?  If not, what is the connection between the hemorrhage and the retinal tear that was diagnosed three days later?  I understand they probably could not see the tear at first because of the blood obscuring the eye.
     I understand that pressure from the fluid leaking behind the retina then caused the retinal detachment.  My concern is that I should maybe have had laser surgery for lattice degeneration years before and avoided all this trauma.  
     Four or 5 years ago, I went to an expensive optometrist (not then understanding the difference between an optometrist and an opthamalogist).  I brought him two serious concerns:  1.  Significant loss of my peripheral vision, and 2.  Significant increase in peripheral black streaks (like noticing the movement of a mouse across the floor or a fly in the air, only there is nothing there).
     His statement to me was that as long as I was not seeing flashes of light,I had nothing to worry about.  Though he noticed "severe peripheral deterioration" (presumably lattice degeration) he said it was just due to aging and nearsightedness.  He did not mention that it could become a problem in the future.  He did not discuss the risk of retinal detachment or the possibility of laser surgery. With the loss of peripheral vision, should I have at least been referred to an opthamologist?  Was he remiss?  The surgical nurse said that both of the concerns I brought him were signs of retinal detachment.  
     My other question is regarding the common signs of future problems.  Upon my return home, the US doctor found another retinal tear and did laser surgery to seal it.  During all these problems, I never had the common signs: flashing lights, black curtain over my vision, increase in floaters.  How will I know if I am having another retinal tear?  Are there any signs that I can watch for?  
     Sorry this message was so long.  Thank you for any help you can be to me.  I learned a lot reading the other messages and am grateful for the forum.  Thanks a lot.  Miriam

Posted by HFHS MD-JL on August 08, 1999 at 22:20:44
People who are very near sighted are at greater risk for retinal detachment during there lifetime and those with lattice degeneration are at greater risk.  Some patients do not have symptoms prior to a tear or detachment but most have warning signs such as increase in floaters, flashing lights or the sensation that a curtain is coming down over your vision.  The symptoms that you were describing to the nurse were not classic symptoms for retinal detachment.
In general, we do not laser people if they just have lattice degeneration unless this is assoc with a tear or they are having symptoms suggestive or retinal traction or they have a history or family history of detachment.
Yes the retinal tear caused the hemorrhage because the retina has blood vessels coursing through it.  It is not uncommon for the tear not to be seen.
It sounds like you are in good hands.  Good luck.
This information was provided for educational purposes only.
HFHS MD-JL