Retinal detachment

[sweetpea53]

My son has been seeing floaters for over ten years. Before going to work overseas, he had a complete physical check up.  An ophthalmologist said that he had lattice degeneration.  Six months later, he rechecked his eyes and was told his eyes were fine.

A year later, he was back to the U.S. for vacation and had his eye checked with another ophthalmologist.  He was told that he had a retina hole. It appeared chronic.  A few days later, he decided to check with another retina specialist to see if he really had a retina hole, just to make sure.

Fist, a technician took him in for questioning and vision testing.   She put eye drops into my son’s eyes, then told him to wait in a waiting room for 15- 20 minutes until his eyes were dilated.  Less than five minutes later, a doctor approached us.  He said that he worked with the doctor with whom we intended to see.  He told us to come into the room so he could examine my son’s eyes.  We told him that it had just been five minutes.  He said it was OK and put several different eye drops into my son’s eye.  

This doctor did not wait until my son’s pupils dilated.  He forcefully pushed down on my son’s eyeball several times with different scopes.  Even with numbing liquid, my son said that he felt extremely uncomfortable and complained of seeing purple after ward. The doctor then proclaimed that my son had a retinal detachment.  He came out to tell the doctor that we intended to see.  This doctor came in, poking my son eyeball repeatedly with a long thin metal object and said that my son had a retinal detachment and needed surgery.  We said that my son had to leave for work overseas in a few days and could not stay for surgery.  The doctor said that he could do a Scleral Buckle or laser treatment to contain the problem right away or the next day.

We were skeptical.  We decided to ask a family doctor for advice.  She told us to see another specialist and not to mention any names or what had happened.  We went to see another retina specialist two days later. This doctor said that my son had a localized detachment on the upper part of the left eye.  He needed laser to weld the retina back.  So my son did the laser treatment. He left for overseas work the next day.

My son is in a country where medical care is limited.  My primary concern is how to preserve my son’s vision.  My questions are:

1. What is the chance that my son will have a retinal detachment in the next twelve months? My son is young; we have no family history of retinal detachment or eye disease except myopia.  

2. When the detachment starts, how much time does he have until treatment has to be done before losing his vision?

3. Will my son be able to recognize symptoms of subsequent retina detachment?  We know the warning symptoms of retinal detachment are seeing a flashing light, sudden increase in floaters, or a shadow or curtain in the field of vision. However, my son did not have any of those symptoms before the last retinal detachment, except seeing purple after the doctor was done pushing down on his eyeball.

4. The doctor who did my son’s laser treatment said that there was no restriction on his activities after the Laser treatment. The earlier doctor said that if my son decided to have the Laser treatment, then he should not carry or lifting heavy things afterward. Which one is correct?  If the later one is correct, then how long does my son have to avoid heavy lifting?  We can’t ask this doctor because we do not want to contact him again.

Thank you very much for your help.

[John C Hagan III, MD, FACS]

First of all the examination of a eye to determine if RD and how big and where the holes are is very uncomfortable: bright light and the poking is an instrument called a scleral depressor. So the MDs and staff were not being rough with him.

1. No one can give you a risk rate not even the MDs that examined him.

2. It varies some retinas detach completely in a matter of minutes and others stop, wall off and never progress even without treatment (chronic retinal detachment).

3. No not necessarily will he recognize them. Some RD occur without symptoms like this one.

4. Go by the directions of the Eye MD that did the surgery.

JCH MD

[sweetpea53]

Is it normal for ophthalmologists to exam the eyes  when they are not fully dilated  and by force?  

[AnnaE]

What do you mean "by force"?

Seems like your son needs to see an eye MD before 12 months--what did the surgeon say?

I know that you are upset by this threat to your son's vision; I have had detachments and lost vision. However, please pay close attention to the details of everything, as you seem to be doing.

The behavior of the doctors is a separate issue. If their behavior turns out to be inappropriate, you can take action. However, concentrate first on your son getting the best possible care.

This eye/retina  damage demands the care of your son, and everyone around him. Please make sure you are following the surgeon's directions. You are also correct to get feedback in other places, like this forum.

I hope he is well.

[John C Hagan III, MD, FACS]

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[Lefteye625]

I couldn't say about whether your son was fully dilated or not, but I can tell you from my experience that the examination is really uncomfortable!  My doctor was apologetic but had to do what he had to do, I guess.  I had a a complex retinal detachment that had gone misdiagnosed in 3 visits to an opthamologist.  I'll tell you, those 3 visits were not nearly as difficult for me to endure, but were a waste of precious time!  

I'm sorry for your son's bad experience.  I hope he'll do well.

[John C Hagan III, MD, FACS]

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[AnnaE]

I have undergone very painful exams--poking, bright lights. They check for hemorrhages, etc. I have had 5 retina surgeries. Please check with the surgeon when he should be seen again. I suggest 3 weeks, six weeks, three months, 6 months after the surgery. But all this depends of so many factors.

[John C Hagan III, MD, FACS]

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