Surgery - Help, Eye Shrunken, Smaller

Hi,
I had a penetrating eye injury (14/December/2007), my Macular was damaged and scarred.

After a about 1 month my retina detached, caused by the scarring, it affected my vision at the top. I had 3 more operations to attach the retina (a total of 4 operations in the space of about 3 months). My last operation was about 1year and 6months ago (March 2008). I also held the eye shut for about 2-3 months straight, fearing that it could get infected. I have retained some vision, mostly peripheral and blurry (no lens).

Today (1/September/2009) everything is together and stable, majority of the retina is flat (except the scars). I have no lens, a gel or oil in the eye and 2 bumps that look like a grain of rice located on the bottom corners of the eye. My Eye pressure has been low, The last to visits with the ophthalmologists, my eye pressure was 20/April/2009 = 13, 15/June/2009 = 8. My eye lid is drooping and looks sunken. Doctors say the eye has shrunken in size. When ever I go out I ware sunglasses, I never get caught with out it. This has affected my confidence causing anti-social, depression and stress. I just want to look normal.

Because I held the eye shut for 2-3 months I fear that Phthisis Bulbi (PB) is occurring. From my understanding, the eye shrinks because its not being used, aqueous production stops and the eye goes blind. I sometimes see a white light, not flashing like it did before the retina detached. This white light occurs less frequent and is like a ball of light moving in a set direction that lasts for a good second.
My eye is sometimes bigger and some times smaller.

If I put a patch on the good eye and use/exercise the damaged eye, is there a possibility that the eye will grow back to its original size and avoid PC?

Nutritionally, what foods are good to eat to maintain healthy eyes (I currently eat Goji berries and Spinach)? Is there any food or steroid that stimulate the production of aqueous?
What about Vitamin E, would it help the scar to heal better, and make it more flat?

Surgically, The Doctors tell me that in the future they will probably take out the gel/oil. If this is done they would need to replace the gel/oil with something similar to aqueous solution. True?
Is it possible to bring the eye pressure/size to the normal size (same size as my good eye) by putting more aqueous solution?

Due to the nature of my injury, is it possible to go cockeyed?

Thank You For Your Time,
Regards, Eliran

[Vision1985]

oops.. posted this in the wrong section

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

Not sure I know what you mean wrong section.
JCH MD

[Vision1985]

sorry, I'm new on this website and not sure how things work. I posted this in the Eye Care Community, then after that i figured out that i might need to post it in the "Ask a Doctor" Forums (Eye Care (Expert Forum)), so I didn't think any expert would answer my question because it is in the wrong section. should I re-post this question in the  Expert Forum, or is it fine to ask here?

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

The physicians that answer both forums are all practicing board certified ophthalmologists appointed by the American Academy of Ophthalmology. The other forum is answered by Eye MDs that do not have the time to answer all the postings so electronically only a certain number can be posted/24 hrs. Dr. O and I have a little more time to devote to answering questions. We can't guarentee an answer but most are and we try to do at least one follow up question if appropriate.

1. You did not cause PB by holding your eye shut. It wasn't a good idea. actually keeping it closed for so long raises bacterial counts on the eye, increase the temperature on the surface and predispose to infection. also with the eye shut there is no effort on the part of the brain to "fuse" and the eye may drift in or out.

2. The most likely cause of PB is scarring in the eye pulling on the ciliary body and showing aqueous production. Or there could be a traumatic damage that has the same effect.

3.  No change in your diet or vitimans will help. The most import thing for you by far is meticulous protection of your good eye from another injury or disease. you should be wearing protective glasses, avoid eye injury activities and wear safety goggles for things like mowing yard/weed eater.

4. Only some one that can examine you eye can tell you about the prognosis.

5. You can always ask for a second opinion.

6. Putting "balanced saline" in the eye when the oil is replaced can temporarily raise the IOP but it will drop again unless you eye continues to produce your own aqueous at a near normal rate.

JCH MD

[Vision1985]

Thank you very much for your time and reply.
I have more questions, but i'll ask them at a later stage if i cant figure it out.

Thank You Again,
Regards, Eliran

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

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