What Doc

[Roadkill95]

I had a vitrectomy for a retinal scesis with detachment approx 3 months ago one week after the first surgery I had to go back and have a buckle put on as there was area that was ok before had fluid under it. They now say its ok and healed. My distant vision was 20/16 in both eyes before the surgery, just wore glasses for reading and out to 2-3 feet.
Now after the 2 surgeries the vision in my eye is 21/600
I have developed a moderate sized cataract in that eye from the gas bubble.
I did see a cataract surgeon at the same hospital and said he didn't think the poor vision was all from the cataract, the retina doc says I should have good central vision as my problem was in the bottom of my eye.
I'm not sure about the docs here as I had to have 2 surgeries to fix the retina and now not sure who is right about the vision. Without naming docs this was in Boston, I was always told was the best for eyes, in fact I had to travel 150 miles to get there.
I guess my question is would a moderate size cataract cause this much vision loss?
How do you know if the surgeon is up to the task?
A lot of docs look good on paper or may be at a good hospital and may not be the best.

[Ray T Oyakawa, MD]

An OCT will deterimine if there is a retinal problem.  However, it could be normal and you could still have decreased vision from the retinal detachment even though it did not affect the macula. You should also get a PAM test.  This test (invented by a fellow resident and a professor at Hopkins) projects a visual acuity chart on to your retina through the cataract and it can determine your visual potential after cataract surgery.  This test depends on the skill of the technician.  Also,  there is a similar test called a RAM test.

Dr. O.

[Roadkill95]

Not sure what the corrected vision would be I just had a brief visit while in Boston with the cataract Doc they did try though not good I know that.

Wouldn't the retina doc see these other problems that you mention?

I don't go back until the end of the month to see both.    I keep thinking maybe I need to see another retina guy, but hate to muddy waters if all is well. Just wished I was getting the same story from both of these guys.

[Ray T Oyakawa, MD]

There are a few factors for the decrease in vision.  The buckle will make you more nearsighted.  What is you best corrected vision?  A mild cataract will also cause a decrease in vision but this usually can be corrected with glasses.  This goes back to my question.  You may have developed a macular problem such as macular edema or an epiretinal membrane.

Dr. O.

[Roadkill95]

Should read 2months not 3 months ago