pain 5 years after scleral buckle

Hello,

I am experiencing an uncomfortable and painful sensation in my buckled eye.  The pain is around the upper part of the eye/buckle.  I have seen two retinal experts, and they both saw nothing wrong and instead commented that the buckle was "nice" and "in a good position."  However, this pain is not going away.  Some background: the pain is not related to movement (like getting up or sitting down); my blood pressure and eye pressure look OK, although I have some signs of beginning glaucoma and family history of it (I'm 30 years old); and I still experience flashes in the area the retina was detached.  

The history:  trauma in 2001, retinal detachment first diagnosed and corrected in 2004, pain began in 2007 and has steadily gotten worse. The pain is now so annoying and distracting that I am wondering if it would be better for me to somehow have the buckle removed if possible and take my chances with the retina detaching again.  Am I correct that the worst-case scenario would be that the retina then subsequently detaches, and I have to undergo the procedure again?

Since I am running out of options for help, any thoughts or advice would be appreciated.  Thanks in advance.

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

May need to see a third retina Eye MD. Specifically:

1. Look for exposed suture or retinal 'hardware' this can be sometimes hard to see.
2. rule out localized infection
3. rule out "intrusion' of buckle
4. ask about cutting the buckle (like letting out your belt to reduce pressure on stomach)

JCH MD

[remarque]

Thanks for the helpful assistance!  Would you please answer a few followup questions?

1. Will cutting the buckle solve the exposed suture or buckle?  What if the exposed portion of the buckle is still in contact with my eye and hurts?  

2. Why not remove the buckle rather than cut it?

3.  If the buckle is merely cut, what happens if the retina detaches again, and I need another buckle?

4. Is it a concern that I still get flashes in the area that the retina was torn?

5. Can you (not sure if this is within the rules of the forum) recommend a specialist in Colorado to help me with this?

Thank you very much for your time and attention.

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

1. No. Exposed sutures need removed and exposed hardward needs covered or removed
2. Less invasive procedure
3. Only an exam by a retina ophthalmologist can tell if anything needs to be done with the buckle. Yes removing involves risks. Yes if it detached it might need rebuckled
4. Only an exam can tell
5. I don't know any personally. you can go to www.aao.org and find a retina MD near you that is a Fellow in the Am Acad of ophthal

JCH MD

[marks1737]

I also had a scleral buckle placed about 6 years ago, and have had nothing but problems since. My vision is so profoundly nearsighted if I don't wear any corrective lens or glasses it is disorienting. The muscles in my eye were damaged by the surgey and my focus in my right eye is down to the left ( near the tip of my nose), so wearing glasses isn't optimal because I don't see "straight" out of my right eye, and if I do wear glasses for a prolonged period I get cluster headches. and probably the most annoying aspect is at night (because of the lengthing of the eye) I get severe dry eye which many nights wakes me up, or I am so dry in the morning I can't find my drops fast enough. My surgeons remarks or plan for all these aliments is drops, drops, and more drops. He has since been fired by me, the next doc said I need to see my original surgeon, Finally my optometrist recommended to a new doc and I see him next week to see if I have any options: releases, removal, or some other procedure. I will post a follow-up. Good luck with your eye!

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

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[semee25]

Hi there,
I'm experiencing the same problem you have described - severe eye pain, 5 years after surgery. Do you have an update on how you handled your situation? I'm having trouble getting the doctors to understand my condition. Not sure if the buckle will need to be removed?

[remarque]

Hi semee25,

I saw a glaucoma specialist who gave me a sterioidal solution that seemed to help.  Apparently the problem was inflammation.  

If that is not your problem, then I would guess your buckle is in a bad position.  You may to see several doctors before you can find one with the expertise to detect this.  You might also try to find someone to cut the buckle, as suggested above.

[remarque]

I believe it is also possible that scar tissue from the buckle formed in such a way as to perhaps push or pull the buckle against the sutures.  Regardless, I think the steroidal solution would be worth a try.