post op blues

Hi I have just undergon surgery (two days ago) to have a scleral buckle put on my left eye to repair my detached retina. the sergion heralded the operation as a success as the retena has been pushed back againsed the back of the eye ball.

before surgery I could get all the way to the bottom line of a standard eye chart. After surgery I can barely get hafl way down the chart as vision is out of focus. I am also getting "fish eye lens" effect when I pan around a room.  also vision is displaced in the left eye ie my two eyes are miss aligned. this last point I expected but concerned about fish eye lens effect and degree of out of focus.

The surgeon was not as infomative as I would have liked before the operation. Does the scleral buckle distort the shape of the whole eye ball? or does it just cause a local indentation around the eye ball?

If the buckle is removed does fluid have to be injected into the eye ball to compensate for the dispaced volume caused by the buckle ?

A lot of questionns ther I know but would be very greatfull if you could answer

yours greatfully

Jon    

[Ray T Oyakawa, MD]

The scleral buckle can change the refraction in the eye.  Usually, it becomes more near sighted.  The misalignment is due to the scleral buckle.   They go under the eye muscles.  This usually gets better with time.  Rarely, another surgery to align the muscles may be needed.

If the buckle is removed (rarely done), fluid does not have to be injected into the eye.

Dr. O.

[cyclops861]

Thankyou for your prompt reply

I suppose time will tell to see if vision will return to near normal. I`m quite resigned to having to wear glasses to correct my vision, it`s a better alternative to going blind in that eye. But just seems a backwards step at the moment, when I was led to believe that eye surgury was relatively quick with results aparent soon after surgery.

Cheers

Jon    

[Ray T Oyakawa, MD]

To put into perspective,  LASIK, rare complications,  cataract surgery 1 to 2 % complications-severe visual loss probably 1 to 2 in a 1000,  retinal detachment surgery -severe visual loss about 2 to 3 %. I am a fellowship trained vitreo-retinal surgeon.

Dr. O.

[cyclops861]

OK  again it`s probably too early to tell, but my every instinct is telling me that the buckle should be removed. How long does it take the retina to attach itself to the back of the eye ball?

  

[Ray T Oyakawa, MD]

Why do you think the buckle needs to be removed??  Removal of a buckle is usually indicated if there is an infection or erosion of the buckle.  If removal is needed, it is best to wait at least 3 months and one years is preferable.


Dr. O.

[cyclops861]

Hi well why do I think it shuold be removed. Fistly my consultant said that it would be no problem to remove if necessary. secondly it feels like i`ve got a log stuffed in my left eye causing a restriction to eye ball mobility and discomfort when I attempt to move the eye ball. I`ts difficult to imagine ever reaching a stage where I won`t notice it`s presents.

I am also concerned about the "fish eye lense" effect looking through my left eye only this may suggest distortion of the lense or eye ball as a result of the buckle.

But maybe this is just post op blues and I will have to wait untill swelling subsides before making informed judgments.

All the best

Jon  

[matt_ret_d_vitrectomy]

Jon-

I'm a scleral buckle patient "survivor" myself - now about 8 months post-op.
Please be patient with your recovery, it's very hard. But, as you said, it's better than being blind.  "Success" is different for every one - if you have "vision" that can ultimately be corrected to an acceptable level on the eye chart, that is one kind of success.  Count yourself lucky to have saved your vision so far.

There have been many useful posts on this site, use the search feature to find them.  You can also click on my user name to read my posts on this topic.

Two days post-op is very early to tell how things will be "long term" give yourself and your doctor a month or better yet, 6 months to a year, to evaluate.  (I was taking some pretty good meds for the pain and discomfort at that point!)  In the meantime, try to accomodate and let your eye heal - its a very sensitive organ, and it takes a long time to recover from surgery.  The discomfort "log in the eye" feeling may go away slowly - mine hasn't yet, but it now feels more like a gentle "push" on my eyeball - only mildly distracting if I have nothing better to think about.
As for getting your sharp vision back, it's entirely normal that your eye's lens natural focal point is no longer focused on your retina - if your buckle encircle your eye, then the eye is elongated by the squeeze in the middle.  You will probably need glasses changed or contact lens to deal with that focal change.  (or an IOL lens implant, but not anytime soon).  And there could be other vision issues (aniseikonia or anisometropia) resulting from the correction in your buckle eye.  Study up and then discuss your long term future with your doctor.  Ask how soon you can start on trying/getting a new prescription for glasses or contact lens.  Don't be suprised if they tell you to wait weeks or months.  (The US standard seems to be somewhat long, partly to let eye heal, but also perhaps to let eye "stabilize" before making a prescription).
I see you are in the UK - perhaps that is why you have a "consultant" answering your questions. Be sure to get your questions answered by your Surgeon.
As for removing the buckle I've got, personally I'd never considered it.  Unless it's necessary, I feel that the fewer surgical procedures I have on my eyes the better.  
Hope you feel better soon!