endophthalmitis complications

[topcat172]

After cataract surgery I developed asevere case of strep endopthalmitis. I had a vitrectomy to resolve the infection. Since then I was diagnosed with acute closed angle glaucoma. I  had 2  patent iridotomys but still have to use glaucoma drops. I still have only light perception as visual acuity. I had another vitrectomy last week to remove an epiretinal membrane and scartissue from the front of the eye. The retina specialist and i both hoped my vision would improve immediately but after the bandage was taken off, i still only have light perception. I now was told I have severe vitreous hemorrhaging in this eye. I was told to wait for one week and come back and would probably have to have another vitrectomy. My eye pressure is very high and was told it was due to the blood in the vitreous. Does vitreous hemorrhage increase the risk of retinal detachment? Also the retina specialist says he cannot see in the eye any better than I can see out, so we do not know if optic nerve has been damaged. Since pressure is incresing is it likely to do damage to optic nerve that we can't see? Since I can't see out of this eye, how will I know if retina does become detached? I meant to ask these questions at my appointment but I always get bad news and forget until I get home. Thanks!!

[Michael J Kutryb, MD]

I'm am truly sorry about your complications.  You have been through so much - you must feel terrible.  Regarding a retinal detachment - if you can't see much - you may not be able to tell if you have a detachment.  Perhaps you might notice new flashes of light - but that would be about it.  Some red blood cells from the vitreous can sneak into the anterior chamber and clog the drainage system causing high pressure.  It can be very difficult to control.  Also sometimes patients get a gas bubble injection into the eye and that can cause the pressure to rise as well.  You know, I am a little puzzled about the blood in vitreous.  The vitrectomy is supposed to help make vision better and is often used to remove blood, not create more bleeding.  Something does not add up.  Why the bleeding?  What is the source?  Try to keep the eye pressure as good as possible and ride out this current problem and let blood settle down and then hopefully it can be something treatable with retinal laser and hopefully no more surgery needed.  I'm worried that you might need more surgery and that prognosis is still not very good.  God Bless You.

Michael J. Kutryb, MD