should I go to a retinal specialist?

[Ed1951]

After having lighting streaks, a friend of a friend was told by her ophthamologist that there was no retinal tear or detachment so far, and that she would continue to monitor the situation.  The next morning she woke up with half her vision in one eye gone and was sent to a retinal specialist who then did the 3 port surgery.  He told her that there had, indeed, been a retinal tear the previous day, but that only retinal specialists have equipment that is sufficiently sophisticated to have detected it.  He said had she come to him the previous day, her surgery would have been simpler and the results better.  Finally, he said that in the future she should come directly to a retinal specialist.

I myself was examined by an ophth. this morning (Monday, 5/11) for lightning streaks.  She told me that the vitreous has separated from the retina but at this point there is no tear or detachment.  I am supposed to go back later this week for another exam, unless something changes in the meantime.  I felt very confident in her skill, but subsequently heard of this other situation.  I am now wondering if I need to go to a retinal specialist right away rather than wait.  Any advice you can give will be appreciated.

[John C Hagan III, MD, FACS]

I think the retina specialist was overstating the case and that it is speculation about whether it was there the day before or not. We have a large retinal practice in our office and its not rare for a patient to see one of our retina MDs have a PVD diagnosed and then in a day or two have more symtoms, loss of field of vision and have a retinal detachment.

I can also tell you that most general ophthalmologists are quite capable of diagnosing retinal detachments.  Moreover because of their narrow focus on retina problems the retina Eye MD has less experience with catracts, glaucoma and neuro-ophthalmology problems.

Your friend "had a change"  we always tell patients "if something changes or something new develops come back for a re-evaluation".  

If you are comfortable with your Eye MD it is not necessary to see a retina specialist unless your Eye MD refers you or if you are going to worry yourself sick.

JCH III MD

[kanan]

My advice is to get your dr. to refer you IMMEDIATELY to a retinal specialist.

I have had three surgeries since March 2007 for retinal detachment and am still not "out of the woods"  Had I gone to the specialist when I first noticed the signs I would probably not be in the predicament I am in now.

Good Luck to you.
Kanan

[Ed1951]

Thank you so much for your response. It really helped me.

[AnnaE]

Ed,

Do you have severe myopia, lattice,degeneration, or has anyone else in your famil had retina problems? These factors would cause you to see a retina specialist. My ophthalmologist should have referred me to a retina specialist years before my three detachments, because I had all three risk factors.

An excellent doctor such as the ones on our forum would have referred me. If you have additional risk factors, I would urge you to see a retinologist now..

I think the story you heard was wrong, or, as the doctor says, the retinologis exaggerated.. Retinologists can help with a detachment if they get the first few weeks. My ophthalmologist would not respond to me when I knew I had a detachment, neither would 2 ERs.

The answer lies in how many risk factors you have, and what your symptoms are. When my retina detached, I had pepper like floaters racing around in my eyes, and flashing lights. I tried so hard to get help, but no one would listen.I thought I was going crazy. My symptoms subsided, but I did not see the curtain until it filled 1/4 of my vsion, 2 months later. I realized that it was not my imagination, and I sought help from a retinologist. But it was too late to save my vision.
You cannot be too cautious. No one has any idea of the trauma brought about by lost vision. Trauma and loss and isolation.

My daughter says she had no symptoms. She was only 18, however, and both retinas detached at once. An ophthalomologist caught this on a routine exam, and she had surgery in a few days with a retinologist. She is fine.

I wish the best for you.Write back to the doctors if you have more questions.

[John C Hagan III, MD, FACS]

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