Dear Dr. Hagan,
I have been reading your posts and hoping you can help me. I had a vitrectomy 6 weeks ago on my OS eye for severe PVD floaters. I was unable to drive or see well out of the eye. 25g, with Kenalog and an air bubble. The surgeon said everything went great, no issues. Immediately after the surgery, I noticed slight distortion in straight lines and my eye feels off. The muscles feel stiffer and like I’m looking through a prescription that is too strong. Everyone said it was the air bubble and not to worry. At my 1 day post op appointment, my pressure was a 5; I became anxious because I had previously read about hypotony maculopathy. The retina doc said the pressure was expected, she examined my dilated eye and it was “normal.” No leaks, she stained the eye to check, etc. she sent me home and I started my drops. The air bubble dissipated after six days but the distortions remained.
My acuity is fine but I am overdue for an exam; OD 20/20, 20/30 OS. I have been very distraught and went to Mass Eye and Ear ER five days after surgery, where my exam and OCT scan were normal. The pressure was at 14. The doctor sat with me and explained the imaging. No wrinkles, edema, swelling, pucker. Again, this doctor told me there was no maculopathy. My surgeon examined me two weeks ago and took another OCT of both eyes; carefully reviewed each scan, scrolled through the entire retina, and compared my left eye to a scan taken before surgery. There is no retinal change. He said my lens has trace peripheral changes possibly due to the air bubble used, but he said he wouldn’t even grade it a 1. He strongly feels it’s a refraction issue, that perhaps my astigmatism increased, and I have an eye exam on Monday. I’ve had this eye my whole life and never experienced distortion. I have read a simple vitrectomy should not change your prescription.
I’m very disoriented wearing my contact lenses, but much less so when wearing glasses or nothing at all. I’m a 44 yo high myope; at my last exam in 2019 I was -11 with .75 astigmatism in the left (operated) eye. I stayed under at -10.50 to avoid reading glasses but my spectacle prescription is -11.50 with the cylinder for astigmatism. I never wear them except while recovering from the surgery, but while I did, I did not feel this level of disorientation that I do in my contacts which are under corrected. At times it almost feels like the eye muscles are struggling.
The distortions have remained stable; an Amsler grid vertically shows lines ever so slightly undulating and ghosting, horizontally a tiny blip appears then flattens; I’ll blink and it will reappear wherever I look again. It then flattens out again and sort of rumbles along the line. Almost like a heart monitor going flatline. A pinhole test improves the distortions but the little blip will still occasionally appear as I move my eye around.
Here is my OCT scan - top image is from December pre surgery, bottom is a few weeks ago. I apologize for the quality, I took a screenshot with my phone at the appointment.
If you have any ideas what could be causing this, I would greatly appreciate it. I have been sick from worry and anxiety for weeks. The only theory I have is that somehow it’s connected to the transient low pressure but I have no evidence to confirm. My eye still has some pain and redness which seems connected to wearing my contact lenses. I have not had a visual field test, but I don’t seem to have any other visual issues, blind spots etc.
Thank you for reading.