Dr has given me a Retinal detachment surgery date aftr 2 mnths. should I be worried?

[Ashraf1984]

I had a tennis ball hit my eye almost 13 months ago. I never noticed much but every now & then i felt something blocking my view. i always thought it was due to me not wearing my glasses. i was being negligent. a week back i realized that I couldn't see 100% with my right eye when i closed my left eye.
I've met a few ophthalmologists and everyone has said that I have a retinal detachment in the lower part of my eye.
My vision currently is 20/40 on my right eye.
the surgeon who is to perform the surgery has given me a date of 1st May since he doesn't have dates available.
is 2 months a long period to wait to get the surgery done?
is there a chance of me deteriorating my vision further during this time and is there anything to I can do to prevent it from being damaged further?
Also, i have to work until i get operated to support my family. is it safe to work? my work involves a lot of driving and being on the laptop.

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

I can only speak to the United States.  Waiting 2 months for a retinal detachment operation would be totally unacceptable and not meet the standard of care and the surgeon would incur legal risk of malpractice.  Yes the retina detachment could extend and if it pulls the reading part of the eye off (macula) the prognosis for good vision post surgery goes way down. The risk of extension is lower because its the inferior retina not the retina at the top (superior) where gravity helps it extend.  You may live in a country where this is the best you can do.  If there are options available to you and a qualified retina surgeon is available who could do the surgery sooner that is something you should strongly consider. The type of work you do is not the kind that makes it more likely the detachment will get bigger. Learn from this and protect your eyes from work or sport injuries with proper protection. Those reading these don't play racquet sports without protection and consider also other sports, I had a serious eye injury from soccer in the office this week.

[Ashraf1984]

Dear Dr. Hagan. I'm really greatful for your timely response and advice. Thank you so much.
I'm due to get my surgery done in the Government hospital and the earliest date available is 1st of May.
If I could trouble you a little bit more, can you please let me know if it would be safe to wait for 2 months or should I visit a private hospital and get the surgery done?
The surgeon at the government hospital told me that I will have to keep my head parallel to the floor and lie on my stomach for 8 weeks and I wouldn't be able to see for those 8 weeks. Only after 8 weeks he would be able to tell me if everything is well or if I would need further treatment. I have read on the internet about patients who's been able to see well in as low as 2-3 weeks.
Also, what are the chances of me not needing further treatment after the first surgery? Considering that our insurance doesn't cover private hospitals and the treatment at private hospitals can get very expensive.
Could you please advise.

Again, thanks a lot for your advise. It truly means a lot.

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

If it is within your means I would consult a private, highly regarded retina surgeon. The wait is unacceptable in the USA.  Second such prolonged head positioning is not used much anymore especially for a retinal detachment on the BOTTOM of the eye.  If the retina is detached on the bottom of the eye it should give you a field defect on the TOP of the field of vision.  85-90% of retinal detachments can be re-attached with one operation. A smaller % need a second or even a third procedure. Even if the retina is re-attached it does not necessarily mean all the vision recovers especially if the macula is detached.  A reasonable course of action would be to pay for a private 2nd opinion and ask the retina surgeon in private practice the same questions you are asking me.

[Ashraf1984]

Dear Dr. Hagan,

Thank you so much again. as advised, I will consult with a private retina surgeon.
As you mentioned, I have a field defect in the top of my vision. when I see with one eye, most of the part a little above eye level is blacked out and when I look straight, some of the straight lines curve at the center of my vision.

I will most definitely keep you posted on my treatment and recovery. You have been very very helpful.
Thank you so much once again.

I'm very grateful to have met you.

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

Your description of what you see is very very concerning as the curve at the center of your vision suggests that your macula may be detaching. I would get at least a second opinion. I'm shocked and disheartened that you, and presumably others in your country (you don't need to say what it is) have to wait this long for what would likely be same day surgery in USA.

[Ashraf1984]

Dear Dr. Hagan,

Thank you for your advise again.

I'm just back from meeting my surgeon at the Govt hospital. I was there to convince him to prepone my surgery date.
He's asked me to run some tests (blood & xray) and get the results and then they will give me a surgery date.
However, he was adamant that I don't need an urgent surgery.
I told him that my central vision is curvy. he said it's bound to happen and that I may have detached my retina 6 months or a year back and these cases there's no urgency to perform the surgery.
He also told me that there are chances of me losing some eyesight forever post surgery or maintaining the same eyesight. he didn't mention anything about recovering eyesight. I always though I'd either maintain or recover eyesight. I never knew I might lose some eyesight post surgery.
As advised by you, i will be meeting a surgeon from a private clinic today as I'm starting lose confidence at the surgeon Govt hospital.

I will keep you posted on the updates.

Again, thank you so much. without your guidance, I may have waited for 2 months.

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

The best way sometimes to evaluate if you have been given good advice by a physician/surgeon is to get a second opinion.  If your consultant agrees with the Govt surgeon you will feel better, if the consultant doesn't then you will have two options.

[Ashraf1984]

Dear Dr. Hagan,

Hope you are doing well.

Just wanted to keep you posted on the update.
During my consultation at the private clinic, The surgeon said that he would disagree with the govt surgeon and that only a part of my detachment was very old. Rest of the detachment was new. He advised me to have the surgery done immediately.
I underwent the surgery at the private clinic on 13th March. I had the scleral buckle + Vitrectomy. It's bn 10 days and the surgeon told me that it's holding well. I'm to keep my head down or to the left for another week until my next follow up.

Thank you again :)

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

Thank you. I'm glad the new surgeon recognized how inappropriate the advice of the "government" surgeon was.  Remember when you have RD one eye chance of RD in other eye may be as high as 10-15 % so be sure you see retina doctor regular and report any new problems such as floaters, flashes, loss of peripheral vision immediately.
       Also there is no reason that even a "govt' doctor should give bad advice.  If there is a mechanism to report him or file a complaint consider doing so.  Unless his superiors are made aware of this he will continue to go on practicing substandard medicine/surgery.

[Ashraf1984]

Dear Dr. Hagan,

I wish I could report the govt surgeon but it's not an option I can take up. I'm an expat in this country.
Also, my Dr checked my left eye and said that there's a tear that will have to be sealed in a couple of months.
I have a follow up on Tuesday, so far everything is holding up well. I've read so much about people redetaching their retina after months of surgery that it's kind of keeping me anxious. I'm always worried that it might detach again and even my Dr can't say for certain thay it will not detach again. He said that there's 90% chances of the surgery being successful.

Thanks again :)

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

Best of luck. If you have time post a follow up in several weeks.

[Ashraf1984]

Dear Dr. Hagan,

Thank you and surely will post an update :)

[Ashraf1984]

Dear Dr. Hagan,

Hope you are doing very well.

Just wanted to post an update.

it'll be 3 weeks for the surgery tomorrow and my next appointment with my surgeon is after 3 weeks.
My last appointment was on 27th March and the Dr said everything is holding on well.

He also said that I need not keep my head facing down all the time and that I can return to work and drive if I feel comfortable.

I'm back to work but however I'm not able to drive as yet.
I have crazy double vision which makes it hard to focus when driving. it's kind of hard to even walk in a crowded mall. probably due to the double vision.

I think I still have probably around 60% of the gas still in my eye. i can see like a water line in my eye above which the vision is sort of normal but not clear and below it's like completely blurred and the vision is similar to under water. The view is like zoomed in.

I also have some growth on my conjunctiva which looks bizarre but the Dr said it's normal and have given me steroids for that.

The Dr has told me that I can return to my normal life and that the vision will keep improving in coming days, weeks and months. However, he told me to stay away from swimming (diving), vigorous head movements etc. He also said that  I may recover good vision since I had pretty good vision before the surgery.

I do however have a doubt if you could clarify. lately I've been reading a lot about PVR and how it's the most common cause for re-detachment. Everything seems to be holding on well so far. Is there any chance that I may develop this complication?


Thank you so much once again :)

Best Regards :)

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

Yes there is a chance but its small. Your surgeon will watch for it. Your medications reduce chance of occurring.  Did you have a 'scleral buckle" or just vitrectomy and gas?

[Ashraf1984]

Dear Dr. Hagan,

I had scleral buckle + Vitrectomy.

Thank you :)

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

The scleral buckle will make that eye more nearsighted (Myopic) and often the imbalance of glasses RX can cause adjustment problems, eye strain and even mile headaches.  Just be aware of this.

[Ashraf1984]

Dear Dr. Hagan,

Well noted.
Thank you once again :)

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

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[Ashraf1984]

Dear Dr. Hagan,

Hope you're doing very well.

Just wanted to post an update.

It's been 7 weeks for the surgery now. I had my last follow up on 24th April and the next will be in another 3 weeks time.
The Dr. said that the Retina is holding up well and flat. I inquired about PVR and my Dr said that it usually happens if the retina is not completely flat and my retina looks completely flat but he didn't rule it out and told me that it would usually happen within 6 months of the surgery. I'm just keeping my fingers crossed that everything works out well.
My vision is improving. my eyesight is +4.00 in my operated eye. I wonder if my eyesight will improve further because the Dr didn't give any definitive answer but suggested I get cheap glasses for now.
As you mentioned, the Dr also said that I will be nearsighted due to the buckle.
I get headaches almost everyday. Sometimes it's just above the eye and sometimes on top of the head. it's worse sometimes but painkillers gives relief after a while.
The Dr also said that I will need to have cataract surgery done but if I wish, I can decide not to have it even for 10 years but I will always have a curtain in my vision if not done.

I still have some gas left in the eye. I guess it's about 20% now.

My life is getting back to normal. I've rejoined work and I'm able to drive well during the day but it's a task to drive at night due to double vision.
Every now and then I tend to close one eye and see from the other eye just to see if everything is alright.

Thank you once again for your advise and suggestions. I can't thank you enough.

God bless.

Ashraf.

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

Don't understand what +4.00 is that is not a visual acuity. If that is your 'refractive error' you are not myopic but farsighted.  Once the retina surgeon is done you will probably need to work with a comprehensive ophthalmologist to get your eyes working together.

[Ashraf1984]

Dear Dr. Hagan,

Hope you are well.

Apologies I mixed up the signs. my prescription read SPH: -4.00, CYL: -1.5 & Axis: 105

Thank you :)

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

that makes more sense. Do you know what the other eye is?

[MrPresley]

Great reports thus far @Ashraf1984, glad for your outcome. In my case my operative eye is at -4.5 after post-vitrectomy cataract surgery and my other eye which has never had any surgeries is -6.0.

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

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[Ashraf1984]

Dear Dr. Hagan,

My left eye is -0.5.
My right eye was also same before surgery. Post surgery it's -4.0.

Thank you,

Ashraf khan.

[Ashraf1984]

Thank you Mr. Presley. By Gods grace everything is holding well. I just prat that it only improves.

I haven't had my cataract surgery. I'm still just 8 weeks in to recovery.

Wish you the best :)

[MrPresley]

Same to you Ashraf, the vision recovery after vitrectomy proceeded very slowly in my own case, over the course of 9 months to a year, but it did. That’s about the length of time that the cataract may take to become much more noticeable.

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

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[Ashraf1984]

Thank you Mr. Presley.

Fingers crossed :)

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

I agree

[Christie_Rosa]

My doctor scheduled me one week after I was diagnosed with a retinal detachment. 2 months is way too much time for something to go wrong.

[ethanscott]

Two months is unacceptable. Anything regarding the eye is prone to worsening every second, and hence any surgery or any procedure that needs to be done on the eye needs to be immediate and on priority.
This is what my doctor said when I got dust in my eye. It caused so much irritation throughout the day and my doctor advised me to come as soon as it happens as postponing the treatment can cause unnecessary damage to the eye.

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

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[DesperateRetina]

Best wishes for a full recovery Ashraf1984.

We all can thank Dr. Hagan for his help and kindness in offering his time so freely.

Be well.

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

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[Ashraf1984]

Thank you :)

I'm greatful to have found Dr. Hagan :)

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

Hope you are still doing well Ashraf1984 with your private clinic surgery.

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

You are welcome

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

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[Ashraf1984]

Dear Dr. Hagan,

Hope you are doing well.

Just wanted to keep you posted on the update.
During my consultation at the private clinic, The surgeon said that he would disagree with the govt surgeon and that only a part of my detachment was very old. Rest of the detachment was new. He advised me to have the surgery done immediately.
I underwent the surgery at the private clinic on 13th March. I had the scleral buckle + Vitrectomy. It's bn 10 days and the surgeon told me that it's holding well. I'm to keep my head down or to the left for another week until my next follow up.

Thank you again :)

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

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