Extremely light sensitive after a retinal detachment surgery

[taurus1203]

I had a scleral bucking surgery 6 months ago on my left eye after diagnosed a partial retinal detachment. The surgery seems to be successful and my retinal was re-attached quite well (according to the surgeon). But I still extremely light sensitive and always get hurt by the light. I still need to wear 2 dark sunglasses (one over another) to drive or have a walk in a garden even at 6pm. I have moderated tinted lens for indoor. I cannot make it too dark as this can make the eye cannot see anything. But this tinted lens is not dark enough to protect me when there is some sunlight passing the window. I always get hurt by the sunlight from the shopping mall or the office.  I cannot watch TV (or patch one eye). I read books and computer using tinted lens. But the tinted lens further lower the vision of this eye.
I closed all the blinds at home to avoid the sunlight. I (and my family) suffered a lot with this serious light sensitivity.

I talked to my surgeon and even he cannot explain it. He only said that I have a mild cataract after the surgery and this may cause the light to bother me.
Can anyone tell me what is the possible cause of the problem ? Is it because of the retina is not recovered ? Or a mild cataract can cause that much trouble.


Taurus

[Pot1234]

Hi  had a ritina attachment  7 weeks ago and had my check up' all is great thay said last week'' but woke up this morning with bright light hurting my eye a bit ?

[JohnHaganMD]

If still painful call your surgeon's office and report

[JodieJ]

My problem related to a post-surgery image size difference between my eyes, which initially caused excessive tearing and increased light sensitivity and (after a number of months) intermittent double vision.  My retinal specialist ignored my repeated requests for a referral, so I fired him.  Another retinal specialist I consulted implied that my symptoms were all "psychological."  Other doctors told me that my condition was "untreatable."

But I did eventually find help.  A Dutch researcher prescribed (online) a contact lens/glasses combination which reduced my image size difference and instantly relieved my symptoms.  Subsequently, an out-of-town retinal specialist identified the source of my problems as scar tissue remaining in my retina.  This was successfully removed during surgery last year.

So, no, I never saw a neuro-ophthalmologist, although such a referral might have spared me so much aggrevation.  I don't know what's causing your light sensitivity and pain--possibly they are related to problems with your eyes working together to process visual stimuli.  I'd definitely recommend consulting an experienced neuro-ophthalmologist as your next step.  S/he can refer you to other specialists if necessary.    

[taurus1203]

Jodie:
I am waiting for an appointment from a neuro-ophthalmologist. I will try my best to speed it up.
BTW, did you see a neuro-ophthalmologist after your surgery ? Can they help you ?
I also have problem about the co-ordination of the 2 eyes. As there is big difference between the vision of the 2 eyes, the one surgery always strained. This is one of the problems. I am not sure my light sensitivity is also related to this.

[JodieJ]

Hey, we're not just talking about some minor discomfort.  We're talking about a light sensitivity so severe that your daily functioning is significantly impaired.  Do your ophthalmologist and psychologist seriously believe that this is the result of anxiety?  (And what person in their right mind wouldn't have anxiety if s/he had to endure this problem every day?)

Just because your retinal specialist can't identify the problem doesn't mean that there isn't one!!!!!  My personal experience suggests that retinal surgery can indeed affect the ability of both eyes to work together, resulting in minor light sensitivity (in my case) and other symptoms.  Before you attribute your current symptoms to anxiety, you need to rule out other (e.g., neurological) causes.  Don't listen to your friends--you DO have a choice.  Go see a neuro-ophthalmologist.  

[taurus1203]

Jodie:
The surgeon and another eye doctor believe that I built up some anxiety. This cause me feel a small discomfort to be pain. I had a few sessions a psychologist. He also agreed with the eye doctors that I have built in a lot anxiety and tension after the surgery. This caused me always feels a small discomfort to be a pain. He also thinks it is possible that this is my tension cause my eye to get tired very easy. He mentioned something cognitive behaviour correction
I didn't believe it at first but all my friends advise me I have no other choice and can only follow his suggestion to use my eye as usual and don't let the eye disturb my life too much.

I tried but it is difficult to use my eye when I really feel tired or even pain to watch TV.
Jodie: It is too good that you are a psychologist.  From a  psychologist point of view, how much do you think a mild discomfort can be magnified by anxiety or stress.

Taurus

[JodieJ]

I am a psychologist, and I can't imagine that stress and tension would cause the type of problems which you described.  I strongly disagree with the advice that your psychologist gave you.  You need to see a neuro-ophthalmologist.  Try to get your retinal specialist (or any M.D.) to refer you.  Or set up an appointment yourself.

This is an old thread.  If you want feedback from Dr. Hagan (or another forum M.D.), repost your questions as a new thread.

[taurus1203]

My retinal specialist couldn't find any problem with retina and my eye. He thought that I am too tensed and that caused my eye strained and tired. He only suggested me to got to see a psychologist. The psychologist advice is to ask me to relax and don't worry too much. Try to make myself to believe that my eye is okay and continue to use it. It should be getter better.

I really don't know how to relax. My eye feel strained even watching TV or comics for a while. It may be caused by the brightness though I set the brightness to be extremely low.


I tend to believe that my eyes are not working well together and that caused both of my eyes very strained, especially the one had surgery. Once the eye get tired, it will feel pain if continue to use it or get hurt by light.

I tried to book an appointment with a neuro-ophthalmologist.
Dr Hagan: Do you think that I should book appointment with some other area ?

Thanks

Taurus

[JodieJ]

I'm not an eye care professional, so I hope that Dr. Hagan provides feedback to you.  It seems to me that your retinal specialist has already ruled out the more obvious possibilities for your extremely debilitating symptoms.  It's my impression that a neuro-ophthalmologist diagnoses and treats less common conditions, including those involving the processing of visual information.  My suggestion is this:  Get your retinal specialist to refer you to a neuro-ophthalmologist.  Referrals coming from another ophthalmologist generally get seen very quickly.  (It's hard for me to understand why your doctor hasn't already initiated such a referral.  What does he expect you to do--go home and live with symptoms that are destroying your quality of life?)

[taurus1203]

Dr Hagan/Jodie:
I tried to make an appointment with a neuro-ophthalmologist. But I don't know when I can have the appointment. Possible 1 to 2 more months.
Originally, I thought a lot of people have extremely light sensitivity problem. But I just found that this is not case.  BTW, I just found after the my eye with surgery recovered more focus power, I feel more strained. I will feel pain after reading for more than 30 minutes.
Can you tell me what is the traditional treatment of neuro-ophthalmologist ?

Dr Hagan had mentioned looking for a E/N/T sinus specialist ? I am going to ask my family doctor to refer me. Just want to know what is the reason behind that ?

Thanks


Taurus

[JodieJ]

You seem to have developed uncommon symptoms following retinal surgery, which are severely impairing your quality of life.  Possibly your extreme light sensitivity is not directly related to a retinal problem, but retinal surgery can change the way your eyes work together to process information.  Since your retinal specialist doesn't have an answer for you, please consider consulting a neuro-ophthalmologist (preferably a doctor associated with a major medical center.)

[taurus1203]

Dr Hagan:
My surgeon told me the same thing and he seriously told me that he doesn't have the answer. Because of this problem, I always need to wear a dark glass on the left eye and further reduce its vision and makes the eye even more strained. I suffer from the eye pain everyday. My life is really ruined.

As I mentioned, I don't really feel very bright but a mild light can cause the eye going to swell. Is it possible that this is by the buckle ?

Thanks

Wilson

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

At 6 months post RD buckle the eye is not useally senstive to light.

JCH MD

[taurus1203]

Dr Hagan,
The pain I experience is not feeling too bright. When I wear light sunglass to drive at cloudy 7pm, my eye (with surgery) doesn't really feel the light too bright. However, my eye feel strained seriously after driving for 5 minutes. The situation get better if I wear a deep dark sun glass. I guess this is caused by the cilary muscle is strained or the cilary nerve is pressed by the buckle. Will it be a possibility ?
If this is because of the buckle, then I should not waste time/effort to try different medication to remove the anxiety or the tense in my mind.

Thanks

Taurus

[taurus1203]

Dr Hagan:
My pupil size is almost back to normal. I would say the difference between my pupils is around 10%. I have a eye exam last week and fully dilated both pupil. I found the light sensitivity didn't increase a lot. I will rule out the possibility of the mild dilated pupil.
Three eye doctors examined my eyes plus the MRI result also indicated no inflammation in my eye.
I didn't notice that there are difference of size of images from the 2 eyes. When I did the amsler grid, everything is okay.

All the 3 eye doctors don't suggest me to do any cataract surgery at least 1.5 year after the retinal surgery to avoid detachment again.
Is there any possibility that the retinal is not 100% recovered and make it still vulnerable to the light ?

Taurus

[JodieJ]

I also experienced light sensitivity following retinal surgery (although not nearly as severe as what you describe) related to an image size difference between my eyes.  If this turns out to be part of your problem, it can be corrected with specially designed glasses.

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

The two most common things:  the cataract. I would suggest getting a second oipinion. If no other cause is found seriously consider taking the cataract off.

Second after a buckle the pupil often is bigger and doesn't work normally. I'm assuming if you had noticed this it would be in your post.

Inflammation can do it but then the eye is generally red and painful.

JCH MD