Flashes after Retinal Detachment Surgery with Silicone Oil and Scleral Buckle

[jayehwhy]

Hi,

My story is:

- 4 years ago (when I was 16) I had a small retinal tear which was successfully sealed using cryo and everything was good and I was discharged from the clinic in April of this year.
- Suffered a retinal detachment in October - diagnosed with a 'giant' tear.
- First surgery consisted of laser and cryo with gas bubble in eye - I know this is rather unorthodox for a giant tear but I believe the basis was to try and have the shortest recovery time.
- Unfortunately this did not work as when the pressure of the gas started lifting scar tissue started forming thus detaching the retina again via several smaller tears and the initial giant one.
- Second surgery consisted of a scleral buckle with silicone oil. This silicone oil is of a very dense variety - I don't know of any specific name.
- It has been almost 5 weeks since the operation and seeing my consultant last week I've been told that the retina looks good (or as good as it can be) and that they are looking to operate again to laser and thus scar the retina more in order to reduce the risk of detachment when they operate to remove the oil. I've been told that after this operation they will operate again to remove the oil and replace/laser the current lens (as I had a cataract operation after the initial surgery 4 years back).

Since the operation I have been seeing two types of flashing lights. The first of which is the type that I experienced during both detachments and thus meant that I went back 4 times in the first two weeks to ensure that the retina was not detaching (a true nightmare for anyone that has experienced this). I have been told by my consultant that these lights are most likely caused by the remaining vitreous as, especially with someone my age, it is very difficult to remove all of it. However, they cannot locate the area in which this traction is occurring.

The second type of flashing lights appears in an aura form and travels around the periphery from the bottom left (usually) around the top and to the right of the eye. I've been told that this kind of flashing light is more often associated with migraines. It seems like my type is the one without an actual headache though.

I was just wondering how common it is to experience flashing lights after my surgery and in particular how common it is to see this kind of aura flashing light. I have used the search functionality and not been able to find anyone who has had similar auras after retinal surgery. I was also wondering whether it would be advisable to see if they can put an IOL lens in to try and counter the fishbowl effect I am having as a result of the band (which is permanent). I have been told that the double vision will get better with time as the eye gets used to it, especially after the oil removal and removal of cataract.

In general, I would like to thank those for posting their experiences on here as it has certainly helped me and my morale levels. I can't wait for this ordeal to be over so I can go back to university!

[Psychl0ps]

Oh man, after i had My surgery to reattach and put in the oil/buckle I had some weird experience like that. My surgery was post trauma, a ruptured globe, i have Light perception, but can not see clear images. It’s like a window shade is pulled down,  If it’s bright enough i see Outlines of darker shapes but it’s all black/grey/brown. I think I see Blue if i sit And focus a while. While i was Standing outside my friends cabin in the dark, and i had Only my right eye open, “looking around” to see if i could See, and, here is what i thought I seen. This place is at the top of a hill, oak trees All over, i was Looking toward the driveway, and seen headlights come up and pull in. It surprised me! I opened My other eye to verify this vehicle, but it was dark. What i seen Was not a car, not in this dimension. It startled me really, i thought I could See… but nope, and it was bright, white like car headlights, moved through the trees it looked like, someone pulled in. I never Knew what to make of it, and like you, had not found anything online about this kind of thing. It’s happened more since then, but that was the strongest instance of this happening.  Where was your surgery done at? I was At UC Davis

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

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[jayehwhy]

I am going to see if it's worthwhile to get a second opinion and will look in to accutane. It is just unfortunate that had I been 20 years older this problem would have most likely been resolved. Guess i'll just have to live with it.

[jayehwhy]

Yeah, surgeon said that initially with the first surgery there was a 1 in 800 chance of surgery in the left eye affecting the right sympathetic eye and with every subsequent surgery the odds increase. To be honest life without one eye is not impossible and I would rather not take the risk, especially with my he and having a more responsive immune system. I believe it's to do with the alteration of the proteins in the eye that surgery entails leading to a response from the immune system. As those same proteins are present in the other eye it is possible, although rare, that it can affect the other one too.

[es98]

Sorry to hear that.  When you say "further surgery inadvertently affecting my right eye", are you saying that you believe surgery on the bad eye will somehow affect your good eye?

A important breakthrough will be when they solve the issue of scar tissue (PVR) formation.  There was a study years ago that showed great promise with Accutane, although I don't know why it was never followed up.

[jayehwhy]

Bad bad news today.

A whole lot of scarring has occurred thus leading to a slight detachment.

If they operate then the odds are scar tissue will form again and I'll be in a similar situation. If they remove the oil it will definitely detach. So the best thing to do at the moment is leave the eye for another 2 weeks or so and see what it is like after scarring has likely stopped and hope for the best.

Plus I am not keen that the odds of further surgery inadvertently affecting my right eye increase with each additional operation.

Guess I'll just have to make do and pray that there is further progress in this field to help me.

[Ruza123]

Thank you. Good luck.

[jayehwhy]

Had the operation yesterday, as assumed the flashes were from traction on the retina from scar tissue that was revealed after the frosting on the lens bag was removed using laser. Unfortunately this traction had lead to a tear forming, although the likelihood of detachment with the densiron would be very unlikely, the oil needed to be changed.

Hence they used cryo and laser techniques to seal the tear and replaced the densiron with a lighter oil. I am currently posturing face down for a day or so and then posturing on my side for two weeks. It is likely that the oil may be permanent but this is one of those situations where the prognosis can change at any time.

The operation itself was grueling as I had it under local anesthetic with the expected operation time being 1 hour. Due to the complications the operation lasted 2 hours and they could not administer any more anesthetic due to my sceleral buckle hence leading to severe pain.

I have come to terms with this whole situation anyway, whatever happens happens.

[Ruza123]

Good luck. Thank you. Hoping for the best. Keep us informed.

[jayehwhy]

nope, assumed to be traction on the retina, probably scars forming.
i have another operation coming up on tuesday to remove the oil, hopefully the retina stays in place!
during my time with the oil i have noticed that my vision has slowly been getting worse as the cataract developing on my lens has worsened. i have less flashes now but still get persistent migraine like auras.

[Ruza123]

did you find out what those short flashes are. I have same thing going on. I had an oil surgery 3 days ago and see flickering and short flashes of second or two.

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

when the oil comes out a eye adjusted physiological saline called balanced salt solution goes in
JCH MD

[jayehwhy]

Thanks for your reply, the flashes don't last for longer than a few seconds and yes I can see them with my eyes shut. I still see the retina-vitreous type infrequently. I was also wondering what substance will be put into the eye (or is most likely to be put into the eye) after the oil removal.

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

You have a very serious problem indeed and one that use to end with complete blindness in the eye. Multiple operations are the norm. As for the types of flashes, those that come from the retina are not persisting aura like. If you get a persisting aura like light especially if in geometric forms, that persists for minutes to an hour or more and that can be see with the eyes shut chances are that is migraine as retina-vitreous flashes are very short duration. These types of cases are all so individuallized its impossible to generalize about them and you will need to get your information from your surgical team.
JH MD