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Giant Retinal Tear
About six months ago I noticed a large floater in the centre of vision of the left eye. I sought advice from an optometrist who gave me a prompt referral to A&E for a possible retinal tear. The intitial diagnosis was of a retinal tear <90 degrees but it rapidly progressed over the following week to a giant retinal tear ultimately of 270+ degrees. I have had the following treatments. Several laser treatments in order to prevent the continued tearing before the following physical operations. A vitrectomy and laser treatment circling the retina inside the tear to prevent detachment. The eye was then treated with silicone to ensure attachment of the retina for approximately 8 weeks. Removal of the silicone and the resulting cataract by phacoemulsification followed by another vitrectomy to remove some oil not removed by the second operation. There was no sceleral buckling.
The eye is now largely healed but remains red and slightly sore after 8 months (last operation about 4 months ago). Vision in the left eye is now about 6/80 and I am advised that is is not likely to improve, with correction the eyesight is about 6/12. I have trouble reading as vision is distorted in the centre of the vision (the picture is, for want of a better discription 'puckered' so that when I concentrate on the centre vision with only my left eye it looks like the vision is 'pinched' together over in a circle in the centre of the vision. I am advised by the surgeon this is caused by a wrinkle in the retina whcih cannot now be repaired.
To the left of my vision is a grey "curtain" which I am advised is a tear which is outside the lasered circle on my retina and is nothing to be concerned about. From my own research I have reached the consclusion that having retained useful vision in the left eye having had a rapidly advancing giant retinal tear is actually a good outcome for which I need to be grateful (and given the apparent risk of blindness I am in fact grateful).
I have been discharged and will not be seeing the Opthamologist or Retinal Surgeon unles other symptoms now develop. I am myopic (wearing spectacles since my early 30s), in my early fifties now and have had no prior eye injuries.
My questions are these:
It seems that GRT are very rare, but I have not seen any clear indication of just how rare they are, what I did notice is that every time I went to the local eye clinic and to the eye clinic of my Retinal Surgeon allthe doctors took a close interes (I have had in excess of 200 eye examinations in the last 8 months).
I understand having had the GRT in the left eye increases the risk of a GRT in the right eye. What is the risk?
I understand that the primary complication from the repair is scarring of the retina, my retinal suregeon says he sees no signs of scarring. What are the possible complications and what can I keep and eye out for (if you'll pardon the pun).
I there any treatment which is lieklky to imporve my vision in the left eye?
The eye is now largely healed but remains red and slightly sore after 8 months (last operation about 4 months ago). Vision in the left eye is now about 6/80 and I am advised that is is not likely to improve, with correction the eyesight is about 6/12. I have trouble reading as vision is distorted in the centre of the vision (the picture is, for want of a better discription 'puckered' so that when I concentrate on the centre vision with only my left eye it looks like the vision is 'pinched' together over in a circle in the centre of the vision. I am advised by the surgeon this is caused by a wrinkle in the retina whcih cannot now be repaired.
To the left of my vision is a grey "curtain" which I am advised is a tear which is outside the lasered circle on my retina and is nothing to be concerned about. From my own research I have reached the consclusion that having retained useful vision in the left eye having had a rapidly advancing giant retinal tear is actually a good outcome for which I need to be grateful (and given the apparent risk of blindness I am in fact grateful).
I have been discharged and will not be seeing the Opthamologist or Retinal Surgeon unles other symptoms now develop. I am myopic (wearing spectacles since my early 30s), in my early fifties now and have had no prior eye injuries.
My questions are these:
It seems that GRT are very rare, but I have not seen any clear indication of just how rare they are, what I did notice is that every time I went to the local eye clinic and to the eye clinic of my Retinal Surgeon allthe doctors took a close interes (I have had in excess of 200 eye examinations in the last 8 months).
I understand having had the GRT in the left eye increases the risk of a GRT in the right eye. What is the risk?
I understand that the primary complication from the repair is scarring of the retina, my retinal suregeon says he sees no signs of scarring. What are the possible complications and what can I keep and eye out for (if you'll pardon the pun).
I there any treatment which is lieklky to imporve my vision in the left eye?
He has been advised that it is not likely to improve. In this case, he should not expect provement. I agree that he at least should get a second opinion, maybe a third. I did not give up on my vision until after the fifth surgery. But I did not have a gaint retinal tear. Wish I knew more about GRTs.
Even though I had been told to give up, I am still trying to retain the best sight possible in both eyes. I still get new opinions, because my right eye is in danger, and I want to learn more about what happened to the left.
Wear goggles/glasses unless there are no risks around--e.g., typing at the computer and handling only a keyboard.
Ask about cerclage on the right eye, but get 3 opinions before you have it performed. It can be risky.
Even though I had been told to give up, I am still trying to retain the best sight possible in both eyes. I still get new opinions, because my right eye is in danger, and I want to learn more about what happened to the left.
Wear goggles/glasses unless there are no risks around--e.g., typing at the computer and handling only a keyboard.
Ask about cerclage on the right eye, but get 3 opinions before you have it performed. It can be risky.
The chances of your other eye suffering a RD has increased, but the odds are that it will NOT occur.
One of the biggest reasons for failure of retinal repair is the formation of scar tissue, aka proliferative vitreoretinopathy (PVR). The scar tissue causes traction against the retina and pulls it apart so the retina will detach. Be on the watch for the usual symptoms of a RD.
As far as visual improvements, you need to be patient, it takes plenty of time for the retina to heal. Also, depending on amount of damage done to the retina, both pre- and post- surgeries, will determine whether or not anything further can be done to help your vision. As Dr. Hagan mentioned you can always seek a second opinion.
Good luck.
One of the biggest reasons for failure of retinal repair is the formation of scar tissue, aka proliferative vitreoretinopathy (PVR). The scar tissue causes traction against the retina and pulls it apart so the retina will detach. Be on the watch for the usual symptoms of a RD.
As far as visual improvements, you need to be patient, it takes plenty of time for the retina to heal. Also, depending on amount of damage done to the retina, both pre- and post- surgeries, will determine whether or not anything further can be done to help your vision. As Dr. Hagan mentioned you can always seek a second opinion.
Good luck.
MEDICAL PROFESSIONAL
1. I don't know that there is any statistic study that will give you the incidence of GRD. In the general population the risk of a RD is one in 8500 people.
2. Nor do I think there are any studies to quantitite the riskof GRD in the other eye. The risk of any RD is probably 3-15%.
3. See another retina Eye MD ophthalmologist and get a second opinion.
JCH MD
2. Nor do I think there are any studies to quantitite the riskof GRD in the other eye. The risk of any RD is probably 3-15%.
3. See another retina Eye MD ophthalmologist and get a second opinion.
JCH MD
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