Wet macular degeneration and retinal detachment. What should I do?

[dadgetsbettersoon]

I'm posting the question for my dad. My dad is 56-year-old now. Last year in November he suddenly found that a huge black spot blocked his vision in his left eye. We took him to the hospital and the doctor told us that my dad had wet macular degeneration and the bleeding caused the black spot. We did first surgery immediately to clean up the blood. After about one month, the doctor found retinal detachment in the same eye. My dad went through the second surgery to inject silicon oil. In the following visit, they found that there was abnormal tissue growing under the eye. My dad went through one more surgery to take out the silicon oil, clean up the tissue and inject the silicon oil again. Just two weeks ago, the doctor said my dad's retina is detached again. They suggest we do one more surgery immediately. It was advised that if we leave it as it is, it will affect the appearance (eye shape will change). My dad just went through the fourth surgery last week. Now he's staying in bed in the face-down position. I hope I can do something for him but don't know what to do. Very suffering.

I wonder is it common for people to have macular degeneration and retinal detachment at the same time? What are the possible reasons for my dad to go through so many surgeries but didn't get any better? Should we keep doing this because it's very suffering for the patient?

Please give me some advice. Thanks!

[JohnHaganMD]

Your father is young for age related macular degeneration. Risk factors for early ARMD include nicotine use, diabetes, hypertension, elevated cholesterol, obesity and bad family hx.  Risk factors for retina detachment RD are high myopia, previous trauma, previous cataract surgery and positive family hx of RD (thus you are at increased risk also).  This surgery is brutal. WIthout the surgery the often is completely flind and can "die and shrink" (pthisis bulbi).  Even with surgery the vision is often very poor.

You should spend some time talking to the retina surgeon about the status of the remaining eye: 1. does it have ARMD 2. does it have anything that would increase risk of RD  3. Does the other eye need any prophylactic treatment 4. What can your father do to keep his remaining eye healthy. 5. What are the risks to you and your siblings?

[dadgetsbettersoon]

Thanks for your reply. Yes I think it's a good idea to talk to the retina surgeon about the status of the remaining eye, since there's nothing we can do about the left eye now. My question is is it common for ARMD patients to develop ARMD in both eyes? As far as I know, the other eye is totally fine now. If dry ARMD is found in the future, what can we do to stop it from developing into the wet type? About the retina, is there any technology in the U.S. that can implement some sort of "artificial retina" in the eye if the RD surgeries don't work out? My dad lives in China so I'd like to know if there's any technology in here that can help him.

[JohnHaganMD]

Yes it is common for ARMD to develop in both eyes almost the rule. It is often asymmetrical in onset and progression.  RD is relatively uncommon so there is no association of ARMD with RD but they can occur sporadically in some unlucky individuals.  There is an artificial eye (Argus 2) but it is extremely rudimentary and offers nothing like normal vision.  As to preventing dry ARMD: Good diet, lots of green vegitables, No nicotine, control blood pressure, blood sugar, cholesterol. Don't get fat, exercise, protect eye from bright sunlight (and injury).  If not eat good diet take a multivitamin plus 2  AREDS 2 Preservision per day.