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Ischemic optic nueropathy after retina detachment surgery
I am going to try to write down as much details that I can.
I am 19 years old. I am obese.
About 2 months ago, I noticed a gray shadow covering a third of my vision in my left eye. I went to a opthamologist and he told me that I had retina detachments. He sent me to retina specialist at a hospital and they told me I had several retina detachments and over ten holes but my macula was still on. So I had surgery same day. They put a buckle and an oil bubble in my eye. Surgery took 3.5 hours and they said I would be fine. Also preSuregery I had High blood pressure. The next day, I had a checkup. Eye pressure 11 and everything normal. 1 week later eye pressure 12 and everything normal but I noticed a lot of eye watering during the checkup.
2 weeks later, I had a pale optic nerve and I could only see 30% of my vision, basically the top left corner and a tiny bit at the bottom right corner. Everything else was black. RS told me I had an optic nerve stroke due to stress on the optic nerve but it honestly sounded like "i don't know the answer so I'm going to give a vague and general answer". When I asked if it could have been caused by the surgery, RS told me maybe indirectly but not directly. A optic nerve specialist came in the room, examined me, then left without telling me anything and spoke with the retina specialist. RS told me that I had an anterior ischemic optic nueropathy and I needed to get an mri and bloodwork.
Bloodwork result: very high cholesterol and triglycerides, glucose was 101. Sediment rate westergrant was 11. C reactive was 11.
1 week later I went to go see the RS and RS wanted to replace the oil bubble with a gas bubble because the oil bubble can cause this problem normally if you keep it in the eye longer than a year and I could be reacting badly to the oil bubble. I agreed to the surgery. Then I went in for an MRI. MRI was after the checkup. 5 days later, went for surgery. Before surgery, RS told me that my MRI was normal and then they did the surgery. Afterwards RS told me that I was not reacting badly to the silicon oil. Next day, optic nerve is still pale, eye pressure 11. 1 week later. Eye pressure is 8. I'm suppose to see the optic nerve specialist 1 week from now, when the gas bubble is absorbed. I can still only see 30%.
I'm really scared bc I read that there is a 20% chance of having the stroke in my right eye
I seem to have low eye pressure so I don't think that high eye pressure cause the stroke.
So any possible diagnosis of the root cause would be appreciated.
So far the only possible other diagnosis which I obtained by google, I can think of is posterior ischemic optic nueropathy, which would explain why it looked normal the first week and migration of the silicon oil to the optic nerve. How plausible are these?
I am 19 years old. I am obese.
About 2 months ago, I noticed a gray shadow covering a third of my vision in my left eye. I went to a opthamologist and he told me that I had retina detachments. He sent me to retina specialist at a hospital and they told me I had several retina detachments and over ten holes but my macula was still on. So I had surgery same day. They put a buckle and an oil bubble in my eye. Surgery took 3.5 hours and they said I would be fine. Also preSuregery I had High blood pressure. The next day, I had a checkup. Eye pressure 11 and everything normal. 1 week later eye pressure 12 and everything normal but I noticed a lot of eye watering during the checkup.
2 weeks later, I had a pale optic nerve and I could only see 30% of my vision, basically the top left corner and a tiny bit at the bottom right corner. Everything else was black. RS told me I had an optic nerve stroke due to stress on the optic nerve but it honestly sounded like "i don't know the answer so I'm going to give a vague and general answer". When I asked if it could have been caused by the surgery, RS told me maybe indirectly but not directly. A optic nerve specialist came in the room, examined me, then left without telling me anything and spoke with the retina specialist. RS told me that I had an anterior ischemic optic nueropathy and I needed to get an mri and bloodwork.
Bloodwork result: very high cholesterol and triglycerides, glucose was 101. Sediment rate westergrant was 11. C reactive was 11.
1 week later I went to go see the RS and RS wanted to replace the oil bubble with a gas bubble because the oil bubble can cause this problem normally if you keep it in the eye longer than a year and I could be reacting badly to the oil bubble. I agreed to the surgery. Then I went in for an MRI. MRI was after the checkup. 5 days later, went for surgery. Before surgery, RS told me that my MRI was normal and then they did the surgery. Afterwards RS told me that I was not reacting badly to the silicon oil. Next day, optic nerve is still pale, eye pressure 11. 1 week later. Eye pressure is 8. I'm suppose to see the optic nerve specialist 1 week from now, when the gas bubble is absorbed. I can still only see 30%.
I'm really scared bc I read that there is a 20% chance of having the stroke in my right eye
I seem to have low eye pressure so I don't think that high eye pressure cause the stroke.
So any possible diagnosis of the root cause would be appreciated.
So far the only possible other diagnosis which I obtained by google, I can think of is posterior ischemic optic nueropathy, which would explain why it looked normal the first week and migration of the silicon oil to the optic nerve. How plausible are these?
Also I don't know if this is relevant or not but after the 1st surgery, the resident who first checked my eye was surprised because i had very low inflammation in my eye.
My macula was on but there was a hole or detachments 2mm away
My retina specialist said that my retina is 80% healed and that was 1 month ago. When I was diagnosed with NAION, the RS said the I should have gotten my vision back already. All she told me about it was it is permanent and I may get some vision back when the inflammation goes down but it won't be much. She only told me to take baby aspirin everyday.
I forgot to mention the medication I was taking. Atropine, vigmox, predinsolone eye drops, famotidine, baby asprin and when I had the second surgery, she prescribed 3 days of prednisone
She prescribed eye pressure medication both times, but she told me not to take them so I didn't.
As for my good eye the RS said that I have an extensive lattice but I wasn't in any hurry to get laser but this was two months ago before the first surgery. I'm guess no holes/tears considering that she didn't check my right eye in the last checkup. But this is just a guess.
Also I do have high numbers for glasses.
No history of RD in family.
My retina specialist said that my retina is 80% healed and that was 1 month ago. When I was diagnosed with NAION, the RS said the I should have gotten my vision back already. All she told me about it was it is permanent and I may get some vision back when the inflammation goes down but it won't be much. She only told me to take baby aspirin everyday.
I forgot to mention the medication I was taking. Atropine, vigmox, predinsolone eye drops, famotidine, baby asprin and when I had the second surgery, she prescribed 3 days of prednisone
She prescribed eye pressure medication both times, but she told me not to take them so I didn't.
As for my good eye the RS said that I have an extensive lattice but I wasn't in any hurry to get laser but this was two months ago before the first surgery. I'm guess no holes/tears considering that she didn't check my right eye in the last checkup. But this is just a guess.
Also I do have high numbers for glasses.
No history of RD in family.
1 Comments
Well as far as the NA I tell people 3-6 months. And emphasize you can get a second opinion about both eyes if you wish. You do need to turn your life around health-wise and life style wise.
Some more questions
1. I read that vision loss from NAION can get better for upwards to 6 months. its been 2 months for me and it hasn't gotten better. Based on your experience, Is there a specific time frame in which vision improves the most?
2. any specific type of diet that would be best?
3. My doctor wants to do laser on my retina in my right eye to try to prevent any possible future retina detachments. What are the risks for this procedure.
Is there a possibility of this triggering NAION in my right eye?
1. I read that vision loss from NAION can get better for upwards to 6 months. its been 2 months for me and it hasn't gotten better. Based on your experience, Is there a specific time frame in which vision improves the most?
2. any specific type of diet that would be best?
3. My doctor wants to do laser on my retina in my right eye to try to prevent any possible future retina detachments. What are the risks for this procedure.
Is there a possibility of this triggering NAION in my right eye?
1 Comments
The problem with your situation is you have TWO problems. Use the search feature and archives and read the many posts here about post RD surgery recovery. It is often slow, painful and incomplete. We could generalize about NAION if that were your only problem but since it happened post RD surgery it is not possible to generalize or predict. Was your macula off?
I had a bad NA this week with no other problems so we told 3-6 months or possible recovery. My mother recovered all vision over 5 months but again neither had RD surgery.
Diet is up to your family MD
Risks of laser are relatively small most important is that may not prevent RD do to formation of new holes/tears. The procedure can be uncomfortable/painful so some people. Its possible to have inflammation and irritation and sometimes light images 180 degree away from the laser treatment. Posts on this website about all of above. You can always get a second opinion about treating your good eye. It's not likely that laser would triger NA in your good eye.
I had a bad NA this week with no other problems so we told 3-6 months or possible recovery. My mother recovered all vision over 5 months but again neither had RD surgery.
Diet is up to your family MD
Risks of laser are relatively small most important is that may not prevent RD do to formation of new holes/tears. The procedure can be uncomfortable/painful so some people. Its possible to have inflammation and irritation and sometimes light images 180 degree away from the laser treatment. Posts on this website about all of above. You can always get a second opinion about treating your good eye. It's not likely that laser would triger NA in your good eye.
Thanks for taking the time to answer my questions. Honestly, I'm freaking out because I don't want to lose my good eye and my doctors aren't really giving me any concrete answers. And also, recently, every time my right eye(the good one) feels even a millisecond of pain or irritation, I get really scared to the point that I take a full dose of aspirin.
Further information:
no tobacco/nicotine but yes to canibis but the last time I smoked was 4 months ago and even then I only smoked 20 times in the last year, and did not smoke before last year.
Also I donot have high blood pressure or diabetes.
I do not take medication for cholesterol, but will try to get them soon
I take baby asprin
Today I went to a hematologist and told I don't have any serious abnormalities, but full tests will take 3 weeks.
I plan to go see a dietician.
Anything else that I can do right now to minimize my risk?
I know I should be asking my doctor for all this, which I plan to do, but any questions that you can answer would be appreciated.
Further information:
no tobacco/nicotine but yes to canibis but the last time I smoked was 4 months ago and even then I only smoked 20 times in the last year, and did not smoke before last year.
Also I donot have high blood pressure or diabetes.
I do not take medication for cholesterol, but will try to get them soon
I take baby asprin
Today I went to a hematologist and told I don't have any serious abnormalities, but full tests will take 3 weeks.
I plan to go see a dietician.
Anything else that I can do right now to minimize my risk?
I know I should be asking my doctor for all this, which I plan to do, but any questions that you can answer would be appreciated.
1 Comments
As I said your biggest risk is another RD in the good eye. What is your glasses RX? Are you a high myope? RD is relatively rare especially at your age maybe one in 7000. However with a RD in one eye the risk of RD in fellow eye in future may be 5-10%. Is there a family history of RD? Are you premature and low birth weight? As to prevention yearly exam, immediate exam with increase of floaters, flashes or loss of field of vision. Avoid trauma to the eye, avoid amusement rides that torque and jerk the head, don't stand on your head (yoga, exercise). Ask your retina surgeon if you have risk factors in good eye such as lattice degeneration, open retinal holes/tears. You can always get second opinion down the line on the good eye risks.
Not very plausible. Anterior ischemic non-arteritic optic neuropathy (ANAON) is common. I saw a bad case this week. You have many risk factors obesity, elevated blood lipids (cholesterol and triglycerides) and elevated blood sugar. It can also occur after eye surgery of any type. It can affect both eyes. Your biggest problem is the retinal detachment. You can lower your risk of the other eye being involved by losing weight, great diet, exercise, medications if needed to lower your blood pressure, lipids and blood sugar.
1 Comments
You didn't mention use of tobacco/nicotine or cannabis which also are risk factors.
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