Macula-Off Retinal Detachment Causing Micropsia (Aniseikonia)

[curio255]

On September 29th I suffered a macula-off retinal detachment. I first underwent a retinopexy with gas bubble, but then the doctor decided to do a full vitrectomy with gas bubble on October 17th.

It has now been 3 weeks since my vitrectomy and my gas bubble is fully gone, but my vision is still very poor. I am experiencing micropsia (aniseikonia) in my affected left eye (objects appearing much smaller than good eye). I am also experiencing metamorphopsia (objects appearing distorted).

Did anyone have these symptoms and is there hope that they will resolve themselves in the future or am I stuck with this as my new normal?

Any feedback would be immensely appreciated. Thank you.

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

I'm sure you realize you have had a very serious problem that left untreated would have blinded your eye. Even if the retinal is reattached if the macula was "ofl" (detached) the eye does not recover full central vision and some distortion (metamorphopsia) is common.  ASK YOUR SURGEON IF HE/SHE DID A 'SCLERAL BUCKLE' if so that makes the eye myopic or nearsighted and the image appears smaller. It will probably be 6-12 months for you to know what your final vision is going to be. REMEMBER THE OTHER EYE: that eye is your better eye and has a risk of retinal detachment it is significant as high as 5-10%. If any flashes, increase of floaters or loss of visual field treat as an emergecy and contact your retina surgeon immediately.

[al_erwin14]

  I did have a Scleral Buckle the last of time surgery was done.

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

That will elongate your eye and make it more near-sighted.  So your eyes are not balanced, with the operated eye being more myopic. This is called aneisometropia.  You can ask your retina surgeon to refer you to a general ophthalmologist or an optometrist to work with glasses or contact lens to try and make the images more equal is size. Or your retina surgeon may want you to wait until your eyes heal more.  As I said your eye may not recover normal vision and some distortion that is permanent is common in macula off RD.

[curio255]

Hi Dr. Hagan. I did not have a Scleral Buckle. I initially had a retinopexy with gas bubble followed by a vitrectomy 2 weeks later. Does the fact that I did not have a Scleral Buckle increase the chances of the micropsia resolving? What about the metamorphopsia?

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

Permanent distorted vision not corrected with glasses or contact lens is common in macula of RD.  The image being smaller occures in all nearsighted people that wear glasses or contacts. The stronger the amount of myopia  the more the minification. Glasses minify more than contacts.  However in regular myopia when appropriae glasses or contacts are worn there is no distrotion (metamorphopsia)  Only time will answer your questions for sure, it could go one of several ways.

[curio255]

Okay, thank you Doctor.

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

Good luck and remember PROTECT THE EYE WITHOUT OUT RD,