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Post vitrectomy surgery slow recovery.

Just over two months ago I got what they call a vitreous bleed from a torn retina. Two days later I was being operated on by a surgeon I knew nothing about. I am very nearsighted with an RK, so I guess I’m high risk.
Well I made it through the bubble, the body positioning, and the big black floaters that have since gone away. After two months there are still several things I’m dealing with.
1. Eye still dilated, still about twice as dilated as my good eye.
2. Eye still red, redness gets better and worse, but won’t go away.
3. Vision comes and goes, seems to take me longer to focus then my good eye. I see better with surgery eye in morning, seems to get worse in evening. Eye drops and liquigel seem to help so I use them religiously, Sunglasses help to.
4. See a red dot near the center of my vision, it comes and goes and has been around since my bubble dissipated enough for me to see it. Sometimes light around it does a strobe like flickering that is short lived thank god. At first I thought it might be scar tissue, but now suspect optic nerve related.
5. Strange stuff on my periphery, reddish waves inside my eye, and blind spot on my periphery opposite where they cauterized the bleed, all of which I believe are par for the course.
Before you say it, yes I have talked to the surgeon’s partner and called the office a number of times, and even sought out a second opinion. They assured me my eye is healing, but none of them have been terribly informative.
A red dot is not on their list of things to watch out for, but what the hell is causing it? The eye dilation might be damage to a nerve, if so where does that leave me? Will it heal? Or am I stuck this way?
Redness is from surgery, and vision could be helped by new glasses, which my insurance won’t pay for until next year. Old glasses are worthless.
I’m posting this in hopes that other people out there have been through this or have an idea what’s going on.
17 Responses
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177275 tn?1511755244
I may well be as a vitrectomy virtually is always followed by a cataract forming. Ask your eye MDs to look at your lens carefully while dilated

JCH MD
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Avatar universal
It appears to be stationary. I'm wondering if it's the beginnings of a cataract.
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177275 tn?1511755244
Others have described the same observation. If it "floats by" its in the vitreous. The red color could come from a small amount of blood.
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177275 tn?1511755244
Yes the surgery can aggravate dry eyes, allergy or can cause ongoing redness and irritation
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1 Comments
Another symptom, hard to explain. When an eyelash or something goes past my pupil I see little almost transparent pock marks around the red dot. It's showed up in the last couple weeks and I don't know if it's significant or not.
Avatar universal
Good point.
I've always had red eyes from allergies. The surgery could have made my eye more sensitive.The redness and dryness have been ongoing since surgery.  
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177275 tn?1511755244
The tear duct (located in the inner, lower lid) drains tears OUT OF THE EYE. If your tear duct was damaged your eye would feel wet and water constantly.
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Avatar universal
I can't help wondering though. If there was no tear duct damage why does my eye keep drying out?
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Avatar universal
Thank you
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177275 tn?1511755244
Thanks for your comments Chazas
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Avatar universal
I've had a detachment followed by a vitrectomy with a gas bubble and scleral buckle and another vitrectomy with ERM peel and cataract removal/IOL implantation. My last major procedure was almost 6 months ago and the operated eye is still redder and more sensitive. I have had an occasional shimmering, fan-like area in my central vision since the first surgery. I have a lot of distortion from the ERM and a significant remaining refractive error and new astigmatism. I didn't have proper contacts that address my current state until a couple of weeks ago.  I still don't have proper glasses. But my contacts now give me a technical 20/20, and I'm very happy for it.

Like you, I want to know exactly what was happening at all times.  But that's not possible. We do the best we can and take comfort in not losing our vision.  I've learned you need to be very, very patient. Take charge of your care, get lots of opinions, but in the end even if things go well it is not likely ever to be perfect.

Best wishes.
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177275 tn?1511755244
These are the answers I think I can provide that might be helpful:

1. Pupil can be permanently dilated after retinal tear/detachment surgery.  Not uncommon, several posts on this problem here. Can improve with time, may be permanent.  I generally tell people if its still there 5-6 months post surgery likely to be permanent.
2. Be sure your retina surgeon has signed off on the use of pilocarpine as one of the side effects of pilocarpine is retinal tear or detachment especially with strength greater than 1%.  Alphagan P does not carry the same risk of RD and often is useful.
3. The stuff you see 180 degrees away from the tear in the periphery is generally due to scar formation from laser or freezing tear (cryo-therapy)
4. Very unlikely that the tear duct was injured as its no where near where the surgery was being done.
5. If your macular OCT was normal not sure what causes the red dots that come and go.
6. Dry eyes can cause chronic redness and variable vision. Read the article on my blog on my home page about dry eyes.
7. When one eye has tear/hole/bleed/retinal detachment very high risk in fellow eye but sure its checked regular.
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Avatar universal
The injection night be for contrast used with digital retinal photography.  I had that done prior to a vitrectomy/ERM peel and the imagery was very detailed when viewed on a monitor.
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Avatar universal
To update the previous post, after the optometrist quit blaming the eye drops I haven't used for months it seems the laser damaged the nerve that controls eye dilation. It should get better with time but may never be like it was. Yippee. The redness is probably due in part to dryness and allergies. I'm wondering if there was tear duct damage in surgery as well and if so what happens then? They don't seem to know what the red dot is either. There's a more involved scan where then inject me with something, but probably not worth it at this point.

I was given 2 drops for symptoms. Prednisone 1% for redness and Pilocarpine 1% for eye dilation. Pilocarpine a little scary. had my pupil down to a pinprick and lasted over a day. Any thoughts or opinions anyone?  
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177275 tn?1511755244
No way to tell from your description. You need to discuss it with your retina surgery who can examine your eye. Be sure you have had a recent macula OCT

JCHMD
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Avatar universal
Thank you for your support and advice, but I would like to point out my questions have not been answered. What is the red spot I see in the morning?
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177275 tn?1511755244
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Avatar universal
Sorry to hear about your complications.  I've been treated for a couple retinal tears, so I know where you are coming from.  Regarding insurance and glasses -- From your remarks, I assume you have some sort of glasses coverage.  If you have not already done so, consider contacting your insurance company and making the case that new glasses are medically necessary after retina surgery.  Ask your retinal surgeon to provide a copy of the surgical insurance claim for documentation.  It may be denied, but it is worth a try.  Best wishes.
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177275 tn?1511755244
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