Very Concerned About Blurry/Cloudy Vision After Vitrectomy

[zmonster]

I had a vitrectomy and scleral buckle inserted exactly one week ago, and an air bubble was pumped into my eye to hold retina in place after the surgery repaired a small tear in the lower-left part of the left eye.  The day after surgery all I could see was the gas bubble, everything was distorted, blurry, and unfocused.  However, I saw no cloudiness.

A week after surgery the gas bubble has dissolved more than 50% such that it is just below mid-eye vision level.  I had expected the vision above the dissolving gas bubble to be 'normal' as the bubble dissolved.  However, vision above the bubble is extremely, extremely blurry, and what is a bit more worrisome is that it's relatively cloudy (faded colors, dimmer light, etc).  All I can see are blobs representing objects, however, if I hold my finger about 4 inches from my eye, it is extremely clear (i.e. not blurry) but still a bit cloudy.  Interestingly, things are less cloudy if I focus on them at 4 inches away when I view through the gas bubble, and they are more cloudy if I view the object from above the glass bubble.

I'm hoping someone can please tell me what I should expect in terms of vision in the field of view that is above the gas bubble as it dissolves.  I thought/was-hoping the vision would be clear and back to normal (because my retinal tear was on lower/left edge), however, as previously mentioned, my vision is terrible, blurry, cloudy.  Furthermore there are a dozen or so small black specs floating around my vision.  These are different from "standard floaters" -- they are distinct, clear, small solid black specs (not gel-like floaters, as would be usual).  Worse yet, if I lay flat on my back and stare into a light, I see a HUGE SEA of black spec and tiny, clear, perfectly round floaters.  It's almost as if the image of my retina is relfecting back into my eye off the gas bubble.  It appears as if I'm looking at a sponge.  Literally, with all of the crevices and dimples that a fine sponge usually has.  It's a very unnerving image to see, but again I can only see it if I'm lying flat on my back staring into a bright light.

I'm really hoping people who've had vitrectomy surgery, or doctors who perform it, can let me know exactly what I should expect to see over the next 'X' number of days and weeks (it's been 7 days since surgery).  My doctor tells me my retina is now firmly attached, healing, and that he sees no other problems.  However, he doesn't really give me a specific answer when I ask him why my vision above the floater is so cloudy/blurry and why I'm seeing black-spec like floaters.  The spec like floaters seem to 'jiggle' along with the air bubble even though they are above the air bubble.  That gives me hope that they're floating in a 'film' that exists above the gas bubble that will dissolve away in the next couple of days/weeks??  If my vision gets no better than this, I'll be very disappointed and upset.  My vision was very good in the left eye before the retinal tear occurred and I assumed it would return to nearly that prescription and clearness after the vitrectomy was healed.

Any advice/info would be truly appreciated.

- Eric

[zmonster]

And can I kindly ask that nobody respond to my post with 'check with your doctor'?  :)  That is OBVIOUS!  However, I can't get a freaking damn straight answer from my doctor.  He's probably afraid of lawsuits, and I can't say that I'd blame him, but this is my damn eye for God's sake.

[Ray T Oyakawa, MD]

This is normal.  I have had your surgery and I also did vitreous surgery until a few years ago.

Dr. O.

[marty127]

Did your vision improve after the bubble completely went away? As your symptoms sound very much like mine I'm 5 weeks post surgery

[robin6464]

I had a vitrectomy 3 weeks ago and my gas bubble is gone, but my vision is still cloudy and like looking through a sponge.  I understand where you are coming from because I can't believe it is taking so long for my vision to become normal again.  I had a macular hemorrhage, blood clot along with infection.  I was being treated with injections for the hemorrhaging and after my 2nd shot I got infection in my eye that would clear up so that is the reason for vitrectomy.  I'm getting down because it is taking so long and the doctor said it could take up to 2 months......I hope he is wrong about that for sure.

[Mjsmerig]

Did your cloudy vision clear up once the bubble went away? My bubble is less than 50% and the vision above it is cloudy or as if there were a film over it.

[Hksb]

Sorry, doc. How can this be normal? My symptoms are very similar to those described by Eric except that mine occurred after oil was inserted as the tamponade. The oil and cataract have been removed but the vision is terrible. Just like Eric, my vision looks like someone has poured white paint over it. Also I can see hundreds of small black specks and half a dozen larger round and hollow floaters.

I have seen three surgeons and they all say the retina looks fine. Based on the fundus and oct it looks fine to me too. But the vision is terrible.

Previously I had a vitrectomy on the other eye and then my vision was fine. So I know that this is abnormal.

I would really like to hear an update from Eric about his vision. Did it improve over time?

[Wishmom]

My mom had vitrectomy 6 weeks ago and bubble has been absorbed really slow ( she still has ~40% left). The real concern is like those described above-- blurry vision of non-bubble area but retina looks fine. Doctor said we should wait and things may get better. Is it possible to improve over time? Any update from others will be highly appreciated.

[Spaceman273]

I had a RD in June using the gel.   In September, after the gel extraction I had another  detachment a week later in the same eye.    My Doc was out of the country so the backup doc did CHRYON treatment for the new tear and a gas bubble.   At first it was still clear but now a week later, I have the cloudiness everyone else has mentioned.    Has anyone from the above posts cleared up yet or is this what I have to look forward to for the rest of  my life?   Is this normal?  I had a follow up with the Doc who also said it all is holding well and looked great, I just can't see anything through the cloudiness.   Please tell me this is normal and that it eventually goes away.

[pjenn2000]

What is your condition now, almost 3 years post-op?  I am having identical experience and am VERY worried. I had 20-30 vision in eye prior and reading all the message board posts about blurry vision and seems there are a huge lack of favorable responses... please give me some good news ...

[Djuar]

I had a Vitrectomy 9 days ago, and I have the cloudy vision as well, and  I see little specs (dots).  My doctor says this is "shake out".  As I understand it, it is the residue that was not visible during that surgery that is now coming down.  My doctor says that my retina is still attached.  All of you above that saw cloudy after the Vitrectomy, please update on your issue regarding the vision being cloudy.  I'm concerned.

[JohnHaganMD]

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[cware6]

I had Yag 2 months ago then visited in Denver where I had spiders webs and light flashes.  On return home my retina detached and had the cyro laser and gas bubble.  retine still attached, bubble smaller but having heavy fog.  Doc is having me wait 2 weeks to see if it clears, otherwise surgery.  My two weeks is up tomorrow so hoping for a good report though still pretty foggy, unable to drive at night also.

[JohnHaganMD]

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[MrPresley]

I had somewhat cloudy vision after a vitrectomy performed on October 1st, but it cleared after the gas bubble was completely absorbed, which took about two weeks.  I assume the cloudiness in my case was due to light refraction through/from the gas bubble.

[JohnHaganMD]

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[Mike_UK]

I had vitrectomy a week ago to address the occurrance of an epi-retinal membrane. The membrane was apparently in 3 layers and quite sticky and restisted removal.  No gas bubble was inserted. After a week the residual air has reduced to about 1/3rd of the field of view. The light transmission is quite cloudy but slowly it is improving. I have seen one or two dark circular spots darting around but think these are just individual air bubbles that arise due to aggressive head motion. When they reach the air/fluid interface th ey appear to disappear. My surgeon was expecting a clear liquid after one week but this may be due to blood vessels close to the surface that were disturb when the membrane was removed. I have   also noticed a few trails of what look like colour fluid that drifts around. I assume that this is traces of blood.  I will for the next week or more try and limit aggressive head movement to give a better chance of the blood vessels healing.

Mike C

[JohnHaganMD]

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[chazas]

I have had two vitrectomies this year, one for retinal detachment (with a gas bubble), one for an epiretinal membrane peel.  I didn't have any clarity or floater problems from the second, but from the first one, the cloudiness and a myriad of little black floaters took months to revolve, but resolve they did.  I think one week can be a little optimistic.  Good luck - we have to have a great deal of patience with these types of eye issues.  Improvements sometimes come slowly.

[Mike_UK]

The residual air completely evolved after 1 1/2 weeks. My sight is still blurred 12 days after the operation but I can see high contrast objects but with no detail. When looking at blank lighly coloured objects I see a slowly drifting very-fine black grain with the occasional streaks with similar graininess. There are also a few black specks within the field of view.

[JohnHaganMD]

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[Mike_UK]

Three to four weeks after the operation all floating particulate in the eye had effectively been filtered out by the body system and I have no visible specks of particulate. If any particles remain I would estimate that they are very small and much smaller than 10 micron. (This is estimated from the size of the gauge 25/27 micro-forceps that were used in the operation and were visible as a shadow on the retina).

An eye test at the opticians after 4½ weeks has measured an improvement in acuity from 20/120 (6/36m) to 20/40 (6/12m). Horizontal lines still show a small amount of distortion (waviness) in the vertical axis and to a smaller extent vertical line waviness in the horizontal axis. The astigmatism has rotated about 25 degrees.

I am hopeful that further relaxation of the retina may reduce the image distortion in time and improve the acuity further. In addition the acuity may be further improved with laser treatment to improve an apparent posterior opacification of the lens capsule.  The opacification is evident via the reduced light levels that I am currently experiencing between the two eyes, although not an excessive difference, and this was confirmed by my optician to be associated with the posterior region of the capsule. The latter symptom is apparently a not uncommon issue after inter-ocular lens implant surgery.

I hope the above summaries will be useful to those considering epi-retinal membrane surgery.  I would certainly have appreciated a better description of the experience before undergoing the operation rather than entering into an “act of faith”.

[JohnHaganMD]

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[Jpug2002]

I am close to two weeks post surgery and I too am extremely frustrated with my cloudy vision.  Mike_UK describes my experience perfectly--just seeing blurry shapes and colors even after the gas bubble has gone away.  I see black streaks in the morning when I wake up and I have some light flashes in the lower periphery of my vision.  I have reached out to my doctor and he said all of this is "normal" but it would have been nice to know exactly what could happen post surgery because it is quite scary when you experience these things.  I have also had lots of headaches, dizziness and nausea due to the vision imbalance.  Again, I wasn't told that could occur.  I know I'm in wonderful hands here in NYC but I do wish there was more preparation in what could potentially happen after the operation.  I have had two post operation appointments and he says everything looks good but the cloudiness is really demoralizing and disruptive.  I am really limited in what I can do and that includes working.  They told me I could return to work the following week (after the surgery) but there was actually no way I could do that.  I'm going on my third week out of the office because I don't trust myself enough to commute to work without a ton of anxiety.  I'm being extra careful because I know the retina is particularly delicate and a lot of activity can hinder my progress.  While I know this surgery was necessary for long term success, I wish I knew exactly what I was going to face afterward.  I had my face down for a a week and it was very, very difficult both physically and emotionally.  Now waking up with all sorts of interesting things happening in my vision just adds on to an already challenging recovery.  My advice to anyone having this surgery is to plan on being out of work for at least 3 weeks and to plan on putting their life pretty much on hold for that amount of time.  Between the headaches, nausea, dizziness, constant eye drops, back problems from being facedown all day and general frustration/depression you really can't do much of anything.  I know I will be happy I did it once I heal, but right now is very difficult and I'm beyond annoyed!

[Jst8131]

I'm 6 week post op and same cloudy, wavy, blurry and double vision, this is my second DR surgery since March,  dr had me out till August if all goes well

[lafmia]

I had the gas bubbe with vitrectomy three weeks ago and I a don't think I was given enough information on what to expect so have called the surgeon's office every time something new happens. I was lucky that I only had to stay face down the first 24 hours. I am on this site to as I think the bubble disappeared this morning but my vision is now a little more blurry and I too have many little black spots. Looks like my symptoms are what others are experiencing.  Thankful for the Internet. Hang in there. good luck with your recovery.