Post-Surgery Concerns for Retinal Detachment and Cataract Patients

Postoperative issues related to retinal surgery?

Hello Doctor, my mother underwent retinal detachment and cataract surgery in the middle of the month, using silicone oil.
So far, she has been lying down for about 10 hours a day.
I have a few questions:
1.
Can she sleep naturally on her side, or should her neck and body remain straight and still?
2.
Her vision is not as dark as it was before and has improved slightly, but I am concerned about why straight lines appear wavy.
The follow-up doctor mentioned that the optic nerve hasn't fully healed and that it may take 2 to 3 months.
Is there a real chance for improvement?
3.
Is the current disparity in her vision causing objects to appear wavy, similar to the sensation of wearing new glasses? Will wearing glasses in the future help improve this? Thank you very much.

Na, 20~29 year old female. Ask Date: 2016/03/30

Dr. Wang Zhishun reply Ophthalmology

Hello, 1.
The duration of postoperative prone positioning is influenced by many factors.
If the physician advises that it is no longer necessary to sleep face down at night, you may adopt your natural sleeping position.
2-3.
Seeing wavy lines when looking at straight objects is related to retinal detachment affecting the macula.
It may not necessarily improve, and wearing glasses will not help.

Reply Date: 2016/03/30

More Info

Post-surgery concerns for retinal detachment and cataract patients are quite common, and it's understandable to have questions regarding recovery and visual changes after such significant procedures. Based on the information provided, I will address your concerns and provide additional insights into the recovery process.

1. Sleeping Position: After retinal detachment surgery, especially when using silicone oil, it is crucial to follow your surgeon's recommendations regarding sleeping positions. Generally, patients are advised to maintain a specific head position to facilitate proper healing and ensure that the retina remains in place. This often means avoiding lying flat on your back or turning your head in certain directions. Instead, your doctor may recommend sleeping on your side or in a semi-upright position. It is essential to clarify these instructions with your surgeon, as they may have specific guidelines based on your mother's individual case.

2. Visual Changes and Recovery: It is not uncommon for patients to experience visual disturbances such as waviness or distortion in their vision after retinal surgery. This can be attributed to several factors, including the healing process of the retina and the adjustments the brain must make as it adapts to new visual inputs. The fact that your mother’s vision is improving, albeit slowly, is a positive sign. The recovery of visual acuity can take time, and it is typical for the vision to fluctuate during the healing process. The statement from the doctor regarding the optic nerve needing 2-3 months to heal is consistent with what many patients experience. While some visual disturbances may improve over time, it is essential to have regular follow-ups with the ophthalmologist to monitor progress and address any concerns.

3. Perception of Distortion: The sensation of seeing straight lines as wavy or distorted can be related to several factors, including the healing of the retina and the brain's adaptation to changes in vision. This phenomenon, known as metamorphopsia, can occur after retinal surgery. It is often temporary and may improve as the retina heals and the brain recalibrates its visual processing. Wearing glasses post-surgery can help correct refractive errors and improve clarity, but it may not eliminate all distortions if they are related to the retinal healing process. Your mother's ophthalmologist will be able to provide guidance on when it is appropriate to start wearing glasses again and what type of prescription may be needed.

In summary, the recovery process after retinal detachment and cataract surgery can be complex and varies from patient to patient. It is vital to maintain open communication with the healthcare team, follow their recommendations regarding activity restrictions and follow-up appointments, and report any new or worsening symptoms. Encourage your mother to be patient with her recovery, as visual improvements can take time. If there are persistent concerns or if her vision does not improve as expected, further evaluation by her ophthalmologist may be necessary to rule out any complications.
Overall, the key to a successful recovery lies in adhering to medical advice, attending follow-up appointments, and being proactive about any changes in vision.

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