Post-Retinal Surgery: Vision Changes After Vitrectomy

Q: Post-Retinal Surgery: Vision Changes After Vitrectomy

Hello Mr. <br>Liu： Since it is difficult to assess your postoperative condition, I cannot provide an accurate answer. <br>I recommend that you ask your attending physician for more clarity. <br>Dr. <br>He Jianxian, Ophthalmology Department, Nantou Hospital.

Post-retinal surgery

Hello Doctor, I have diabetes and experienced a vitreous hemorrhage last October.
Since then, my vision has been clouded for nearly 10 months.
I previously consulted a doctor who mentioned that there is a fibrous membrane in my eye that may have adhered to the retina, and there is slight retinal detachment, but it has not affected the macula yet.
Before the surgery, there was a fixed shadow in my central vision that did not move with eye movement, although it shifted with eye rotation, it was distinctly different from the movement of blood floating in the eye.
On August 13 of this year, I underwent a vitrectomy.
Before the surgery, I could see a little through the blood, and the visible objects were clear.
After the surgery, the doctor injected gas into my eye, and now (about 12 days later) most of the gas has been absorbed.
The doctor also mentioned that the retinal attachment looks good, but there is still some bleeding in the eye (with a few black spots).
After researching, I found that when there is gas in the eye, I need to wait for it to be fully absorbed to see clearly.
Currently, the gas bubble has shrunk to about one centimeter, but my vision remains very blurry, with everything appearing gray.
I can see movement about a meter away when I wave my hand, but I cannot discern how many fingers I am holding up (even when close, it is difficult to tell).
Is this situation normal?

Liu Xiansheng, 30~39 year old female. Ask Date: 2020/08/25

Dr. He Jianxian reply Ophthalmology

Hello Mr.
Liu: Since it is difficult to assess your postoperative condition, I cannot provide an accurate answer.
I recommend that you ask your attending physician for more clarity.
Dr.
He Jianxian, Ophthalmology Department, Nantou Hospital.

Reply Date: 2020/08/25

More Info

After undergoing vitrectomy, especially in the context of diabetic complications such as vitreous hemorrhage and retinal detachment, it is not uncommon to experience significant changes in vision. Your situation, where you have been dealing with a fixed shadow in your central vision prior to surgery, followed by a post-operative period of blurred and hazy vision, raises several important points regarding recovery and expectations.

Firstly, it is essential to understand that the healing process after vitrectomy can be quite variable among individuals. The presence of gas in the eye post-surgery is a common practice to help flatten the retina and promote healing. As the gas gradually absorbs, which can take several weeks, your vision may fluctuate. Initially, while the gas is still present, it can obstruct your view, leading to a cloudy or hazy appearance. This is a normal part of the healing process, and many patients report similar experiences.

The fact that you are seeing some movement at a distance but are unable to discern details, such as the number of fingers being held up, indicates that your vision is still recovering. The presence of residual blood or debris in the vitreous cavity can also contribute to the haziness you are experiencing. This is particularly relevant given your history of vitreous hemorrhage, where blood can linger in the eye for some time after the initial event and surgery.

Regarding the fixed shadow you experienced prior to surgery, it is likely related to the fibrous membranes that were present, which can cause distortion in vision. Post-surgery, if the retina is well attached and the gas is absorbing, you may still experience some visual disturbances as your brain adjusts to the new visual input and as any residual effects from the surgery resolve.

It is also important to consider the potential for complications. While your doctor has indicated that the retina is well attached, any persistent or worsening symptoms, such as increased blurriness, pain, or new visual disturbances, should be promptly reported to your ophthalmologist. They may want to conduct a thorough examination to rule out any complications such as retinal re-detachment or other issues that could affect your recovery.

In terms of your diabetes, it is crucial to maintain good glycemic control during your recovery, as uncontrolled diabetes can impact healing and overall eye health. Regular follow-ups with your ophthalmologist are essential to monitor your progress and to make any necessary adjustments to your treatment plan.

In conclusion, while your current visual status may be concerning, it is not uncommon for patients to experience a period of hazy vision following vitrectomy, especially given your complex medical history. Continue to follow your doctor's advice, attend all scheduled follow-ups, and communicate any changes in your vision. With time and proper care, many patients see gradual improvement in their vision post-surgery.

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