Vision Changes After Retinal Detachment Surgery

Q: Vision Changes After Retinal Detachment Surgery

Hello： 1. It may be caused by residual oil. It could also be due to retinal damage. 2. Currently, the macula is fine, but it cannot be determined if there was any injury at the time that could lead to sequelae. 3. It is considered severe. 4. Whethe

Visual field and vision after retinal detachment surgery?

Hello Doctor,
I am currently four months post-silicone oil injection surgery for retinal detachment in my left eye (both eyes are approximately -4.00 diopters).
After the oil was injected, I noticed a faint white light in the upper right corner of my visual field when I close my eyes.
This light appears as a shape similar to ink spreading, and the area becomes somewhat blurry, resembling a distorted water pattern whenever I look at something in that region.

I have consulted five or six doctors, and after undergoing OCT scans, they all stated that my macula is healthy and that I will gradually recover.

1.
What could this phenomenon be?
2.
If the macula is healthy, can we confirm that it is not due to damage to the macula from the retinal detachment?
3.
Lastly, is the silicone oil injection for retinal detachment considered serious? Before the surgery, the doctor mentioned whether to use laser treatment or silicone oil, and he decided on silicone oil due to multiple retinal tears, stating it would help flatten the tears.
Therefore, I am unsure about the severity of my condition.

4.
During my follow-up visit, the doctor did not mention whether there was any damage to the macula.
Is it standard practice to inform patients if the detachment has affected the macula? Prior to the surgery, I also had a fundus examination, and currently, I can read 0.4 to 0.5 on a 3-meter vision chart at home, but it is a struggle to see the gaps.

Thank you for your assistance.

Niming, 20~29 year old female. Ask Date: 2022/05/12

Dr. Gao Pilin reply Ophthalmology

Hello: 1.
It may be caused by residual oil.
It could also be due to retinal damage.
2.
Currently, the macula is fine, but it cannot be determined if there was any injury at the time that could lead to sequelae.
3.
It is considered severe.
4.
Whether the macula is affected may depend on future recovery.
If vision worsens, it is likely that there is an impact.

Reply Date: 2022/05/12

More Info

Understanding vision changes after retinal detachment surgery can be complex and often requires a thorough understanding of the underlying anatomy and the surgical procedures involved. Based on your description, it seems you are experiencing some visual disturbances following your retinal detachment surgery, specifically after the removal of silicone oil. Here’s a breakdown of your concerns:
1. Understanding the Visual Phenomenon: The "faint white light" you are seeing, which resembles ink spreading, could be related to a few factors. After retinal surgery, especially involving the vitreous and retina, patients may experience visual distortions such as floaters, flashes of light, or even visual field defects. The area you describe as being affected may be due to residual changes in the vitreous gel or the retina itself. The fact that it appears as a distortion or a "water wave" effect is not uncommon, as the brain adjusts to changes in the visual input post-surgery.

2. Health of the Macula: If multiple doctors have assessed your macula and confirmed it is healthy, this is a positive sign. The macula is crucial for central vision, and damage to this area can lead to significant visual impairment. If your macula is intact, it suggests that the retinal detachment did not extend to this critical region, which is reassuring. However, even with a healthy macula, the brain may still take time to adjust to the new visual signals, leading to temporary distortions.

3. Severity of Silicone Oil Use: The use of silicone oil in retinal surgery is often a necessary step, particularly in cases with multiple retinal tears or significant detachment. While it may sound severe, it is a common practice to help stabilize the retina and promote healing. The decision to use silicone oil versus laser treatment depends on the specific characteristics of the detachment and the surgeon's judgment. It is not uncommon for patients to feel uncertain about the severity of their condition, but the use of silicone oil indicates that the surgical team was taking appropriate measures to address the complexity of your situation.

4. Communication Regarding Macular Health: Typically, if there is any concern regarding damage to the macula, the surgeon will inform the patient. It is standard practice to discuss potential risks and outcomes with patients pre- and post-operatively. If your doctors have not mentioned any issues with the macula, it is likely that they did not observe any significant damage during their examinations. However, if you have ongoing concerns, it is always appropriate to seek clarification from your healthcare provider.

In summary, while the visual changes you are experiencing can be distressing, they are not uncommon after retinal surgery. The brain often needs time to adapt to the new visual input, and many patients report gradual improvement over time. It is essential to maintain regular follow-ups with your ophthalmologist to monitor your recovery and address any new symptoms that may arise. If you continue to have concerns about your vision or the surgical outcomes, consider discussing them directly with your surgeon for personalized insights and reassurance.

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