Post-Scleral Buckling Surgery: Vision, Pain, and Recovery Insights

Q: Post-Scleral Buckling Surgery: Vision, Pain, and Recovery Insights

Hello： <br>1. <br>Based on the symptoms you described, the tightness, pain around the eyes, tingling, and foreign body sensation may be normal reactions following scleral buckle surgery. <br>The eyes may require a longer time to recover and adapt, especially during prolonged near

Postoperative issues related to vision, visual field, and pain after scleral buckle surgery?

Dear Doctor,
I have experienced a retinal tear and detachment in my right eye, for which I underwent scleral buckle surgery in mid-March of this year.
Postoperatively, due to subretinal hemorrhage, I had to undergo gas tamponade and thrombolytic agent injection surgery.
During follow-up visits, it was confirmed that the retina is properly attached and the blood clot has been pushed away and absorbed.
However, examination with instruments revealed that there are folds and traction in the macular region.

Now, nearly three months post-surgery, I would like to consult you regarding issues related to postoperative vision, visual field, and pain:
1.
I have returned to work about a month ago, where I need to use the computer for long hours (8-10 hours daily).
I often feel tightness in my right eye, with a sensation of tight pain around the eye socket (near the inner corner and bridge of the nose), as well as a prickling and foreign body sensation inside the eye.
Is this a normal postoperative sequela of scleral buckle surgery, and does it mean I do not need to seek medical attention since there is no severe pain? Would keeping my eyes moist (using preservative-free artificial tears daily) and taking more breaks help improve this condition?
2.
Currently, I feel that the visual field in my right eye has decreased (occasionally, I bump into objects on my right side because I cannot see them).
I also notice distortion in viewing objects and text (both vertical and horizontal lines appear wavy in grid tests), along with a sensation of haziness and dimness in my vision.
As a result, I primarily rely on my left eye for work and daily activities.
Is this a postoperative sequela or an effect of the macular folds? Should I undergo further detailed examinations or consider additional surgery for the macula or other areas?
3.
May I engage in light exercise such as cycling (spinning) or using a stair stepper post-surgery?
Thank you for your guidance on these matters!

Miss Mo, 30~39 year old female. Ask Date: 2023/06/05

Dr. Gao Pilin reply Ophthalmology

Hello:
1.
Based on the symptoms you described, the tightness, pain around the eyes, tingling, and foreign body sensation may be normal reactions following scleral buckle surgery.
The eyes may require a longer time to recover and adapt, especially during prolonged near-vision activities such as using a computer.
Keeping the eyes moist, using preservative-free artificial tears, and taking regular breaks can indeed help alleviate symptoms.
However, if the pain persists or worsens, or if you are concerned about your symptoms, it is best to consult your attending physician to determine if further evaluation is needed.
2.
Postoperative symptoms such as a reduced visual field, distortion, and blurriness may be related to issues with the macula, such as macular folds or other potential impacts.
These symptoms may require further assessment and examination to determine the condition of the macula.
You can discuss with your attending physician the possibility of further tests, such as Optical Coherence Tomography (OCT) or other detailed examinations, to gain more insight into the status of the macula and to determine if additional treatment or surgery is necessary.
3.
For light cycling (spinning) or elliptical machine exercises, it is best to consult your attending physician.
Depending on the type of surgery and your individual circumstances, your recovery progress and eye condition should be evaluated to determine if these activities are appropriate.
Mild aerobic exercise is generally beneficial for health, but caution is advised during the recovery period, especially following eye surgery.

Reply Date: 2023/06/05

More Info

Post-scleral buckling surgery is a significant procedure aimed at addressing retinal detachment, and it can lead to various postoperative symptoms and complications. Based on your detailed description, let's address your concerns regarding vision, pain, and recovery.

1. Postoperative Symptoms: The sensations you are experiencing, such as tightness around the eye, localized pain near the nose and brow, and a feeling of foreign body presence, can indeed be common after scleral buckling surgery. These symptoms may arise from the surgical manipulation of the eye and the healing process. It is essential to understand that the eye is a delicate structure, and postoperative discomfort can be expected as the tissues heal. Using preservative-free artificial tears is a good practice to keep the eye lubricated, especially if you are spending long hours in front of a computer screen. Regular breaks and eye exercises can also help alleviate some discomfort. However, if the pain intensifies or if you notice any changes in your vision, it is crucial to consult your ophthalmologist for further evaluation.

2. Changes in Vision and Visual Field: The changes you describe, including a reduced visual field, distortion of images, and a cloudy or hazy vision, could be attributed to several factors, including the presence of macular folds or other complications related to the surgery. Macular folds can lead to visual distortions and may require further intervention, such as a surgical procedure to address the issue. It is advisable to discuss these symptoms with your eye doctor, who may recommend advanced imaging tests like Optical Coherence Tomography (OCT) to assess the condition of the macula and determine the best course of action. Early intervention can be crucial in managing these complications effectively.

3. Physical Activity Post-Surgery: Regarding your question about engaging in light exercises like cycling or using a treadmill, it is generally advisable to avoid strenuous activities for a period following eye surgery. However, light to moderate exercise can be beneficial for overall health and recovery, provided it does not involve heavy lifting or activities that could strain the eyes. Always consult your surgeon or ophthalmologist before resuming any exercise regimen to ensure it aligns with your recovery progress.

In summary, while some discomfort and visual changes can be expected after scleral buckling surgery, persistent or worsening symptoms warrant a thorough evaluation by your healthcare provider. Keeping your eyes lubricated, taking regular breaks from screens, and following up with your ophthalmologist will be essential steps in your recovery process. Your vision and comfort are paramount, and proactive management of any complications will help ensure the best possible outcome.

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