Post-Retinal Detachment Surgery Concerns: A Patient's Inquiry

Q: Post-Retinal Detachment Surgery Concerns: A Patient's Inquiry

Hello： <br>1. <br>The inability to focus and blurred vision in your right eye may be due to the presence of silicone oil, which can affect light refraction. <br>The presence of silicone oil may lead to poor image quality, similar to seeing a mosaic-like image. <br>This is a norma

Post-operative issues following retinal detachment surgery?

Hello Doctor, my husband is 53 years old and has severe myopia of -1000 diopters.
He underwent laser surgery to correct his vision to normal about 10 years ago.
Currently, he has glaucoma.
In mid-March, he had cataract surgery on his right eye, and by the end of July, he developed a retinal tear that required emergency laser treatment.
In early September, he experienced retinal detachment and underwent emergency silicone oil tamponade surgery.
At the beginning of October, during a follow-up visit, the doctor said the repair was good and that he could stop sleeping face down.
However, he still feels that he cannot focus properly with his right eye, and everything appears very blurry, which worries him about the potential impact on his work and daily life.
I have the following questions for you:
1.
Could the inability to focus and the blurry vision be due to the silicone oil still being in place, making things look pixelated?
2.
After the silicone oil is removed in December, what effects can we expect on his vision or visual acuity?
3.
If his vision still appears pixelated after the oil is removed, does this indicate an issue with the macula? What treatments are available?
4.
If his vision worsens after the oil is removed, will he be able to wear glasses or contact lenses?
5.
His left eye also had a retinal tear in September that was treated with laser.
Will this be affected by the condition of his right eye? Currently, his left eye has presbyopia of +2.00 diopters.
How can we prevent further degeneration in the left eye?
Thank you, Doctor! We appreciate your help!

Miss He, 40~49 year old female. Ask Date: 2023/10/20

Dr. Gao Pilin reply Ophthalmology

Hello:
1.
The inability to focus and blurred vision in your right eye may be due to the presence of silicone oil, which can affect light refraction.
The presence of silicone oil may lead to poor image quality, similar to seeing a mosaic-like image.
This is a normal phenomenon after surgery.

2.
After the silicone oil is removed in December, there may be a significant improvement in vision and visual clarity.
The removal of silicone oil will allow light to enter the eye correctly, which may enhance focusing ability.

3.
If you still experience blurriness or a mosaic-like vision after the silicone oil removal, it may be related to the macula.
The macula is a critical area of the retina that is essential for visual function.
If there are any abnormalities, the ophthalmologist may consider further treatment options, or it may be deemed untreatable.

4.
If your vision only slightly worsens after the silicone oil removal, you might consider wearing glasses or contact lenses to help improve your vision.
Glasses can correct refractive errors and provide clearer sight.

5.
Your left eye has also had a tear and treatment, which typically would not be directly affected by the condition of the right eye, but regular follow-up examinations are necessary.
However, since your left eye currently has presbyopia, which naturally occurs with aging, you may consider using reading glasses to improve your vision.

Reply Date: 2023/10/20

More Info

Hello! Thank you for reaching out with your concerns regarding your husband's post-retinal detachment surgery condition. It's understandable to feel anxious after such significant procedures, especially when it comes to vision. Let's address your questions one by one.

1. Silicone Oil and Blurred Vision: Yes, the presence of silicone oil in the eye can contribute to blurred vision. Silicone oil is often used in retinal surgeries to help keep the retina in place, but it can also cause visual disturbances, including a "mosaic" or "pixelated" appearance. This is because the oil can create a different refractive index than the natural fluids of the eye, leading to issues with focus. It’s important to discuss these symptoms with the ophthalmologist, as they can provide specific insights based on your husband’s condition.

2. Impact of Silicone Oil Removal: When the silicone oil is removed, many patients experience a change in their vision. Some may find that their vision improves significantly, while others may still have some residual blurriness. The outcome can depend on various factors, including the health of the retina and the presence of any underlying conditions, such as macular involvement. Your husband should have a thorough examination post-removal to assess the state of his retina and overall eye health.

3. Potential Macular Impact: If, after the silicone oil is removed, your husband continues to experience a "mosaic" effect, it could indicate that there is an issue with the macula, which is responsible for sharp central vision. If the macula has been affected, further treatments may be necessary, such as laser therapy or injections, depending on the specific diagnosis. Again, this should be evaluated by his ophthalmologist.

4. Vision Correction Post-Oil Removal: If his vision does not improve after the silicone oil is removed, he may still be able to use glasses or contact lenses to enhance his vision, depending on the nature of the visual impairment. It’s essential to have a comprehensive eye exam to determine the best course of action for vision correction.

5. Left Eye Concerns: The left eye, which has previously undergone laser treatment for a retinal tear, should be monitored closely, especially since your husband has a history of retinal issues. While the left eye's condition should not be directly affected by the right eye's surgery, the overall health of both eyes is crucial. To prevent further complications, regular eye exams are essential. Additionally, managing any existing conditions, such as glaucoma, is vital. Encourage your husband to maintain a healthy lifestyle, including a balanced diet rich in antioxidants, and to avoid activities that could strain his eyes.

In summary, it’s crucial for your husband to maintain open communication with his ophthalmologist regarding his symptoms and concerns. Regular follow-ups will help monitor his recovery and address any complications that may arise. If he feels that his current doctor is not providing adequate answers, seeking a second opinion from another specialist may also be beneficial. Remember, the journey to recovery can take time, and staying informed and proactive is key. Wishing your husband a smooth recovery and improved vision!

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