Why Frequent Ultra-Widefield Imaging is Crucial After Retinal Surgery - Ophthalmology

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Why is it necessary to perform intensive ultra-wide-angle photography?


On December 22, 2023, I underwent a vitrectomy due to a dislocated lens caused by being hit by a badminton shuttlecock.
The lens was removed, and the damaged areas of the retina were treated with laser.
However, a month later, I noticed a shadow, and upon emergency examination, it was discovered that I had a retinal detachment.
On January 25, 2024, I underwent another vitrectomy and scleral buckle surgery, and gas was injected into the eye.
It has now been 7 weeks since the gas was injected, and the doctor said that the retina is currently attached well.
However, there is still a semi-circular dark shadow at the bottom of my eye.
The doctor mentioned that I need to stay in a prone position due to the gas, which is meant to protect the retinal attachment, but also noted that I should be cautious of potential elevated intraocular pressure and keep up with follow-up appointments.

I have been attending follow-up visits for four consecutive weeks for ultra-widefield imaging, and I have another appointment next Tuesday afternoon.
The gas has not yet dissipated, and I still need to sleep in a prone position.
I am confused about the necessity of such frequent ultra-widefield imaging.
Isn't its purpose to check for any remaining retinal tears? What is the reason for the intensive schedule? I am worried about how this might affect my upcoming artificial lens suturing at the end of March.
I live in a state of anxiety and partial blindness, and the doctor is quite reserved with information.
I am puzzled but can only comply with the follow-up visits and medical advice.
I hope the doctor can provide some suggestions.
Thank you!

Niming, 40~49 year old female. Ask Date: 2024/03/06

Dr. He Jianxian reply Ophthalmology


Hello Ms.
Anonymous: When performing wide-angle photography, it is important to check whether the retina is fully attached.
Even if this procedure is not done, it may still be necessary to dilate the pupils to examine the fundus, as the underlying purpose is the same.
Dr.
Ho Chien-Hsien, Ophthalmology Department, Nantou Hospital.

Reply Date: 2024/03/06

More Info


Frequent ultra-widefield imaging after retinal surgery is crucial for several reasons, particularly in the context of your recent experiences with retinal detachment and subsequent surgeries. Understanding the rationale behind this intensive monitoring can help alleviate some of your concerns and provide clarity on the importance of these follow-up appointments.

First and foremost, ultra-widefield imaging allows for a comprehensive view of the retina, capturing a larger area than traditional imaging methods. This is particularly important after surgeries like vitrectomy and scleral buckle placement, as these procedures can lead to changes in the retinal structure that may not be immediately visible. The imaging helps the ophthalmologist assess the integrity of the retina, ensuring that it remains attached and that there are no new tears or detachments. Given your history of retinal detachment, this monitoring is essential to catch any potential issues early.

Additionally, the presence of gas in your eye, which is common after certain retinal surgeries, necessitates careful observation. The gas bubble serves to support the retina as it heals, but it can also create visual disturbances, such as the half-moon shadow you are experiencing. Regular imaging allows your doctor to monitor the gas bubble's behavior and its impact on the retina. As the gas gradually dissipates, the retina's healing process can be evaluated, ensuring that it remains properly attached throughout this time.

Moreover, frequent imaging can help identify any complications that may arise, such as increased intraocular pressure, which you mentioned your doctor has cautioned you about. Elevated eye pressure can lead to glaucoma, a serious condition that can further compromise your vision. By conducting weekly imaging, your healthcare provider can monitor for signs of increased pressure and intervene if necessary, thereby protecting your long-term vision.

The emotional toll of living with visual disturbances and uncertainty about your eye health is significant. It’s understandable to feel anxious about the impact of these ongoing issues on your upcoming artificial lens surgery. However, the intensive follow-up care you are receiving is a proactive approach to ensure that your retina heals properly and that any complications are addressed promptly. Your doctor’s focus on regular imaging is a testament to their commitment to your eye health and recovery.

In summary, the frequent ultra-widefield imaging serves multiple purposes: it provides a detailed view of the retina, monitors the healing process, checks for complications like increased intraocular pressure, and ensures that your retina remains attached. While it may feel overwhelming to have so many appointments, each one is a critical step in safeguarding your vision and preparing for your future surgery. It’s important to communicate openly with your healthcare provider about your concerns and to seek clarification on any aspects of your treatment plan that you find confusing. Your active participation in your care is vital, and understanding the reasons behind these recommendations can help ease your anxiety.

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