Navigating Eye Health: Managing Cataracts and Glaucoma After Retinal Detachment

After monocular retinal blindness, the other eye has cataracts and glaucoma?

Five years ago, I underwent surgery (gas tamponade) for a retinal detachment in my right eye at a well-known ophthalmology clinic.
After the surgery, I experienced distorted vision, and the doctor attributed this to cataracts.
Following cataract surgery, I had bleeding, and a month later, the doctor said there was another detachment.
After a second surgery (oil tamponade), it did not heal properly.
I sought treatment at a teaching hospital and subsequently underwent four more surgeries.
Currently, I cannot see out of my right eye (which is filled with oil).

I also have cataracts and glaucoma in my left eye, for which I am using glaucoma eye drops.
The cataracts cause blurriness and light sensitivity, making it difficult to see, so I rely on a hat and sunglasses.
I am hesitant to undergo cataract surgery because I only have one functioning eye left, and my right eye has been non-functional since the cataract surgery.
Although I have regular follow-ups every three months at the largest hospital, I am afraid to ask the doctor questions because he is quite stern.
My right eye has failed after four surgeries at this large hospital (and I had four surgeries at a well-known private clinic before that).
Given my situation, would it be safer to avoid surgery on my left eye unless new techniques emerge that can guarantee safety? Thank you; this question has troubled me for many years.

Sun Mike, 50~59 year old female. Ask Date: 2024/06/15

Dr. He Jianxian reply Ophthalmology

Dear Mr.
Sun,
There is no such thing as a guarantee of surgical safety; surgery inherently carries certain risks.
Even with the latest equipment available to assist, there are still risks involved.
If your vision has deteriorated to the point that it severely affects your daily life, I recommend that you consider surgery.
It would be beneficial for you to consult multiple ophthalmologists to find one that you can trust.
This is my personal suggestion.
Director He Jianxian, Ophthalmology Department, Nantou Hospital

Reply Date: 2024/06/15

More Info

Navigating eye health, especially after complex issues like retinal detachment, cataracts, and glaucoma, can be incredibly challenging and emotionally taxing. Your situation, having undergone multiple surgeries on your right eye and now facing complications with your left eye, is understandably concerning.
Firstly, it’s important to recognize that cataracts and glaucoma are both common conditions that can significantly impact vision, especially in individuals with a history of retinal detachment. Cataracts can cause blurred vision, sensitivity to light, and halos around lights, while glaucoma can lead to peripheral vision loss and, if untreated, can result in blindness. Given your history, it’s crucial to manage these conditions carefully.

Regarding your left eye, the decision to proceed with cataract surgery should not be taken lightly, especially since you have only one functional eye left. The fear of complications, particularly after your experiences with the right eye, is valid. However, it’s essential to weigh the risks and benefits of surgery. Cataract surgery is generally considered safe and effective, but in your case, the presence of glaucoma complicates matters. Glaucoma can affect the healing process and the overall outcome of cataract surgery.

Here are some considerations to help you navigate your situation:
1. Consultation with a Specialist: If you feel uncomfortable with your current ophthalmologist, seeking a second opinion from another eye specialist, particularly one who has experience with complex cases involving retinal detachment, cataracts, and glaucoma, may provide you with more clarity. A more empathetic doctor might help you feel more at ease discussing your concerns.

2. Understanding Risks and Benefits: It’s crucial to have a thorough discussion about the potential risks of cataract surgery in the context of your glaucoma. While surgery can improve vision, it may also pose risks, such as increased intraocular pressure or complications related to your previous surgeries. Understanding these risks can help you make an informed decision.

3. Monitoring and Management: Since you are already under regular observation every three months, it’s essential to continue this practice. Regular monitoring can help catch any changes in your eye health early, allowing for timely intervention if necessary.

4. New Techniques and Technologies: Advances in surgical techniques and technologies are continually being developed. Discuss with your doctor whether there are any new methods or technologies that could minimize risks for someone in your situation. For example, minimally invasive techniques or advanced intraocular lenses might be options worth exploring.

5. Support Systems: Dealing with vision loss and the fear of surgery can be isolating. Consider seeking support from groups or forums where individuals share similar experiences. This can provide emotional support and practical advice from those who have faced similar challenges.

6. Lifestyle Adjustments: In the meantime, continue using hats and sunglasses to manage light sensitivity and protect your remaining vision. Additionally, ensure that you are following any prescribed treatments for glaucoma, as managing intraocular pressure is crucial in preserving your vision.

In conclusion, while the fear of surgery is understandable given your history, it’s essential to have open discussions with your healthcare providers about your concerns. Weighing the risks and benefits, considering new technologies, and seeking second opinions can empower you to make the best decision for your eye health. Remember, maintaining regular check-ups and managing your current conditions is vital in preserving your vision for as long as possible.

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