Retinal Detachment and Cataracts: A Patient's Journey

Retinal detachment + cataract

Dear Dr.
Chang,
I would like to ask about my brother.
He has developed a "vascular membrane" in his eye, which has previously caused bleeding and affected his vision.
Last year, due to the vascular membrane, he experienced retinal detachment in both eyes and has undergone surgery (air injection).
During the treatment, mild cataracts were also discovered in both eyes, and shortly after, the doctor recommended cataract surgery.
Since then, his vision in one eye has been poor, making it difficult to read text.
Currently, one eye has experienced another retinal detachment, and he has undergone surgery again due to the presence of mucus.
He is currently unable to see and is residing at Chung Shan Medical University in Taichung.
I would like to know what can be done about his eye condition, as the mucus from the vascular membrane is causing poor adhesion of the retina.
What kind of medical assistance should we seek for him? How can we help him in daily life? Is there a risk of blindness in his situation? If he does become blind, what should we do? We are very worried and scared.
Dr.
Chang, I sincerely ask for your advice.
Thank you very much!

eva, 30~39 year old female. Ask Date: 2004/05/05

Dr. Zhang Zhengzhong reply Ophthalmology

Hello Ms.
Eva,
First, I would like to apologize for the delay in response due to Dr.
Chang's busy schedule.
Regarding your questions, here are my answers:
1.
Since your brother is still hospitalized, it is important for you to communicate with his attending physician to address any concerns you may have and to gain a thorough understanding of his condition.
2.
The severity of complications related to "hemangiomas" affecting the retina can vary based on factors such as the location and extent of the lesions, among others.
These factors differ from person to person.
However, for any physician, it is challenging to make an accurate assessment without personally examining your brother and seeing the actual situation.
3.
If you are seeking a second opinion regarding treatment, you may consider waiting until your brother's current treatment concludes and he is stable enough to be discharged.
Afterward, you can seek the advice of retinal specialists at hospitals near Taichung, such as Dr.
Cai San-Zhang or Dr.
Chen Wen-Lu at China Medical University Hospital, or Dr.
Cai Hsien-Yang at Taichung Veterans General Hospital, among others.
Best wishes,
Dr.
Liu Jing
Attending Physician, Department of Ophthalmology
Retina and Neuro-Ophthalmology
Chung Hsing Hospital
TEL: 02-25523234-6278
E-mail: [email protected]

Reply Date: 2004/05/05

More Info

Retinal detachment and cataracts are significant ocular conditions that can severely impact vision and quality of life. Your brother's situation, involving both retinal detachment and cataracts, is indeed concerning and requires careful management.

Understanding Retinal Detachment
Retinal detachment occurs when the retina, the light-sensitive layer at the back of the eye, separates from its underlying supportive tissue. This can lead to permanent vision loss if not treated promptly. In your brother's case, the presence of a "blood vessel tumor" (likely a retinal vascular lesion) that has caused bleeding can lead to complications such as retinal detachment. The surgical intervention he underwent, which involved injecting gas into the eye, is a common method to reattach the retina. However, the success of this procedure can be influenced by various factors, including the extent of the detachment and the underlying health of the retina.

Cataracts and Their Impact
Cataracts, which are characterized by the clouding of the lens in the eye, can further complicate vision, especially after retinal surgery. It is not uncommon for patients with retinal issues to develop cataracts, particularly if they have undergone surgery or have had prolonged inflammation in the eye. The recommendation for cataract surgery is typically made when the cataracts significantly impair vision.

Current Concerns
Given that your brother has undergone multiple surgeries and is still experiencing poor vision, it is crucial to follow up with a retinal specialist. The presence of "mucus" in the eye, as you described, could indicate ongoing issues with the vitreous gel, which can affect the retina's ability to remain attached. This situation may require further intervention, such as vitrectomy, where the vitreous gel is removed to alleviate traction on the retina.

Seeking Medical Help
1. Consult a Retinal Specialist: It is essential for your brother to see a retinal specialist who can assess the current state of his retina and determine the best course of action. They may perform imaging tests, such as optical coherence tomography (OCT), to evaluate the retina's condition.

2. Regular Follow-ups: After any surgical intervention, regular follow-ups are crucial to monitor the healing process and detect any complications early.

3. Consider a Multidisciplinary Approach: If cataracts are also affecting his vision, a coordinated approach involving both a retinal specialist and a cataract surgeon may be necessary.

Daily Living and Support
In terms of daily living, here are some suggestions to help your brother:
- Assistive Devices: Depending on the severity of his vision impairment, consider assistive devices such as magnifiers or specialized glasses that can help him read or see better.

- Home Modifications: Ensure that his living environment is safe and accessible. This may include removing tripping hazards and ensuring adequate lighting.

- Emotional Support: Coping with vision loss can be emotionally challenging. Encourage him to seek support from family, friends, or support groups for individuals with vision impairment.

Risk of Blindness
While your brother's situation is serious, it is essential to remain hopeful. Many individuals with retinal detachment can retain some level of vision, especially if they receive timely and appropriate treatment. However, if he were to lose vision in both eyes, it would be crucial to explore rehabilitation services that can assist him in adapting to his new circumstances.

Conclusion
In summary, your brother's condition requires immediate attention from specialists who can provide targeted treatment for both his retinal detachment and cataracts. By seeking the right medical help and providing supportive care at home, you can help him navigate this challenging journey. Remember, early intervention is key to preserving vision and improving quality of life.

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