Retinal Detachment: Causes, Treatments, and Recovery Insights

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Hello, doctor.
Two years ago, I accidentally injured my left eye while playing basketball, which led to a retinal detachment.
After returning home, I noticed a decrease in my left eye's visual field and immediately went to the emergency department at Veterans General Hospital.
The emergency physician advised me to register for surgery.
I had to re-register, and the doctor scheduled the surgery for over a week later.
However, my vision continued to deteriorate, and on the day of the surgery, the doctor discovered that the detachment had expanded and required a scleral buckle procedure.
The surgery lasted two hours, and I was hospitalized for eight days.
After returning home for recovery, I had to visit the clinic monthly, where it was found that there was significant neovascularization, causing my left eye to appear blood-red.
I had to undergo laser treatment.
After a year, my left eye's vision remains at only 0.3, with symptoms of distorted visual field, color desaturation, and other issues.
After examination, the doctor noted signs of retinal degeneration.

I have several questions:
1.
Can surgery be performed immediately in the emergency department?
2.
What causes my left eye's vision to remain at only 0.3, with symptoms of distorted visual field, color desaturation, and other issues?
3.
What are the causes of retinal detachment?
4.
How can the blood-red appearance of my left eye be resolved?
5.
Is there any hope for retinal degeneration?
6.
My left eye's prescription increased from -2.50 to -8.00; what factors contributed to this change?
7.
Is there a possibility of retinal detachment occurring in my right eye?
8.
Is there a chance for my left eye's vision to recover?
9.
What are the potential complications of the scleral buckle procedure? Will the implanted material need to be removed, and will there be scarring on the conjunctiva?
I apologize for the lengthy questions, and I appreciate your answers.
Thank you.

Xiao Yu, 20~29 year old female. Ask Date: 2005/04/07

Dr. Cai Jingyao reply Ophthalmology

1.
Whether surgery can be performed immediately in the emergency department depends on the patient's condition, making it difficult to generalize.

2.
The left eye's vision remains at 0.3, and there are phenomena such as distorted visual fields and faded colors.
The cause is difficult to determine without direct examination, but it is likely related to the macula or optic nerve being affected.

3.
The causes of retinal detachment are mostly unknown.
Trauma or diabetic retinopathy can easily lead to it, and high myopia is also one of the risk factors.

4.
The left eye appears blood-red, which likely refers to conjunctival redness.
If so, it is mostly related to local vascular proliferation during wound healing, and it requires time to recover.

5.
Is there a chance for recovery from retinal degeneration? If there is already established damage, the chances are smaller.

6.
The refractive error in the left eye increased from 250 degrees to 800 degrees afterward.
What factors contribute to this? Scleral buckling can lead to an increase in myopia.

7.
Is there a possibility of retinal detachment in the right eye? Regular check-ups are necessary for safety.

8.
Is there a possibility for the left eye's vision to recover? It depends on the condition.

9.
What are the potential complications of scleral buckling surgery? Is it necessary to remove the implanted material? Will there be scarring on the conjunctiva? The material does not necessarily need to be removed after retinal repositioning, and conjunctival scars generally heal well.

Reply Date: 2005/04/07

More Info

Retinal detachment is a serious condition that can lead to permanent vision loss if not treated promptly. It occurs when the retina, the light-sensitive layer of tissue at the back of the eye, separates from its underlying supportive tissue. Understanding the causes, treatments, and recovery insights related to retinal detachment is crucial for anyone who has experienced this condition.

1. Emergency Surgery: In cases of retinal detachment, time is of the essence. If a patient presents with symptoms such as sudden vision changes, flashes of light, or a curtain-like shadow over the visual field, it is critical to seek immediate medical attention. Emergency departments can assess the situation, but the ability to perform surgery immediately depends on the availability of specialized ophthalmic surgeons and the severity of the detachment. In many cases, surgery can be scheduled quickly, but delays can occur if the condition worsens, as you experienced.

2. Vision Loss and Distortion: The persistent low vision (0.3) and visual distortions you are experiencing can be attributed to several factors. After retinal detachment, the retina may not fully reattach, or there may be complications such as the formation of scar tissue or new blood vessels (neovascularization) that can distort vision. Additionally, the health of the retinal pigment epithelium and the overall integrity of the retina play significant roles in visual acuity. The presence of new blood vessels can lead to bleeding, further complicating vision recovery.

3. Causes of Retinal Detachment: Retinal detachment can occur due to various reasons, including trauma (as in your case), age-related changes, high myopia (nearsightedness), or previous eye surgeries. The trauma from your sports injury likely caused a tear or hole in the retina, allowing fluid to seep underneath and separate it from the underlying tissue.

4. Managing Blood Redness: The appearance of a blood-red eye can be due to several factors, including bleeding from new blood vessels or irritation. Treatment options may include anti-inflammatory medications or laser therapy to reduce neovascularization. It is essential to consult your ophthalmologist for appropriate management.

5. Retinal Degeneration: Retinal degeneration can occur after a detachment due to a lack of oxygen and nutrients to the retina. While some treatments may help stabilize the condition, complete recovery of vision may not be possible. Ongoing monitoring and treatment can help manage symptoms and prevent further deterioration.

6. Changes in Prescription: The increase in your left eye's prescription from 250 to 800 degrees may be due to the eye's response to the detachment and subsequent surgery. Changes in the shape of the eye or the lens can occur after such trauma, leading to significant shifts in refractive error.

7. Risk to the Right Eye: While having a retinal detachment in one eye does increase the risk for the other eye, it does not guarantee that the right eye will also experience detachment. Regular eye examinations are essential to monitor the health of both eyes.

8. Potential for Vision Recovery: While some recovery of vision may be possible, especially with ongoing treatment, it is essential to have realistic expectations. The extent of recovery often depends on the initial severity of the detachment and the success of the surgical intervention.

9. Scleral Buckling Complications: Scleral buckling is a common surgical procedure for retinal detachment. While it can be effective, potential complications include changes in eye shape, discomfort, and the possibility of scarring on the conjunctiva. In most cases, the implanted material does not need to be removed unless there are significant complications.

In conclusion, managing retinal detachment and its aftermath requires a multidisciplinary approach involving regular follow-ups with your ophthalmologist, adherence to treatment plans, and lifestyle adjustments to protect your vision. While the journey can be challenging, understanding the condition and its implications can empower you to make informed decisions about your eye health. Always consult your healthcare provider for personalized advice and treatment options.

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