Post-Retinal Detachment Surgery: Navigating Vision Challenges in Teens

Q: Post-Retinal Detachment Surgery: Navigating Vision Challenges in Teens

Hello： The discomfort your child is experiencing after getting new glasses is due to the distorted image in the right eye not being able to merge with the normal image in the left eye, resulting in a sense of strain. <br>When switching back to the old glasses, it effectively blur

Vision Problems After Retinal Detachment Surgery

My child is eighteen years old.
Last year, he discovered that his right eye was experiencing distortion and narrowing while looking at objects.
After being referred for examination, he was diagnosed with retinal detachment.
The doctor mentioned that the detachment had likely been present for some time, resulting in some atrophy of the macula, but no tears were found (the doctor believed that the accumulation of fluid in the eye was covering any potential tears).
After undergoing scleral buckle surgery (during which no tears were found, and he is not highly myopic or diabetic), I inquired whether it could be caused by central retinal inflammation, but the doctor confirmed that the fundus photography did not indicate that).
During his hospitalization, daily examinations showed no issues (the attending physician conducted morning and evening checks).
Three days after discharge, when he returned for laser surgery, fluid accumulation was again observed.
The doctor suggested monitoring whether the fluid would continue to increase.
Eventually, the fluid in my child's eye slowly diminished, and his vision improved.
The doctor believed that the fluid accumulation in the central area had been present for a long time and was more viscous, which is why it had not been fully drained (it has been a year since the surgery, and there is still some fluid present, but since it is not located at the macula, the doctor proceeded with laser treatment on the stable areas).
Before the surgery, my child only felt that his vision was blurry (I also took him to an ophthalmology clinic during this period, where his intraocular pressure was normal, and the doctor believed it was due to excessive fatigue from heavy academic workload).
If he hadn't playfully closed one eye, he wouldn't have noticed the difference in vision.
After the surgery, the distortion became more pronounced, and he began to see a ring-like object.
The doctor explained that this was due to the buckle placement and the remaining fluid in his eye.
Once the fluid is completely drained, the ring-like object should disappear.
My child has accepted this situation and must return for regular check-ups.
I would like to ask: On September 1, during a follow-up visit, the doctor noted that his vision had improved (before the surgery, his right eye vision was 0.3, and after the surgery, it was approximately 0.1, with the right eye seeing small print appearing almost as a black blur, but it has been gradually improving).
The doctor suggested he could get new glasses, and his vision was measured as follows: VOD: 0.8X-1.0, astigmatism -2.0x180; VOS: 1.0X-2.75, astigmatism -1.25x165 (before getting new glasses, the right eye was 0.6, 50 degrees).
After getting the new glasses, both eyes became clearer, but there was significant disparity and overlap in the images (the left eye was normal, while the right eye was distorted), making it difficult for him to see.

Dr.
Hu, should he revert to his previous prescription, or will this situation improve after some time? What would be the best course of action for him?

nataliechen, 40~49 year old female. Ask Date: 2009/09/10

Dr. Hu Yusheng reply Ophthalmology

Hello: The discomfort your child is experiencing after getting new glasses is due to the distorted image in the right eye not being able to merge with the normal image in the left eye, resulting in a sense of strain.
When switching back to the old glasses, it effectively blurs the image seen by the right eye, which prevents interference with the image from the left eye.
You have two options: 1.
Make an effort to adapt to the new glasses for two weeks; the brain may be able to reorganize the images into a single one, alleviating the discomfort.
2.
Wait for the distortion in the right eye to improve before trying the first option again.
Wishing you peace and health.

Reply Date: 2009/09/10

More Info

Post-retinal detachment surgery can be a challenging experience for both the patient and their family, especially when it comes to navigating the complexities of vision changes and recovery. In your child's case, it sounds like he has gone through a significant medical journey, including the diagnosis of retinal detachment, surgery, and ongoing recovery. Here’s a comprehensive response to your questions and concerns.

Understanding Vision Changes After Surgery
1. Post-Surgical Vision Distortions: After retinal detachment surgery, it is not uncommon for patients to experience visual distortions, such as blurriness, distortion, or even the perception of halos around objects. These symptoms can be attributed to several factors, including the presence of residual fluid, changes in the retina, or the effects of the surgical procedure itself. In your child's case, the persistent fluid and the placement of the scleral buckle (the ring used to support the eye) may be contributing to the visual distortions he is experiencing.

2. Vision Improvement Timeline: Vision recovery after retinal detachment surgery can be gradual. It is encouraging to hear that your child's vision has improved from 0.3 pre-surgery to 0.8 post-surgery. However, the presence of fluid and the adjustments the eye is making can lead to fluctuations in vision quality. It is essential to maintain regular follow-ups with the ophthalmologist to monitor these changes and ensure that the eye is healing properly.

Prescription Glasses Considerations
3. Choosing the Right Prescription: Given that your child is experiencing significant differences in vision between the two eyes, it is crucial to approach the decision about new glasses carefully. If the right eye is still experiencing distortion, simply reverting to the previous prescription may not provide the best visual outcome. Instead, it may be beneficial to work with the ophthalmologist to determine a prescription that accommodates the current state of the right eye while also considering the left eye's normal vision.

4. Adaptation Period: It is important to understand that after significant changes in vision, such as those following surgery, there may be an adaptation period. Your child may need time to adjust to any new prescription, especially if it differs significantly from what he was previously wearing. Encourage him to wear the new glasses consistently, as this may help his brain adapt to the new visual input.

Recommendations for Moving Forward
5. Regular Follow-Ups: Continue with regular follow-up appointments with the ophthalmologist. These visits are crucial for monitoring the healing process and making any necessary adjustments to the treatment plan, including the prescription for glasses.

6. Communication with the Doctor: If your child is experiencing significant discomfort or difficulty with the new glasses, it is essential to communicate this to the ophthalmologist. They may suggest temporary solutions, such as adjusting the prescription or providing additional therapies to help with the adaptation process.

7. Patience and Support: Recovery from retinal detachment surgery can be a lengthy process, and it is vital to be patient. Encourage your child to engage in activities that do not strain his eyes and to take breaks when needed. Emotional support during this time is equally important, as adjusting to changes in vision can be frustrating and disheartening.

Conclusion
In summary, your child's experience post-retinal detachment surgery is not uncommon, and the visual challenges he faces are part of the recovery process. It is essential to work closely with his healthcare team to monitor his progress and make informed decisions about his vision care. With time, patience, and the right support, there is a good chance that his vision will continue to improve.

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