Visual Distortion After Retinal Detachment Surgery Without Macular Involvement

Even if the retinal detachment has not affected the macula, why is there still a distortion in vision?

Hello, Doctor: I previously underwent scleral buckle surgery due to a retinal detachment in the upper right quadrant of my right eye.
It has been nearly a month since the surgery.
My attending physician initially informed me that the detachment did not involve the macula, and my vision should recover well.
However, currently, when I look at straight lines with the affected eye, they appear slightly distorted, and when reading printed text, it seems less neat, almost as if the font has changed from a standard typeface to a playful one.
Does this indicate that the retinal detachment may have involved the macula at the time?

yiwen, 30~39 year old female. Ask Date: 2013/08/20

Dr. Wang Zhangji reply Ophthalmology

It is recommended that you visit the outpatient clinic for a detailed examination to understand the current condition of the macula.

Reply Date: 2013/08/20

More Info

After undergoing retinal detachment surgery, particularly with scleral buckle placement, it is not uncommon for patients to experience visual distortions, even when the macula (the central part of the retina responsible for sharp vision) was not directly involved in the detachment. Your description of straight lines appearing slightly curved and printed text looking distorted can be attributed to several factors related to the healing process and the nature of retinal surgery.

Firstly, it’s important to understand that the retina is a delicate structure, and any surgical intervention can lead to temporary or permanent changes in visual perception. Even if the macula was not detached, the surrounding retinal tissue can still be affected during the detachment and subsequent surgical repair. The surgery itself can cause changes in the retinal structure, leading to visual distortions known as metamorphopsia, which is the perception of objects being distorted or warped.

The fact that you are experiencing these distortions does not necessarily mean that your macula was involved in the detachment. It is possible that the surgery has altered the way light is processed by your retina, leading to the perception of distortion. Additionally, the healing process can involve swelling or changes in the retinal layers, which may contribute to these visual symptoms.

Another factor to consider is the role of the vitreous gel, which fills the eye and is closely associated with the retina. If the vitreous is still in the process of detaching or if it has undergone changes due to the surgery, it can also lead to visual distortions. The vitreous can exert traction on the retina, causing temporary changes in vision.

In terms of recovery, it is essential to give your eye time to heal. Many patients report gradual improvement in their visual symptoms over weeks to months following surgery. However, if the distortions persist or worsen, it is crucial to follow up with your ophthalmologist. They may perform a thorough examination, including optical coherence tomography (OCT), to assess the condition of your retina and ensure that there are no complications, such as a new detachment or other issues.

Regarding your concern about whether the distortions indicate involvement of the macula, it is best to consult your surgeon or a retina specialist. They can provide a more accurate assessment based on your specific case and the results of any imaging studies.
In summary, while visual distortions after retinal detachment surgery can be concerning, they are not uncommon and do not necessarily indicate a problem with the macula. It is crucial to maintain open communication with your healthcare provider and report any changes in your vision. Regular follow-up appointments will help monitor your recovery and address any ongoing concerns you may have.

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