A Question from Alex

[AntonReiser]

"Hello,
I have been afflicted with a RD in the right eye since the end of October 2011. The RD was operated after a diagnosis on the eve of the surgery directly on the following day with a PPV (including oil-fill). On the evening of surgery day, I already found out during the "look test" that I had a visual field loss. This loss stands forth from the right side like a tongue / flap sharply defined as a gray area in the field of view of the right eye. on the eve of the diagnosis was not relevant to the macular region, but the failure has a lot to do with the macula.
Questions to the attending specialist lead to no results. From the outside, everything looks "perfect" from, the testimony of all physicians who have previously considered the matter. After nearly six months of this scotoma regarding location and size has not changed. It bothers me very much and there's no explanation. My local eye doctor withdraws the statement: Since you have to ask your surgeon. He could not say what had happened. According to surgical report manipulation of the retina had not been performed. To me it looks like the shape of a spatula, maybe even but once someone "pressed".
My question to the forum: Are there more such failures in the field of view immediately after the operation? Before the surgery I didn't have anything like this.
Which causes for this postoperative scotomas come into question?

Greetings Alex
PS:
Could the retina have been damaged by a vitrectomy tool?"

Translated by Google Translate and AntonReiser

[Alex1959]

Dear Dr. Oyakawa,

here Alex writes. I'm the person who has the scotoma. Maybe that the retinal detachment was complex when it occured. My surgeon says to be before surgery that he decides 50/50 to use gas or oil after having removed the vitreous. He use oil. The oil was removed after 9 weeks.
Immediately before the PPV surgery I had no scotoma, only I saw a black wall on the right. The retinal detachment was located at 10 to 12 clock in the right eye. The macula was not affected. After I awoke from the anesthesia I had the effect of the scotoma (see drawing). The macula is affected by the scotoma, the detachment not. So I do not understand what is happening in practice. Doctors have no explanation for it currently.

Best regards
Alex

[Ray T Oyakawa, MD]

The use of silicone oil suggests you probably had a complex retinal detachment.  The visual field defect is probably due to the damage to the retina from the detachment.  I doubt this was due to the surgery since it was present before surgery.

Dr. O.