Raised & Displaced Scleral Buckle

[zmonster]

I have three very experienced and respected retinal surgeons telling me my scleral buckle has become raised and displaced, AND they find evidence that the corner of the buckle literally broke through the skin, caused a small hole to form, and that somehow my body grew a thin layer of cells to cover the hole.  

I had a very sudden onset debilitating double vision four years ago that continues to this day, and the onset of double vision was accompanied by severe eye pain in the upper/nasal corner of my eye, which is exactly where the buckle has apparently broken a very small hole through the eyeball (that now seems to have been grown over by a thin layer of sclera to heal the hole).  I also had a ton of “gunk” ooze from my eye that day, and there’s a chance I could have contracted an outer eye infection that also (miraculously) healed itself.  I have several pictures of my eye during the first 4-5 days of this episode.

However, my original retina surgeon, who installed the buckle, insists they’re all WRONG.  

I find this disconcerting because it should be a trivial matter to identify if raised & displaced buckle that has broken a small hole through the outer layer of my eyeball!

The situation needs to be fixed because I can’t continue on productively with this debilitating double vision.

—> Is my original eye surgeon obligated to inform me that my buckle has become raised & displaced?  I can’t fathom that he’s not obligated to inform me if indeed that has occurred (regardless of whether or not it’s due to incorrect installation of the buckle or not — I don’t really care, I just want the situation fixed).

[John C Hagan III, MD, FACS, FAAO]

If you have been told by 3 different retina surgeons that the scleral buckle is "intruding" through the sclera into the retina and the original surgeon says it isn't the most likely thing is that the 3 are right and the original is wrong. This is not rare.  Often all that need be done is cut the sclera band to relieve the belt like pressure that would make it sink deeper into the eye. Sometimes the buckle has to be removed and that is a big big operation in some cases.  NOTE: it is not uncommon for  people to have double vision after RD surgery where a buckle is used. NOTE CAREFULLY  cutting the buckle or removing it may not have any effect on your double vision since the buckle is UNDER the eye muscles. When they do the surgery the "sling" and pull on the eye muscles to move it, and sometime freeze or diathermy over the muscle or its nerves.   You will need to pick the retina surgeon you most trust and use that person for guidance. Ask if cutting the buckle or removing it will cure the double vision, I think not. You might want to see an Eye MD ophthalmologist that specializes in eye muscle surgery (strabismus surgery) sometimes called pediatric surgeon but most do adult surgery.  As there opinion about treating the double vision.

[zmonster]

Thank you.

I have only one eye, so the double vision is almost certainly due to the buckle releasing event.

I am highly, highly disappointed that my original retina surgeon is likely lying to me, as I infer from your response.  Highly disappointed.

[John C Hagan III, MD, FACS, FAAO]

Not to get too technical but if you only have one eye you cannot have true double vision. What you may have is monocular ghosting.  This is usually due to corneal astigmatism regular/irrecular or macular disease like an epiretinal membrane. Best of luck with your problem.