Macular edema can occur after any intraocular surgery. You are on the correct treatment: steroid drops (prednisolone) and non-steroidal drops (Ketorolac). The edema should begin to clear in about a month, and then the drops will be tapered slowly. You need to see your retina specialist as soon as possible. I am concerned about the loss of the lower peripheral vision: this could indicate a retinal detachment.
It was a PVD induced Vitrectomy, 25g sutureless.
Is it still too early to see changes?
Local Ophthalmologist detected no cataract formation, no detachment, no infections, pressure normal. But OCT scan is abnormal - the shape has a depressed curve in the Avascular zone suggesting macula swelling.
How long does retina swelling usually last?
Follow up appointment is next Monday.
Thank you Dr.Fazio,
I had a checkup with another Ophthalmologist yesterday to get a 2nd opinion. His conclusion were about the same as my Post-Op DR. The pressure on my operated eye was 21, same pressure as my non-operated eye. My retina was still swollen.
The 2nd DR also could not detect retina detachment... Could it just be blood in my lower peripheral vision that is taking longer to dissipate than the rest? but then again my periphery is completely opaque.
The DR gave me a referral for a retinal specialist in 2 days.
What I see in my lower peripheral vision does look similar to retinal detachment: It is like a curtain, there are glowing cobwebs like lines in the curtain, and any visual information that touches the edges of the curtain looks heavily distorted/wavy.
Hard to believe neither my surgeon and 2 local Ophthalmologists could detect any retinal detachment. Although I really hope they are right.
Retina specialist should be of help with what's going on. Hopefully, it will be one that is not connected with the practice of the office who did the surgery. You want straight answers here and not answers that are protecting another doctor for any reason, right?
I had vitrectomy/epiretinal membrane peel 3 years ago. Had some edema post surgery that showed up on OCT as little dark pockets in the layers of the retina.
Have your doctors show you what they are talking about on your OCT results. The more you understand, the more peace of mind you will have.
My edema (fluid pockets) dispersed in a month or so, but my retina is still abnormally thick/swollen. The OCT tests show you normal (on your good eye) and abnormal (on surgery eye) numbers so again, review with your doctor. I am left with a little distortion and a blank spot in the middle of my vision (macula region=central vision=worse place to lose vision).
Keep us posted and good luck !
Retina specialist should be of help with what's going on. Hopefully, it will be one that is not connected with the practice of the office who did the surgery. You want straight answers here and not answers that are protecting another doctor for any reason, right?
I had vitrectomy/epiretinal membrane peel 3 years ago. Had some edema post surgery that showed up on OCT as little dark pockets in the layers of the retina.
Have your doctors show you what they are talking about on your OCT results. The more you understand, the more peace of mind you will have.
My edema (fluid pockets) dispersed in a month or so, but my retina is still abnormally thick/swollen. The OCT tests show you normal (on your good eye) and abnormal (on surgery eye) numbers so again, review with your doctor. I am left with a little distortion and a blank spot in the middle of my vision (macula region=central vision=worse place to lose vision).
Keep us posted and good luck !
If your peripheral retina exam is obscured by layered blood, an ultrasound will be helpful in determining if there is an underlying retinal detachment present.
Thank you Luvtoski and Dr.Fazio,
Luvtoski I am so sorry to hear of your Post-Op issues. Do you see any glowing vein like shapes in your blank spot? has the blank spot improved at all over the 3 years?
I'll be sure to ask for an ultrasound Dr.Fazio. Neither of the 2 Post-Op doctors I am seeing are connected to the hospital where I had the surgery. Although I fear that the DRs could be obscuring facts for fear of liability issues. Most doctors won't even see me if I tell them it is for Post-Op. Should I even tell the retina specialist that I recently had Vitrectomy? Please advice!
Thanks again.
I see bright flashes whenever there are sudden changes to my heart beat, such as when I am surprised, someone suddenly yelling, or when the percussion or any sharp instruments first cuts in in a song. I only see the flashes when I close my eye. I do not see flashes when I quickly move my eyes from side to side. I also see 'ripples' that appear synchronized to my heart beat, but not always, again I only see this with my eye closed.
First answer, no my blank spot never really improved over the 3 years, but my brain has progressively adapted better with time. What also helped is that I made an effort to take my mind off of my eyes. At first, for months post op, I would test my eyes several times thruout the day with closing one eye at a time, writing down my results etc. I was fixated on whether I saw improvements or declines in my vision. Afterall, as you know, losing ones vision is a huge deal...especially when one has been 20/20 their entire life.
What I found is that the less I concentrated on my vision, the better my brain fused the two images. My brain neuro adapted and does a pretty good job of filling in the blank spot when I use both eyes.
I never did see any glowing veins in my blank spot but when I close my eyes and focus on it, I do see a weird circular revolving spot...like the blades of a fan in slow motion.
Sounds like your flashes directly relate to your blood pressure in your eye veins. Not sure what that means though. I do know the eye has to get rid of waste products thru the layers of the retina and that process is important. Perhaps a question as to whether that function of your eye is still working properly might be worth asking. Just throwing out random ideas here as I am not a Doctor, just someone who researched eyes extensively 3 years ago.
Here is my opinion on how to handle future appointments. I went to 4 Retina specialists prior to my decision on whom to have do my surgery. Even though they were in different offices in Seattle, somehow I felt like they knew I went to their competition and were guarded as to what they told me.
What I do know is that the Doctors "read" you and how nervous or stressed you are about your condition, so play it cool. If you show anxiety or mistrust, they will likely clam up and not give useful information.
You will find the occasional "rebel" that has no problem telling you that so and so perhaps did some aspect of the surgery different than they would...but most doctors think I liabilities unfortunately. Read between the lines if they say something as a "hint" even.
Also, I found the doctors assistants / techs can be quite helpful if you find one that will open up and talk. I bring my Dr. tech a Starbucks gift card each follow up appointment as a thank you for your time and honesty. She has responded with invaluable information on things that the Dr. never said.
Your surgery may have went perfectly and your eye healing normally for you and your condition...so be open to that also.
First answer, no my blank spot never really improved over the 3 years, but my brain has progressively adapted better with time. What also helped is that I made an effort to take my mind off of my eyes. At first, for months post op, I would test my eyes several times thruout the day with closing one eye at a time, writing down my results etc. I was fixated on whether I saw improvements or declines in my vision. Afterall, as you know, losing ones vision is a huge deal...especially when one has been 20/20 their entire life.
What I found is that the less I concentrated on my vision, the better my brain fused the two images. My brain neuro adapted and does a pretty good job of filling in the blank spot when I use both eyes.
I never did see any glowing veins in my blank spot but when I close my eyes and focus on it, I do see a weird circular revolving spot...like the blades of a fan in slow motion.
Sounds like your flashes directly relate to your blood pressure in your eye veins. Not sure what that means though. I do know the eye has to get rid of waste products thru the layers of the retina and that process is important. Perhaps a question as to whether that function of your eye is still working properly might be worth asking. Just throwing out random ideas here as I am not a Doctor, just someone who researched eyes extensively 3 years ago.
Here is my opinion on how to handle future appointments. I went to 4 Retina specialists prior to my decision on whom to have do my surgery. Even though they were in different offices in Seattle, somehow I felt like they knew I went to their competition and were guarded as to what they told me.
What I do know is that the Doctors "read" you and how nervous or stressed you are about your condition, so play it cool. If you show anxiety or mistrust, they will likely clam up and not give useful information.
You will find the occasional "rebel" that has no problem telling you that so and so perhaps did some aspect of the surgery different than they would...but most doctors think I liabilities unfortunately. Read between the lines if they say something as a "hint" even.
Also, I found the doctors assistants / techs can be quite helpful if you find one that will open up and talk. I bring my Dr. tech a Starbucks gift card each follow up appointment as a thank you for your time and honesty. She has responded with invaluable information on things that the Dr. never said.
Your surgery may have went perfectly and your eye healing normally for you and your condition...so be open to that also.
Oh, and sorry for the long answer but hopefully something I said will be of help.
Remember, do not ever leave out the fact that you had a vitrectomy. They will most likely have your medical records from your previous surgeon and you do have to fill out their forms answering those kind of questions.
Just play it down and say you simply want to get someone elses insight as to what might be going on in your eye and if , in their experience, they think it will improve. Remember, the Dr. is reading your intensity.
Very valuable information and advice, thank you so much Luvtoski! One more day to go until my appointment.
I guess another way to describe the glowing vein like shapes in my blind peripheral area are like pressure phosphene, or maybe retinal migraines? They flicker constantly like a strobing back-lit LCD or an old tube TV. I think they are getting brighter and more obvious every day, I can see them even in well lit environment.
May have something to do with your critical layer of photoreceptors. If that layer is interrupted, mine is from epiretinal membrane and surgery tugging on my retina...then the photoreceptors cannot do their job.
I have an interruption in my IS/OS junction with layer of photoreceptors. If you have the time to google that, it might give you another clue/topic of conversation with your Retina Specialist should he not have any ideas.
Hope this helps.
I had an appointment with a retinal specialist today and while the testing results were good: my pressure was normal, my lens were clear, the retina was no longer swollen... However, all my visual disturbances remain - foggy/washed out vision, grey smears everywhere, curved vertical lines, the loss of peripheral and a about a quarter of my central vision and the glowing phosphenes in the periphery. The DR also detected some membranes/scars forming in the retina.
Both the retinal specialist and my Post-Op Ophthalmologist believe that my symptoms are due to malfunctioning optic nerve, they want me to see a Neuro-Ophthalmologist as soon as possible. I am trying really hard to book an appointment with a N-O but most aren't available for at least a month. I hope my eye does not progressively get worse till then.
Right now my operated eye has about 10% usefulness, I'd extremely happy if I could get even 50% vision back.
I can't believe things have gone from bad to worse.
Hang in there. The scar tissue alone can cause distortion in vertical lines and fogginess...like looking thru crumbled celophane.
Thank you Luvtoski, your information has been really helpful!
Hmm maybe you are right, but my Doctor said the membranes don't usually go away, that is very disappointing :(
I finally booked an appointment with a neuro-ophthalmologist early next week, I hope I can get some explanation to my loss of peripheral vision and the flashing phosphenes.
I am nearly 3 weeks Post-Op, I don't know...Maybe I should give it more time.