Arvind Gopu's home on the web!

Retinal Detachment - My Experience

On this page, I'd like to share my experience having suffered a detached retina back in spring 2006, and having got surgical treatment for it. I also have a page with information about RD and links to webpages that explain RD and treatment options in great detail.

As much as I hope you find this webpage on my RD experience useful, I strongly recommend you go read the excellent site by Jim Lawton linked off here about his RD and treatment experience -- with images and animations illustrating shadows, floaters, what a gas bubble does to your vision temporarily, so forth. Againh highly recommended: Go read it NOW!

Note that this is a work in progress as of 2007-08-31, and so I might add a few more topics to this section of my website, do revisit in a few weeks!

Obvious Disclaimer: I've described my experience when I suffered a detached retina and the follow-up to that. But (quite obviously), I am not a doctor, so if you suspect something is not right about your vision, then contact your doctor!


Background

I am one of those peculiar ones that started with -0.25 and -0.75 when I was in sixth grade but whose myopia got worse and worse pretty quickly.

I've had fairly high myopia since I was around 15... my prescription had more or less settled at -5.5 / -7.0 diopters spherical with around -3.0 / -2.5 diopters cylinder (astigmatism), give or take a bit, between when I was 18 and 25.

I've been getting advice from my eye doctors, since I was around 18, to look for any unusual floaters or flashes of light; I say unusual because I've seen floaters almost my entire life, at least as long back as I can remember.

When I first heard I was at risk for retinal detachment: In October 2004, I was also told that there were tiny retinal holes in my eyes, and also possible weak retinal regions also known as lattice. The advice I got was, not to freak out, just look for unusual floaters or flashes of light. I was told that with any treatment of the lattice, including in-office LASER treatment, the risks out-weighed the risk of RD itself. Now, in hindsight I am not sure about that -- I am not so much trying to argue against statistical/medical evidence but rather I wish I'd got those tiny retinal holes LASERed. Why? Read on ...

More on lattice degeneration here.

Signs of Detachment (and yes, with hardly any warning)

In April 2006, I started noticing a slight skew in my peripheral vision in my right eye -- towards the top right corner of my vision field. I found incidentally that when I looked at my computer screen with my left eye closed (Useful home test for those at risk), a tiny portion on the top left corner did not look right. It looked more like a shadow of the screen, that one tiny part, rather than the screen itself.

And in a day or so, the top left corner (about 5%) of vision on my right eye was pretty much dark -- looked like there was a large cataract or a shadow in my line of sight in that area.

Now, like I said, I'd been advised by my eye doctors during previous eye exams to watch out for flashes of light and/or additional floaters but I did not have any of those warning signs. The first sign that something was not right, was loss of vision dude to retinal detachment in my case.

Detachment gets worse

I setup an eye appointment for early next morning (12th) on April 11th, not really knowing how serious this was. And even before I knew it, the shadow was coming in more and more, and I'd lost about 45% vision in that eye by the time I saw my eye doctor. Luckily, the macula was not affected (even though the detachment was awfully close to it!).

Dude this ain't looking good

The folks at the IU school of optometry gave me a vision field test, and then dilated my eyes to take a look.The intern took a look first, and then Dr. Pence did the same. The response was pretty simple: Look! Your girlfriend has 10 minutes to get lunch, but then she's going to drive you up to Indy for eye surgery. . And oh, no food all day!

Drive to the Surgeon's office

On the afternoon of April 12th, I saw Dr. Raj Maturi in the Mid West Eye institute; They have two offices: one in Caramel and the other inn Greenwood. Given how succesful my surgery was, I'd higly recommend Dr.Maturi to anyone who needs retinal surgery.

Side note - Paper work: As with any new medical facility, We had to fill out some paper work, which was rather distressing considering how fast my retinal detachment had been worsening but we got through it :-) I just wish in cases of emergency they'd skip paper work but then given the state of health care in the US, I doubt that will ever happen anytime soon. ~Sigh~.

Surgical Options

The folks at MWE institute dilated my eyes again, and then Dr.Maturi surveryed the damage, so to speak. He then calmly explained to me (and Lavanya) what my treatment options were; he also have us a book that explained these procedures in more detail. NOTE: If you live around Bloomington and would like to check it out, please let me know, and I'll be glad to lend it to you.

Anyway, back to my surgical options, the ones I had were:

  • Pneumatic retinopexy: A simple office procedure in which two things are done. Retinal holes that may be allowing fluids to go back behind the retina and cause detachments are frozen -- the cells are frozen to death. And a gas bubble is injected into the eye to push any existing detached area in the retina back. The bubble is only effective if you lie down in a certain posture so it can push the retina Just remember: the bubble always floats up!

    This procedure could be done immediately in a surgeon's office without anaesthesia.

  • Scheral Buckle: This is a surgical procedure in which a silicon buckle is stitched to the sclera (the white part) of the eye, in turn pushing that area inward so it can re-attach itself to the retina. This required settign up an appointment for surgery and going under anaesticia.

  • Vitrectomy: This was the last procedure Dr.Maturi explained to me. It's a lot more involved than either of the above two procedures. The surgeon removes the vitrous humor out of the eye, and then proceeds to go in and put the retina back in place using precise tools made for this purpose. He said we may not need this procedure in my case, since we'd caught the detachment reasonably early.

Given the above three choices, I was leaning towards the first two. Vitrectomy was our last choice .. last ditch effort in case all else failed. And I chose option one (pneumatic retinopexy) given how fast the detachment was progressing and the situation that I'd have had to wait at least 48 hours for a scleral buckle appointment -- by when I might have gone blind in that eye, or could have possibly lost macular vision. Our take on that was: the procedure could either fix me up or at least it would let me buy time while I wait for a more involved procedure. I am so very glad I made this choice!

Gas bubble in the eye

So I had pneumatic retinopexy done on the right eye. In essence, Dr. Maturi freeze-sealed the little holes in my retina that had allowed fluid to go behind the retina, and then injected a gas bubbled into the eye so it could push the retina back in place The gas bubble fixed the detachment temporarily.. it even looked encouraging when during my follow-up appointments in the April 13th - 17th time frame, it appeared as though the retina was almost completely flat, and re-attached.

Side note - Hard part? Lying down in particular way: The hardest thing about the gas bubble for me, as with most people it seems, was the position in which I had lie down through sleep all night, and also during the day time. In my case, I had to lie down on my left for the most part (to push the detached parts of the retina back), and on my stomach with my forehead preferably at a lower position than my chin (to push the fold in the retina I had in the lower right part of the eye, which corresponds to up and left portion of vision).

Another side note: Go check out Jim Lawton's page linked here if you have not already do that. He has very nice images and animations to illustrate a lot of the topics I am discussing here.

More detachments ...

But more retinal tears showed up in the following two weeks .. consequently more fluid build-up behind the retina ... consequently further detachments. It was getting to a point where I had fluctuating vision towards the end of May: I'd sleep on my side, the bubble would push the retina back, vision would seem sort of normal but then the shadow would reappear. Dr. Maturi at that point told me at that point that we'd tried our best to treat the detachment with just the gas bubble but now it was time to go under the knife.

Side note - Hard part? Again ditto: Lying down in particular way ... as I had expanded on, in the previous section.

Time to buckle up!

I went in for surgery on May 1st .. had a scleral buckle put in. Quite a bit of pain initially for a week. The week after, I started working reduced hours again and the 3rd week I was back to normal working hours. There was not much pain after the first two weeks following surgery, excepting when the eye or eyelid is tired.

How is the vision following surgery?

I was very lucky because I regained almost 20/25 vision in my right eye following the surgery, and new prescription glasses.

  • The retina is almost flat that I see a square almost to be a square except for a couple of skewed spots on the II quadrant (of vision :)).
  • Of course, the vision is not perfect even though the acuity is 20/25.
  • There's almost always a bit of haze -- which makes it a touch hard to drive especially when it's dark. The haze creates halos around vehicle lights during night driving.
  • Above mentioned difficulty w.r.t. night driving could be partly due to another factor: my visual sensitivity. I've always found it hard when vehicles in the opposite direction have really bright headlights. That, I've inferred through my research, is likely due to the fact that the lowest brightness my eyes can detect is lower than what normal adults with 20/20 vision, and no or very little myopia can. For more on this, read on ...

Vision Field Results

To get an idea of what I was talking about in the previous section, check out my latest vision field results:

  • LEFT eye / RIGHT eye.
  • Did you notice how the best number at the macular (central vision) area is about 30-31? I am told that normal adults my age have their macular vision level at around 35. So in general, my vision field numbers are about 5 under what normal adults my age would have. Consequently, the lowest brightness I can see in my macular or peripheral vision is a little lesser ... and when a bright headlight shows up, the dimly lit sections of the street become harder to see. I hope this makes sense!
  • Also, did you notice in the above right eye link, how certain sections of the vision field are grey or black? Those are the areas my retina got detached or where it had holes, and the surgeon had to freeze 'em up.
  • Finally, did you notice the small black area on both the links, left and right of the macula respectively? Those are the blind spots in the eye, and it's normal not to have any vision in those areas. If you are not familiar with the eye's blind spot, then check this out.

Future ... Travelling, etc.

Air Travel: I had been advised by Dr. Maturi not to fly for the entire time the gas bubble was inside the eye (visibly), or even more preferably, not for at least a period of 90 days (to be on the safe side -- I ended up missing my brother's wedding :( ). I was pretty nervous myself about flying -- what if a detachment recurred at 30,000 feet? But I finally flew again in November 2006 without any problems. I guess, I shall live in the eternal hope that I never have any more retinal detachments ever! :-) Or at least, I am more prepared for any emergencies with a lot more knowledge on my side.

No more hits to the head: I suspect, I am done (for life) with hard physical contact sport like racquet ball or basketball, with joy rides in theme parks, etc. Luckily, I was never into (or should I say, I was never good at) sport like basket ball or racquet ball; and I've never been a fan of trying to fling myself at high speeds on rides, while trusting someone else for my safety. So I am not missing out much, I don't think :-) And I am protecting my vision, do I need a bigger motivation? No!

Conclusion

I hope this page proves helpful to anyone who's reading it ... especially if you're highly myopic or fairly highly myopic with astigmatism (like me), or you've seen floaters .. or if your eyes are weirdly shaped like mine .. or if someone you know is at risk for RD. Please pass the word along if you know someone like that. Being prepared can mean the difference between going partially/completely blind and catching the problem in time, and getting fixed up almost entirely! Cheers,-AG