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Old 02-24-2013, 04:44 PM   #1
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my vitrectomy feb-14

Hi

I had my vitrectomy on Feb 14 with gas bubble in my right eye & I am a computer programmer and with 2 kids and wife and I am the only earning member of the family & 41 years of age

The reason i went for Vitrectomy was due to an accident while playing racquet ball on Feb 7th

Today its 24th and the gas bubble looks like a dime now and I can see all the images with my right eye but not clearly little blur

If I look through the bubble then I can read small letter

Please advise me whether the whole was closed or not?

How long it will take to get proper vision?

Please help and I need to get back to work at the earliest

Also Let me know if you have any other questions and I can reply at the earliest

Thanks

Last edited by Sree234; 02-24-2013 at 04:45 PM.

 
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Old 02-24-2013, 08:08 PM   #2
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Re: Post-Vitrectomy Vision & Possibility of Repeat Retinal Detachment

Hi Sree234,

You need to ask your dr "why" the vitretomy was done in your case. Did the accident cause retinal detachment (RD)? How bad was it - just peripheral RD, or central (macular) RD too? Is it a "macular hole" or a "macular pucker" (epi-retinal membrane), or both? Was there hemorrhage inside the vitreous? Was your lens damaged too? I am no doctor, but each case has its own prognosis, and recovery time. In my case, lens removal (due to cataracts) and replacement with IOL was the least of my problems, and I started seeing clearly immediately after the operation. I write this because if your lens is damaged then I am hoping they can replace it by an IOL (intra-ocular lens).

But RD repair is a wholly different ball game, you have to have patience, and as others will atest, lots of it. My right eye, with peripheral RD, took only about 16-19 days to recover completely with 20/20 post-op, but the left eye with "macular RD" is still a reovering saga 6.5 weeks afte vit sx, although I started driving, working and everything else 21 days post-op. I had kept meticulous notes of how the air bubble was shrinking with time in both cases - literally drew graphs with time (listen carefully to the dr when he examines you - he will note the % air-bubble volume remaining during every visit, and you can extrapolate - linearly, or otherwise, as to when it will completely go away). Also, you need to gage its size 'relative' to something at the same distance - like standing with face down near a commode, and comparing its size (diameter) with respect to the commode-ring diameter. Absolute size is difficult to measure through our eyes. My dr said that when you look through the air bubble, the liquid portion acts like a small spherical lens actually, and you can see very sharply at close vision - words in a book, etc. As the air-bubble is automatically replaced by your own liquid (saline solution) your vision will improve slowly, and the shimmering, etc., from the air-bubble will go away. But what your final stable vision becomes, depends on what the vit sx was done for. My air-bubble took 15.5 days and 18.5 days to vanish completely, but it can vary with each person. In any case, when the air-bubble is present in the eye, you MUST follow your doctor's instructions on sleeping position (face-down, no face-up, etc.) very, very meticulousy for a successful recovery. The face down position may create swelling of the cornea sometimes (it looks like mucosy stuff on the cornea and ugly), but it goes away with time.

Finally, forget about your work and everything else during you recovery - your vision is far more important than few days work. I was lucky to take sick-leave for 2 and 3 weeks for each eye, and rest completely. I am sure you can do that too. All the best, and keep us posted!

 
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Old 02-24-2013, 08:47 PM   #3
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Re: Post-Vitrectomy Vision & Possibility of Repeat Retinal Detachment

Hi Vitca 2

Thanks for your reply

The reason I went for Vitrectomy was due to a macular hole and the size was around 622 ( I am not sure about the unit) due to that accident I had while playing racquet ball & NO lens damage

I was requested to face down for 4 days and I met the doctor 2 times and he said with the gas bubble still inside the eye ( on the 2nd and 5th day) he was not able to see whether the hole was closed or not?

I told I could see through the bubble clearly and he mentioned that's your answer but he will confirm after the OCT on my next appt (Mar 6th) & I am counting my days to get an answer from the doc

Still at I night most part I am trying to sleep face down position

Currently the bubble size is like a dime and decreasing day by day and I think in another few days it will be done I guess (today is 10th day)...

Question for you: After the gas bubble complete gone will the vision will improve or not? currently I can see all the objects with blurriness & I can see the colours as well but not clear


Yes. I can take few weeks off not an issue & My only worry is to get back my vision back to normal

Once again thanks a lot for your valuable feedback

Let me know if you need more details

Thanks

 
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Old 02-24-2013, 08:49 PM   #4
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Re: Post-Vitrectomy Vision & Possibility of Repeat Retinal Detachment

Hi Vitca 2

Thanks for your reply

The reason I went for Vitrectomy was due to a macular hole and the size was around 622 ( I am not sure about the unit) due to that accident I had while playing racquet ball & NO lens damage

I was requested to face down for 4 days and I met the doctor 2 times and he said with the gas bubble still inside the eye ( on the 2nd and 5th day) he was not able to see whether the hole was closed or not?

I told I could see through the bubble clearly and he mentioned that's your answer but he will confirm after the OCT on my next appt (Mar 6th) & I am counting my days to get an answer from the doc

Still at I night most part I am trying to sleep face down position

Currently the bubble size is like a dime and decreasing day by day and I think in another few days it will be done I guess (today is 10th day)...

Question for you: After the gas bubble complete gone will the vision will improve or not? currently I can see all the objects with blurriness & I can see the colours as well but not clear


Yes. I can take few weeks off not an issue & My only worry is to get back my vision back to normal

Once again thanks a lot for your valuable feedback

Let me know if you need more details

Thanks

 
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Old 02-25-2013, 11:08 AM   #5
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Re: Post-Vitrectomy Vision & Possibility of Repeat Retinal Detachment

Hi Vitcat2

Please see my replies below and thanks for your support & I wish good luck for your speedy recovery

By size, do you mean the diameter of the macular hole near the central fovea? Units for these retina-related things are in "mirometers." That is, 622 micro-meters, or 0.622 mm in your case.

Sree: Yes. That's correct. I only know these terms last week Only & I never had any problem with my eye it was with very good vision

The operation performed for was

Don't be fooled by the smallness of this size - everything there is really, really small, but the vision from the fovea (it is just 0.3 mm in diameter, and can have 175,000 cone cells in 1 sq. mm - cones are densely packed only in the fovea and give color perception and visual acuity) occupies 50% of the imaging from the visual cortex in the brain; rest of the imaging is for rest of the retinal area! (See some of the numbers I have mentioned in my other posts in this thread.) By the way, do you have macular edema (swelling) too?

Sree : No macular edema only the macular hole


Also, ask your dr if it was really a "hole" in the macula, or macular "detachment" but not really a hole (see my other post on it: Stage 1, 2 and 3 - see NEI website on this) - the rate of recovery and the final state of vision can be different in both cases. I had Stage 1 macular detachment, and I am still recovering after 6.5 weeks. An OCT scan tells a lot of things about the retinal cross-sectional thickness distribution, amongst other things - it is done in just a few minutes, and totally painless. But with the air bubble still in there, I don't know if they can do that yet. They use infra-red light and ask you to focus on a cross-hair through a desk-top machine, and get the OCT. Macular hole, even after repair, usually causes some vision distortions - which I am going through myself (that's the reason I started this thread -read my first post), and still keeping my fingers crossed for full recovery. Waviness of vertical/horizontal lines, image size distortion, and stereoscopic vision are the main problems - dr says time will improve them, but perhaps not completely. If your other eye is good, you are in luck, since it will simply dominate most of the vision, as in my case, and I can do everything normally otherwise. It's the coordinaion of both eyes in the brain that's the issue![/QUOTE]

Sree: They performed OCT on both of my eyes and that's how they found this issue and I was told by several other doctors also not to delay the surgery and that's why I went in the next week after the accident

My other eye is good and if see through both eye no problem at all & I am back to normal

I am praying god for your successful recovery as well & Good luck

I guess since its only ten days it will be too early to make any guess with the gas bubble still inside (i think 25 %) on the vision recovery & I will keep you posted

Definitely its better than last week before surgery & that time I was not able to see in the middle of my at all & All I was able to see was a black hole

Now at least I can see the center also clearly only problem is not able to see anything clearly as my left eye...hopefully that should improve in the next few days as the bubble size reduces..Praying God for successful recovery

Thanks a lot & I will keep you posted

Thanks




 
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Old 02-25-2013, 11:22 AM   #6
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Re: Post-Vitrectomy Vision & Possibility of Repeat Retinal Detachment

Hi Vitcat

sree234: See my replies below & Thanks for reply and I am praying god for your speedy recovery

By size, do you mean the diameter of the macular hole near the central fovea? Units for these retina-related things are in "mirometers." That is, 622 micro-meters, or 0.622 mm in your case.

Sree: Yes. That;s correct & I only had macular hole and no other issue ( The surgery was hyperemia and dramatic macular hole surgery)

I went with second opinion also and they told me to do the surgery at the earliest
because after the accident i was not able to see the middle of the eye and its all balck not able to read anything but now its definitely better but not as good as the other eye

I am not able to get to the wensite you mentioned: NEI

Can you give me the url details please?

By the way, do you have macular edema (swelling) too?

Sree : No swellling at all and no pain after the surgery as well

My other eye Ok and I am able to see if I use both eyes without any problem

I think the current blurriness I have is because of the gas bubble still inside my eye and that's the reason not able to see clearly

Praying god for successful recovery and I will keep you posted

Thanks
Saravanan

 
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Old 02-25-2013, 04:02 PM   #7
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Re: Post-Vitrectomy Vision & Possibility of Repeat Retinal Detachment

Sree234:
1. With macular hole, it seems it will take some time for your vision in that eye to stabilize, even after the air bubble is gone; the retina has to flatten against the base. Mine was Stage 1 macular hole, and after 6.5 weeks there are still some vision distortion issues; yours is Stage 3, so may take longer. Immediately after your air bubble is gone (which may be 15-16 days after vit sx. since it is dime-sized now), if you see well, then fantastic - it did happen to me after my right eye vit sx (with peripheral RD and no macular hole).
2. google NEI = National Eye Institute for "macular hole," or any eye issue
3. No, I do not have macular edema in either eye.
All the best, and keep us posted about your progress.

 
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Old 02-25-2013, 04:20 PM   #8
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Re: Post-Vitrectomy Vision & Possibility of Repeat Retinal Detachment

Hi Vitcat

Thanks for the reply again

How do you clasify mine as stage3 ?

And what are the success facctors for stage 3 macular hole

I mean will it improve 100 % or 90 or so?

Also when in your post you mentioned 20/20 and how do you measure that?

What is good vision...please help me to identify

Thanks

 
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Old 02-25-2013, 04:27 PM   #9
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Re: Post-Vitrectomy Vision & Possibility of Repeat Retinal Detachment

Hi Vitcar

Another questions please

I have read some posts where the macular hole will get fixed automatically without surgery & In my case do you think surgery was right or not?

Thanks

 
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Old 02-25-2013, 04:28 PM   #10
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Re: Post-Vitrectomy Vision & Possibility of Repeat Retinal Detachment

Hi Vitcat

Another questions please

I have read some posts where the macular hole will get fixed automatically without surgery & In my case do you think surgery was right or not?

Thanks

 
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Old 02-25-2013, 06:05 PM   #11
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Re: Post-Vitrectomy Vision & Possibility of Repeat Retinal Detachment

sree234:
1. Again, I am no doctor, so please take my words from a patient's viewpoint; I have learned these things, just like everybody else, I guess, by looking up on the internet, or medical books, and it certainly helps to self-educate in these matters - because it is YOUR eye!
2. Please see the NEI website for Stage 3 classification, and decide for yourself. That is not to scare you but it is just an aid to see the severity of the macular hole. I did not know about this stage classification, until I saw it on this NEI government site; to be sure, I haven't seen it elsewhere.
3. There are no gaurantees in this business whether it is 100% or 90% vision recovery, may be, there are statistics on success rates for each stage of macular hole - I don't know, but they too depend on the skill of the particular surgeon. So, it may be best to ask your surgeon how many times he has done this particular type of surgery, what his personal success rate was and what sort of vision improvement you can expect, given your pre-conditions. That's perhaps the best way to judge the future success of your particular case. But how many patients dare to ask all these questins to their surgeons? There may be general numbers out there: like, cataracts 98+% succes rate, retinal detachment, may be, 85%, I heard. Also, it depends on what the dr measn by success - typically, they may just be saying that okay your retina is attached, and his job is done, but that does not mean you got back your binocular vision, or your vision may not have distortions.
4. By the way, I have not read or heard of any cases where the macular hole gets filled up automatically without any surgery. Where did you read this? So, retina repair surgery looks essential. "Retinal holes and tears," on the other hand, are treated by outpatient laser retinopexy ("spot-welding" around the hole), but "macular hole" is a different beast altogether since it involves the central vision which governs visual acuity and color perception. Since laser retinopexy can destroy the cone cells (in the fovea) where the laser spot lands on the retina, I think, they use cryopexy (cold probes) in those sensitive macular regions, however, this is just my guess. During my vit operation, I kept on hearing the surgeon asking his assistants alternately for laser and cryo probes; of course, I did not know what portion of the retina he was treating every time since it was anesthesized.

 
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Old 02-25-2013, 06:33 PM   #12
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Re: Post-Vitrectomy Vision & Possibility of Repeat Retinal Detachment

sree234:
20/20 is a visual acuity scale in US and elsewhere; it simply means that if the smallest object that a person with "good" vision can see at 20 ft, your eye can also see it at 20 ft; hence, "perfect" vision or 0 diopter (D) or plano. The height of the smallest object subtends a particular angle at the retina - which is the smallest angle a good eye can distinguish (I forget how much but it is something like 1 minute of an arc, or 1/60th of a degree).
On the other hand, 20/40 means, if the smallest object that can be seen by good vision is at 40 ft, then for you to see it clearly it needs half that distance, 20 ft, etc.
In few other countries they use the metric scale: 6/6, 6/12, etc., where 6 is in meters, although 6 meters is not exactly 20 ft. (See "visual acuity" in wiki for more technical info.)
However, there is no direct one-to-one correspondence between this number and lens diopter number, as it gets complicated by things like astigmatism.
As a rule of thumb, for small refractive corrections, each line in the Snellen eye chart is -0.25D apart. And those lines, I think, are sequentially 20/20, 20/25, 20/30, 20/40, 20/50, etc. So, 20/50 is roughly -1.0 D but could be -1.25D due to other corrections.
Somebody, please correct me if this is all wrong!

Last edited by vitcat2; 02-26-2013 at 08:50 AM. Reason: added a link

 
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Old 02-25-2013, 08:26 PM   #13
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Re: Post-Vitrectomy Vision & Possibility of Repeat Retinal Detachment

Hi Vitcat

Good news...now the gas bubble reduced little bit and I am able to see few letters from TV and microowen at least now (This happened today evening)

Compared to morning its litter better now and I guess it will improve moving forward & I will keep you posted

Thanks for all your suggestion

Last edited by Administrator; 02-25-2013 at 08:44 PM.

 
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Old 02-25-2013, 09:12 PM   #14
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Re: Post-Vitrectomy Vision & Possibility of Repeat Retinal Detachment

Great, sree234! Hope you get back all your vision soon.
Is there any waviness when you see vertical lines, or wiggliness when you read words from a book with the operated eye, or, it looks just fine, just like the other unoperated eye?

 
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Old 02-26-2013, 12:46 PM   #15
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Re: Post-Vitrectomy Vision & Possibility of Repeat Retinal Detachment

HI Vitcat

Sorry for the delay in replying

What I meant was I am able to see big letter like a stop sign etc

Still I am having difficulties with books/Computer

I can see it but not clear & I am not sure how impact the gas bubble will have on seeing things

I dont see any vertical/Hortzontal line...I can see the imgaes same as the other eye but the only problem is not clear

I will keep you posted after few days

I guess the vision will defenitely will improve after the bubble is completely gone

I am praying god for successful recovery of both of us

Take care in the mean time

Thanks

 
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