Detached retina

[Craftysue]

My son - early 20's has a partially detached retina
His optician spotted it during a routine eye test. He saw the consultant next day and hopes to have surgery this week. Has anyone any advice on what to expect? He's not too worried about the surgery as he's had operations before, it's more about what to expect during recovery and how long he will need to have off work. It's been a bit of a whirlwind and he didn't ask many questions
Thanks

There are different surgical routes to fixing a retinal detachment so my experience may not be the same as his but here goes.

I had a Vitrectomy and lens replacement, then the retina was reattached with stitches and laser.

Vitrectomy is removing all the vitreous fluid from the eye to allow them to get to the retina.

I needed stitches and laser because it was fully detached and buckled.

Lens replacement is done because when they do a vitrectomy they then put a gas bubble into your eye to hold the retina in place and that gas will more likely than not cause a cataract to form if you don't have an artificial lens.

Surgery was bloody brilliant, they gave me Valium, I was awake throughout and so blissfully wonderfully calm and lacking in any worries it was lovely. I was completely aware, able to have discussions, move as needed, I just wasn't bothered about anything. It took just over an hour, I spent more time waiting for my slot in the waiting room than I did in the surgery, then I was only around long enough to have a coffee and biscuit before I went home.

Recovery was fine but a bit odd. I had to do posturing (look it up as there are different positions based on where the detachment is), for me that meant I had to be face down for 3 days, I was allowed to be upright for a max of 10 minutes an hour, at all other times I needed to be flat on my face or bent at the waist nose parallel to the floor. It's to ensure the gas bubble is pushing against the repair like a plaster, holding it in place while it heals.

Other than that I had a plastic shield overnight the first night, then it was off and I just had a few different drops that needed putting in several times a day for a couple of weeks.

There were 3 stitches in my eyeball which were dissolving ones so no after care on those.

There was no pain but my eye felt dry and was very very angry looking for a couple of weeks. It also took about a week for vision to return as you have to wait for the gas bubble to dissipate and be replaced by new vitreous fluid, you can't see through the gas and it reduces a little each day so it's kind of like you are half submerged in water and can see a bit over the water line.

I had 2 weeks off work and that was plenty, probably could have gone back after a week but I'm office based, if he has a more physical role he may need longer, you are warned not do do very physical sports/exercise for 6 weeks.

This was my eye the day after

The main ways to repair a detachment are:

— gas bubble (needs vitrectomy)
— oil (needs vitrectomy)
— buckle
— cryotherapy (can be done with a vitrectomy, unsure if it is always needed)
— laser (can be done with or without a vitrectomy)

If a gas bubble is used it can last up to 10 weeks. There are a couple of different types of gas; one lasts much longer than the other. Sometimes oil is used instead, and this can be left in for many months if needed. It all depends on where exactly the detachment is and how bad it is.

If gas is used then your son cannot fly or go up a mountain until it has completely gone. This is absolutely non-negotiable. (If for some reason he has to fly then tell the ophthalmologist and oil could be used instead.) Flying with gas in the eye can lead to blindness. Once any gas has dissolved though he will be OK to fly, it’s not a permanent restriction. :)

You wouldn’t ever have a gas bubble and oil together, it’s one or the other, but other than that it’s pick and mix or all of them, depending on your son’s exact issue.

He might not need to posture, or he might need to do so for longer than the previous poster. If oil is used then it’s very unlikely he would need to, but it isn’t unheard of.

Thanks - I'm not sure what surgery he's having, he's got a pre op appointment on Tuesday so we will ask them . His work have said to take the time he needs so it looks like around 2 weeks
We just want to get it done now - fingers crossed for a cancellation. Thanks again for the information

You have had very comprehensive explanations. I had vitrectomy in August with a gas bubble that lasted exactly a month. It made me woozy at times. I had a week of posturing and was advised that following this strictly is the key to the success of the procedure.
I had a mac(ula) off detachment and have wavy distorted vision.

To add, he does need to be mentally prepared for the POSSIBILITY that he may not regain full vision in that eye.

Mine was complicated because the retina had been moving out of place and detaching for a long time due to some other deformities around my optic nerve, but I have been left severely visually impaired in that eye, with very little central vision.

Now in reality that doesn't mean much of anything in day to day life. The other eye is good and makes up for it so I can still drive and do everything I need to do, but it is possible that he won't end up back where he started.

Thanks - the vision in the affected eye is really poor anyway
Luckily his other eye is very good

Is there a family history of RDs, hearing issues or early onset arthritis?

The main things of note were taking it very easy for the first few days, no vigorous activity for a few weeks and no flying until the gas bubble disappears (around 6 weeks). Dp had a couple of days off work then worked from home for a couple of weeks. No driving for 6 weeks as he had to wait to order new glasses

Everyone is different. There is no set period of time for recovery. Mine took ages, as I had the long lasting gas bubble. I had a general anaesthetic but this isn't standard. No pain at all in the eye at any point, although I did have pain around the eye for a few days post-surgery, simply because of the trauma. I was very lucky with posturing afterwards. I had to lie flat on my back. Having to stay face down is just hideous. My sight has never fully recovered but I am still eternally grateful to my surgeon for saving my vision.

Face down was just ridiculous, I bought a sun bed with a face hole designed to allow you to read while you sunbathe, set it up in the living room and was on that 23 hours a day. Also had a weird contraption I found on Amazon designed for sleeping sitting up, like a metal frame that rested on my knees and had an adjustable face hole.

I had an underbed storage box filled with snacks and activities I could do laying down and just spent 3 days watching stuff on my iPad, snoozing and trying not to get too bored.

Thanks everyone for taking the time to reply , It's all been a bit of a whirlwind but I'm taking him to the pre op tomorrow so can ask a few questions re recovery period - he still lives at home . I'm just hoping it's done quickly now

Hi

How did you son get on?

I hope everything went well xx

Sadly it's not worked - he's developed a cataract and there's a lot of scar tissue. He's blind in one eye. We're just waiting to see if they can do anything for him.
Very kind of you to ask

Can I ask again if there is any history of RDs in the family, high myopia, hearing issues or early onset arthritis?
I'm sorry to hear about your son. Similar happened to my family member who has since got a diagnosis of the connective tissue disorder that caused it and he has had specialist treatment as a result that's helped and had preventative treatment on his other eye. It's the most common cause of RDs in young people and slightly different treatment is needed Vs a conventional RD to prevent vision loss.

@Craftysue

Oh my goodness, I'm so sorry.

I hope there is something the doctors can do xx

@Craftysue really sorry to hear this.
I hope they can work on a solution. I have had 4 rds and am lucky enough not to have lost too much vision. Do you have a local VI society? Has his work been good with adjustments?

His consultant doesn't think he will get the sight back sadly. They have sent his scans to another specialist at our regional eye hospital and we're just waiting to hear back. He's taken the news really well - he did everything they asked him to - lying on his front for a week wasn't fun 😬 . We're just mystified how it happened. Luckily his other eye is healed and his vision is good.

No family history of any DR or connective tissue disorders. I've had Rheumatoid arthritis since my twenties but that's autoimmune rather than a connective tissue disorder

Did they do a lens replacement as part of the retina reattachment?

I had one, just a plain lens they didn't try to correct my sight with a prescription as said it would leave too big of a discrepancy between my eyes. They were adamant that a lens replacement was needed because the gas bubble inserted as part of the retina reattachment causes cataracts so frequently if you don't have a plastic lens.

As it turned out I ended up getting some opacity form on the plastic lens but was able to just have a quick laser treatment to break it down.

No - and he has a cataract.which they are not going to remove - no point having more surgery as it won't make any difference to his vision.

Injection july. 10 days later blind ! Sent to another hospital. They were horrified. Said retina detachmen t caused by being injected into retina. Oil taken out but still can't see out of one eye.