Retinal Detachment At 40
No floaters. No flashes of light. No shadows. No pain. There were no signs, until it was too late.
Retinal Detachment is the medical state when the retina pulls away and separates from the back of the eye. This typically happens with a combination of age and predetermined genetic conditions. There are 3 main causes of retinal detachment but I’ll describe only the most common.
The eyeball is filled with a gel like fluid called the vitreous which changes in consistency and may shrink with time. As it undergoes these changes it may separate itself from the surface of the retina, this separation may induce tearing of the retina allowing fluid to get in behind the retina between the back of the eye and retina — thus ‘detaching’ the retina.
T-Minus-3 Weeks to Surgery
Just a little under three weeks before undergoing emergency eye surgery an indication that something was wrong had surfaced. Slight visual distortion with text and with lines that are supposed to be straight. This was the only sign, I knew something wasn’t right but didn’t think much of it so an appointment was scheduled to see a nearby optometrist as early as could be scheduled, in 3 weeks time.
T-Minus-2 Weeks to Surgery
Business as usual. No floaters. No flashes of light. No shadows. No pain, just the inconvenience of visual distortion if I were to close my good eye (right). The body is amazing at adapting.
T-Minus-0 Days to Surgery
I had visited the optometrist on a Saturday morning where I elected to have retinal imaging performed (fundus photography) instead of having my pupils dilated for a visual examination. The resultant images showed that my retina was detached from the bottom and was separating upwards, partially affecting the macula which is responsible for central vision. Because the detachment had already reached my macula it was imperative that I undergo surgery as soon as possible in a effort to reattach the retina before the macula was completely separated resulting in permanent vision loss.
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I was sent to the Emergency Room straight from the optometrist’s office where I could be evaluated by the on-call ophthalmologist before going into surgery, but not before waiting anxiously for 7 hours in the waiting room. The medical team was top notch, two doctors thoroughly examined both my eyes as I was led from examination room to examination room looking through the lenses of various medical equipment. The diagnosis was 2 horseshoe tears in the lower region of my retina allowing fluid to ingress, separating the retina from the back wall of the eye. This was likely the primary reason why I hadn’t experienced any symptoms, because gravity was working in my favour.
There are two commonly employed surgical procedures used to reattach retinas; vitrectomy and the scleral buckle. Generally speaking, vitrectomy involves the extraction and replacement of the eyes natural vitreous gel with a substitute such as a gas bubble or silicone oil. And a scleral buckle is a procedure involving the stitching of a silicone sponge, or band around the sclera (white part of the eye) to reattach the back wall of the eye to the retina. Either or both surgeries may involve cryopexy or photocoagulation (laser surgery) to seal the tears in the retina. Both have their pros/cons and my doctors decided the scleral buckle would be the best procedure for me given my age. Although it’s a more invasive surgery, it was chosen because they felt it would provide better long term outcomes. Primarily eliminating the need for cataracts surgery that is a common side effect of the vitrectomy procedure.
(US) Insurance companies don’t typically cover retinal imaging as it’s not considered a medical necessity. However, I would highly recommend it as the benefits far outweighs the costs. The images provide insight into health of the retina, associated blood vessels, and the optic nerve. Allowing medical staff to identify any pathologies before they affect a patient’s eye health.
Road to Recovery
The surgery lasted roughly 2 hours and was by all accounts successful. I wore an eye patch for the first 12 hour or so and once removed revealed a swollen, extremely red eyeball with highly blurred vision. Any tears my eye would produce would be blood tinged. The first week involved 10 eye drops a day from 3 different bottles spaced evenly during hours of non-sleep. This is reduced to just 4 drops from 1 bottle after the first week. Tylenol is taken as needed to help with the pain.
It’s been just over a week and a half now and my vision is no better, my eye has difficulty focusing on objects near or far. At this point it’s not sure how much vision will be regained, it will be a long road to recovery but I remain hopeful.
Summary — The Importance of Eye Health
Vision, something we may take for granted but is so essential to our day to day quality of life. Please learn from me and take care of your eye health, have yearly eye exams even if there’s nothing ‘wrong’ with your vision. Splurge for retinal imaging while you’re there. Early detection of holes in the retina can be treated with lasers, no invasive surgery or lengthy recovery needed.
