A Belt, A Buckle and Suspenders – Surgery To Repair A Detached Retina

To repeat my introduction from last week: In December 2016, I experienced a retinal tear in my left eye, which has left me with unstable vision. In April 2017, I had a vitreous hemorrhage in my right eye, and still don’t know the full outcome from that episode. I want to reiterate the importance of recognizing and understanding the symptoms and dangers of torn or detached retinas.

As our eyes age, the clear vitreous gel that fills the central eye cavity liquefies and separates from the retina. This is a natural occurring event that happens in most people between the age of forty and seventy. When the gel separates, a person will often see floaters—dots, spots or curly lines, which move with the eye. Usually this quickly settles down and everything returns to normal. Sometimes, most often with people who are extremely nearsighted, the retina will tear or detach when the gel separates. A vitreous hemorrhage can occur when blood vessels are damaged during the above process, filling the eye cavity with blood.

If you experience any of these symptoms, seek immediate medical attention.

Catch up on my previous posts here.

After another restless night, on the morning of my surgery I woke up with a splitting headache. Lack of sleep and nervous tension, I imagine. Hubby had me at Mount Saint Joseph Hospital half an hour ahead of my appointment. At eight o’clock, I was taken to a curtained cubicle to change into a hospital gown. Eye drops were administered and I answered all the same medical questions I’d answered the previous day.

An anesthesiologist put an IV in my hand and explained he’d be injecting a local anesthetic into my eye in two places. He told me it wouldn’t hurt as much as getting the IV, which had actually stung quite a bit. The first injection into my eye was really unpleasant, but thankfully the pain was brief. My eye was frozen enough when he did the second injection that I didn’t feel anything.

Around 10:00, I was brought into surgery. The anesthesiologist touched my upper cheek and apologized for bruising me while freezing my eye. I assured him I bruise easily. A sheet was placed over my face, leaving only my eye exposed. I heard someone ask the retinal surgeon which procedures he’d be using. The doctor joked he’d be doing the belt, the buckle and suspenders, meaning he needed to do several procedures besides the scleral buckle.

During the procedure, I occasionally felt sensations in my eye, but no real pain. At one point the surgeon said, “Oh my God!” in a rather strained voice, then he asked for PFO. Seconds later, he repeated more urgently his request for PFO. Definitely not what I wanted to hear from the person operating on my eye, and I made a point to remember those words so I could ask what this meant.

After surgery, the surgeon told me I needed to get on my tummy right away, then he left. Because I didn’t get a chance to ask him about PFO, I’ll explain what my local ophthalmologist told me. PFO’s full name is Perfluoro-N-octane, and it’s a heavy liquid used to flatten the retina during complex detachment surgery. Although he couldn’t say for certain because he wasn’t there, he believes the surgeon must’ve been having difficulties getting my retina to stay flat.

I got back to the cubicle at 11:00, so surgery took approximately one hour. I had a shield covering my eye, and the nurse instructed me on the importance of keeping my head postured down for the next 24 hours. Silicon oil had been inserted into my eye cavity during surgery—more on that in my next post—and facing downward, even while sleeping, ensures the oil bubble floats to the back of the eye to keep the retina flattened.

Hubby arrived soon after to take me back to the hotel. He picked up some straws, so I could still drink with my head down, and he also bought a selection of tempting foods. Despite missing breakfast and lunch, I felt too queasy to eat much. I had surprisingly little eye pain, but between the pounding headache I’d woken up with and my arthritic neck complaining about the position I had to keep it in, I was extremely uncomfortable. I alternated between lying on my stomach with my forehead resting on a pillow, which gave my neck a break but tensed up my shoulders and back, and sitting with my face supported in my hands and my elbows braced on my knees.

Next week, I’ll go over all the procedures used during surgery, and explain what I was told in my follow-up appointment the next morning. (Next week’s post)