An Acute Retinal Detachment Is An Ophthalmologic Emergency – Learn The Dangers

In an effort to bring awareness to the symptoms and dangers of torn or detached retinas, I’ve been chronicling my own experiences with this serious issue. (Catch up here) 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.

Important signs to be mindful of:

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.

Last week, I described the surgery to repair my detached retina. Following surgery, I needed to keep my head facing downward for 24 hours. I was so nervous about accidentally rolling onto my back, I didn’t sleep a wink that entire night. Early the next morning, I became incredibly nauseous and from that point on, I threw up nonstop.

Prior to my follow-up appointment, I was allowed to raise my head and remove the eye patch. My eye looked horrendous, but the pain was tolerable. I could see lightness and unrecognizable blurry shapes. Hubby helped me apply three different eye drops: Zymar, an antibiotic, used four times a day for one week. Combigan, to treat high eye pressure, used twice a day for two weeks. And Prednisolone, to treat symptoms of inflammation, used four times a day for four weeks.

In the crowded hotel elevator, I concentrated on protecting my eye from wayward elbows and not upchucking. Thankfully everyone got off before us because the moment I stepped off the elevator, I got sick. With my eye swollen shut and badly bruised, and vomiting into a plastic bag, I must’ve looked like I’d been on a bender that ended in a brawl.

The assistant surgeon at the clinic said vomiting was actually quite common after eye surgery. Something about how the brain interpreted high eye pressure. I wish I’d been forewarned, so I could’ve been prepared.

I asked if the retina had been detached and he said, “Oh yeah, a complete detachment. It was really bad.” He felt confident surgery had stabilized the eye and I should have a good outcome. There’s a difference between repairing the retina and restoring vision, however.

An acute retinal detachment is an ophthalmologic emergency. The longer the wait for surgery, the lower the chances of a positive outcome, because the retina becomes starved of oxygen without proper blood flow. This not only can lead to irreversible vision loss, the health of the entire eye is endangered. Stabilizing the eye and preventing redetachments are higher priorities than restoring functional vision. That doesn’t mean they don’t care whether I ever see again, it’s just not their main objective.

At my prior appointment, the ophthalmologist explained that after surgery either air, gas or silicon oil would be injected into my eye cavity. Air and gas both dissipate on their own over a matter of weeks. Oil, usually chosen as a last resort for complicated detachments, must be surgically removed. Because of the severity of my detachment, the surgeon opted for oil over air or gas. So yay, I’ll need another surgery requiring more needles in my eye.

Four procedures were used during surgery. A vitrectomy, which involves making small incisions in the eyeball so the surgeon, using a microscope and special lens, can insert micro-surgical instruments to clean the vitreous and blood from the middle eye cavity.

A silicone scleral buckle was sutured around the outer wall of the eyeball to create an indentation inside the eye. This pushes on the retina and effectively closes the break. Scleral buckles usually remain in place indefinitely.

A laser beam were directed at the retina to make tiny burns. These burns form scars which seals the retina.

And the last procedure involved injecting silicon oil into the eye cavity. The oil pushing against the retina improves the likelihood of it staying attached. While the oil’s in place, my vision will be poor, but using the oil may increase the overall visual prognosis.

The doctor stressed that I must take it very easy until told otherwise. He looked over at Hubby and told him he felt as though these instructions needed to be emphasized. I obviously have a tattoo across my forehead that says, This lady doesn’t know how to relax.

I’d need to wear an eye shield at bedtime for several weeks, and either the shield or sunglasses when going out, to protect the eye. Then I got some good news. As long as we took the longer, low elevation route, we could go home that day. It’s ironic that I’ve been bugging Hubby for years to take that slower, more scenic highway between the Okanagan and Vancouver, and when we finally did, I couldn’t enjoy it. I threw up all the way home and mostly kept my eyes closed.

I owe my hubby and son such a debt of gratitude. I don’t know how I would’ve managed without them. My son navigated us around to my various appointments, which saved us all kinds of time and stress, and he babysat Roxy so we didn’t have to leave her alone at the hotel. And poor Hubby! He taxied both my son and myself back and forth to all our appointments, while coping with big-city traffic, pedestrians and cyclists. He doted on me constantly, taking care of my every need. And he did it all with surprising patience and good humour.

My next post will give an update on my progress so far. I might include some photos. They won’t be as pretty as the ones I usually post, just to warn you. (Next post here)