There are 3 reasons to have retinal detachment surgery. More than just to restore vision, there are emotional and physical factors that need consideration. There are complications to long term retinal detachments. Your doctor should prepare you for all of them.
Saving Your Vision
The most obvious reason for retinal detachment surgery is to save your vision. A detached retina has no chance of spontaneously fixing itself. An operation is needed.
Remember that retinal detachments cause blindness. Reattaching the retina may not restore your vision completely, but it will prevent blindness.
Usually with proper timing of retinal detachment surgery, the better your visual prognosis and, in most cases, we try to operate within a short period.
On occasion, I’ll see a patient who has had a retinal detachment for a long time. Last month, I operated on a patient with a retinal detachment for about 2 years. The vision was quite poor and unlikely to improve despite successful surgery, but we needed seriously consider surgery.
There are emotional and physical reasons to operate, too.
Value in Trying
My patient is relatively young. While I have seen miraculous improvements in similar circumstances, the chance of his regaining useful vision was quite small. We discussed this.
In my experience, the younger patients tend to have more of the “miracles,” that is, given his age, he has a chance of getting some moderate improvement.
I am a big believer in “closing the loop” on something and moving on. This is how I also approach patients with complicated and devasting vision loss. We’ll try everything we possibly can now, if it doesn’t work, we know we’ve tried so that years from now…there are no questions or reservations.
There is value in trying.
It is a healthy approach. I have met too many patients that weren’t properly prepared for the long term possibilities…and can’t move on.
Physical Changes to Retinal Detachment
A long standing retinal detachment will lead to blindness.
A long standing retinal detachment can also lead to a shrunken and disfigured eye. The eye is “dying” and can become visually unappealing. This condition is called “phthisis bulbi.” It doesn’t happen to every blind eye, but occurs more often in patient unrepaired retinal detachments.
The long term physical changes occur gradually. Phthisis bulbi can take years to occur. It is not reversible. It is less of a concern with older individuals.
Reattaching the retina can prevent this cosmetic nightmare.
What Does This Mean?
A retinal detachment can have long term complications…and more than just your vision. The emotional trauma that may occur with permanent vision loss can be life changing. I am not discounting the significance of losing vision, but one needs to be aware of this possibility.
A physically disfigured eye can be more traumatic than simply going blind. Complications of long term retinal detachments should be dealt with “up front.” Most of the time, these are only potential issues.
The decision for retinal detachment surgery is usually straightforward as we are often faced with the question of restoring vision. In cases where visual improvement is unlikely, there are still complications that must be faced. Your eye doctor should help you learn about these.
Randall V. Wong, M.D.
Ophthalmologist, Retina Specialist
Fairfax, Virginia
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I absolutely agree Dr. Wong… I had a detached retina when I was 16 years old (I’m now nearly 37). My retina had detached 2/3 and when I saw a specialist, he admitted me into the hospital that night and I had my surgery the following morning. While it was a scary experience at the time I am so grateful to my doctor (Alan Norton in Bev. Hills ~ back in 1990). My vision, while not perfect, was improved significantly. I would recommend to anyone facing this to move forward with the surgery. It could absolutely save your sight! I went from having a “black curtain” over a majority of my vision in my right eye to having only a small irregularity where my doc couldn’t re-attach my retina over the optic nerve. Good luck to anyone else with this problem.
Erin,
Sounds like you’ve done quite well. Thanks so much for following and reading.
Randy
My retina has been detached since 1997. I can see only light in the 30% part that is attached. I know there are some blood vessels behind the retina at this time. I saw only one or two drs and they didn’t recommend an opperation because the “optic nerve won’t probably function”, but I still see light and sometimes colors and so I’m not convinced. I’ve met people who regained their vision more than 10 years after losing it. Any recommendations for me? Is there a way to restore my vision? Should I give up or should I seek more help…Note, my right eye is prostetic.
Thanks
Moe,
If I understand you correctly, your left, and only, eye is detached and you have a prosthesis in the right?
How did you lose the right eye?
Depending on the condition of the retina in the left eye, operating could be a consideration, if, indeed, there is a detachment to fix. While I agree that there may not be a huge improvement, reattaching a retina at this very late stage has some potential benefits; some subjective improvement and a decreased chance of losing more sight from an enlarging detachment.
In short, I think it depends upon the nature of the retina right now.
Look forward to hearing from you,
Randy
hi doctor i was born with cataract, i got operated 6 to 7 times my right eye went well but the left was unlucky every time at the age of 8yrs i again went under a cataract operation but the doctor found that i had retinal detachment too and he tried fixing it but no proper post operative care by the doctor resulted in retinal detachment once again, i just visited a ophthalmologist in the month of march and he said i have occurred some Ocular Hypotony / Phthisis Bulli in my left eye they say it is the worst an eye can get is that true and is any operation available for me if not then till when is it expected to come up. I’am 18yrs old right now please help
Dear Paresh,
If your eye has hypotony or is described as phthisis bulbi….it is unlikely you can salvage the eye, regardless of an operation.
I am sorry.
Randy
Dear Dr Wong,
I had a vitrectomy, gas bubble, and scleral buckle 6mos ago. I incurred optic nerve damage perioperatvely. Is this a common occurrence? I have only the very top of my visual field left, the rest of my visual field is black. Thank you.
Teacher Anna,
Visual field loss as related to optic nerve damage is possible, but not usual from retinal detachment surgery. There may have been some other events that occurred? I am assuming, at present, your retina is reattached.
Randy
Sir, i have lost my vision in 1992 due to the retinal detachment with the injury in my right eye.. from that day i havent consult any doctor, My eye have shrunken and disfigured. Is there any new inventions to get my vision back. In future is there any new inventions wil come..Otherwise i’l go for cosmetic ocular prosthesis,.. Plz suggest me
Dear Dr. Wong
My boyfriend is diabetic and only 23. In January he had multiple surgeries in attempt to reattach his retina. he had scar tissue that was removed and blood vessels had burst causing him to see red spots or have blind spots. all that was mostly taken care. After a few attempts the doc said it just couldn’t be reattached maybe because it wouldn’t lay flat against the eye, I’m not sure the reason. My question is, although it has been over six months with it unattached and he does not see light, is there any slight possibility that it could still be repaired with any kind of surgery or anything? Is there anything that anyone can do or is it to late altogether?
Thanks,
Christy
Dear Santosh,
From your description, I’d suggest you follow through with the prosthesis. I am not aware of any way to reverse the vision loss.
Sorry,
Randy
Dear Christy,
Although the prognosis is not very good, it might still be possible to reattach his retina. It really depends upon the condition of his eye right now and, obviously, I can’t tell from here.
If indeed, he is unable to see projected light (at all), then the further operations may not be helpful as complete loss of light perception is a bad indicator.
Randy
can i do physical construction work with detach reina with s oil in it
Dear Don,
Probably. If I were your doctor, I wouldn’t see why not unless you just had it put in and have to maintain a certain head position.
Randy