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Decreased Vision Following Retinal Detachment

There are many reasons why your sight may be poor following retinal detachment surgery.  Obviously, it is possible that the disease actually led to loss of vision as retinal detachments can lead to blindness.   There are, however, other less serious reasons for loss of vision following retinal detachment surgery.

Scleral Buckle for Retinal Detachment Repair

A scleral buckle is common method to fix a detached retina.  In most cases, a band is passed around the circumference of the eye.  This is similar to donning a corset around your mid-section, except in the case of the eye, the eye elongates.

The lengthening of the eye causes a change in your refraction, or, the strength of glasses needed to correct your vision.  A scleral buckle causes an increase in nearsightedness.

Other surgeons may elect to place a buckle only a small portion of the eye, but the result is the same; a scleral buckle changes the refraction of the eye.

Cataract Formation

This is a very common cause of decreased vision after successful retinal detachment surgery.  Intraocular gas is often injected into the eye to help repair the detached retina.  While the gas is very helpful in reattaching the retina, it is not so good for the natural lens and hastens the development of a cataract.

Epiretinal Membrane Formation

An epiretinal membrane can form on the surface of the retina and cause decreased vision and/or distortion.  These are also called “macular pucker” or “cellophane maculopathy.”  While these membranes may form in eyes that never had a retinal detachment, they are commonly associated with retinal detachments.

Recurrent Retinal Detachment

Of course, it is also possible that the retina simply came off again.  This may be due to additional retinal tears or to a disease termed “proliferative vitreoretinopathy” or PVR.

What Does This Mean? Retinal surgeons are usually pretty successful at reattaching a retina.  The whole process of recovery; however, can extend months beyond the actual surgery date.  None of the causes listed above can be self diagnosed and it is imperative you stay close to your doctor, preferably the retinal surgeon.

Contrary to what you may believe, retinal detachment surgery often, not always, leads to improved vision.  Thus, decreased vision after surgery should be evaluated by your doctor.

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A detached retina is potentially blinding. The retina is the light sensitive tissue that lines the inside of the eye. A retinal tear or hole usually leads to a retinal detachment. Floaters can sometimes be the earliest, and only, symptom. Many times there is little warning and a retinal detachment usually occurs without trauma.

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Randall V. Wong, M.D.
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