Detached retina

[Sheepshanks]

Wife had detached retina repaired in late 22. It was middle/top right of her left eye. She got a follow-on cataract and had that done in early 23.

Her vision quickly became iffy again and she had YAG laser treatment Jan 24. The consultant noticed a “tide mark” at the bottom of her eye and thinks there must be a small hole, although he can’t see it.

He’s suggesting, but is very 50/50 about it, getting in there and fixing it. His main concern (beyond all the usual risks) seems to be the face down posturing that would be required for 10 days. Alternative is regular checks to see if the tide mark changes.

Anyone been though similar?

[jules_s]

Yep,

Clearly everybody wants to avoid another detachment...

My mrs had the same (very very similar MO) and her surgeon is really guarded about going in again unless it's 90:10 needed. They keep a really close 'eye'on her though.

And if there are any changes whatsoever we get her to the eye hospital - no fking about.

The tide mark (bottom side) 'could be the start of a detachment if your Mrs sees it (they read upside down) but IME if he's just seeing a ripple in the retina where it hasn't seated I'd be leaving well alone and monitoring it.

Has she had all the vitreous gel removed? presumably so?

[Sheepshanks]

jules_s said:

Has she had all the vitreous gel removed? presumably so?

No - consultant said it gets absorbed, but thinks more is leaking through so the tide mark appears unchanged since it was last looked at.

I said he was 50/50 about doing it - if anything he was erring on the side of wanting to do it. He said leaving it risks it becoming an emergency and it's better to deal with it in a planned way.

[jules_s]

Sheepshanks said:

jules_s said:

Has she had all the vitreous gel removed? presumably so?

No - consultant said it gets absorbed, but thinks more is leaking through so the tide mark appears unchanged since it was last looked at.

I said he was 50/50 about doing it - if anything he was erring on the side of wanting to do it. He said leaving it risks it becoming an emergency and it's better to deal with it in a planned way.

So many variables here - you need another chat with the surgeon tbh.

The only time I've ever heard of any 'absorption' in the times ive been present is when the retina bled after a repaired lazer tear repair or bleed . I've never heard of a detachment not needing a gel removal (granted I'm one patient partner in thousands mind you)

The last time I was there a lazer repair was bleeding and there was a ghost/floaters around which was concerning but it was decided to monitor it to see if 'it' (the blood) got absorbed

As far as I know the gel thins/drops over age and sometimes when it drops it takes the retina with it (detachment) or rips it (retinal tear)

At a complete guess I'd say they might be considering removing the gel. As far as the posturing is concerned it carries risks the surgeons cant control so they really try to avoid it unless completely necessary (and from my pov it was tough given the statics and drops etc)

Tough decisions I know. I'd seriously advise having another chat with the surgeon (they've all been bloody brilliant ime)

[Sheepshanks]

jules_s said:

I'd seriously advise having another chat with the surgeon (they've all been bloody brilliant ime)

Thanks, I don't what else he can say - we're just un-nerved by him being so 50/50 about doing it. I've had a couple of medical issues where the consultant (private, so you'd imagine they'd be up for the business) has said "no way will I operate until it's much worse" and we expected the eye-man to say "leave it alone", but as I say, if anything he was erring on the side of doing it.

This is NHS, by the way. The consultant did the original emergency detached retina repair and has done all the work on wife's eye. After the initial repair we did talk to a private guy we vaguely know and he said to stick with him.

[Mr Pointy]

I was fortunate as I had to lie right hand side up not face down but if she does have to do it then you can hire posture tables (just an example Google hit):

https://www.facedownsupporthire.com/

[Sheepshanks]

Thanks - they may come in useful!