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Dr. Chan
Dr. Chan, Ophthalmologist
Category: Eye
Satisfied Customers: 356
Experience:  Board Certified in ophthalmology
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I am 44,female,healthy overall. ON may 2nd, I woke up w/ blurry

Customer Question

I am 44,female,healthy overall. ON may 2nd, I woke up w/ blurry vision on right eye (nothing visibly wrong on the outside). Went to optometrist, she saw an "eye hemorrage", sent me asap to a retina specialist. Retina spec said the eye hemorrage was due to High blood pressure. Gave my some eye drops (xibrom) and said the only treatment for my condition was to TREAT the high blood pressure. I started treatment for high BP right away. 3 days later blurry vision was almost cleared out,I was happy then realized I had forgotten to put the drops in my eye. That day, I put 2 drops in the morning/ 2 at night. The very next day, my vision was blurry again, I thought it could be from the eyedrops, since I saw on the net that medication is for cataract surgery. Contact the retina spec, she said xibrom is for several other things, ask me to go back to see her again. IS it possible that XIBROM made my eye worse?
Submitted: 7 years ago.
Category: Eye
Expert:  Dr. Chan replied 7 years ago.



I never want to say never, but I doubt it. Xibrom in an antiflammatory drop. It is used to help with the postop inflammation after surgery; but it is also used for other causes of inflammation as well (like in your case).


The retinal swelling from high blood pressure usually takes longer than 3 days to resolve. What I think happened is that the swelling fluctuates (like ankle swelling). Some days it is better than others. My guess is that the swelling never completely cleared but is just improved some, and now it is more swollen again. This fluctuation may continue until the swelling is resolved (which may take several weeks to months). Also, the blood pressure may fluctuate and cause your vision to fluctuate as well.


Hope this helps and thank you.

Customer: replied 7 years ago.
tks. my question is longer, I just needed to stop at that point because of "size" restraints. Continuing, ok, so I went back to the retina spec. and at this time, there was A LOT of fluid and she said now I had a "clot" in my eye... (I did not understand exactly why, did I have another hemorrage? Did I have a hemorrage or a clot? she did not explain well, just said all of this is cause by high blood pressure (at that point, the BP was NOT under control). ok. At this point my eye was REALLY blurry and I realized the first "blurry" was really minor. OK. She said there was an injection she could give to help my condition but I needed to fix the BP first. I returned to the retina spec. after 2 weeks, the vision had improved a bit (I could see better now) but they were totally READY to give me an EYE injection. I HAD READ On the net the eye injection is for macular degeneration and whatever damage you have in your eye, the eye injection does not really help, only prevents more "degeneration" so to speak. Of course, I said> NO eye injection today, I want to understand the reasons why (since the ret. specialist hadn't explained to me what the eye injection was for). When I questioned the eye injection, she then had another exam to check the fluid in my eye and said it was MUCH better and actually I did not an eye injection anymore... so then I questioned> I don't need an eye injection because I really don't OR you are not giving me an eye injection because I questioned the reasons for? She really did not explain, said the eye was fine, and when I asked> what does this injection do? she said it was pointless to explain since I was not having the eye injection anyway...
I am supposed to go back to this doc in a couple of weeks... my eye seems to be improving, but... still blurry... the blood pressure is under control...

well> the question> now I question this "specialist" behavior - was she going to give me an injection I Don't need?? Is this injection actually USEFUL for my condition??? and lastly, and I am wondering if I should have a second opinion on my eye, or... there is nothing else that can be done other then just wait for the fluids to clear out............. ?? please, help :o) thank you.
Expert:  Dr. Chan replied 7 years ago.



First of all, there are 2 types of injection. One is for macular degeneration (which you read about); and there is some data to suggest that it not only stops the bleeding but indeed does help some with vision. The second is an injection of steroids that is to treat swelling in the macula (such as you have). It is actually a relatively common treatment.


In terms of the condition of your eye, swelling of the retina does fluctuate. If the swelling continues to improve, we will hold off on the injection. But if it plateaus or worsens, we go ahead with the injection. Medicine is an art, and we can't predict; so we only go with what we see. If she saw that your fluid was not improved, she would have recommended the injection. Once she saw that it was improving, she changed her mind.

Customer: replied 7 years ago.
ah, ok...thank you. Can you tell me the name of the injection for the swelling? and for macular degeneration (I only found this one on the net). Is it painful? Other then the injection, is there something else I can do to improve the condition (other then controlling the blood pressure??) thanks for your answer :o)
Customer: replied 7 years ago.
I've found the answers for the previous question, tks. I think I got confuse since she never mentioned "swelling" of the "macula", only "fluid" inside my eye. She's mentioned several times it will take time for the fluid to clear up... by your experience, since I do have the BP under control now, is there a time frame I can expect my eyesight to go back to normal? I am afraid this injection is something too drastic and wouldn't it make my vision even more blurry since more fluid will be injected into my eye?? tks for your help.
Expert:  Dr. Chan replied 7 years ago.



The fluid that she is referring to is not in your eye, but inside your retina. It is swelling inside the tissue itself. The timeframe with no treatment is usually several months. However, keep in mind that there is a percentage of people in which the swelling does not resolve. Then we would have to do something more (i.e. injection).

Customer: replied 7 years ago.
ok, so my last question is>> the injection does not have to be done in a timeframe, it will help even 3 months after the problem started? another thing, If I had had the injection right in the beginning, would it have avoided or helped with the swelling?? THANK you very much.
Customer: replied 7 years ago.
sorry ,I have another question> you said the "timeframe" with no treatment is usually several months? what exactly do you mean by that, " no treatment"? Since I am being seen by a retina specialist SINCE THE BEGINNING and I am getting "the treatment" she is RECOMENDING it to me... she said it herself there is nothing she can do other than wait and control the Blood pressure and maybe injection which she decided I didn't need... So, what exactly is the "treatment" you are mentioning?? Are you suggesting there is something else that could've been done or should've been done in regards XXXXX XXXXX of this condition?? What is the right "treatment" for this condition? I really appreciate if you be totally clear with that point. Thanks.
Customer: replied 7 years ago.
understand I am using your expert advice as a "second opinion" to decide if I should be seen my another doctor, since we are dealing with my EYEsight here and I do not want to be on the hands of somebody that is not doing everything humanly possible to resolve my problem and help me get back to 100% health in my eye... Thank you very much.
Expert:  Dr. Chan replied 7 years ago.



Let me clarify. When I see someone with swelling in the macula, I give them an option: do an injection or wait. If we wait, I usually check them every month or so. If by 3 months, the swelling is not better or worse, I will recommend an injection. If the swelling is getting better, I wait a little longer. If by 6 months, the swelling is better, but not gone, I would go ahead and recommend an injection anyway.


If the injections don't help, we even do a laser treatment on top.




Customer: replied 7 years ago.
I guess I don't understand why the injection is something that is optional to the patient... if it is helpful and needed to improve the swelling, why not do it right away? What is the negative about doing the injection or the positive of not doing it? tks.
Expert:  Dr. Chan replied 7 years ago.



It is optional initially because there is some percentage of patients who improve with no treatments. Just that treatment may speed up the improvement. But at some point, if there is no improvement, I don't consider it an option.


Since the injection is into the eye, there are risks of more bleeding, infection, etc. So these have to be weighed against the benefit.


That is why initially for me, it is option. As the patient, you have to decide whether the faster improvement with the injection is worth the risk. After 3-6 months of no improvement or worsening, it no longer is an option for me, as the physician.

Dr. Chan and other Eye Specialists are ready to help you
Customer: replied 7 years ago.
thank you so much, Dr Chan. I think I have all my doubts cleared at this point :o)
Expert:  Dr. Chan replied 7 years ago.
You are welcome and good luck.