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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7921
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I had two Pingueculas removed via bare scelera with MMC. A

Resolved Question:

I had two Pingueculas removed via bare scelera with MMC. A bad infection post op and now have thinning of the scelera and what may possibly be signs of either what's called sceleral necrotizing or sceleral melt, from the info I can find on the net. Anyhow, I am not good with medical terms or spelling of the words. What I would like to know is how I can locate a very very good doctor who specializes in this condition. I understand that early treatment is important and cost is not a factor at this point.

Thank you so much for any advice or direction.
Submitted: 3 years ago.
Category: Eye
Expert:  Dr. Rick replied 3 years ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Customer:

Hello Rick, I am not sure if you are still on line.

Dr. Rick :

I'm here

Customer:

Hi there

Customer:

Dr. I do not exactly know where to start except to see a specialist in my type of conditon.

Dr. Rick :

You have come down with one of the most dreaded complications of the use of mitomycin-C in pinguecula treatment.

Customer:

Yes, that is what I am finding out.

Dr. Rick :

Do you know if you have any retina issues at this point?

Customer:

no I do not believe I have any retina issues, as yet.

Customer:

What are the symptoms of thtat

Dr. Rick :

That is good.

Dr. Rick :

vision loss

Dr. Rick :

Where in the US are you located?

Customer:

No none at all and the melting if that is what it is called is somewhat slight at this point however I will describe to you what is going on if you like ... yellowish spots 2 of them near the corner of each eye that turn yellower and then sort of slough off into gell. But it is slight and seems to be lessening although I cannot be sure

Dr. Rick :

is there any bluish color showing through in the affected area?

Customer:

Well,,, just sort of. It is starting to get bluish and then it seems that my eyes are also trying to gain some white back into the areas. If that is possible.

Customer:

I am taking serious vitamins for the eyes and also flax oil. Topical lubricants, etc. Also Can-C drops.

Customer:

I am, out of intuition taking things to cut down any inflamation

Customer:

A vitamin studied called Curcumin as well

Dr. Rick :

Yes, that is possible. The bluish color is the "inside" (uvea) part of your eye showing through the thinning scleara. While you will not make new, normal, scleral tissue, scar formation can fill the thin area back in....although stopping this new tissue formation is just what MMC is best at....

Dr. Rick :

Vit C has, in some studies, been shown to be helpful....

Dr. Rick :

so the Can-C is good...

Dr. Rick :

On the positive side, I bet your pinguecua will not grow back ;)

Customer:

I am also taking vitamins that have to do with cell regereration and all the amino acids and branched chain amino acids, the list goes on and on..

Customer:

Yes that is positive. lol

Customer:

My opth. that did the surgery told me to have lower plugs put in and step up the flax oil.

Customer:

He is in CA. I am unsure why he is not more concerned. I sent photos

Customer:

I do not care about the why, just the solution.

Customer:

I have always been in the minority and should have know the chance, even however small, is there....

Customer:

Have you any knowledge on AMT?

Customer:

It may be a bit soon for me to consider all this however I want to be proactive,

Dr. Rick :

plugs is a good idea. How long ago was your surgery?

Customer:

Dec 09, 2010

Dr. Rick :

Ok. In general, do you think things have reached their worst point and now seem to be getting a little bit better, or is it hard to tell?

Dr. Rick :

did you send photo's for my review?

Customer:

Well ... my eyes still look pretty darn good, however there is changes taking place and it is hard for me to tell if the changes are for the better or the worse. The yellowish areas seem to slough off and then there is white showing through and all seems to seem better... then yellow will show up again and a little more seems to slough off. Is that a familiar pattern to you. I am just not sure but think I need to start making a plan to respond or if possible start to see a doctor to get an opinion.

Customer:

I will send yyou photos in the morning if that is ok

Customer:

Do you know of anything I can take to help this condition, ..vitamin wise or other?

Dr. Rick :

I can show you how to upload them easily here if you like.....

Dr. Rick :

Save your picture on your computer, someplace easy to find it such as your desktop.


Go to www.tinypic.com


Upload your picture to the site tinypic.com by browsing for it as directed.


Once you do that it gives you a bunch of links you can use, one of which says "direct link for layouts" It is important to use this box. It is the forth one down from the top of the page.


Copy the link from inside this box and then paste it into your justanswer dialog box and send it to your expert.


 

Customer:

Sure, except I am on a work computer and the photos are on my lap top

Dr. Rick :

ok....no problem.

Dr. Rick :

So, am I correct in assuming that you are on the West Coast?

Customer:

Yes

Customer:

I have a small bus and was up late, paperwork

Dr. Rick :

Are you North, South or?

Customer:

North

Customer:

Thank you for your time and thoughts.

Dr. Rick :

The yellowish stuff that keeps coming off may be inflammation tissues and/or thinning sclera....hard to tell

Customer:

:)


 


 


That sounds like it may be 'kinda' good news


 


 

Dr. Rick :

My pleasure. Even after you hit "accept" this thread will remain open and you can uplink your pictures. Are you near SF?

Customer:

It is interesting because the yellowish areas are right exactly at the ends of a few viens that popped up after the surgery

Dr. Rick :

hmmmmm.....could be cholesterol etc leaking out of the damaged,new blood vessels. That would not be all that bad. Beats the other option which is the wall of your eyeball melting away....

Customer:

It is almost like the veins are putting off some substance or something. It is exactly the same and in the same exact place on the inner corners of each eye. I almost thought that there could be something being depositing there.

Dr. Rick :

could also be "scuz" (technical, medical term) from dryness, hence your doc's recommendation for punctal plugs

Dr. Rick :

If you want I can give you some names of docs for a second opinion on treatment options should it come to that.....

Customer:

Well, my eyes do not seem that dry however anything is possible

Dr. Rick :

True....

Customer:

That would put my mind at ease, and getting a second opinion cannot hurt. Besides, I need to have someone look into placing the plugs if that is a correct step.

Customer:

I did have several tests done before and after surgery that indicated no dryness or prssure problems, etc. Everyhting was in normal range.

Customer:

Do you know Dr. Boxer Wachler?

Dr. Rick :

Plugs are easy to place, any ophthalmologist can do if for you. I went to UC Davis a long time ago......what major city are you near and I can try to get a name or two for you.

Dr. Rick :

Ya.......nice web site.

Customer:

My late father went to USD. I am near Anchorage Alaska.

Dr. Rick :

Nice area to live.

Customer:

I have good insurance however an not opposed to spend money. My eyes are dear to me.

Customer:

Alaska is fun.

Customer:

Do you live in the west?

Dr. Rick :

Northern Wisconsin, not far from Lake Superior.

Customer:

I have never been there. I am sure it is beautiful. Anyhow I know your time is worth more than I am paying you, so please tell me what you want me to do next.

Customer:

I really do want to see the most experienced doctor I can find, and will travel.

Dr. Rick :

This guy seems to be the only cornea/external disease specialist in Alaska:

Dr. Rick :

He would be a good person to see for a second opinion.

Customer:

Perfect. Thank you so much. I will contact him and see him at his earliest convenience.

Dr. Rick :

Don't worry about it....I do just answer because I enjoy it, I make my Wife work to pay the bills lol!

Customer:

Perfect!! She probably does not mind...Lol

Dr. Rick :

OK. If you have a chance drop me a note and let me know how things turn out.

Dr. Rick :

I

Customer:

You are a gem. Keep up the good work and thank you again for being so generous. I will drop a line and let you know, for sure. Julie

Dr. Rick :

I'm trying to get her to start a second job. Heck, after dinner is served and the dishes are done, say around 6:30, there is still plenty of time to work at a second job, say from 7pm to 1am, before going back to her day job.....but, for some unknown reason, I''m meeting with a lot of resistance on this issue. :o)

Dr. Rick :

My pleasure. I hope thing improve for you soon.

Dr. Rick :

And, now, the obligatory word from our sponsors: :o)


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Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7921
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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