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Dr. Tom
Dr. Tom, Board Certified MD
Category: Eye
Satisfied Customers: 263
Experience:  30 years experience treating patients with eye problems
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Had a recent craniotomy (10wks post op) to remove a 3.5cm meningioma

Resolved Question:

Had a recent craniotomy (10wks post op) to remove a 3.5cm meningioma from my temporal region...but also lost bone in my eye socket and had lots of bone cut away where tumor invaded the sphenoid wing.....how long before the bone heals and how long until the swelling of my eye/face on side of surgery finally goes away? My vision is still impaired...any chance it will continue to improve as swelling subsides?
Submitted: 1 year ago.
Category: Eye
Expert:  Dr. Tom replied 1 year ago.

Dr. Tom-Eye : Hi, I'm online now and would be happy to help you with your question.I understand what you are asking. Just reply and we'll get started. Dr. Tom
Dr. Tom-Eye : Please let me know when you are available to chat.
Dr. Tom-Eye :

Hi, I'm just checking to see if you received my greeting?

Dr. Tom-Eye :

Let me know when you are available to chat.

Dr. Tom-Eye :

It appears that you are typing. So I would just stand by until you are ready to get started.

Customer:

sorry for the delay, had to switch computers....my kindle wasn

Customer:

wasnt responding

Dr. Tom-Eye :

No problem take your time

Customer:

I am available to chat now

Dr. Tom-Eye :

Well, it certainly sounds like you've had a pretty rough couple of months. I understand that your primary question is....."how long before the bone heals and how long until the swelling of my eye/face on side of surgery finally goes away?"... and will get to that in just a minute. First I would like to get a little more information if you don't mind. Did you have any impaired vision for your surgery. Give me some indication of the amount of the reduction of swelling from the first several weeks until now. And please give me some idea of the degree of visual impairment you have. Such as decreased to near vision decreased for vision or double vision

Customer:

prior to the docs finding the tumor, my L eye began to swell, conjuctiva filled with fluid on several occasions, and the eye was protruding...as each day passed my vision became very blurry and the eye painful.

Customer:

more to type sorry....hit reply by mistake

Dr. Tom-Eye :

While you are finishing your response, I'm going to step away for a minute to check on another patient and will be right back to pick up when you're finished typing your response. Don't worry I'm going to stay with you until we have satisfactorily answered your question.

Customer:

the day before surgery my neuroopthomalogist ran some more tests and I remember being pretty much almost completely color blind and my eye was measured at 26 or 27mm compared to my right eye that was at 21mm....my field of vision test was full of alot of the black blotches in the lower quandrant areas, especially t he left side (although I don't know what that all means in medical terms) three weeks after surgery I saw my eye surgeon again....he told me the tumor had been pressing on the optic nerve and muscle, reason why I could not look side to side, but had not attached to it which was good. the tumor did however eat away at the bone leading into my eye socket, so they did not replace it with bone but instead said soft tissue would heal in its place. He re-examined me and I was able to see the colors/shapes on several of the pages in the color blindness test...he said I went from a 3 to 7 score on that and my field of vision test showed some improvement, but obviously not where it should be. At that point my left eye measured 21mm and my right eye 19mm, so that was good news that they were moving back into place. currently when I look thru my left eye without my glasses, I can only barely make out the top line on an eye chart....my vision mimics a camera trying to focus, with the object i am looking at steadily moving closer and further away constantly....if i strain and focus real hard, i can eventually make out only a portion of the top of what i am looking at, but the bottom remains a blur....with my glasses on and looking through both eyes, it looks like someone smeared vaseline on my eyeball it is so blurry & annoying....sometimes it looks like double vision, but not a clear double.....its confusing when i try to figure out what my eye is really doing because it strains when i put it to use too much. As for swelling.....for the first 2wks post surgery I looked like a boxer healing from a fight....my eye was swollen shut for a while, then slowly I could pry it open but would have to clean it alot becauses it was discharging fluid/gook from it.....in the last month I wake up with it swollen usually under the left eye and my cheekbone in the front of the face is a little more round, red, and bumpy but goes down within an hour....as the day progress and I am vertical I start to swell again, but this time my face/ear/gums & teeth begin to feel the discomfort too.....most days now when I feel the swelling, most people just looking at me in passing don't notice it....but I feel it and notice it very easily, especially inside.

Dr. Tom-Eye :

Thank you for that excellent background. It sounds as if you have had excellent evaluation, surgical care and follow-up. Your improved color vision, reduction in proptosis and what is likely some improvement in your visual field is extremely reassuring. All of your presurgical symptoms fit pressure on the optic nerve as opposed to invasion of the nerve by the tumor. Your observation that ' it looks like someone smeared vaseline on my eyeball " is consistent with the relative optic neuropathy you had. There is still time for improvement. And when the time is right, you should get an up-to-date refraction, meaning a new eyeglass prescription. It's certainly possible that a change could have occurred. And remember around age 42 we all start needing slow increases in our requirements for reading vision. As far as the swelling that you mentioned, given that most people don't notice it is also very good news. If no one else has recommended it, consider sleeping on a couple of pillows with your head elevated to about 45 degrees. You had a lot of comments, which I really do appreciate, but I want to make sure that I've addressed your specific questions. So please let me know what else we can go over in our chat?

Dr. Tom-Eye :

It seems that we have become temporarily unconnected. But I'm standing by to hear from you.

Customer:

Thank you, XXXXX XXXXX definitely reassured me about my eye.....I was hoping down the line if my vision is still poor that a new prescription might be possible to correct it....I don't go back until march for my eye follow up with the surgeon, so in the meantime I am finding ways to adapt my activities. Do you have any idea of what is a reasonable time to wait before we accept my vision where it is at and get a new prescription? Aside from my vision issue, I pretty much am curious to know how long the healing process is for all the bone that was damaged/cut through in my surgery and should I expect this swelling much longer (i do sleep elevated periodically to help, they taught me that in the hospital)

Dr. Tom-Eye :

Regarding your question about the reasonable time before the refraction update, March would be perfect. As I'm sure your neurosurgeon explained, the healing process for the surgical entry to remove the meningioma takes several months, and it sounds like you are on schedule with this. And that also relates to the residual swelling that you are experiencing. One of the old standbys for improving slow improvement in swelling, particularly when it is intermittent as you describe, is the application of warm, moist heat compresses. In the course of my years in this specialty, and followed many patients following them meningioma surgery, it certainly sounds like you are progressing normally, and at this point you have good reason to expect continued improvement. Please let me know if this covers everything you need at this point. If it does, thank you very much for allowing me to help you today, and I hope you have a very successful, and healthy new year.

Customer:

Thank you very much for your feedback, which definitely makes me feel reassured at this point.....I guess the most difficult part of the whole recovery thing is that it seems that everything takes "months", but no specific time frame (no fault of your own of course)...I was just trying to see if miraculously I could get a better handle on how long this whole thing would take since I am a teacher out on disability and with the slightest improvements everyone expects me to go running back to work, but I know that what I am experiencing inside and with my vision, etc. leaves me unprepared to return to my normal duties and it stinks :(

Customer:

I wish you a wonderful New Year as well :)

Dr. Tom-Eye :

Thank you very much. Now the last thing is for you to click on one of those smiling little faces. And remember you can always come back if you need any follow-up.

Customer:

Okay, will do....thanks again!

Dr. Tom, Board Certified MD
Category: Eye
Satisfied Customers: 263
Experience: 30 years experience treating patients with eye problems
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