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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7367
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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Hi ! I have recurrent central serous retinopathy bilaterally,

Resolved Question:

Hi ! I have recurrent central serous retinopathy bilaterally, additionally my left eye has had a central neovascular bleed 13 years ago before anti VEGF injections, had laser to the macula area and I have no central vision in that eye. My right eye had a retinal detachment off the macula (scleral buckle) in 1996 leaving me now with 20/300- corrected in the right eye. In the past few years, I have been developing a cataract in my right eye which is now 'significant,' Although cataract surgery is low risk, given there is some risk, and given my situation, I am holding off. I met an MD turned ND (naturopathic) who told me about n acetylcarnosine drops (Can C) which I have using for 10 weeks now in an attempt to dissolve the cataract. I know that this might be for naught, but I am willing to give it the 6 months to see if I can avoid the cataract surgery. Here is what I noticed yesterday: as I tilt my head down (no squinting) towards my chin, the top ~10% of my view from my right eye has both more color contrast and improved acuity. My feeling is that this is not retinal, but cataract and my best guess is either that the drops are beginning to work in that 10% area or that my cataract is getting 90% worse. Any thoughts? Thank you.
Submitted: 11 months ago.
Category: Eye
Expert:  Dr. Rick replied 11 months ago.

Dr. Rick :

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

Dr. Rick :

I am a retina surgeon. Thank you for your informative post.

Customer:

Hi there ! I jsut re-checked, it is more like 50% when my iPad eye chart program

Dr. Rick :

I have to let the dogs back in.....be back in a second :)

Customer:

I know how that goes - I'll be here

Dr. Rick :

Ok. I'm back. Let me re-read your post closely....

Customer:

Sure

Customer:

I'm no stranger from retina docs

Dr. Rick :

I can see that...

Dr. Rick :

I am sorry to hear about all the retina problems you have had over the years and I can fully understand your desire to do anything to avoid another eye surgery.

Dr. Rick :

That being said, after over two decades of practicing retina surgery and, by my work in fixing retina problems, causing thousands of cataracts to form I can tell you that Can C drops will not improve your cataract at all.

Customer:

That comes as no surprise

Dr. Rick :

I have had many patients over the years try them and they have never worked.....also, physiologically it is impossible for a drop to get to the the lens and reverse the biological, chemical changes in the lens matrix that cause a cataract.

Customer:

So what is causing this difference between top and bottom view acuity?

Dr. Rick :

But, that being said, the company does a great job of advertising their product and they do make a good profit selling it.

Customer:

I fully understand

Dr. Rick :

I believe that you have found a clear spot in your cataract. This is very common as the cataract, many times, has clear spots in it

Customer:

Retina doc told me to hold off and that I would come toh im when the time is right for me. Told me that protocol now is one anti VEGF injection 10 days before cataract surgery. Any decrease in vision post-op is a game changer

Dr. Rick :

That being said, it will not hurt you at all to give the drops a try.....If anyone deserves to have Can C work, it is you after all your retina's have gone through :)

Customer:

So maybe it was always there, and I never noticed it before?

Dr. Rick :

He is right. In your case I would consider avastin pre op, although there are, of course, risks to the injection......nothing in life is free.

Dr. Rick :

That is exactly what I think is going on.

Customer:

Yes, he and I became close and I am aware, which is why I am holding off. Before my cataract developed, right eye was 20/200 so , of course I also do not know if 20/300- is due to cataract or retina, and neither does he.

Dr. Rick :

And your retina doc is correct....there is no rush to remove the cataract. Waiting will not harm your eye in anyway at all.

Customer:

and when he looks at the OCT pics, he remarks, "If I was looking at your right eye for the first time and did not know your history, the picture looks like a normal retina"

Customer:

But he is not seeing it histologically, I guess

Dr. Rick :

As you know, sometimes it is hard to tell where the new decrease in vision is from but, if there is new lens changes and the retina looks the same, it is probably from the cataract.

Dr. Rick :

It sounds like you are getting excellent care.

Customer:

I am very fortunate that although my retina detached in Mexico, and was off the macula 2 days later in Boston, I had a great retina surgeon then

Dr. Rick :

That is why it is so important to have a doc that knows you....and a histological exam requires removing your eyeball....not worth it for the new data obtained in the process lol!

Customer:

Yup. I took my anatomy courses years ago :)

Dr. Rick :

There is some University in Boston....I think it starts with an H....supposed to be pretty good ;-)

Customer:

I went to Mass Eye and Ear, Schepens back then ... now live in Florida

Dr. Rick :

I have family in West Palm Beach.

Customer:

15 minutes away

Dr. Rick :

The internet make the world much smaller, eh?

Customer:

yup. I play online chess with a 'friend' in Austria. It still atartles me

Customer:

startles

Dr. Rick :

What are our Grandkids going to do? Play chess with friends on Mars?

Customer:

Yes, but they might be able to walk over to their house, it seems

Customer:

Where do you practice?

Dr. Rick :

Northern Wisconsin. My new, hungry, young partner and I are the only retina docs in over two hour drive in any direction.

Customer:

Good! Let him travel !

Dr. Rick :

Let him have the practice so I can live off my wife!

Customer:

There does become a time to quit

Dr. Rick :

And it is rapidly approaching. I would like to be retired in less then two years....just gotta get the new guy up to speed and help him afford buying me out.

Customer:

I highly recommend it. It happened to me at age 44 for the above reasons. Horrific when I was forced into retirement, and later to stop driving, but the new lifestyle is very relaxing

Dr. Rick :

He was away from the practice last week for a family issue and I was quickly reminded that I no longer want to work that hard. 11 surgeries, one macula on RD in the middle of the night......too much work.

Dr. Rick :

What did you do at 43?

Customer:

Practiced Dentistry for 20 years, moved here, back to school, now a part time psychotherapist

Customer:

It's the Type A that got me CSR in the first place at age 32

Dr. Rick :

My dad is a general DDS, my uncle is a general DDS and my other uncle is a peridontist.

Customer:

what cities?

Dr. Rick :

Chicago.

Customer:

I know a retired dentist from Pekin, but no one in Chicago

Dr. Rick :

I've never had a cavity. My dad used make me "try out" the new fluoride flavors when he got samples :(

Customer:

Anyway, what are the percentage risks of cataract surgery decreasing my vision?

Customer:

Systemic fluoride was a real game changer in the 70's

Dr. Rick :

Based, of course on the limited data of your post and our brief chat, and with modern cataract surgery, low, less then 1%

Customer:

Oh good, I was never in " the 1% anyway" :)

Dr. Rick :

and I had all the, some pretty horrible, flavors

Customer:

Don't hold it against your Dad, jsut his dental sales rep

Dr. Rick :

Me neither.....to be in that group you have to be in Upper Mgmt of places like Enron.

Customer:

Before they went bust

Dr. Rick :

And that was in the days when you sat with the trays dripping down your throat for 20 minutes with the suction trying to keep you alive.

Customer:

Maybe you're right - you should hold it against Dad still

Dr. Rick :

Excellent plan :)

Customer:

but having a buckle under local is no picnic either

Dr. Rick :

No. I suppose not, although from my side of the table it's not too bad ;)

Customer:

My Ob-Gyn brother says it best: "I don't want to be a patient"

Dr. Rick :

I would not do well having the things I do to others done to me.. "hold still, while I stick this needle in your eye and try not to mess everything up..."

Customer:

I can tell you similar feelings about Dentistry but that's another topic :)

Dr. Rick :

I remember when my dad switched over from string drills to the high speed air drills...and stuck the drill through a patients cheek.......couldn't do that with the old technology.....

Customer:

there's a lot to be said for pen and paper, rather than technology

Dr. Rick :

truth.

Customer:

well, enjoy your Sunday and thanks for all

Dr. Rick :

My pleasure. Nice chatting with you and I wish you the very best.

Dr. Rick :

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS

Customer:

Thank you ! I hope your retirement plans go smoothly, as well

Dr. Rick :

and that they go soon ;)

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7367
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Expert:  Dr. Rick replied 11 months ago.
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