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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7755
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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Part 2 After reading that I am possibly blind forever. What

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Part 2
After reading that I am possibly blind forever. What is the "WORST" risk of having a surgery if I am possibly blind anyway? I mean is it a risk because I might go blind or is it a risk because it might make the blood vessels bleed again?

Last question, originally they said I had 20/50 in left eye --now it is "HM @ 2 feet" and my right eye vision has gotten worse (20/20 before and now 20/25. My question is, does your right eye try to make up for left eye (blurry peripheral vision on left and right) The reason I ask is at this rate it will take until July 2014 before the blood goes away and puts a scar on the inside of my eyeball and I am wondering if the vision will continue to decline every 6 weeks until 2014 rendering me possibly blind in my right eye?

Sorry one last question: What does this mean?
"Periphery Left: Pavestone at 2 o'clock. 360 SDE attached, VH and I know what Mac Scar means.

I am so sorry for what probably appears to be a book but I was reading your questions to others and thought I would try to answer you questions your normally ask while asking my probably too many question; however, I am desperate as all of this does not fell right to me (to be released on a watch and see every 6 weeks). Your help/ opinions would be greatly appreciated!!!!!!!!!
Sabrina, in North Carolina.
Submitted: 10 months ago.
Category: Eye
Expert:  Dr. Rick replied 10 months ago.
Hi Sabrina,

I'm Dr. Rick and I have two decades of ophthalmology experience. I'm online and happy to answer your question today. I am a retina surgeon.

I am unable to access "part 1" of your question. Could you please summarize what that issue was?

What surgery are you scheduled to have?

Let me address the other issues you have posted:

1. Having poor vision in one eye almost never causes the vision in the other eye to go bad. You do not have to worry about going blind in your right eye. Also, vision can vary from test to test and just because you read 20/25 on your last exam doesn't mean your vision is actually getting worse...you just might have been having a bad day...

2. Pavingstone is just a common clinical finding of small, rounded areas of pigment loss and retinal thinning. They are typically yellow-white in color, frequently show the underlying choroidal vessels, and often possess a dark margin. They do not put you at risk for any ocular problems or a retinal detachment. I see them almost every day in my office....nothing to worry about.

The next term says that your retina is attached all the way around. VH stands for vitreous heme (blood inside your eye)

Does this make sense to you?



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: replied 10 months ago.

Hi Again,


I don't know what happen to part 1; I hit the 5000 limit and submitted. Unfortunately I didn’t save a copy so I will try to gv a summary again.


Background:


07/26/13 I had a ruptured Retina Arterial Macro Aneurysm in my left eye. The retina specialist did the dye to see how much blood was in my eye. I had so much blood, it wouldn’t show any arteries to tell where the bleeding was coming from. I also had a lot of fluid in the bottom. They said I was too bad for surgery due to large volume of blood and my only hope to get my vision back was Avistan shots which I recv’d on Monday 07/29/13. He said normally shots are every 30 days but w/ my volume of blood he wanted me to wait 6 weeks.


 


09/09/13 I went for f/u appt. I was so excited to tell him that light went into my eye 5 days earlier and I got slight amount of peripheral vision on left and right. Vision is blurry w/ 2 eyes & I hv to close left eye 95% of the time due to light hurting and this is the only way I can focus to see detail. (My right eye has far/near sighted & astigmatism w/ 20/20 vision).


 


He was so upset when I told him about the light, he thought my retina had detached. He looked at my eye and said "You have “FRESH” blood." He took a needle thing and pushed my eyelids down to the very bottom all the way around. When I tried to question him about the ‘fresh’ blood, he ignored me or changed the subject every time. (He also didn’t document this in his medical records!). He immediately told me originally the aneurysm burst behind my retina. Now it has jumped into my eyeball and there was already a scar forming; therefore, I couldn’t have injections and surgery to remove the scar or the large amount of blood was too risky. He said less than 20% of the blood was absorbed & it was going to take months to go away; roughly until July 2014. Then I was shocked when he technically “released me” WITH FRESH BLOOD STILL IN MY EYE. He said we now have to play watch and see what the blood does by an appt. every 6 weeks.


 


Today I got a copy of my records & I ended up w/ more questions that is bothering me.


 


My questions were:



  1. When revw’ing the records I am taking the below comment to mean I’m basically blind: “She has a large ruptured Retinal-Arterial Macro-aneurysm with both pre & sub retinal hemorrhage. The blood has traversed into the vitreous cavity as well as forming a macular scar centrally.

    1. What is the WORST RISK you can have with trying to remove a large amount of blood from my eyeball? Is it the fact that I might go blind? If I am basically blind already, what is the difference? How can the surgery be a risk?

    2. Or is it a more serious risk such as my layers of blood vessels might start to bleed or something worse?


  2. I was wondering if I had ANY bleeding in or behind the eye, is there any way possible the bleeding could hv went into my brain?

    1. I am asking this because I started noticing speech problems before this happened but it has gotten worse after this happened. For example I mixing up words like Canky Yandles, I hv to “think” before I can remember the word I am trying to say & I start trying to describe the word I’m thinking should go into my sentence. Then I am using the “wrong” word when I KNOW what I’m trying to say. For ex. tonight I tried to ask the time; I knew the word I was trying to say but I ended up saying door, TV & stove before my son stopped me and sd you mean microwave. Maybe it is because I'm stressed but I feel this is NOT normal and would like to know if the aneurysm could have possible affected my speech although it was not in my head?


  3. I read your other comments and noticed you told a guy after he had surgery do not bend his head down. I have done this and it caused MAJOR pressure over BOTH eyes/ forehead}

    1. Would this apply to me even though I didn't have surgery?

    2. When I bent my head down those couple of times, did “I” make the blood flip into my eye?

    3. Can the blood possibly flip back behind my retina and how will I know if it does?

    4. I’m asking because I was kicked in the eye by my 35 lb g/daughter w/ her entire heel fitting into my left eye and slammed my head sideways while she was sleeping with me on the bed. (That was a one-time sleeping on the bed as I sleep in a rocking chair). She hit me 2 days after my f/u visit. Could she have knocked the blood back behind my eyes? If so, could that mean I will be waiting 6 weeks with bleeding behind my eye and no one would know until it was too late or please let me know if I am worrying over nothing?


  4. You also said to keep head still (I don’t) and don’t pick up heavy objects that will strain your eyes. (I pick up my 30lb dog & I strain because I'm weak with Carpal Tunnel.)

    1. I was told that I could go back to work, do anything I wanted to do; I had NO restrictions. I tried to tell them I left work for my emergency vision appt. because I couldn’t see the computer. When I again tried to explain I work on a computer for 8 hours straight with only a 30 minute lunch to sleep due to constant migraines. I told her it was a strain on my eye. She said working on the computer will not hurt you and go back to work. My question is, if your eye is full of blood, w/ both of your eyes open it makes things blurry & you hv to close your left eye to focus on detail which make your eyes are hurting from straining, is this a standard comment everyone gets in my situation or would you recommend a 2nd opinion?



Sorry I wrote a book but I wanted you to hv all information. Thanks for answering the other 2 questions; however, if you feel this information changes your original response, please let me know that also. Thanks!


Sabrina

Expert:  Dr. Rick replied 10 months ago.
Sabrina,

Today is my wife's birthday and we are heading out to dinner. I noticed your posting just now. I hope you don't mind if I don't respond until I get home from the festivities......
Expert:  Dr. Rick replied 10 months ago.
Sabrina,

Let me go through your points in order:

1. I would not remove the subretinal blood as that really doesn't work well. If the vitreous heme does not clear that can be removed easily with a standard vitrectomy. All surgery has risks, so I'd just give it time to reabsorb on its own.

There is a risk of re-bleed, but it is not that large so I'd not worry right now.

2. There is no way at all that the bleeding spread into your brain. The speech issues have nothing to do with the bleeding in your eye, nor does the bleeding in your eye increase the risk of bleeding in your brain.

3. You should try not to bend over just to allow the blood to settle inside your eye. You have not done any damage at all by bending over. The blood will not flip around or behind your retina just because of how you bend over or move your head. But I would hold off on your boxing lessons for a bit ;)

You daughters foot did no damage. You are worrying for nothing....

So what is the take home message? Try to relax. The best thing you can do at this point is give the blood time to reabsorb and your eye to heal and continue to follow up with your eye doc as you have been.

From what you have posted, it sounds like you are in good hand.

Whew! My fingers are all wore out from typing...time for bed :)

Does this make sense to you?


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
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7755
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Customer: replied 10 months ago.

Hello there,


I hope you and your wife had a great night out and she has enjoyed turning 25 again. :)


 


I would like to say thank you very much for your excellent feedback. I appreciated the outside opinion as I have been going crazy with no sleep for the last 40 hours because of these issues. You have taken so much off my mind, I now feel like I can breathe again and stop stressing out over all of this.


 


I bet your fingers ARE tired after that thoroughly detailed explanation and I made sure to give you $20 tip.


 


Thanks again for everything, you have taken a biggest LOAD off of me. I now know to not bend my head over and appreciate the heads up on that piece of info. I promise I'm going to hold off on my boxing classes for a little while longer. (-:)


 


I can't say thanks enough. Now I can FINALLY go to sleep. I hope you have a WONDERFUL day when you read this in the morning and I appreciate the information you have shared. This is honestly the best website EVER!!!!

Customer: replied 10 months ago.


I apologize, I didn't know how to give you a tip so I edited my original $48 to $68 for the $20 tip.

Expert:  Dr. Rick replied 10 months ago.
Sabrina,

I am glad that I could help. I hope that your retina heals and your vision gets better soon.

Let me know if there is anything else I can do to help.

Dr. Rick

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