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Dr. James
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2286
Experience:  Eye Physician and Surgeon
20222826
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For Dr.James ,presuming you will remember me. Last contact

Resolved Question:

For Dr.James ,presuming you will remember me. Last contact about 5 days ago, since then I'd like to bring you up date and get any suggestions/recommendations you would care to make. Do you have the past e-mails regarding my "case"? Retina detachment surgery 21Feb10. Consisting of a bubble,laser,and buckle repair. Last visit to my surgeon showed a reading chart 20/40 in my right eye,improved in a week from 20/60 and in two weeks from" zip." Heres status now in the form of my "complaints" ,fears, or concerns. All have been mentioned to my Doctor who again does not seem bothered at this point. At night all lights have a high glare/stare effect,as I had with the cataract before it was removed. Indoors it is the same a star effect. 2) If I look at the TV screen with my left eye (normal eye) and the close that eye and look at the same tv,same distance,same channel, same position,screen seems smaller and further away and moved right. I have additional questions -continued when driving and using my right eye only ,depth perception ,lane markers road shoulders etc. are not where they seem to be. Side vision not improved all that much. I must admit I am really really worried. Mind games? Do you suggest a second post- surgical opinion? Next appointment this Thursday. Please answer at you convienence.
Submitted: 7 years ago.
Category: Eye
Expert:  Dr. James replied 7 years ago.
Hello,

Yes, I remember your question. First a few questions.

Do you still have a gas bubble?
Have you been checked for a new glasses prescription?
Have you had any additional tests done since the surgery? OCT?
Have you had a laser done after the cataract surgery to remove scar tissue behind the implant?
Was there still gas in your eye at the last visit?
Customer: replied 7 years ago.

Sorry about delay,just opened response. 1) As of last visit (April 1) gas bubble still present. It appears in my eye (to me) as a dark 1/2 moon. 2) No other test done other then routine eye chart , "slit lamp" exam. 3) No laser on cataract after surgery which was 5/26/09.Please address the issue I mentioned about depth perception, distance and shape differences etc. Will this return to normal? As a matter of fact can I expect a return to normal (corrected) vision?

Expert:  Dr. James replied 7 years ago.
At night all lights have a high glare/stare effect,as I had with the cataract before it was removed. Indoors it is the same a star effect.

This can be due to increased scarring of the membrane behind the lens implant. This commonly happens after routine cataract surgery and can be accelerated after subsequent surgery. When you see your doctor again, as him if the glare is due to a "PCO".

The glare can also be due to light scattering through the gas bubble. It should be nearly gone by now.

2) If I look at the TV screen with my left eye (normal eye) and the close that eye and look at the same tv,same distance,same channel, same position,screen seems smaller and further away and moved right.

This can be due to a change in the refractive error of the eye. The scleral buckle is a plastic band that cinches around the middle portion of the eye. The pressure exerted can sometimes cause the eyeball to shorten or elongate, thus causing causing things to look smaller and further away.

The image being moved to the right can be due to two things. Your eyes can be misaligned causing this double vision. The scleral buckle is passed underneath the eye muscles. Because of the close contact, it can sometimes cause misalignment of the two eyes. Another possibility could be the retina itself has moved. The goal of the surgery is to redrape the retina back against the wall of the eye.

I have additional questions -continued when driving and using my right eye only ,depth perception ,lane markers road shoulders etc. are not where they seem to be. Side vision not improved all that much.

Depth perception using one eye is definitely different. This is a something that your brain has to adjust to. It is important to know your limitations and drive carefully. As the other eye heals from the surgery, then you should regain your depth perception and binocular vision again.

Will this return to normal? As a matter of fact can I expect a return to normal (corrected) vision?


It is difficult to say how much that eye will return to normal. It is encouraging that your vision was 20/40 even with a gas bubble. It is important to ensure the gas is all gone, perform a YAG capsulotomy if there is scarring present behind the lens implant, and recheck your glasses prescription.
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Customer: replied 7 years ago.
DR. JAMES DO YOU RECOMMEND A SECOND EXAM /OPINION AT THIS TIME?
Expert:  Dr. James replied 7 years ago.

I would wait to see what your doctor says at your appointment this week. You are still in the healing phase of the surgery, so most doctors would be uncomfortable offering a second opinion at this time, especially if they were not involved in the surgery.

I'd recommend you push your doctor for clear answer, similar to the questions you posed to me.
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Customer: replied 7 years ago.
I have read your answer and will discuss all my concerns with my Dr. I am sure you will hear from me again. It is now starting seven weeks from the date of surgery and I feel I should be MUCH FURTHER ALONG/IMPROVED.