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Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3343
Experience:  Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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I am writing on behalf of my 68 year old father. He had a

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I am writing on behalf of my 68 year old father. He had a trabeculectomy procedure approximately 4 weeks ago for glaucoma. It was initially very successful with vision better than prior to the surgery, pain present but able to be managed and no infection. He followed the after care instructions to the letter and wore the eye shield for 8 days although advised to wear it for only 7 days. On day 11 post operative his eye was itchy and during the night when he was a sleep he unknowingly rubbed/scratched his eye. He had no vision in that eye on waking and 2 weeks later still has minimal vision (sees some colours/movement).
His specialist has not explained the extent of damage to the eye / trabeculectomy procedure although the loss of vision is obvious. He was prescribed more steriod drops (to minimise scaring I would imagine), told there would be some improvement with time, and then advised to return for medical review in 4 months.
Is this the most appropriate treatment plan?
What questions should my father be asking his specialist?
What are the chances of recovery from this current status?
Would there be an option for further surgery to improve this situation?
Thank you.
Hello and thanks for your question. I'm online now and will be responding to your questions as you read this
Customer: replied 4 years ago.

Thank you, ***** ***** forward to your response.

I will be on and off line throughout the day. So I will check back later.



Let me start with some initial observations. It is a fortunate thing that your father had initial improvement with his vision after the surgery compared to prior to the surgery; however, this surgery is not meant to improve the vision so this improvement in vision he saw can only be viewed as serendipitous.
It would be difficult for me to define exactly what happened to his eye based solely on knowing that his vision was severely diminished after rubbing it and that it is still diminished.  However, what happened to him could represent anything from a large corneal abrasion to collapse of the space between the cornea and Iris causing significant swelling in the cornea to the raising of eye pressure, causing permanent damage to the optic nerve.  Unfortunately, without being able to examine his eye I'm afraid that my answers to these questions would be no more than supposition. However, I can suggest questions to ask and can comment on these scenarios I've described. Stay tuned for this information.
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I would recommend asking the surgeon what problem your father has with his eyes that caused his vision to be abruptly worsened. I would then ask the surgeon's opinion about whether this problem is reversible, and if so how long he would expect the problem to take to reverse itself and also whether he feels the vision would come back once this reversal took place. If he does not feel this is reversible, then I would ask what can be done to improve the vision and what is his overall prognosis because of this problem.
If the abrupt change in vision were to have occurred because of a corneal abrasion, I would have expected this to have resolved by now. If the space between the cornea and Iris collapsed causing swelling to the cornea, I would expect that this would take longer to resolve, possibly several weeks; however, some people's corneas cannot overcome that swelling insult and the swelling may never go away without a corneal transplant. If the pressure were to have raised significantly causing optic nerve damage, then it's possible that the vision doesn't improve. Does all this make sense?
Does this information help address your concerns? Do you have any other concerns or questions about this topic?
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My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor. Thanks for your inquiry!