Tag Archives: detached retina

Back to Addenbrookes for my scheduled checkup.Their waiting times have not improved (worst luck), the clinic waiting room was packed solid. After the initial excitement of having my vision test, dilating drops, pressure test, then some retinal scans and photographs it was then back to the chairs for a overlong wait. All in, I was there for over 4 hours, 3 of which were waiting.

Anyway, eventually I was called in to see one of Mr Newman’s team and the good news was that he was happy with the surgery and how my eye had healed. I had good scar tissue and the retina was nice and flat, it’s just a question of waiting for a bit longer for the healing process to complete (plus I still have 2 weeks to go with the eye drops).

We had a discussion about the cataract in my right eye and he has now put me on the list for that to be done. Hope I don’t have to wait too long.

I’m posting the following tale in case anyone who has been similarly afflicted is reading this blog, is wondering what happens to their gas bubble and what happens after it goes away,

So yesterday (7th October) my gas bubble had gone. As I’ve mentioned previously the bubble gradually shrinks over time and (because the brain sees everything upside down) the “horizon”, above which one can see, gradually works its way downwards towards the bottom (top) of the eye. As it gets smaller one sees a curve develop and, finally, it ends up as a spherical, almost opaque, bubble, getting smaller until one realises it has disappeared completely.

Ok. Phew. It had gone. I’d passed a significant milestone. Then I noticed a sort of dark area in the same place as the repair. There were also a few tiny black specs floating about which I understood from previous conversations to be debris and nothing to be concerned about. This dark area wasn’t always visible but the more that I noticed it the more I worried. In the end I caved in and tried to contact Addenbrooke’s Eye Clinic on their emergency numbers. Unfortunately I couldn’t get through. I left numerous messages to no avail. This is one area where they fall down and is, no doubt, one of the reasons why the Trust is under special measures. Eventually I decided that without an answer I would become a gibbering neurotic so I made the trek over there once more.

Once at the clinic I discovered that the reason I couldn’t contact any medics was because all the ophthalmic doctors and nurses were away on a training day. Unbelievable! The unhelpful receptionist did her best to fob me off but I’m a persistent chap when I need to be. Bear in mind that all the doctors I had seen to date had emphasised that if I had any related symptoms I was to go straight back to see them. Anyway, I eventually managed to find and speak to a nurse. Under interrogation she let slip that there was an on-call doctor “for emergencies”. After some pressure from me, she asked the Doc to speak to me; what a transformation! This lady doctor was really helpful (as Addenbrooke’s eye doctors always are) and after a brief chat she stated that she would add me to her list but to be prepared for a bit of a wait.

At Addenbrooke’s, waiting is a given. On this occasion, I was prepared to tough it out. As an aside, I learnt later that this lady doctor was the only one in the clinic and had been on duty since 8am. Meanwhile, the admin staff had underestimated the number of emergency patients to expect, they had also “forgotten” to arrange for a second doctor to be assigned to cover the clinic. Some 3 hours later I was eventually seen by a different doctor – this chap had returned from his training, seen the queue of emergency patients and decided to pitch in.

Anyway, the important bit from all this was that my eye was fine. The repair had taken well and had developed good scar tissue. What I was seeing was this scarring or, more accurately, I couldn’t see it. The scar tissue meant that the light sensitive cells on that part of my retina had stopped working, hence the absence of image signals to the brain. I was told that one of two things would happen as my eye healed; either the light sensitive cells would gradually regenerate and I would get the sight back in that area, or they wouldn’t repair themselves in which case my brain would eventually learn to ignore the absence of signals from that part of the retina. Luckily the repaired area is at the extreme periphery of my retina so it won’t  impact on my overall vision.

It’s a pity I didn’t know about this before, I would have saved myself from a fairly major flap. 🙂

I found the first few days at home to be fairly unpleasant. In addition to all the eye drops, I’d been prescribed acetazolamide tablets to reduce the pressure. Fortunately I only had to take these for one more day after I got home but they made me feel quite lousy. Then I read up on the side effects of this drug. Blimey.

Once a couple more days had passed and the drug was out of my system I felt almost back to normal. My eye still looked “spectacular”. That’s my Halloween makeup sorted:

Eye - post surgery

So all I had to contend with was the upright posturing. At least I’d had experience of this before so it was manageable although I was not used to sitting still for hour after hour.

Oh, and I was to all intents and purposes pretty much blind to start with. The gas bubble completely obscured the vision in my left eye and I had the cataract in my right which made my vision blurry. There was a bit of a silver lining though: the consultant had said that, based on my last vision tests, the vision in my right eye wasn’t as bad as I thought it was. His explanation was that my brain had made use of my good eye and deliberately under-used my right because of the cataract. Now that my left eye was useless, my brain would “swap” eyes and make more use of the right one. Which turned out to be the case. So I was able to navigate around, although I couldn’t read comfortably and watching TV was a bit pointless. Published wisdom advised against using a computer screen as it would put strain on the eyes (not that I could see much anyway). I did occasionally get Siri to read web pages to me with varying levels of success. It was at this point that I discovered audio books!

I had to keep up the posturing for 10 days and, by this stage, the gas bubble had partly dispersed. By now I was just able to see “over the top” of the bubble to the extent that I could see out of the top third of my eye. Sort of.

The next day I was back at Addenbrooke’s for my 2-week post-op checkup. Everything seemed to be progressing nicely. The next time they want to see me would be in about 6 weeks by which time all the redness and swelling will have gone. They also promised to discuss setting a date to remove the cataract. Good news!

Or, Surgery Day plus one.

The day started at 6am with the usual “obs” and was followed by lots of eye drops. This was repeated at frequent intervals in between which I managed breakfast, lunch and the posturing.

Mid-morning and one of the doctors examined my eye, liked what he saw and said he would arrange my discharge.

Then just before lunchtime, Mr Newman came to get me for another examination. He checked everything out once more and said he was happy with his handiwork. New posturing instructions: the left side/right side was just for the first 24 hours (for the reason mentioned in my previous post). From now on I was to keep my head upright, this was for 10 days even if the gas bubble has not completely dispersed. This was very similar to the last time and was the best possible orientation, some patients have to keep on their side, flat on their back or, worst of all, flat on their front 24 hours a day. This time he said I didn’t have to sleep completely upright, I could sleep on a slope provided I slept with my left cheek in the pillow. (In the event, at home I found it easier to sleep sitting nearly upright).

Meanwhile I would be allowed home but wasn’t allowed to leave before they had delivered my medication to take home. Not like last time then!

Finally everything was in order and a nice nurse escorted me through the labyrinth from the ward to the main entrance where I waited for my lift home.

I must give the staff a mention, not just the skill of Mr Newman and his team but the nurses who were, without exception, lovely. It was saddening to learn, some days later, of the problems Addenbrooke’s Trust is having, the special measures, etc. I personally couldn’t fault the medical staff although I can believe the problems lie with the executive and the administration.

7.30 am on the 18th of September and I’m back at Addenbrooke’s Clinic 14.

Clinic 14 entrance

The usual sight test and lots of dilating eye drops later and I’m chatting with my consultant, Mr Newman. It’s like I’ve never been away. He’s confirmed that he needs to operate, the procedure will be similar to before. This has me worried, to be honest, because my vision in the other eye isn’t brilliant (because I have a cataract which he is supposed to be removing any time soon) and I’m worried about being a bit blind. He is adamant that the operation has to be done now, while the detachment is very small. If it is allowed to get worse that could affect the final quality of my vision whereas by doing it now he expects my vision to be as good as before. I can understand this, my previous detachment involved a large part of the retina and damaged the macula. We don’t want that to happen in the other eye.

OK, said I, reaching for the consent form. It did seem a bit weird though, there I was with good vision having an operation to save my sight in the knowledge that my vision would actually be worse afterwards (if only in the short term).

If you are at all squeamish you can skip this next bit. Today’s procedure involved incisions into the eye, draining the vitreous gel and repairing the damage using cryotherapy, then inserting a bubble of gas into the eye which would act as an internal splint to keep the retina up against the back of the eye while it formed scar tissue.

Then it was off for a briefing from one of the specialist Retinal Nurses followed by some more waiting. She then sent me off on a mission around the hospital, firstly for a blood test and then an ECG so that the doctors could ensure I was fit for general anaesthetic. Anyway, seems I passed the tests as the next item on the agenda was a checkup with another doctor who drew an arrow above my left eye. At least everyone would know what bit they were operating on.

He drew an arrow on my forehead

Finally I was moved next door into the Cambridge Eye Unit to get gowned up, meet my anaesthetist and wait for my turn in the spotlight. A lot later, at 3.30pm, they came to get me! Onto a bed, more checks that I was who they thought I was and we were off. On my previous visit they had used the Cambridge Unit’s own theatre but today I was off on a long journey up to the main theatre wing. More ID checks, confirming what Op I thought I was having, etc. then needles, etc. and…

Several hours later I woke up with the (almost) familiar patch over my eye and then we were off once more, this time to the main ward as they were keeping me in overnight. Once I’d recovered sufficiently to take in my surroundings, a nurse came in and arranged for some food and a cup of tea. Marvellous stuff! Actually quite impressed, they had given me my own room with en suite and – if I’d been able to see it – a pretty good view. Excellent!

This time, my posturing instructions were to lie on my side with my cheek in the pillow for one hour then swap over to the other side for an hour, then repeat until told otherwise. I was allowed out of bed to use the bathroom, etc. and of course once they’d removed my eye patch they interrupted my snoozing with regular “obs” (BP, temp, etc.), pain relief and eye drops. Overnight it was nice and quiet in my own room but I did wake up a few times so was able to turn over. I found out next day that the reason for alternating sides was so that the gas bubble would roll from side to side, smoothing out my retina around the area of surgery.

Four weeks ago today I was back at Addenbrooke’s being operated on for another retinal detachment, this time on my left eye. Unbelievable, eh?

Up until a few days previously, I had thought things were beginning to get back on track. I was looking forward to my next Consultant appointment to discuss removal of the cataract in my right eye. Then I began to see some floaters in my left eye – the good one – and I also thought that I could see some sort of faint object on the extreme periphery of my vision.

So, on Wednesday 16th September, I presented myself at Luton & Dunstable hospital’s eye clinic where the doctors were kind enough to see me as an emergency. Unfortunately they confirmed my fears that the eye had experienced a PVD although they didn’t think the retina had detached. They decided to perform a laser repair. The tear was at the extreme top right edge of my retina and it proved difficult to see and target the laser. That was quite an experience. Possibly the brightest light I’d ever encountered! Having said that it wasn’t painful. The treatment seemed to go on for ages but the doctor finally said he had finished. He then said he wasn’t completely happy with the result (because of the extreme location) and he asked me to come back next day so he could check whether the laser treatment had worked.

Thursday 17th, and I was back at the hospital bright and early. The doc and his boss had a good look and concluded that the laser treatment hadn’t worked: there was vitreous fluid behind the tear which was preventing the laser from sticking the retina back in place. At this point they decided that I needed to have Addenbrooke’s look at it (that’s because only Addenbrooke’s were able to perform “back of the eye” surgery). This was beginning to sound all too familiar.

Clinic waiting room

They sent off a referral to Addenbrooke’s then off I went to Cambridge. After a long wait,  a doctor from Mr Newman’s team carried out yet another detailed examination. Her diagnosis was that my retina was beginning to detach and I needed an operation. She issued me with instructions: Return to the clinic in the morning when I would be seen by Mr Newman, he would decide whether surgery was required. If it was, then it would be done the same day so the second instruction was “nothing to eat after midnight”. Great! I have definitely been here before!

Back to Addenbrooke’s for the scheduled checkup. My surgeon wasn’t available (he was in theatre carrying out emergency surgery) so, perversely, the waiting time to see his stand-in was considerably shorter.

Dr. Stand-in put my eyes through an extensive examination which, for the first time, included a super duper new laser scanner; he was pleased with my progress. He found that the anticipated cataract has started to develop, although it’s not yet bad enough to warrant putting me on the list for an op. Something to look forward to. The formation of a cataract is a pretty much inevitable consequence of the retinal surgery, it’s not a question of if a cataract forms, post-surgery, but when. Anyway, he wants to see me in six months at which time we’ll see whether it has progressed sufficiently to need treatment.

On Saturday I got to reduce the Dexamethasone eye drops down to once per day. The Timolol/Brimonidine stays at twice per day. My eye seems to be tolerating this very well, also the stitches seem to have dissolved. So I’ve just got 2 weeks more before stopping the eye drops completely and then its back to Addenbrookes for a checkup.

Back in the day – also known as “Before Detachment” – I usually wore contact lenses. I had the prescription set up thus:

Distance – right eye

Reading and things about 18″ away, e.g. computer screens – left eye.

I know that might sound a bit weird but it does work, the brain soon adjusts to it and “knows” which eye to use for differing distances.

“Post detachment” I can’t wear my contacts because I need my left eye for distance and my left lens can’t do that. Actually, I was originally told by the medics that I couldn’t wear contacts for now so it’s academic anyway. Instead, I have been wearing my “distance” glasses which means I can’t see the stuff that’s close up. To do that I can swap to the glasses with my reading prescription, so it’s not normally problem. Except for scenarios like shopping (yeah, I know, unlikely) – I can’t read what it says on the stuff on the shelves!

Of course I have to get some new glasses and I’ll probably end up with varifocals, but it’s early days; my surgeon said there’s no point in an eye test for new glasses yet. Any prescription I got now would change again within a couple of months.

At least I have an excuse ready for when my wife asks me to go food shopping. 🙂