I'm writing this blog to try to help fellow retinal disease patients who are undergoing retinal detachment and repair surgery to gain from my own experience some idea of what one patient experienced as his recovery progressed. I am not a medical professional and this blog is not intended to serve as medical advice or as a substitute for appropriate counsel from a doctor or other licensed professional. I am just one patient and my experiences may not be typical or representative of what other patients can expect. I advise you to consult a licensed and trained medical doctor for medical advice.
Nine AM Monday morning found us in the retina surgeon's office for our scheduled first follow-up visit.
As instructed, I had kept wearing the eye patch that the doctor had taped into place after the surgery. I've read that the eyelid and the eye are somewhat paralyzed during the surgery, so it is important to keep the eye patch in place to properly protect the eye for the first day after surgery. My "vision" in my right eye during the night and that morning was like a colorful abstract painting. I remember some bright blues and greens and some moving shapes, and that's all. I really had no idea what to expect in terms of vision in my surgery eye after the surgery. When the technician removed the eye patch, I was able to open my eye and look around. I basically saw a big blur in my surgery eye. I couldn't see the eye chart. I couldn't count the technician's fingers. I couldn't even see him waving his hands around. I could just see light and dark. I was a bit disappointed, but the doctor said that this was completely normal for anyone with a gas bubble in their eye. He said that I was trying to look through a gas bubble and our eyes aren't designed to see that way. He said that it would take about eight weeks for the bubble to disappear, and that I shouldn't have expectations for my vision until the bubble is gone. The internal pressure of my eye was measured and it was apparently within the expected range.
The doctor reminded me again of what he had mentioned at our first visit, that with the bubble in my eye, I couldn't fly on an airplane and I couldn't go to the mountains. The reason is that the bubble will expand in the reduced pressure, and that will cause the pressure inside my eye to increase drastically and that would be very dangerous. I had no concerns about this because we had no such travel planned.
The doctor told me that he was now asking me to change my positioning from looking downward to lying on my left side, and that I needed to position myself that way almost all the time for the next 10 days, not just the 5 days that he had mentioned at our first visit before the surgery. He said that my retinal detachment was on the lower part of my retina on my right side, toward my right temple. Because the function of the gas bubble is to push gently against the repaired part of the retina, when I lie on my left side, the bubble will rise to the right side of my retina and provide the required pressure to hold the retina in place as the laser scars heal and complete the re-attachment of the retina. He said that the very best positioning would be with the top of my head pointing a bit downward on my left side, but that that isn't practical because it isn't comfortable enough for people to maintain that position. He said that I should use as small a pillow as possible or no pillow at all in order to keep my head flat on my left side. The doctor said that he wanted to see me in a week.
We went home and I set myself up on the sofa to live on my left side for ten days. Reflections on the first week:
- My lovely wife is my helper and my partner in my recovery. She was amazing throughout my recovery, but never more so than during the first two weeks, when I had to lie on my side almost all the time. She has a full life, including being an active grandmother and helping to take care of our little granddaughters, and she also has a big responsibility to take care of her elderly mom who needs to get to lots of doctors' appointments. I was pretty self-sufficient, but I couldn't have done as good a job of taking care of myself without my wife's help.
- The doctor prescribed lots of eye drops. I was taking some drops up to four times a day. It was very helpful to have my wife put in the drops. With no vision in my surgery eye, I couldn't see the dropper tip, so when I tried putting in the drops myself, I would often miss and it could take up to four drops to finally get one in my eye! The others were wasted on my eyelid or my cheek. The drops were antibiotics, dilation drops, steroids and some others. The antibiotics were stopped after a couple weeks, then the steroid was reduced from four to twice a day to help keep the eye pressure lower. The Atropine dilation drop was stopped after 5 weeks.
- Our living room sofa is a sectional with a chaise section that has an open end with no arms or back on it. This made a great place for me to position myself on my left side facing the TV and a coffee table. Friends could come by to visit while I was lying on my side and we could visit.
- I was reasonably comfortable most of the time. But after a few days, I noticed some pain in my left hip and shoulder, the pressure points as I lay on my side. For most of my positioning time, I was always trying to find ways to reduce the pressure on those pressure points and relieve that discomfort.
- My iPhone and Facebook were my link to the world. I tried reading but it wasn't comfortable lying on my side and I wasn't sure that it was okay to read during that period. (The doctor later said that it was fine.)
- I watched TV some of the time. I watched the entire Fawlty Towers series, a favorite of mine, and some movies and other TV. But I didn't really enjoy watching TV lying on my side. It was hard to read words on the screen while lying in a horizontal position.
- I was able to nap and when I'd had a bad night trying to sleep, I would nap for several hours to catch up on my sleep.
- Sleeping on my left side was difficult for me at first. I bolstered myself with pillows and I thought that I'd wake up if I tried change position, but that didn't always work. I was used to sleeping on my right side or on my back. I would wake up often, and my wife would notice that I had rolled during the night and she would remind me to roll back to my left side. I wasn't very comfortable in bed and I often had nights without much sleep. I tried sleeping on the sofa some nights, thinking that I might be able to keep myself into position better using the sofa's back as support to help me to stay on my left side. That seemed to work pretty well, but the firm sofa cushion was hard on my painful hip.
- Overall I did a good job keeping my position as prescribed. I was a diligent and obedient patient.
- My vision during that first week was a complete blur. I was able to see light and shadow. For the most part, it looked like I was looking through a whitewashed window, but there wasn't any detail, just light and shadow. I could look up to the high windows in our living room and I imagined that I could see the lacy branches of eucalyptus trees. But then I checked with my left eye and found that I was imagining the trees. I couldn't see motion or any detail at all.
- I had a few headaches that I didn't worry about too much. The headaches responded well to Tylenol ES.
I did a lot of reading online on my phone about retinal detachment surgery and recovery. I found that I had gone into this surgery with a poor understanding of how serious and significant the surgery was. I had a pretty light hearted view of the surgery at first, probably because of my very positive experience with the laser repair of my retinal tear three years earlier. From my reading during my first week of recovery, I learned that retinal detachment surgery is a very serious thing, and that the recovery of good vision is by no means guaranteed. I also learned that the return of the best vision possible after the surgery is a slow process, taking several months, and that some improvement in vision after the surgery can take a few years. I also learned the difference between the several types of retinal repair surgery. Because I had a gas bubble in my eye and because I had heard for pneumatic retinopexy before, I thought for a while that that was the surgery that I had had. But I realized that I had had a vitrectomy with a gas bubble, not a pneumatic retinopexy. I read that a vitrectomy is usually reserved for more complex detachments than retinopexy, which doesn't involve the removal of the vitreous. After learning more about the surgeries, and especially about the recovery of vision, I found myself sobered and hungering for more information about how and why vision recovers after these surgeries.
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