Scleral Buckle Surgery for Retinal Detachment

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Scleral Buckle Surgery for Retinal Detachment

Scleral buckle surgery has been instrumental for fixing retinal detachments for over 75 years. To me, this means the surgery inherently "fixes" the problem of retinal detachments.

A scleral buckle is one of several ways to “fix” a retinal detachment. Other ways include vitrectomy eye surgery as well as a combination of scleral buckle and vitrectomy.  An office procedure, called pneumatic retinopexy, is sometimes used as well.

Scleral Buckles are “Oldies But Goodies”

The scleral buckle has been employed for about 75 years.  The principle behind a scleral buckle is to cause the shell of the eye, or sclera (the white “wall” of the eyeball) to indent, or “buckle.”  The most common way to achieve “buckling” is by oversewing a thick piece of silicone rubber or sponge around the eye or encircling the eye with a silicone band and pulling it tight (same as a belt “buckle”).

The longevity of the scleral buckle implies, at least to me, that it is inherently very good surgery.  It corrects the principal problem – relieving “pulling” on the retina.

A Scleral Buckle is Placed to Repair a Retinal Detachment

The Scleral Buckle Reduces the Diameter of the Eye (Yellow Arrows)

Pretend You Are Sitting inside Your Eye

The result of any scleral buckle  is to reduce the internal diameter of the eye.  In doing so, the vitreous can no longer pull on the retina.  The cause of a retinal detachment is a retinal tear (or retinal hole).

For example, suppose the room in which you are sitting is the eye and you are the vitreous.  The wallpaper of the room is the retina.  Stretch your arms apart and pretend you can reach from one wall to the other.  Your fingertips are glued to the wallpaper.  This is how the vitreous adheres to the retina.

If you move to the left, your right arm now pulls on the wallpaper (or the retina) and you cause a tear on the right side.  Similarly, if you move to the right, you create pulling, or traction, on the left wall and cause a tear.

By placing a scleral buckle around the eye, the internal diameter is reduced.  This would be the same as moving the walls of the room closer and, as a result, your arms would bend and create slack in the “vitreous.”  You could move left or right with less pulling on the wallpaper, and less likely to cause a retinal tear.

Same with the retina!

“Side Effects” of a Scleral Buckle

Side effects, or possible complications, of scleral buckle surgery include;

  • increased myopia (you will be more nearsighted) – due to the increased length of the eye.  There may also be a large change in the refraction due to astigmatism.
  • double vision – uncommon, but the buckle is placed outside of the eye and underneath the eye muscles.  By manipulating the eye muscles, double vision is possible.
  • pain – usually not an issue and is usually (in my experience) amenable to Tylenol/Advil.

Fun Facts About Scleral Buckles

  1. The eye is not taken out.  We wouldn’t be able to put it back in.
  2. The “buckle” is usually made of silicone rubber (different than silicone oil) and has no known systemic side effects.  It can also be made of a silicone sponge material.  These, too, are safe.
  3. The “buckle” is intended to be permanent.  At times, it may extrude, but it is very uncommon.  The buckle only really needs to be in place for a couple of months, but we usually never plan on removing them.
  4. Some surgeons use metal clips to help fasten the buckle around the eye.  This can be a problem if future MRI’s are needed.

What Does This Mean?

Though “old,” scleral buckles are not obsolete.

There has been a shift in practice patterns among retina surgeons over the past 15 years.  About 15 – 20 years ago, pneumatic retinopexy was first described (aka invented).  Scleral buckles with vitrectomy became popular in certain areas of the country and, more recently, vitrectomy alone has  become popular.

As I’ll explain in the next few posts, vitrectomy surgery has become instrumental for the repair of retinal detachment, but there is still a role for scleral buckling.

I believe it to be a very valuable tool for retinal detachment surgery, but their use is sometimes based upon the length of time a surgeon takes to perform that part of the operation.  It can take a matter of minutes…to hours.

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Comments
  • Young joon April 14, 2010 at 2:45 pm

    Very good! I’m also one of buckler. But sometime i asked to myself that vitrectomy might be better in ths case. What do you think about phacovitrectomy in young patient on these refractive surgical era?

    • Randall V. Wong, M.D. April 16, 2010 at 4:55 am

      If you are asking my opinion on patients with retinal detachment, requiring removal (phaco) of the lens at the same time, I’d advocate vitrectomy with scleral buckle if left aphakic.

      If I didn’t understand correctly, please ask me again…thanks.

      r

  • Anne May 11, 2010 at 3:14 am

    My husband recently had a 3rd eye surgery for re-detachment of the retina secondary to proliferative vitreoretinopathy (a complication of previous retinal detachment surgery). Since the 3rd surgery he has about 3 days per week when he has tender, slight swelling – mostly over his cheek bone below his operated eye. He also has pain – not in his eye, but around his eye. There is no sign of infection in his eye. Sometimes he feels feverish (though his temp usually doesn’t go up over 37.5C) and usually gets some relief with acetaminophen. What are some possible causes for the intermittent swelling of the cheek and pain? (We realize this isn’t a diagnosis, but we would like some ideas of what to explore as to cause. Our eye doctor says his eye is fine and isn’t worried about the swelling & pain, nor does he have any idea why it occurs. But it is miserable for my husband to be going through!) I hope you can help us.

    • Randall V. Wong, M.D. May 11, 2010 at 4:32 am

      Dear Anne,

      I am sorry for your husband’s complicated path. Most likely and in my opinion (disclaimer), the causes for you husband’s swelling are due to the following; 1) if he has to keep his face down, fluid can accumulate due to this dependent positioning, there may be more fluid, or cheek swelling, than before as this is the third surgery and even more surgical trauma to the tissue surrounding the eye; especially if a scleral buckle were placed, 2) he could have an allergy to the drops, often times the drops used to dilate the eyes (used my many physicians) are actually the culprits, the allergy can be manifest in the sinuses and could lead to 3) a sinus infection.

      Hope this is helpful. Write back and let me know how he is doing.

      Randy

  • Anne May 13, 2010 at 4:07 am

    Thank you for your comments. Because he had major hyphema post-surgery, he has not spent any time face-down. However the allergy &/or sinus infection is a possibility. He has been on drops now for 4 months (anti-inflammatory & antibacterial).
    He had another visit today and we learned that they found an oil cyst on his sclera. Eye pressure is up slightly at 26. No treatment was suggested at this time.

    • Randall V. Wong, M.D. May 13, 2010 at 4:54 am

      I hope he is doing well. As you are experiencing, retinal detachments can be a long and tiresome process. Stay in touch.

      All the best,

      Randy

  • Anne May 13, 2010 at 4:05 pm

    Thank you for having this blog. It is helpful to have someone else who help explain or suggest other things to consider. We had no idea that the process could be so long & complicated.

  • cmstorrs July 14, 2010 at 2:30 am

    Hello:
    I am a 42yo (half Japanese) female who is very nearsighted with astigmatism in my right eye. At the end of May, I noticed cloudiness in my right eye. Went to my optometrist who immediately referred me to an opthamologist.

    Initially diagnosed with ‘PVD’, I was monitored for several days. Apparently due to the cloudiness/blood inside of my eye caused by the PVD and no improvement in vision, I was referred to another opthamologist. Almost 10 days after I first noticed the vision problems, I had a detached retina with a substantial tear which resulted in an emergency vitrectomy; lasered repair of the tear/detachment; and injection of a gas bubble with the requirement to lay face down for a week.

    Five weeks later, no improvement was noted in my vision. While I was able to start discerning a horizon of the bubble – as well as light and shadows – my vision did not improve/was about the same pre-op. Unfortunately, my surgeon informed me today that the healing/scar tissue caused another retinal tear and a 2nd surgery is needed – this time using a scleral buckle, as well as another gas (or possibly silicon) bubble and a face-down recovery.

    After discussing some negatives with my dr today (increased nearsightedness, cataracts, no change or worsened vision, etc) and reading others’ online post on their experience with the schleral buckle procedure, I’m actually wondering if I should even go thru with this procedure or just accept my vision loss, thanking God for my ‘good’ eye.

    • Randall V. Wong, M.D. July 15, 2010 at 5:13 am

      Dear cmstorrs,

      I am sorry to hear you are having problems. Your story is not uncommon. Retinal detachment surgery, unlike most “eye surgery,” can be very complicated, and, despite all that you do and endure, can have lousy results.

      I would urge you to have the second surgery. While it sounds like you don’t feel it is worth it, reattaching the retina, despite poor visual results, is worthwhile. At the very least, you are saving your eye.

      Please let me know how you are doing.

      Randy

      (Feel free to email if you want).
      RWong@RetinaEyeDoctor.com

  • DON CRAIG July 14, 2010 at 10:31 pm

    Dr. Wong,
    I’m a 31 year old male who had two catract surgeries and a week after both surgeries I developed giant retnal tears with major detachments. I recieved a Scleral Buckle and vitrectomy procedure done. My right eye healed great I’m seeing 20/20+ vision in that eye. My left eye the giant tears and detachments were over 285 degrees. Since that surgery my vision has not improved to the liking of the surgeon I’m expierencing fuzzy vision, a large vertical black line in my center of my vision, I lost part of my perioheral vision, pain sensation just under my eye which is a constant 5-6/10 on the pain scale. I also have a constant headache since my surgery on May 7th I have been to numours doctors who keep saying different things on my conditions. Do you think I will ever regain any vision in my left eye or do I have to live with relying on my right eye for now on? Please help! Do you know of any doctors in the NW PA area that you could suggest me seeing to help regain my vision?

    Thank You

    • Randall V. Wong, M.D. July 15, 2010 at 5:26 am

      Dear Don,

      Wow! You ‘ve been through a lot. As you may know, giant retinal tears are very difficult to fix and, unlike most retinal detachments, often lead to blindness.

      With regard to your second eye, it is difficult to say what’s going on without an examination. It sounds like your vision is related to the initial detachment. I’d urge you to ask you own doctor why your vision is so different in this eye.

      Same with the pain. There are a variety of possible causes; the scleral buckle (very rarely), eye pressure, etc. and I would only be guessing at the cause without an examination.

      With regard to your location, where are you in NW PA?

      Please feel free to email me or reply here. Your choice and best of luck.

      Randy

      RWong@RetinaEyeDoctor.com

  • Kyle Johnson August 8, 2010 at 1:18 pm

    Dear Dr Wong,
    I had 3 surgeries early this year to fix my retina detachment. Gas Bubble, Scleral Buckle and Oil treatment. My vision failed completely, in the right eye, after the Scleral Buckle. Would it possibly get better if the Buckle were removed? Thanks.

    • Randall V. Wong, M.D. August 8, 2010 at 2:23 pm

      Dear Kyle,

      A scleral buckle usually affects only your refraction, or rather, the strength of your glasses, and not how well you see with those glasses.

      Repeated detachments often lead to poor vision due to damage from the detachment. Even with perfect glasses, the retina often can’t function well.

      When I use silicone oil, I also don’t expect my patient to see well.

      The short answer is that simply removing the buckle will probably not change your vision at all.

      Hang in there and write back!

      Good luck!

      Randy

  • Peter August 12, 2010 at 2:47 pm

    Dear Dr Wong,

    I am 60 year old male, two older siblings have had detached retinas in both eyes. Mine just detached in one eye and I am undergoing pneumatic therapy presently. Question – since I can assume my other eye will eventually detach given my sibling history, is it ever indicated to get a prophylactic scleral buckle in the good eye to prevent or reduce the risk of, a detachment?

    Thanks!

    • Randall V. Wong, M.D. August 13, 2010 at 10:33 am

      Dear Peter,

      You have some justified concerns. There is a condition, called a giant retinal tear, a very specific and “aggressive” type of retinal detachment where there seems to be a likelihood of both eyes becoming affected. Often the other eye is either lasered or treated with a scleral buckle as prophylaxis.

      This was a long winded way of saying yes, I think you have reason to consider prophylactic surgery.

      Let me know if your surgeon agrees.

      Randy

  • Peter August 17, 2010 at 9:20 am

    Dear Dr Wong

    Thanks for your reply! My doctor does indeed agree that he wants to do a prophylactic procedure in my good eye, but doesnt want to go into detail until we resolve the damaged eye.

    Meanwhile, I have done 7 days of recuperation after the pneumatic procedure, keeping my head down. My checkup on the 7th day showed that reattachment has been occuring where the bubble is centered, but the doctor sees evidence of fluid behind the retina in other areas, my vision in that eye has recovered to where the dark area is gone, and I can see the bubble. Now the doctor is recommending what sounds like a vitrectomy due to the concern that the retina is not fully reattaching. However, I am debating whether to go through with this due to the cost and the longer convalesence. If the consequence of not doing the vitrectomy is that my vision remains as is, then I might not consider the vitrectomy. I am not clear on what the possible negatives would be to not doing the vitrectomy and would appreciate any clarification you could give me on this.

    again, thanks very much!

    • Randall V. Wong, M.D. August 17, 2010 at 12:03 pm

      Dear Peter,

      Sounds like your doctor is not satisfied with the initial results of the pneumatic retinopexy. I would follow his guidance about the next step. It is always difficult as a physician to recommend additional surgery when the vision has improved, but trust me, your retina may not be yet fixed despite good “vision.” It is likely that your peripheral retina is detached way to the side, yet it is not in your conscious vision.

      The short answer – if you are still detached, you need an additional procedure.

      I am not sure how your doctor operates, so I can not make a statement about the cost or longer recovery (mine are the same – give or take a day).

      Negatives about vitrectomy – almost none. There is the risk of blinding infection (no more than the pneumatic).

      Here’s an article on the risks of surgery.

      All the best,

      Randy

  • Krista Devins August 17, 2010 at 9:25 pm

    My husband just got the buckle surgery done, and he is experiencing much pain as I type. He has the surgery done on his left eye, which is bandaged until he goes back to the doc tomorrow, however he feels awfully weak, and can’t keep his right eye open without the feeling of his left eye wanting to open. He is taking percocet’s for pain medication, I’m wondering if this has anything to do with these side effects or if it’s from the surgery itself. Any comments would help!! Thank you.

    • Randall V. Wong, M.D. August 17, 2010 at 9:33 pm

      Ms. Devins,

      Pain can vary from patient to patient (different tolerances) and from surgeon to surgeon (different techniques and abilities), but…….it is not unusual to have some discomfort (what we call pain) after a scleral buckle. The discomfort can be bad enough to keep the other eye closed. The weakness can be from the operation (alot of people hate having anything done to their eye producing nausea), but more than likely the weakness is due to the anxiety of the whole situation and……..the anesthesia.

      Was he under general anaesthesia or local? Usually general anaesthesia can really knock you out for a day or two (i’ve had it myself).

      Let me know,

      Randy

      BTW – I don’t always answer this rapidly. Just lucky for you!

  • Sridevi September 14, 2010 at 4:51 pm

    Hi,

    I am a myopic with right eye(-12) and left eye(-10). I have undergone LASIK in June,2007. Now I have the doubt that I have retinal detachment as I observe some floaters from 2 months. I am going to the docter at my earliest. I want to know whether I can take retinal detachment surgery if needed as I have already undergone LASIK. Please, please clarify me. I am 25years old. Also, are there any precautions that I can follow to avoid heriditary myopia for my kids. Please help me doctor.

    Thanks,
    Sridevi.

    • Randall V. Wong, M.D. September 14, 2010 at 5:08 pm

      Sridevi,

      Having had LASIK does not prevent you from having retinal detachment surgery. You are wise to get examined especially since you have had new floaters and are myopic.

      I am not aware of any specific precautions to avoid myopia for your kids.

      Take things one step at a time, get yourself checked first.

      Best of luck,

      Randy

  • sridevi September 15, 2010 at 3:35 pm

    Hi Dr. Randy,

    Thank you very much for your response. I have lost all my old reports which are prior to my LASIK surgery. I am having reports of recent check-ups i.e after my LASIK. Are the old ones needed in future for any check-up’s or surgeries to do. Please let me know. I am very much thankful for your replies.

    Thanks and Regards,
    Sridevi

    • Randall V. Wong, M.D. September 15, 2010 at 4:36 pm

      Sridevi,

      In my opinion, your previous records aren’t necessary. I don’t want to speak for your surgeon, but I doubt they would be of any use.

      Did you actually get evaluated yet?

      Randy

  • sridevi September 15, 2010 at 4:55 pm

    Hi Dr.Randy,

    I know the previous power. But I am not having them on paper. I only know the approximate power. So in a worried pace, I asked you regarding my reports. Thank you again for your swift response.

    Thanks and Regards,
    Sridevi

  • Mrs. Brown September 19, 2010 at 4:37 pm

    Dear Doctor: My husband is going in to have a belt and a buckle put on his eye, due to the past 2 surgeries where the doctor put gas bubbles and used some freezing technique to re attach his retina, failed.
    What should I expect, from this 3rd operation? I will be “taking care” of him, and would like to know
    how long this takes to heal, how long the surgery usually takes, what medicines will he have to use,
    (antibiotics, I’m sure), and what should I look for, during his recovery, that might necessitate a call to the doctor?

    • Randall V. Wong, M.D. September 20, 2010 at 10:58 am

      Dear Mrs. Brown,

      It sounds as if your husband is going to have a scleral buckle. The outward appearance, after the surgery, will be a bit worse than before, probably some more swelling than the first time.

      My recommendations, and you should check with your own surgeon, is that be on the lookout for worsening pain and worse vision than AFTER the surgery. It is a little tough to advise you accurately as I am not the operating doctor and don’t want to second guess your physician’s recommendations.

      Recovery, too, can vary. One variable is the type of gas the might be used.

      I hope this was somewhat helpful. Thanks for the inquiry!

      Best of luck to your husband.

      Randy

  • Mrs. Brown September 19, 2010 at 4:40 pm

    Thanks for this blog. Pretty helpful. Are there any videos on You Tube that will show this belt
    and buckle procedure being done?
    I saw one, which looked like there was a plastic lens being put on the patient’s iris.
    http://www.youtube.com/watch?v=nsp_X0EHQ7s
    Most of those videos are too gross for me to watch, though. You get told all your life to protect your eyes, and then these videos! Yuck!

    • Randall V. Wong, M.D. September 20, 2010 at 11:01 am

      Mrs. Brown,

      I personally have yet to post any YOU TUBE videos. I just haven’t had the time and I haven’t seen any in particular. You may want to check my article here on retinal detachment surgery.

      Randy

  • Mrs. Brown September 21, 2010 at 2:55 pm

    Dear Doctor: We were told by the physician/surgeon to keep the eye clean from crustiness, which means he wipes his eye each morning with a clean washcloth, and tap water, and that we were to let him know if pain increases, because that would indicate a possible infection.
    Right now, I give him a drop of antibiotic every 4 hours, and some antibiotic ointment at night, and he
    has to sleep with a clear plastic patch taped over his eye.
    I cleaned the plastic, with alcohol, after checking with the doctor, so he wont’ have any residue on the
    patch.
    The physician/surgeon also told him to keep sitting up, so, he sleeps in a rather upright position now.
    Yes, he had a belt/buckle put on.
    What do you mean by “worse vision than after the surgery”?
    Right now, he has that gas bubble in there, and he can’t see much of anything, which the doctor said was normal, until the gas is absorbed into the body. They also removed some of the vitreous fluid.
    To stop the fluid from tugging on the walls, right?

  • Mrs. Brown September 21, 2010 at 9:04 pm

    One more thing, my husband is a gamer. He likes to play online video games, on a wide screen computer, and he will play sometimes for 4 or 5 hours at a time.
    He has now learned that this rapid eye movement, constant scanning, is probably the worst thing
    a person with his condition can do.
    The doctor told him NO gaming for a while. I hope he will stop for good. All that scanning is bad for someone like him. What are your thoughts on this? Have you come across fanatical gamers, who
    have eye problems?

    • Randall V. Wong, M.D. September 21, 2010 at 11:08 pm

      Mrs. Brown,

      I might agree that gaming is bad, but no more so than reading. Think about the rapid, and forceful, to and fro motions the eyes undergo when reading. Not much different than gaming.

      Also, during sleep, we all (usually) enter “REM” sleep. REM stands for Rapid Eye Movement and is a necessary stage of sleep. My point is that we naturally go through normal periods of forceful eye movement that is involuntary and can not be helped….therefore, I doubt the gaming really puts him at additional risk.

      Sorry!

      Randy

  • Dick D. September 22, 2010 at 3:19 pm

    I had retinal detachment eye surgery about eight months ago and still can’t open my eye all the way(about 85%). What could cause this? I was told (by a doctor but not my surgeon) that the eyelid muscle had to be cut to perform the surgery nd may have been shortened during it’s repair. Is this possible?

    • Randall V. Wong, M.D. September 22, 2010 at 3:42 pm

      Mr. D.,

      I doubt that any muscle was cut in order to perform the retinal detachment repair. Two things come to mind as possibilities; either the muscle that raises the lid has yet to return to full function (this is not uncommon, for reasons I am not clear), or, your operated eye is slightly recessed and the lid appears lower because the eye is actually somewhat sunken into your eye socket.

      I’d defer to your surgeon. Can you see him? In most cases, by the way, it can be repaired.

      Randy

  • Adam October 11, 2010 at 1:38 am

    Hi dear,
    I had a retinal detachment surgery in 1998, and I am now 27 years old. My vision at that time was improved, years later I noticed that my vision is decreased gradually. Now , I lost my vision in my left eye 🙁 I’ve been trying to get some solutions to this problem, yet no one can help me with my vision issue. My question is, is there any treatments/suggestions that help my vision to get back? Thanks

    • Randall V. Wong, M.D. October 11, 2010 at 11:28 am

      Dear Adam,

      Without examination, it’s hard to know exactly the cause of your decrease vision.

      Here’s a recent article that may be helpful.

      Randy

  • Margaret Patt October 16, 2010 at 1:03 pm

    My husband had 3 surgeries for detach retina. Had the (2) gas,(1) oil been on drops still, hole is not repaired. Gets crusty eye – cleaning with baby shampoo & warm water & vaseline to keep area around eye from drying out. Has pressure problems all the time. Has never been out of pain & still cannot see. Is there anything on the horizon that will help him get his eye sight back. His doctor is really nice, we had a second opinion & he told us that he would not have done anything different than his treating doctor.

    • Randall V. Wong, M.D. October 17, 2010 at 12:53 pm

      Margaret,

      Sounds like a tough situation. If he still has oil in the eye, however, he may get improved vision (I confess, I don’t know all the details of his surgeries) when, or if, the oil is ever removed. I’m glad to hear the doctor rendering the second opinion was in agreement.

      Thanks for sharing. Best of luck to your husband.

  • Lynnly October 28, 2010 at 4:53 pm

    Dear Dr. Wong.
    I was pa patient of yours while you were doing your residency. I have some questions fro you. Is it okay to ask on this site?
    Lynnly

    • Randall V. Wong, M.D. October 29, 2010 at 8:59 pm

      Lynnly,

      Please ask away! Give me a hint of “the old days” when I was a resident. I look forward to hearing from you.

      Randy

  • Ron Barnes November 9, 2010 at 3:19 pm

    I have been extremely myopic all my file. I had cataract surgery in both eyes in May and June of 2010. In July, I had 2 retinal tears, then a detachment, all in my left eye. I had the re-attachment surgery which included a buckle. The retina is completely healed now, but my opthamologist says that my left eye is far-sighted, not near-sighted. Is that possible? Everything I’ve read says a buckle causes near-sightedness. The prescriptive lenses for both distance and reading do not alleviate the not-so-slight double vision. My basic question is: Can glasses be made to correct the effects of a scleral buckle, and if so, can they eliminate the effects or just reduce them slightly?

  • Cheryl Pheal November 10, 2010 at 9:31 pm

    Hi Dr. Wong:

    My husband has diabetic retinopathy. He has had laser treatment in the left eye and after about 1 week, his sight is more blurry. The plan is to remove scar tissue from his right eye and use the gas bubble (the retina is being pulled, not completely detached). Since the vision in the left eye diminished following the laser treatment, this same procedure is now scheduled ahead of the right eye. Why is the gas bubble chosen over the scleral buckle? How soon should my husband be able to see after being face down? How long typically does a person have to be face down?

    • Randall V. Wong, M.D. November 10, 2010 at 11:46 pm

      Cheryl,

      In my experience, the decision to use gas with or without a scleral buckle is a judgement call and depends upon the nature of the detachment. It also depends on the surgeon’s experience with both gas and a scleral buckle. I wouldn’t say that using gas alone is either right or wrong.

      The time your husband needs to keep “face down” is dependent upon the type of gas used. There are really 3 types of gas used, but two most popular are C3F8 and SF6. Most retinal surgeons use C3F8. I have my own bias and prefer SF6 exclusively. SF6 is much shorter acting and positioning is required for about a week at most.

      Ask your doctor which he/she uses. C3F8 can last several weeks (ugh!).

      Randy

  • Qwen November 23, 2010 at 5:08 pm

    hi-
    I just found out my retina has detached again. I had outpatient hospital surgery -vetrectomy, scleral buckle and gas bubble late Sept.. The detachment is in another area of the eye. My dr suggested I might want to look into seeing a dr at Boston eye center where they may deal with recurring retinal detachments on more regular basis. He said he sees about 6/yr and is comfortable treating them as well. Do you have any thoughts/suggestions about this?
    thanks

    • Randall V. Wong, M.D. November 23, 2010 at 5:33 pm

      Qwen,

      Without knowing the details, I’d recommend a second opinion. In my judgement, someone who only sees 6 redetachments a year probably doesn’t see enough retinal detachments to begin with. Are you closer to Boston or Washington DC?

      As an alternative to Boston, I could offer seeing you near Washington DC. My offices are in the DC suburbs.

      All the best

      Randy

  • IJ December 3, 2010 at 10:21 pm

    I just had the buckle put on 2 days ago. Pain is unbelieveable! At the county hospital not given much instructions or information. I have the drops to put in my eye. I realize it is a process of recovery. Should I be working on opening my eye? Should I exercise it? It hurts so much do I just wait till it feels better? Only instruction was not to lift, do not bend over, no driving, What is an average time to feel better? The initial review of my eye yesterday was that the surgery went very well. I could read the eye charts but again of course it was painful to do so.

    • Randall V. Wong, M.D. December 4, 2010 at 1:34 pm

      Dear IJ,

      REST!

      A scleral buckle is pretty traumatic surgery and discomfort is common (not so much frank pain). Go slow and easy on yourself. You don’t need to force the eye open nor do you need to exercise the eye. It will open and move naturally.

      Be patient!

      Good luck. Take it a day at a time.

      Randy

  • IJ December 4, 2010 at 10:42 pm

    I truly appreciate the fast response. Today is better than yesterday. My eye opened without the pain. Of course it is swollen and uncomfortable. Is there any reason I should not put on a warm compress or an ice pack to help the swelling?

  • Bijan December 10, 2010 at 12:14 am

    Hi,
    I had a detached retina and had surgery a year ago.
    I have very little sight in my eye that was operated on after the surgery and was wondering if this is going to strain my good eye and cause blindness?
    Thank you .
    Bijan

    • Randall V. Wong, M.D. December 11, 2010 at 5:08 pm

      Dear Bijan,

      Perhaps one of the most common fears is causing “strain” on the healthier eye. There really is no such thing! Overall, your two eyes are separate and independent of each other!

      Not to worry!

      Randy

  • IJ December 11, 2010 at 8:47 am

    Doc Randy thanks for the advice about taking it slow. It has been 10 days now and there are things that are better. I can even see better. Still have a few questions…1) What is the possible reasons for the pain I experience? The last 2 days when I leave my eye open all day I have a tremendous headache about 7 or 8 pm. I take tylenol with codine and while I wait for it to work I cry myself to sleep. What is going on with the healing process that makes it hurt sooo much 2) You mentioned that for this procedure “scheral buckle” they did not take the eye ball out. How did they perform the surgery? 3) Most of the time I can move my eye around during the day and no pain but every once in a while I look a certain place, can’t figure out where, and the pain will zing me to the point of dropping me to my knees. Did I somehow interact with the ‘buckle’ more when I moved my eye a particular way? and last questions for the day 4) my affected eye does not open as wide right now but of course it appears that it is open as wide as possible. Is the swelling – which has decreased- the reason for the size difference and as the healing continues the eye should return to normal? Thanks so much in advance for your answers. I truly appreciate you taking the time.

    • Randall V. Wong, M.D. December 11, 2010 at 5:16 pm

      IJ,

      1. I’ll defer to your doctor, as I’m only guessing. Usually shouldn’t be too uncomfortable by now.
      2. The lids are kept open by a wire “speculum.” This allows enough exposure to the outside of the eye to place the scleral buckle. Depending upon the size of your eye socket there may not be a lot of room to operate, thus requiring a lot of minipulation (pulling and tugging) to get to certain parts of the eye. It can cause a bit of trauma to the eye.

      3. I don’t think it has anything to do with the buckle per se…I wonder, though, about the eye muscles?

      4. The eye should return to “normal,” but may take several weeks.

      Hang in there.

      Randy

  • IJ December 12, 2010 at 1:28 am

    Doc Randy, you are the coolest! Thanks so much for the response! If I have to have another surgery I may have to move to D.C.! Happy Holidays!

  • IJ December 13, 2010 at 4:04 pm

    Doc Randy, What is your ‘opinion’ on eye vitamens like Ocuvite with Luten? Are they helpful in my type of surgery and recovery? ( I dance and roller skate and want my activity to continue without worrying about retina detachment again.. for either eye!) What is the status of my Macula now that I have had retina attachment surgery? ( I did not go to the emergency room the first day I noticed my eye change. I was told had I gone that day they would have performed emergency surgery to try and save my Macula but since I came in 24 hrs later the surgery was scheduled for a week later because the macula was already damaged) What happened to my Macula? Does it participate in the vision process now? I can see out of my right eye, of course the nearsightedness has increased but I can see. Btw the pain has subsided! Yeah and my vision is improving. Just being still is driving me a lil stir crazy. Look forward to hearing from you when your schedule permits. Thanks again.

    • Randall V. Wong, M.D. December 15, 2010 at 11:46 pm

      Dear IJ,

      My opinion about eye vitamins such as Ocuvite is that they are oversold and only proven to be of benefit for a small subset of patients, those patients with wet macular degeneration with medium to high risk characteristics.

      The Ocuvites have never been PROVEN to do otherwise. While the AREDS 2 study is underway, there is lots of circumstantial evidence that these vitamins may prove to be beneficial in other scenarios, but, again, not yet proven.

      I have no idea about the state of your macula. Only your doctor, who examined you before, during and after the operation can assist you.

      I am glad your eye is more comfortable and thank you for actively contributing to this web site.

      Please stay in touch and best of luck.

      Randy

  • candy December 30, 2010 at 12:17 pm

    When I pull down the lower eyelid, the buckle is visible..is that usually the case?

    • Randall V. Wong, M.D. December 31, 2010 at 11:13 am

      Dear Candy,

      The more anterior a buckle is placed, the more likely it is that you can “see” it. I try to place the buckles rather posteriorly to make them less visible and less likely to erode through the conjunctiva.

      I guess to answer your question, while it not usually the case, it is not uncommon.

      Randy

  • Aaron Petruccelli January 9, 2011 at 12:06 am

    Dr. Wong,

    I was wondering what the typical recovery time is for this surgery? I am a competitive athlete and have been told that i’d have almost zero physical activity for 3 months. Is this the usual case?

    Aaron

    • Randall V. Wong, M.D. January 9, 2011 at 11:22 pm

      Dear Aaron,

      This is a tough question to answer, but I find 3 months pretty extensive.

      Can you provide me with a few more details of the surgery?

      Thanks,

      Randy

  • Aaron Petruccelli January 12, 2011 at 8:56 pm

    I just completed having my buckle installed, along with a Cryopexy to take care of the tears? Total time under the knife was 90 minutes. I am due for a follow up tomorrow. Don’t know if this helps but on my discharge

    RD 3:30 – 7:00
    Mac off
    Recommendation SB surgery within the week.

    • Randall V. Wong, M.D. January 17, 2011 at 9:57 pm

      Dear Aaron,

      The notes indicate that your retinal detachment extended from about 3:30 o’clock to 7:00 o’clock (if the retina/eye were a clock, that is, from the doctor’s perspective). The macula was detached (“mac off”) and, hence, you probably lost your central vision. Due to the fact the macula is detached, there is no rush, and surgery is recommended within the week using a scleral buckle.

      Was gas injected into the eye? If so, this might incapacitate you for a few weeks at the most. Personally, I don’t recommend extended layoffs for any situation. I use a shorter acting gas, and, I also am a firm believer that REM sleep subjects the eye to more “trauma” than any physical activity.

      Write back if you can.

      Randy

  • Jessica January 19, 2011 at 3:27 pm

    I had a buckle placed in my left eye last June . Then had cateract surgery with a multifocal lens placed. Is the eye ever going to feel normal again. My vision is better but the eye still feels that there is still something wrong . Is it because of the buckle. I just want the eye to be normal like it used to be. Thanks so much.

    • Randall V. Wong, M.D. January 20, 2011 at 2:57 am

      Dear Jessica,

      Could you give me an idea in what way the eye is not normal feeling?

      How is the vision in your other eye?

      Randy

  • Katie January 23, 2011 at 9:36 pm

    Dr. Wong, I had a buckle placed in my left eye a few years ago. My vision is back to normal, but there is a tiny “dip” in my central vision. I’m fine with that, but I was wondering about the buckle itself; does it degrade or need replacing? I am 28 years old, and am worried that it might have to be taken out one day…So far as I know, it’s a silicone ring. Also, should I have an x-ray taken before going for an MRI, as I’m not sure if the eye surgeon used metal clips or not? And the third and final question is: do I need to keep seeing a retina specialist for the rest of my life, or is going to my normal eye doctor sufficient for detecting a new tear or complication?

    • Randall V. Wong, M.D. January 25, 2011 at 12:01 am

      Dear Katie,

      A couple of questions/comments;

      1. Is the dip new?

      2. If silicone rubber, there should be no intention to remove it. I’ve removed only about 20 or so after 18 years of practice. They don’t degrade, but they can erode through the conjunctiva. Most of these were poorly placed to begin with. Incidentally, you probably only need the buckle in place for a few weeks!

      3. Good idea about xray and the concern about metal clips. I prefer using sutures for this reason…never have to worry.

      4. I personally think that your eye with the scleral buckle is more stable than your other eye. If you were my patient, I wouldn’t feel that I need to see you regularly. Definitely get to retina specialist/eye doctor if you have new symptoms such as flashes, floaters or decreased vision. Most patients are sensitized enough after the first retinal detachment that they seek medical attention pretty quickly with any new symptoms.

      Helpful?

      Randy

  • Hans January 24, 2011 at 8:44 am

    Hi,
    On 08th January , I was hit in the left eye with a squash ball.I was examined and found to have a low grade hyphaema.The retina was checked and found to be intact.I was given timolol/pred forte and cyclopentolate.On 10th January , I noticed a large floater and went back to the eye department.They said that a superio-temporal retinal tear was now evident.The next day , I had laser treatment to the tear and an encircling scleral buckle.The large floater was a Weiss ring.
    On Day 5 post-op ,16 January,I noticed multiple dot floaters , which moved with eye movements.I went back to the eye dept-the retina had no new tears and the pressure was ok.
    When I went home I looked against a bright white background and I think that there must be over 100 would be more accurate.There is no perceptible loss of peripheral vision.They are grey/black and appear to be at different depths within the left eye vision.They move with the ocular movements (flit and dart) but not as smoothly as the Weiss ring.They have not changed since yesterday.
    I wonder why this has happened.I am recovering well from the operation- less pain and better vision,but now this myriad of dots/spots ?
    Can the Weiss ring disintegrate to produce them ?
    If the Weiss ring represents the posterior vitreous detachment after the trauma are these further floaters part of the natural history of the process? ? Are they common post laser /buckle surgery for a tear ?
    Might have they been there at Day 1-4 post-op , but I could not open my eye enough to allow sufficient light to notice them ?
    Has you got any advice regarding this?
    Thank you.

    • Randall V. Wong, M.D. January 26, 2011 at 8:14 am

      Dear Hans,

      My best guess is that the myriad of spots is…blood. The Weiss ring usually doesn’t/can’t break up. Make sure you have been examined since these have developed. You can always get another tear.

      I doubt they were there on days 1-4.

      Please get checked and let us know what happens.

      r

  • Aaron Petruccelli February 4, 2011 at 8:23 pm

    I had to undergo a second procedure in addition to my buckle . I underwent a vitrectomy eight days ago, the doctor usfed a C3F gas? I must remain in certain head positions for most of my day for at least another week. My second follow up showed that my retina has reattached. Now it’s just a waiting game.

    Aaron

    • Randall V. Wong, M.D. February 5, 2011 at 1:13 am

      Dear Aaron,

      Hang in there. It will be worth it! Glad to hear you are attached!

      Randy

  • Gary T February 13, 2011 at 7:46 pm

    Dear Dr.

    It has been 9 weeks since my buckle was installed and the retina was reattached i am 54 years young. Although I have made steady progress and vision is 20/70 out of the injured eye it is very blurry and dark shades around the outer edges of my sight.. I really struggle to see from that eye with the blurriness. I went to an Optometrist for eye glasses only a corrective lense for my non-injured eye but he checked both eyes and said with the knowledge of the buckle that I had a cateract starting in my injured eye. (7 yrs ago I had corrective mono laser with my injured eye to see distance)

    Will the blurriness go away and what is your thought on my how much more vision i will regain

    • Randall V. Wong, M.D. February 19, 2011 at 7:46 pm

      Dear Gary,

      The answer rests in the state of the cataract and whether or not your macula detached. Both questions can be answered by your doctor. If your macula remained attached, then your prognosis is much better.

      Randy

  • J Cruz February 22, 2011 at 8:37 pm

    Dear Dr Wong
    Very interesting and informative article and I appreciate your time and energy spent responding to everyone.
    I will be 51 on the 24th of this month and fairly good health. Now a little history on my right eye. I underwent cataract surgery and had the Restore lens implanted in April of 09 and all seemed fine. That is until Dec 21 of 09 when my retina detached near the bottom and I had a vitrectomy immediately and was healing well. Then on Jan 5, 2010 I detached again opposite of the original repair and had a scleral buckle procedure.performed and was healing well aqain except my eye was turned up and out a bit. In Feb 2010 I detached again in another side of my retina and had another vitrectomy.
    And finally in March another detachment opposite again of the last, the doctor sacrificed a small piece of the bottom of my retina before reattaching, another vitrectomy with silicone oil put in instead of gas at that time.
    I still have silicone oil in my eye now and my doctor is waiting until March to let a colleague see me to determine when and if the oil will be romoved. My vision is very blurred now due to some oil that leaked to the front of the eye.
    Do you have any words of encouragement for the future of my eye? I believe removing of the oil will restore some of my sight and hopefully I will not detach. Would performing a surgery to align my eyes put me at risk for another detachment? What I understood was causing my detachments after the first one was my eye healing too fast due to my relatively young age and scarring was pulling on the retina.
    Again, Dr Wong, I sincerely appreciate your time in reading and responding. You are a very kind and condsiderate man.
    Sincerely, J Cruz

    • Randall V. Wong, M.D. February 22, 2011 at 9:27 pm

      Dear J,

      You are lucky that I’m working on the computer tonight! Thanks for subscribing and commenting.

      Based upon your description, you have a condition called “Proliferative Vitreoretinopathy.” This is a very tough disease and usually leads to legal blindness due to repeated retinal detachments. Now, it is impossible for me to know your true potential as I can’t examine you. It is possible that significant decreased vision is experienced due to the oil that migrated forward.

      I’d have to rely on your surgeon for his opinion about your chances of improved vision.

      One good note; your retina seems attached with the oil present.

      It is always nerve wracking to remove the oil in a patient that has detached several times.

      Look forward to hearing from you,

      Randy

  • J Cruz February 22, 2011 at 9:51 pm

    Wow, Randy, amazingly quick response. It is my lucky night. Thanks for the information. I will stay catiously optimistic and hope and pray for the best outcome. Now, I better understand the hesitation in removing the oil. I remain in good spirits knowing things could be much worse in other ways. Many are less fortunate than I. At least I can see and function albeit with some limitations but I will continue to adabt and adjust and make the best of my situation. Thank you again for your time.
    Sincerely, Joaquin

  • Shelly February 26, 2011 at 10:13 pm

    I had 3 seperate retinal detachments over a 7 month period. The first surgery involved a scleral buckling. Just this evening, it felt like there was something in my eye and it started to ache. I think I see the buckle which appears to have moved toward the front of my eye. I can push this “band” back and forth with my finger. Obviously being a Saturday, I won’t be able to see my doctor until Monday…..is this anything I should have looked at before then???

    • Randall V. Wong, M.D. February 27, 2011 at 8:08 am

      Dear Shelly,

      Please understand that I need to qualify my answer as I am not able to examine you.

      Assuming that you are correct and that the band is moving, there is probably no real emergency. At times scleral buckles do erode through the overlying tissue, the conjunctiva, but at other times, though rare, it is possible that there might be an infection. Of course, it could be something else.

      If you are having changes in your vision or experiencing pain, I must advise you to at least call your doctor’s office, even on the weekend. They should have someone on-call. If this fails, seek attention at the emergency room.

      Let me know how things turn out.

      Randy

  • dee February 28, 2011 at 6:08 pm

    Hi Dr. Wong!

    What a great site this is, very helpful!

    I’m 4 weeks post-op scleral buckle surgery , it was a small tear in my right eye.

    2 weeks ago the doctor said I could go back to normal life, no restrictions. Not having much pain or anything, my eyesight is good. So this weekend we moved a couch to our basement and after I noticed a dime sized purplish area under my eyelid. I called my doctors office and the girl answering the phone said it was probably just a bruise and not to lift anything heavy for a while and watch it.

    Is this normal? Do you know how long I’ll need to watch the heavy lifting? We were in the process of remodling our house when this happened and I want to get back to work but don’t want to jepardize the healing process. Thanks for any help!

    • Randall V. Wong, M.D. March 1, 2011 at 9:43 am

      Dear Dee,

      If the area in question is indeed your lid, there is probably no association with the eyeball itself. I agree that you should be able to return to normal activity.

      I’d double check with your doc, but if you were my patient, I’d recommend working on your house!

      Randy

  • Catherine Cornu-Quinn,FNP March 5, 2011 at 9:59 pm

    Appreciate your blog, Dr. Wong.
    Am a 72 y/o female in excellent health. 8 months ago underwent elective L eye cataract surgery subsequently secondary to lens fragments had vitrectomy, then sclera buckle and vitrectomy for detached retina – all within 3 weeks.
    As a result have lose of definition, myopia, vision much worse, feel something just not clear on left outer aspect of vision field, dryness, minimal bloodshot, periodic persistent fluttering kaleidoscopic black, white imagery, diffusion of lights at nighttime.
    Told everything was good.
    A week ago start having short, pin like stabbing pain, lid swelling in outer aspect of eye, noticeable when up and about. Told could be inflammed and taking Zylet drops which has helped some but symptoms still present.
    Why the fluttering imagery?
    Why recent continued pin like pain/discomfort, lid swelling? Is it connected to buckle?
    Could replacing lens give more definition/clarity, correct myopia which never had?
    Thanks Dr Wong for any feedback as want to return to volunteer overseas for Doctors without Borders but feel this eye isn’t working out.
    Cathy

    • Randall V. Wong, M.D. March 10, 2011 at 12:01 pm

      Dear Cathy,

      Wow.

      1. Don’t know about the kaleidoscope. Could be anything.
      2. Pain could be from the buckle. It is sewn on the “outside” of the eye. I’d have someone take a look.
      3. Unless the implant is cloudy, I don’t think changing the implant is going to do much. More than likely the symptoms are just due to the retinal detachment.

      Let me know if this answers any of your questions.

      r

  • Janice April 12, 2011 at 10:58 am

    Hi Dr, Wong-
    I am a 47 yr old female.I had scleral buckle surgery with gas bubble on April 1st for retinal detachment in my right eye. My left eye was also operated on using laser to correct any weak spots in order to prevent any future problems.
    I have 2 questions-
    !) How long does the bubble usually take to dissolve? We go camping in the mountains every year, but I know I can’t go to high altitude locations until it is completely gone.
    2) Will there be some permanent physical restrictions? Should I restrain from heavy work and lifting forever? I’ve been so traumatized by this experience that I think I’ll always be afraid to do anything physical.

    • Randall V. Wong, M.D. April 18, 2011 at 10:24 pm

      Dear Janice,

      1. I use a mixture of a gas called SF6 and I usually see it disappear/absorb by no more than 14 days. I am, however, a minority in the use of this gas as most use a gas, C3F8, with a larger molecular weight (i.e. bigger molecule) and takes 3-4 weeks to absorb, depending upon the concentration used by the surgeon. Until the gas is completely gone, regardless of type, you shouldn’t go to high altitudes.

      2. In my practice (hedge), I don’t forecast any long term/permanent restrictions. I personally don’t believe that heavy work or lifting is bad and is a remnant from the old days of cataract surgery where larger cuts were made into the eye….but this is my opinion and please ask your own doc.

      I am often asked this second question by many people. My answer is that every night you go through REM sleep. During REM sleep the forces generated inside the eye are so high, they can not be replicated by any physical activity…just a thought.

      Randy

  • Jez Lonsdale April 27, 2011 at 6:11 pm

    I had a buckle fitted last September. The surgery was successful and I was able to resume my career in teaching and my hobby of running (I am 49). There has, however, been a down side in recent months. I am experiencing a reasonable, but bearable, amount of pain but that is slowly increasing. The lump where the buckle is attached is getting bigger; I have flashes of brilliant white light that travel (always in the same direction) across my eye and the amount of floaters I am experiencing range from flocks of small birds, hovering bees and/or a grid of pin pricks (30 or more) across my eye.

    Does all of this sound normal? I appreciate any help or advice you can give.
    Jez Lonsdale

    • Randall V. Wong, M.D. May 2, 2011 at 8:02 pm

      Dear Jez,

      Are you in contact with your doctor?

      Wondering if you need to see your specialist….

      Randy

  • Amboy J May 4, 2011 at 9:33 pm

    Dear Dr. Wong-
    I am currently 5 weeks post-op from scleral buckle surgery for a retina detachment which did not effect the macula. I was not given a gas bubble since the doctor said it was a small detachment. I have been going back for re-checks every 2 weeks. The doctor says I’m healing fine,and they only thing we are waiting for is for the small pocket of fluid to dry up and the pupil to un-dilate. Otherwise, the vision has returned to pre-RD accuity. My pupil being dilated makes it really difficult to go out in the sun,even with sunglasses. As for the small pocket of fluid, it obstructs my vision just a bit, mostly when I look to the right. Though it usually appears as a blurry spot, if I’m in a darkened room it is black,and if I stay outside for a while and come in, it appears as white. Can you give me an idea as to how long in general it can take for the pupil to un-dilate and the fluid to finally dry up?

    • Randall V. Wong, M.D. May 10, 2011 at 9:49 am

      Dear Amboy,

      Not sure if what you are experiencing in your vision is related to the retinal detachment. Usually, when the visual change is noticed, it so regardless of where you are looking.

      The constantly dilated pupil may be due to continued use of dilating drops? What drops are you taking?

      r

  • wong ling hui May 5, 2011 at 5:02 am

    Hi Dr Wong,

    My right eye was injured when i was 5yrs old, after that a cataract len was implanted. Everything is fine and i only go for follow up check up once a year. When i was 25yrs old, my doctor said there are some tissue grow from below the len. He strongly advise me to do a quick laser to remove those tissue, and i was told can see more clearly or brighter. So i did the laser.
    Frank to say i don’t find my vision was improved after the laser, and it was just a begining of nightmare. 4 month later, i start seeing floaters. I see floaters quite often so i doesn’t treat it serious. When i go to doctor, only know that was retinal detachment. The next day i had the Scleral Buckle Surgery. Gas was injected, the len was removed because of the difficulty of surgery.
    This is my 2nd year after the surgery. The retina was stitch back but Im still under follow up check up. My vision is bad, double vision, and very blur. My right eye looks so different compare to left one. the color is faded, become bluish grey, and one size smaller than the left eye. It was quite sad when i looking at mirror and lose confident when looking at others.May i know is that a side effect of the surgery? what can i do with the unequal size and color of eyes..(beside of cosmetic lens)?
    I had do a few research online, get to know there is a surgery called iris reconstruct surgery. And a new iris implantation surgery. Is that suitable for my case?

    • Randall V. Wong, M.D. May 10, 2011 at 10:10 am

      Dear Ling Hui,

      Hard for me to know if that is the basis of your real problem. I would suggest see if the whole eye is affected? That would make more sense to me as it seems there is a noticeable cosmetic difference between the two eyes. The problem may be more than just the iris.

      Randy

  • lynhue wong May 5, 2011 at 5:19 am

    Hi Dr Wong,

    I had the Scleral Buckle 2yrs ago, on my right eye. Now my right eye color become bluish grey, and one size smaller than the left eye. And it always have blood vessel burst around the iris. Is that a side effect too? My len was removed so i have double and poor vision now.

    Thanks for your precious time , im a 28yrs old lady, wish to be pretty again =)

    • Randall V. Wong, M.D. May 10, 2011 at 10:12 am

      Dear Lynhue,

      As I just wrote to your other comment. I am most concerned regarding your mentioning the color change and smaller size of the eye. I would suggest you ask your doctor if any type of ophthalmic plastic surgery might help the appearance of the eye.

      Randy

  • Lynne May 8, 2011 at 6:31 pm

    Dear Dr. Wong,

    My husband had a sclera buckle put on his right eye five days ago along with a gas bubble that is suppose to dissipate in 2-3 weeks. He is still complaining of extreme headache pain…some pain in the eye. I can see stitches sticking out of his eye. He has to lay down on his right side for 2 hours every morning and afternoon. He has been reading, watching T.V. and doing some work on the computer. The redness and swelling in his eye appears to me to be decreasing. I’m worried about his headaches. He is taking Percocet to manage the pain and he wants to stop taking it but tylenol doesn’t seem to help the pain. (He cannot take codeine, aspirin, or NSAIDS) Is this type of pain normal? How long will the intense pain last? Seeing the stitches on the eye normal? Thanks for your advice!

    • Randall V. Wong, M.D. May 10, 2011 at 10:16 am

      Dear Lynne,

      Determine the cause of the headaches. Simply could be from surgery, but I usually don’t have to prescribe pain killers afterwards. There could be problems with the pressure in the eye.

      Without being able to examine him, it is likely that you can see the small sutures on the outside of the eyeball.

      Stay in touch with your doctor if the pain persists. At least make sure that he is aware that you are both concerned.

      Randy

  • Amboy J May 10, 2011 at 8:44 pm

    Dr. Wong-
    This is in response to my earlier question (above-from May 4th)

    I haven’t been using the eye drops for 3 weeks so my dilated pupil isn’t from using them.

    My detachment was a small one. When it started, I only had a blind spot when I looked all the way to the right. I didn’t lose any periphial vision other than that. I went to an opthalmologist that told me it was a floater since he couldn’t even find it. He referred me to a retina specialist to be sure and I had to wait 2 weeks for an appointment. By then, my “spot” had only progressed to the point where I could see it all the time in the inner corner of my eye. So now, 6 weeks later, it’s to the point where I only see it if I look all the way to the right,as it was at the beginning. My doctor says it still needs to dry up. My question is about how long on average do these pockets of fluid take to be absorbed? Thanks!

  • Jean-Marc Gladu May 16, 2011 at 12:32 pm

    Dear Dr. Wong,
    You have a great sense of empathy to take the time to answer all these patients’ questions. This is very comforting. Thank you.
    I had the buckle installed in my right eye (with the cryogenics to seal the tear) on March 23. I turned 50 a couple of weeks after. According to the specialists the tear was from about 2:30 to 10? The recovery period was about 5 weeks (staying home and not doing much activities). I saw the retena specialist every week following the operation. The pain subsided shortly after the 1st week. I have been able to start working from home for now (until I can get my vision properly corrected). The first estimate is I will go from 7.5 dioptre to 9.5 (to be confirmed this week with my optometrist). I slowly started exercising 2 weeks ago (stationary bike instead of running).
    I sometimes see a small “shiny butterfly” in my field of vision then it disappear. Is this a sign that more tears are occuring or is it a normal “ghost” effect from the surgery? I will see my specialist this week. I will ask him the question but he is so busy. There are usually a lot of patients waiting. He has done a great job with the surgery but does not always have the time to address all questions. This is the harsh reality of our social medicine… Everyone gets treated but our physicians are extremely busy…
    Thanks again

    • Randall V. Wong, M.D. May 16, 2011 at 5:49 pm

      Dear Jean-Marc,

      Where do you live? I am curious.

      The “butterfly” can be worrisome, but is probably related to your recent surgery. Most of the time, in my experience, redetachments are not associated with any symptoms…especially with gas in the eye.

      BTW – I don’t personally believe that exercising has anything to do with retinal surgery success.

      You will have to ask your doctor your question. I’d love to, but I can’t examine you!

      Best of luck,

      Randy

  • Jean-Marc Gladu May 16, 2011 at 7:53 pm

    Thanks for your quick reply Dr. Wong. I will let you know what my specialist says next Wednesday about these sporadic butterflies. With regards to the exercises, I believe they wanted me to take it easy because at the beginning i still had bleeding inside the eye and they wanted it to be controlled before I did any activities that would bring up my blood pressure. Then they recommended low impact exercises to prevent discomfort.
    Earlier today the optometrist was a little concerned as my vision was not as good and easy to assess as the last time. He wants to wait until I see the ophthalmologist again before seeing me to correct my eyesight. He thinks I might have an inflammation of the retina in the macular area…
    FYI I live in Montreal and was seen at the McGill University Health Center… And I have not seen such an informative blog on our side of the border. Thanks again. JM

  • Miki May 18, 2011 at 3:26 pm

    Hello,
    This website is really helpful – the only one which explains this surgery in words that I can understand!! Thank you! I was just wondering how easy it is for the retina to detach again after surgery..It’s been about 10 months since I had my surgery but I still get easily paranoid about hitting my head, putting pressure on my eye with my hand, warning people to stay away from my eye, etc..I’ve been told many times during checkups that my surgeon did a very good job with the scleral buckling, and I’ve also had laser applied to stop it from detaching even more.

    Thanks =]

    • Randall V. Wong, M.D. May 22, 2011 at 4:32 pm

      Dear Miki,

      There is really nothing you can do, such as, putting pressure, keeping people away..etc.

      In my experience, a retina that has been reattached with a scleral buckle..and stays attached 10 months later is unlikely to re-detach.

      Randy

  • Jean-Marc Gladu May 20, 2011 at 12:34 am

    Hi again, I saw my specialist yesterday and he said the “shiny butterfly” could be residual effects from the previous tears. However I should not worry about them as the buckle is in place and it should prevent any further tearing from occurring. FYI my appointment at the hospital was at 2:35 pm. I did not see the technicians for the drops and initial tests until 3:45 pm and I was seen by the specialist by 6:15 pm (for 10 minutes during which he hardly had any time to answer my questions). So, as I mentioned, social medicine has its pros (everyone gets treated and it costs only the cost of our heavier taxation system) and its cons (waiting lists, waiting periods, no choice in level of care, lower quality of doctor-patient interactions, etc.). Good thing there are blogs like this one to ask the questions left unanswered. Many thanks, JM

    • Randall V. Wong, M.D. May 22, 2011 at 4:34 pm

      Jean-Marc,

      I think the vitreous could be tugging on the old tears…..glad you were seen.

      Stay in touch.

      Randy

  • Crystal May 27, 2011 at 9:33 am

    I had a scleral buckle in March for retinal detachment. I also had laser and cryotherapy done to this eye. My surgeon told me that I could resume wearing contacts 1 week after I completed steroid therapy. I completed the steroids 3 weeks ago. I went 2 days ago to my regular optometrist that found the detachment. He checked everything out and placed me in contacts. The first pair that I was in before the exam were easy to remove. The second pair he placed me in were hard to remove that night from the eye that I had the buckle in. My family noticed that my eye was red about 30 minutes after I left the office. That night it was very red. When I finally got the contact out I felt (with my finger) the buckle and you could see it when my eye moved to the right. I hadn’t noticed this before but really never looked at my eye when I moved it either. Yesterday when I woke up my eye was crusted over, the sclera was very red, and I had a white sticky discharge from the corners of the eye and on the lower lid. I did not put the contacts in. I called my optometrist for them to see me in the afternoon. When I went to the appointment, my optometrist had spoke to my surgeon and they had agreed to put me on steroid drops again but I could still wear the contacts. He looked into my eye and then said change of plans. The buckle had shifted. I have an appointment with the surgeon on Tuesday. Does this mean I will have to have surgery again? There is no change in the vision. The eye is no longer red. There is no pain.

    • Randall V. Wong, M.D. May 29, 2011 at 11:06 am

      Crystal,

      1. I would never consider contact lens wear that soon after surgery only because your eye will get red quickly (as it did).

      2. This sounds like a pretty complicated situation, and I don’t know the nature of the scleral buckle shifting. I think the redness and the buckle shifting are unrelated…which explains the absence of redness. If the buckle has truly shifted, you’ll probably need some surgery to either replace the buckle or remove it.

      Let me know how this turns out.

      Randy

  • Tony June 9, 2011 at 2:37 pm

    Dr. Wong
    I had my first rd on 5/28/10, and had a cryo-retinopexy done that day as well. I returned to work on 6/11/10. On a follow up visit with my retinal surgeon on 4/24/11, my doc noticed another rd, and scheduled me for a TPPV and scleral buckle surgery on 4/28/11. It had not affected the macula. As of 5/27/11, my retinal surgeon stated the surgery went as well as he had hoped, and all seems well. I drive a commercial vehicle for a career, and my vision has to be a minimum 20/40 corrected for me to work. I saw my optometrist on 5/28/11 as my surgeon recommended I should do, and the best she could get me to see was 20/200. I therefore cannot work. She recommended I try again at the end of June. My eye sight does not seem to be getting much better, My doc also noticed a “thin membrane” over the retina that he did not think would result in a “blind spot”. My two questions are: do you have any idea, or experiences with the thin membrane over the retina post-op that my doc referenced, and what is the “typical” time period for patients who had my type of surgery for their vision to return to somewhat normal? I am 52 yrs. old and I had a mild eyeglass prescription (20/20 corrected) for distance vision prior to the last proceedures. Thanks!

  • Tony June 14, 2011 at 1:49 pm

    Hey Dr. Wong,
    Unfortunately the link for your article re: “causes of decreased vision after successful retinal detachment surgery” pops up with the registration site for a hockey tournament in Pittsburgh! Please resend me the link for your article, thanks..

    Tony

  • Elizabeth Abrams June 18, 2011 at 7:49 pm

    Dear Dr. Wong,
    I’m happy to have an opportunity to ask you a question. Two years prior to my Retinal Detachment
    surgery in September, 2008, I had been using Restasis for very dry eyes. It didn’t seem to help
    much, but I kept on hoping. After my surgery, my eyes could no longer tolerate the Restasis.
    It caused unbelievable burning that did not cease. So my Opthalmologist recommended I use
    one of the many, many drops over-the-counter. For almost 3 years, my left eye makes me
    miserable every single day. I had pain, burning and it has caused a negative effect on my
    daily life. I am totally miserable. My retinal surgeon tells me that the Scleral Buckle surgery turned
    out wonderfully and my Opthalmologist really doesn’t have a good answer why my eye is
    causing me such discomfort. Both of these physicians have the highest credentials and I do
    trust them implicitly, but would like to get an opinion as to why I am in so much pain.
    My right eye hurts as well – possibly in sympathy for the left. I have, once again, been corrected
    to 20/20 vision and I’m told I’m so lucky to have that. Believe me, I am so grateful, but I am
    just so miserable. Before I even open up my eyes in the morning, I can feel the pain and burning.
    Hope you have an idea.
    Happy Father’s Day.

    Elizabeth

    • Randall V. Wong, M.D. June 20, 2011 at 10:22 am

      Elizabeth,

      I have no answer for you. I don’t prescribe Restasis as a retinal physician has no use for it. It might cause some burning when instilled. Many times the pH of drops needs to “burn” so the drug stays stable while in the bottle. You may be sensitive to the solution, too.

      I would recommend you seek the aid of a corneal specialist in your area. They are the eye docs who specialize with dry eye and such when Restasis and the like don’t work. Sounds like you?

      All the best and good luck!!!

      r

    • Randall V. Wong, M.D. June 20, 2011 at 10:23 am

      Elizabeth,

      Thanks for the Happy Father’s Day!!!!!
      Had all 5 kids for lunch, and almost all gone by dinner time 🙁

      r

  • Elizabeth Abrams June 20, 2011 at 10:09 pm

    Dear Dr Wong:

    Thanks for your reply, but I think I explained my problem in a very confused manner.
    I haven’t used Restasis for almost three years. My issue, in the past 3 years, is that
    my left eye (with scleral buckle in 9/08) hurts and burns every single day. It causes
    me to be completely miserable. Even my right eye hurts. Can you think of any
    reason, after retinal detachment surgery, that would cause my eye to feel this way.
    I use over-the-counter drops for extreme dry eyes, but there’s no relief there.
    Thanks in advance for any idea pertaining to my problem

  • Tim Banach June 28, 2011 at 7:25 pm

    Hi Dr. Wong,
    I had both a scleral buckle and a vitrectomy performed on 5/11/11. The retina reattached in a day and all seems to be well (ok, it seems to have induced a case of “Map Dot Fingerprint Dystrophy” that was misdiagnosed as an infection for two weeks, but that is coming around now that it is being properly treated.) My question is that ever since the surgery my repaired eye has not had very good pupil response. The day after the surgery it was actually trapezoidal in shape but has since returned to the normal circular form. But it responds very weakly if at all to light – and yes, my eye is light sensitive. My regular opthamalogist seems to think it was nerve damage from the detachment but the pupil was fine before the surgery so I have my doubts. Is this a common side effect? Does it/can it heal with time? Trust me, I’m happy to have my sight back but am concerned if it will always be light sensitive.
    Thanks!
    Tim

    • Randall V. Wong, M.D. June 29, 2011 at 10:39 am

      Dear Tim,

      I think you are right. I see this often retinal detachments that have “done well.”

      There is no damage per se as I couldn’t tell you how it might occurred.

      On the other hand, there is nothing to do if related to the surgery.

      Off the top of my head, most of these return to normal with time. It may also be helpful to know if you used some long-acting dilating drops after the surgery. Atropine, for instance, can last weeks.

      Randy

  • Missee July 21, 2011 at 5:09 pm

    I had retinal detachment surgery around three years ago and had a scleral buckle put in my right eye. In the last month to a month and a half my right eye has been very sore in the corner near my nose. It hurts when I blink, and the pain is exasperated when I put my contacts in. My eye does not become overly red or anything like that, but I can barely walk outside without my eye tearing up and tears running down my face. Is this something that is normal? Should I see a doctor?

    • Randall V. Wong, M.D. July 22, 2011 at 7:28 am

      Dear Missee,

      You should definitely see your doctor. This is not normal.

      Randy

  • patrick Humphreys July 25, 2011 at 5:34 pm

    I had retina surgery over a year ago, May 2010. A scleral buckle was put in. After my recovery time of around 3 to 4 months i have a experienced pain in that eye when ever i travel up or down in altitude. My eye starts watering and feels like it’s being squeezed. I also was told that after the operation that i would not feel the buckle and i can and do feel it 24/7. I also feel like my vision is restricted when looking left, right, up and down. Is this normal or something that should be taken care of? why is this happening?

    • Randall V. Wong, M.D. July 29, 2011 at 8:36 am

      Dear Patrick,

      I would doubt if it is the buckle, unless it is exposed. My first inclination is to check and see if there is any exposure (piece not covered by the conjunctiva) and also ask your doctor to check for dryness. Regardless, this seems unusual and I would encourage you have your doctor check it out.

      r

  • Lauren July 30, 2011 at 2:22 pm

    Hi Dr Wong
    I was referred to the hospital by my optician as I was experiencing a flicker in my vision in the lower inner corner of my left eye. This problem started about 2 months ago, then a couple of weeks later I also started getting flashes of light in the same eye. I had my hospital appointment 2 weeks ago where I was told I had a detached retina which would require surgery. I was told that at 25 years of age this was extremely rare but had occured as I am very short sighted. I was told that I had five holes/tears in the retina. I have since had a buckle fitted 22/7/11 and was seen 3 days later by my consultant. He was pleased with the result and said that most of the fluid which had seeped through the holes had gone. He did however say that as part of my retina had been detached for years, most but not all of the retina had been reattached. He also mentioned that he may do some laser surgery on the eye in the next couple of weeks but said that I should not require anymore major surgery in the near future. I explained to him that since the operation I was still experiencing the flashes of light but was told that this is to be expected and that this will never go away completely. Since this appointment the flicker that I was experiencing before the op has now returned and the flashes of light seem to be occuring more regularly, about the same, if not more than prior to the op, particularly when I first close my eye. I am due to see the consultant again on 11th August but I am worried about these symptoms. I understand that if part of the retina is still detached I may still experience symptoms but do not understand why I am getting them so frequently (approx 20 times throughout the day) if most of the retina has been reattached. The flicker I am experiencing is in the lower inner corner of the eye only and lasts for a couple of seconds at a time. I would be grateful if you could advise me.
    Thanks Lauren

    • Randall V. Wong, M.D. August 7, 2011 at 10:15 am

      Lauren,

      Sorry for the delay.
      In my opinion, the flickering is to be expected and is a sign that the retina has simply undergone surgery…and nothing more. It doesn’t really mean a good thing or bad thing.

      Keep us updated!

      Randy

  • Susan August 1, 2011 at 4:33 pm

    Dr. Wong
    Thank you for hosting this opportunity for questions. I am 3+ weeks post-op from a second repair (same eye) of a partial detachment. The first repair was 7.5 weeks ago. The first repair was with a gas bubble. This latest repair was laser, a gas bubble and a partial buckle. I have a history of 3 tears in the other eye 2.5 years ago repaired with a laser. All of these tears and detachments have occured either when I have been in high altitudes (over 9000′) or following an episode of heavy lifting or great emotional stress. Is this a coincidence or it there a connection? Thank you.

    • Randall V. Wong, M.D. August 7, 2011 at 10:18 am

      Dear Susan,

      I believe to be simply and unfortunate coincidence. I can’t imagine how lifting, stress or altitude can matter.

      Stay well and good luck!

      Randy

  • Jean-Marc Gladu August 3, 2011 at 5:41 pm

    Hello Dr. Wong,
    I had a buckle installed on March 23rd on my right eye and I had written about recurring “flashes” following surgery. I am from Montreal. You wanted to know if there were developments… They figured out today what was wrong. I had lots of internal bleeding following surgery. The accumulated debris and tissues inside my eye formed a “tissu ring” that is pulling on my retina causing the flashes. I am scheduled for a vitriectomy on September 13th. The specialist says it will remove the debris and the ring which should stop the flashes and hopefully improve my vision. He estimates the risk of detaching the retina from the procedure at only about 5%. He says the chances are better because I have a buckle. The down side is to expect the develolpment of a cataract within 2 years. I am hoping this will settle my vision issue. I will let you know how it goes. I trust you are doing well. Thanks, Jean-Marc

  • Lauren August 4, 2011 at 6:54 am

    Hi Dr Wong
    In addition to my earlier post I just wanted to give you some more detail with regards to the flicker in my vision I mentioned. I think it is a line or a dot of shadow at the very lowest part of my peripheral vision but it flickers at a very rapid speed. I don’t think it is a floater as such as it does not move around the eye. I can also see the flicker when I close my eye. Previous to the operation this ‘flicker’ only lasted for say 3-5 seconds at a time but now it seems to be happening more frequently and each episode can last up to around 30 seconds. In fact I seem to spend more of the day with this flicker than without it. I have searched the net and read other people’s experiences of retinal detachment but none of them seem to mention anything similar. I can’t feel this happening I can only see it and I do not have any pain.I am still experiencing the light flashes too which seem to be 2 large blobs of light that move along the bottom of my eye from left to right then disappear when they reach the corner of my eye, these last only a second. Both symptoms are really worrying!
    Thanks again
    Lauren

    • Randall V. Wong, M.D. August 7, 2011 at 10:31 am

      Dear Lauren,

      Let us know what develops. As I said in my earlier response, I don’t think this is a danger sign. Just make sure that your doc is aware.

      r

  • Miki August 12, 2011 at 12:37 am

    Dr. Wong,
    Thank you for the reply, there is no information on the internet about re-detachments! And consultation fees are very expensive for just a few questions…
    Does the procedure require physically stitching/attaching the rubber pieces onto the eye? Is this why even impact to the head will not simply ‘dislodge’ it? Also, what kind of symptoms would show if the retina did re-detach?

    Thank you so much for your quick replies

    • Randall V. Wong, M.D. August 19, 2011 at 11:39 am

      In most cases the scleral buckle is physically sewn to the eye. Early symptoms of retinal detachment can include loss of the peripheral vision.

      All the best!

      r

  • David August 12, 2011 at 9:09 am

    Hi Doctor,

    Just went through my second vitrectomy to my left eye in the past 3 weeks, This time I received the scleral buckle and oil. I took the week off and must return to work on Monday. The retina has apparently not completely re-attached at 6:00 and there is a shadow in my vision at 12:00. What makes the retina re-attach itself in these conditions and typically how long will that take?

    Thanks, Dave

    • Randall V. Wong, M.D. August 12, 2011 at 11:05 am

      David,

      Concerned our retina is not reattached due to a condition called PVR?

      Ask your doctor if this is responsible, otherwise I would expect your retina to be reattached shortly. Normally, and in most successful cases, the fluid underneath the retina self absorbs…

      Randy

  • Lauren August 12, 2011 at 11:55 am

    Hi Dr Wong
    Thanks for the reply to my earlier posts. I visited my doctor yesterday, you were right, he says the flashes and flicker is totally normal. He is really pleased with both the result of the surgery and how my eye has healed. He has therefore told me I can now discontinue the antibiotic and dilating drops, however he wants me to continue with the steroid drop for another week. I work in hospital pharmacy myself and it was only after my appointment that I realised he didn’t mention anything about gradually reducing these drops over a period of time as oppose to stopping them abruptly. To my knowledge this type of drop should be reduced gradually. As of next week I will have been using one drop four times a day for four weeks. What is your opinion on this? Also although my buckle surgery has been a success and the doctor says no more surgery is needed at the moment he cannot guarantee that twelve months down the line this will still be the case. In your experience what is the likelihood that I could have a re detachment in the future? My doctor has told me that there is part of the retina that will never reattach as it was detached for so long,probably a couple of years, but looking at it yesterday said there was nowhere near as much fluid there than before the op. Also as my detachment in my left eye was due to my poor vision, which is about the same prescription as my right eye, is it likely that my right eye will also detach in future? I’m only 25 so will the likelihood of detachment continue to increase as I age? Sorry for the million questions!

    Thanks
    Lauren

  • Lauren August 12, 2011 at 12:08 pm

    Sorry Dr Wong
    Not sure I made myself clear, I am happy to stop both the antibiotic and dilating drops and have done so as of yesterday. It was only the steroid drop as was concerned about stopping abruptly as I thought steroid drops were supposed to be reduced gradually.

    Thanks
    Lauren.

  • David August 13, 2011 at 3:57 pm

    Hi again Doctor,
    The first vitrectomy, ( laser and gas bubble,) resulted in a re-detachment within 2 weeks. He attempted to repair that with another air bubble followed by cryo the next day. This didn’t work, resulting in the retina ” closing like an umbrella” on all sides and leading to the second vitrectomy with buckle and oil. I would asume that such a comprehensive repair could likely result in one area or another with some fluid under a portion of the retina and I hope it self absorbs. ( It’s 8 days post surgery.) I’m scheduled to see my Doctor on Monday 8/15 and will ask about the PVR.

    Thanks much, it’s good to discuss this with you!

    David

  • David August 17, 2011 at 6:27 pm

    Good afternoon,
    Your PVR prediction was correct, ( unfortunately.) The doctor tells me that the scarring radiates from the center of the eye to the side, I can’t see from straight ahead to the bridge of my nose, but my peripheral is OK. He seemed to indicate that based on location of he scarring, another surgery might be in order.
    I see him again next Tuesday to see what’s changed, if anything from Monday’s visit.

  • Mike B August 19, 2011 at 12:25 am

    Dr Randy,
    Thank you for your super amazing blog!! It’s beyond any expectation.
    Dr. Randy, I am a professional but I totally adore the strenuous workout, which I pursue for even more than 2 hours per day. It’s really a way of life!
    I had two scleral buckles done three and two weeks ago. Not that I needed two, but at the first one a stitck, which was holding the silicon sponge, broke. For now I feel good, under the circumstance. I was told that after 10 days I still have some fluid under the retina and my Doc will isolete the fluid with the laser. I trust my Doctors, which I highly respect.
    Nonetheless, I never got a clear answer whether or not it is risky to strenuously work out in the future, what are the eventual risks, what am I allowed to do, what am I forbitten to do, and when can I eventually restart my customary way of life.
    Thanks in advance for your feedback and advice, Dr. Wong

    • Randall V. Wong, M.D. August 19, 2011 at 11:43 am

      Dear Mike,

      Can’t answer for your docs.

      If you were my patient, I would say that once you are stable, strenuous activity is encouraged because in my opinion, it has nothing to do with detachments.

      If there are doubters….think about the forces inside the eye generated during REM sleep. They far outweigh those forces experienced during exercise.

      Randy

  • Mike B August 19, 2011 at 12:35 pm

    Dear Dr Randy,
    Thanks a lot ! You did not answer instead of my Docs but you answered instead of all retina specialists!!!
    Your answer (ref: REM) is short, clear and to the point!
    I really got it!
    How would the medical world would be if all the doctors would have your communication skills?

  • Mike B August 21, 2011 at 10:00 pm

    Dr Randy,
    I know you can’t speak for my doctors, but I would really appreciate your opinion based on the information I will provide you. This because I find my case unusual !
    The facts are as follows. Last year, in June, I had a routine eye check up, and the ophtalomologist sent me to a retina specialist who said that I have a retina tear and an associate of his ( most likely working towards his specialist degree) rasered me.
    Six month ago I felt like seeing some floaters and I imediately went to my ophtalomogist who, after examining me, told me that there is nothing to worryabout, it is probably a thickening of the liquid, but there are no tears and no retina detachment.
    Four weeks ago I started noticing blurrying of the wision in my left eye and a relatively small decrease in my left superior visual field. I went right away to my ophtalmologist who, after examining me, showed me my retinal detachement and sent me to a specialist.
    Three days after, when I got to the specialist the initial diagnosis was confirmed and I was sheduled for a sckleral buckgle the next day. Apparently, the surgery went well, but after some 6 days I felt a blurring of the vision and called my specialist. I wasn’t given pretty much any explanation but scheduled, the next day, for another scleral buckling, The only information I was really given was that they are going to put another silicone rubber band, close to the initial one, because I still have liquid under the buckle.
    So, we did the second scleral buckling intervention.
    Following that intervention I went to three check ups and It was determined that I still have fluid.
    Putting a bubble is not be an option, because the detachment is at the very bottom of the ocular globe and it would mean that I would have to sit … bottom up, which is rather impossible.
    Last time I went, which was two days ago, it was decided that they will try to segregate with laser the liquid, hoping that it will not advance toward the center of the eye and eventually go away.
    While trying to do this, the doctor doing this ( I think the doctors doing the laser are not the specialists but the ones working toward their specialist degree) concluded that he can’t “stick” the retina, because it doesn’t stick, which means that there is liquid under the retina, even though they did not see it even with the magnifying glass.
    Meanwhile the specialist lasered me the retina to make a sign and see if the liquid advances, and I will meet them in two weeks, on August 30.
    I trust the doctors, they are a bunch of young specialists, with the specialist designation got two to four years ago. I also feel that they try to do the best, and I know that they consult each other. All in all there were 3 retina specialists involved in handeling me.
    My question is Dr Randy: is it possible that they “wrinkled” my sclera in between the two successive silicone bands? Is it possible to have liquid which is completely invisible at several examinations and be perceived only when trying to “stick” the retina back with the laser?
    Based on the information I provided you what is usually done? ( I know you can’t speack for my doctors, but I am looking just for a comment)
    Is it worthwhile to go and see a retina specialist with more years of practice? I trust and respect my doctors, but being myself a specialist I know that a professional is, somehow, like the wine, most of the time, years of practice make a difference.
    Thank you, a lot, in advance.

    • Randall V. Wong, M.D. August 22, 2011 at 11:38 am

      Dear Mike,

      1. You are right, I can NOT speak for your doctors.
      2. If the retina specialist had an associate, that person is already retina trained. It is possible that your specialist is training someone to become a retinal specialist and that term is a “fellow.” A retinal fellow is a person who has already completed ophthalmology training and wants to become sub-specialized.
      3. Inferior retinal detachments can be very difficult to treat.
      4. I would suggest getting another opinion. While I don’t think anything is being done wrong, you need to have peace of mind that everything is being done correctly for you.
      5. At times, a small amount of fluid underneath the retina is impossible to see and, yes, you can only tell when you attempt to laser that area…detached retina doesn’t absorb the laser.

      Keep in touch.

      r

  • Mike B August 22, 2011 at 6:43 pm

    Dear Dr Randy,
    Thank you for the very timely feedback.
    Based on your extensive experience:
    1) in the case of on inferior retinal detachment how likely is for the detachment to progress? I am thinking of the gravitational forces which, at least theoretically, should traction the retina in oposit direction from the direction of a detachment.
    2) how possible is for the relatively little fluid which is now under the retina to build up to something more significant, and what are the influencing factors?
    3) how likely is for a small quantity of sub-retinal liquid to “go away” when it didn’t go away three weeks after the scleral buckling
    4) what is the standard procedure in these kind of situations?
    5) am I allowed to workout in this conditions? (i.e. inferior retinal detachement, some liquid under the retina etc.)
    Dr. Randy, I know you can’t speak for my doctors, but I am looking for your opinion based on what you have seen in your lenghty practice as retina specialist.
    Thanks in advance,
    Mike

  • David August 22, 2011 at 6:54 pm

    Is it not uncommom for PVR diagnosed patients, ( with 2 vitrctomies to the left eye behind them,) to forego any further treatment? From what I read, the results from the retinopathy(?) to scrape the retina clean only results in sub par vision at best, and that only 50% of the time.
    I already have that now. I can see larger objects in bright light or sunshine, ( kind of like vaseline is smeared across my eye.) and I can live with that, in that I still have the peripheral in that eye, and I’m also 58 years old. I just don’t want to go through the expense yet again, and the arduous recovery only to find that my vision is only marginally better than it is now (maybe!). Currently I’m blessed with a 20/15 right eye….and as long it stays healthy, I think I can live a pretty normal life.
    What do you thnk?

    Thanks in advance…

    David

  • Kym September 7, 2011 at 11:28 am

    Dear Dr. Wong,

    I first want to thank you for this blog. It has been very education, however I am still hesitant. I have recently been diagnosed with a retinal detachment (actually 2). I am 45 years old and have been told that the first detachment probably occured 20 years ago but because of the location (bottom, rear) it never progressed. (I was diagnosed in my mid teens as having a small retinal hole at the bottom of my eye and that gravity should hold it there, not requiring treatment) Now there is a second detachment (a progression of the first) that the doctor said has been there 5 to 10 years. He recommends the scleral buckle procedure. I don’t have any vision problems except for the occasional flashes of light when I look a certain way and the floaters that have been there as long as I can remember. I’ve read so much about this procedure, good and bad. The risks scare me as my vision is fine, but could get worse. He gave me a month to think about it. I’m not really sure what to do. Do I wait until I absolutely need the surgery or take the risks of losing vision (or worst case my eye) and have it done now? I kind of feel like it’s been there so long maybe it won’t progress for another 20 years… The whole thing scares me to death. Any thoughts?

    Thank you in advance, Kym

    • Randall V. Wong, M.D. September 7, 2011 at 5:06 pm

      Dear Kym,

      In seasoned hands, you should not fear a scleral buckle. I would look at your situation as just plain lucky that you haven’t detached your macula…yet.

      In most cases, the detachments progress to involve your central vision and this can cause permanent vision loss. Your doctor doesn’t want to risk this and I would agree. If you have doubts, you should take this month’s time and find someone with whom you can relate better…and trust.

      Best of luck, but I would urge you to get something done. You have nothing to gain by waiting longer.

      Randy

  • Kym September 8, 2011 at 11:53 am

    Thank you Dr. Wong. I hadn’t really thought of a second opinion, but that’s an excellent idea. I did speak at length with my family doctor and he agrees that I should go ahead and have the surgery. I deeply appreciate your quick response and wish I lived close enough to come see you! Keep up the rgeat work you do in educating people and taking the time to answer questions!

    Respectfully, Kym

  • Amboy J September 13, 2011 at 10:00 pm

    Dear Dr. Wong-
    I had a scleral buckle done for a retinal detachment that did not involve the macula 5 months ago. I still have a blob of sub-retinal fluid that has not dried up. So I am still seeing the original “blob” that brought me to the doctor in the first place. My doctor says he is really puzzled as to why it hasn’t dried up yet and just says to come back every 2 months for a recheck and to call if it gets worse. The pupil of the eye is also still dilated all this time (I”m not using any drops). Will the unabsorbed fluid ever go away or will I have to learn to live with it? Will my pupil ever un-dilate?

    • Randall V. Wong, M.D. September 19, 2011 at 6:11 am

      Dear Amboy,

      Difficult to say. In theory, it should dry up. I did have a patient a few years ago who required additional surgery.

      There are many causes of a dilated pupil. As I can’t examine you nor do I know all the details of the surgery, I can’t say for sure. I would consult your doctor on this one.

      Randy

  • Brenda September 14, 2011 at 1:23 pm

    Hello!
    I’m 4wks post-operative scleral buckle and vitrectomy (2nd vitrectomy in same eye) in right eye.
    I have Stickler’s Syndrome (manifested only with eye issues; no cleft pallet).
    I received a scleral buckle in 1972 at the age of 13 in left eye.
    I had intra-occular implants in each eye during my 30’s and 40’s, followed later with YAGs.
    Since my teen years I have had so many laser treatments for retina tears that it’s difficult to keep count.
    Here’s my concern: In the recent post-op recovery room I had to have 4 units of morphine and 2 more shortly thereafter for the horrific pain I was experiencing. For the past 4 weeks I have continued to be in pain, but thankfully the pain has gradually reduced. Ice packs and Lortab were used daily for the first 3 wks after surgery. Visited the surgeon this morning, who noted that swelling in the back of my eye was still present. Futhermore, he believes that the swelling has been the culprit of all my pain. He reminded me that I also had a post-operative bleed. He was hestitant to give me Lortab b/c he thought I had a low tolerance for pain and that I was being a drama queen. After all the surgeries and interventions I have had in the past 40 years, I never had to take more than a few Tylenol.
    Why do you think I had such excruciating pain with this last surgery? Lastly, do you know any retina specialists who also specializes with Stickler’s Syndrome. Thank you for your response.

    • Randall V. Wong, M.D. September 19, 2011 at 6:19 am

      Dear Brenda,

      You are tough!

      RE: Pain…no idea, but is very, very atypical.

      RE: Stickler’s. Off the top of my head, I do not know anyone who specializes…it is not that common.

      I wish I could be of some help. I know I didn’t answer anything.

      r

  • Russell Smith September 16, 2011 at 2:33 pm

    Dr Wong, this is a great service you are providing, as these symptoms can be so worrying and we are all anxious about our vision.

    I have a question similar to one above. I had a scleral buckle a month ago, for a retinal detchment. I saw the surgeon four days ago and he said it was looking good and I could stop taking the atropine drops. So I stopped taking atropine four days ago, but the pupil is still fully dilated and unresponsive to light. I am extremely sensitive to light and find it hard to go outdoors. Is this normal? Is it possibly a result of some trauma done to the nerves during surgery? Will my pupil be permanently dilated?

    Thanks

    Russell

    • Randall V. Wong, M.D. September 19, 2011 at 6:28 am

      Dear Russell,

      Atropine can work for 2-3 weeks after cessation. It is possible, however, that some damage from the retina or to the optic nerve is causing dilation, too, but for now, I’d expect the dilation may be from the drops.

      If the dilation persists, make sure to bring this to your doctor’s attention.

      r

  • Russell Smith September 19, 2011 at 9:06 am

    Thank you!

  • Lauren September 21, 2011 at 2:39 pm

    Hi Dr Wong
    It’s now been 9 weeks since my buckle surgery and although my vision is fine I am still experiencing the flashes of light I was getting prior to surgery. They are also happening more frequently then before my operation, about 20 times per day. As I mentioned in my earlier posts my doctor said that part of my retina had been detached for years therefore not all of the retina has reattached after surgery. When I mentioned the flashes to my doctor he said this was normal and would continue indefinitely . However I do not understand how they can be a symptom of detached retina, yet I am still getting them after having the buckle fitted, is this because part of the retina is still detached? And more worryingly as this was the symptom that first prompted me to have my eye checked out how would I ever know if I had a further detachment if I am just accepting these flashes as normal? I don’t really understand the theory behind these lights and would appreciate it if you could fill me in!

    Thanks

    Lauren

  • Brenda September 22, 2011 at 1:42 am

    Dear Sir:

    I am touched by your kindness of responding to my Sept. 14th request. I am pleased to report that at the time of this writing, I am practically pain-free. My vision was completed restored. Still a few weeks away from a new refraction since the intraoccular implant is, of course, askew now.

    I failed to mention in my first note that my 17 yo son also has Sticklers. He also has Horner’s Syndrome in one eye. At age 10, he had a vitrectomy. Three years ago he had an intraoccular implant (which “slipped” and the surgery had to be repeated 2 days later). He, too, has had a couple of laser treatments. My hope is that he never has to have a buckle. But if he does, I wanted to have some pointers for him if he too experienced alot of pain.

    Stickler’s is rare, but not in my family. My father and grandfather became blind from it along with countless relatives. We’ve traced it as far back as one family member going blind in a prison camp during the Civil War! Ooops. Didn’t mean to bore you. I want to give thanks to God and my surgeon for saving my eye sight and my son’s to date. Thank you for allowing me to post feedback.

  • Kym September 23, 2011 at 10:41 am

    Hello Dr. Wong,

    Just checking in to let you know my surgery is scheduled for next week. I’m nervous, but ready to get it over with. I’ve been reading the posts here and want to ask what percentage of your patients who have the scheleral buckle surgery, where the detachment (an old detachment I’ve been told) has not affected the macula yet, have the long recovery time and issues with pain and vision, that some of these people posting have had? (by the way everyone, I feel for you and pray for your continued recovery!) I think it’s what happens afterward that is scaring me the most!

    Thank you in advance, Kym

  • Marie November 2, 2011 at 7:02 pm

    Dear Dr. Wong,
    23 years ago at the age of 23 I had bilateral retinal detachments and had scleral buckle and banding and cryotherapy. My sight was restored with reduced superior visual fields. My myopia increased to -17 left eye and -15 right eye. 7 years ago my left eye retina redetached and I had gas insertion which resulted in a bubble on my iris, immediate cataract and a further redetachment. The retina came off the macula. I was given further surgery with silicone oil which was removed 6 months later-with catarct operation and 5 months fter, ERMP. My resultant vision was CF and radically reduced fields in the left eye.
    Although the oil had been removed there had always been one tiny miniscule of an oil globule floating within my eye like a glowing light. Recently my intra ocular pressure in my [left eye only] suddenly increased from 20 to 24 then to 26 within 3 months. (My usual pressure is 18-20 both eyes and has never increased past this point. I was seen urgently in the glaucoma clinic but then the pressure dropped to 20 on it’s own. However, I was diagnosed with secondary glaucoma in my left eye only possibly caused by the oil (even though the oil was removed 6 years ago). I was told to take a variety of eye drops but reacted badly due to beta blocker allergy (which was unknown to me). There has been many weeks without any drops and my pressure remains 18-20 in both eyes. The thing is I no longer see that tiny globule and nor can the specialists. I am wondering if by any chance initially this oil globule may have caused a blockage and with the intermittent use of only a few eye drops within 6 months the oil globule escaped during drainage because during my diagnosis my drainage system is very good and my angles are very good.
    I would be most grateful for a possible explanation as I am concerned about using any drops (even those without beta blockers) when I always have long term problems with medication. The next suggestion is a trabeculectomy (which I know about) but I am reluctant in having further surgery if my pressure is within normal range without drops. There is no mention about using drops for my right eye even though the pressure is the same level.

    Thank you in advance, Marie.

    • Randall V. Wong, M.D. November 5, 2011 at 10:49 am

      Dear Marie,

      There are many variables to consider when choosing a trabeculectomy. While your IOP seems normal, it may not be low enough for you specifically, and thus, you would need to consult your glaucoma specialist as to why you may need surgery.

      I wish I could help more, but I have too many questions about your present status.

      r

  • Kenni André Pedersen November 21, 2011 at 2:19 pm

    Hi Dr Wong. Im a 25 year old guy from Norway, who had surgery for a retinal detachment in my left eye the 8th of November this year so its not so long ago. I had been having symptoms with flashing lights and a shadow on my left side that was only invasive when it was dark in the room for a while (since summer). Thats the reason why i didnt seek immidiate help. I was treated at Oslo University Hospital, and had cryopexy and a scleral buckle to attach the retina again. Im going in to see my surgeon december 8th, 4 weeks after surgery, but ive been at my eye doctor for a checkup in the meantime, and she says everything looks fine and stable. Ive been scouring the web for information in the period since the surgery and I know all that i can know about retinal detachments now. But still i was wondering about a few things i would hope you could answer me.

    1. Im using a medication called Tobrasone in Norway, i think its similar to TobraDex in the US, to prevent infection. I have been given instructions to use this 5 times a day, until i see my surgeon again. The problem is that i’ve read that i should not use this for more than 24 days, and that i should go down on the dosis and not stop abruptly. What do you think about these instructions ive been given? I have read that you can go down to 3 times a day after 2 weeks.

    2. Im really scared of a second detachment in the fixed eye, and of PVR. I’ve been having flashes of light in the eye, and still have a bit of a wavy vision in the peripheral part, where i had the detachment. Is this normal in the recovery period? And is PVR treatable?

    And now i need to stop reading everything thats on the web. 😉 It would be nice if you could answer these questions Dr. I would be really happy.

    Have a nice Day!

    • Randall V. Wong, M.D. November 26, 2011 at 8:10 am

      Dear Kenni,

      1. Seems excessive. I usually just use a steroid drop, but I don’t see anything wrong with what your surgeon advised.

      2. Yes, it can be normal. Yes, you could get PVR…it’s too early to tell. In my experience, PVR shows up a couple of weeks to a month or so after the initial surgery. It is a good sign if the distortion remains stable.

      Randy

  • Gary Ferguson December 9, 2011 at 1:08 pm

    Dr Wong,

    I am 3.5 weeks post op virectomy and scheral buckle in my left eye and though vision is improving I have noticed virtually no decrease in pain or discomfort. Previously my body rejected what I understood to be dissolvable anchors were used by my Orthopedist used to repair my right rotator cuff as well as permanent Tytanium anchors. They were just happily floating around in my shoulder causing me acute pain when I would move my arm this way or that when I finally convinced my Dr to go back in. I had also developed an unusual mottled rash on my right shoulder that wasn’t particularly painful but was not responding to treatment from my Dermagologist. When my Orthopedist finally removed the screws the rash disappeared shortly thereafter. Is it possible that the material in the anchors is similar to the medical grade silicon of the scheral buckle and that my body is negatively reacting the the foreign invader. My scalp has also been extremely sensitive to touch since my eye surgery although I have no apparent redness or discoloration. Would getting a referral to an Allergist make sense? If the pain doesnt improve soon I would rather be one-eyed than continue on.

    Sincerely,
    Gary Ferguson

    • Randall V. Wong, M.D. December 12, 2011 at 11:07 am

      Dear Gary,

      Unusual events for sure. Although I don’t use them, there are titanium clips that are used by some surgeons. I would definitely ask you retina surgeon.

      Randy

  • Tim Banach December 20, 2011 at 7:36 am

    Just a follow up to my earlier post. It’s seven months later and two things are known. One, the buckle fixed my detachment. That’s the good news. The bad news? The surgery brought on a herpetic infection and the retinal doc missed it. For two months after it took hold. My regular opthamalogist spent another two months repeating what the retinal doc did to rule out bacterial based infections, recurring erosions, etc. But I now know what the issue is and it does respond to treatment (drops when active and oral suppresion when not) very well. A learning is that if this is your situation and you can’t take the oral drugs for a few days (say, with a stomach bug) PUT DROPS IN! ?Allowing it to recur is simply not fun and since the nerves seem to be regenerating, actually more painful than it once was.
    Take care,
    Tim

    • Randall V. Wong, M.D. December 21, 2011 at 2:27 pm

      Dear Tim,

      As you are aware, retina problems can be so frustrating.

      Hang in there. Thanks for you input!

      Randy

  • Dana P January 7, 2012 at 2:33 pm

    I had surgery to place the buckle on my left eye due to detached retina. I always thought the bright flashing lights would be like fireworks or a flash bulb going off, instead mine were like a slow wave of low intensity light…almsot as if someone was using a flashlight inside my eye. On Jan. 3rd 2012 i noticed that lines that were know to be straight were kind of saggy and the top portion of my field of vision in my left eye was kind of in a shadow. Was sent to retina specialist on Wed 1/4/12 and he did surgery 1/5/12. Saw him 1/6/12 for post surgery said all looks good. I haven`t much pain just feels like sinus pressure ….my question is how long does it take the bloody eye look to go away. I could scare little children with my eye! Not to mention it looks gross to me.

    • Randall V. Wong, M.D. January 9, 2012 at 11:24 am

      Dear Dana,

      If you mean the blood on the outside of your eye where your eye is normally white?

      I’d expect tremendous bruising/blood for a few weeks. Your surgeon had to cut underneath this tissue to place the scleral buckle. If the kids get scared…explain it to them. Surgery helped prevent you from becoming blind!

      r

  • jill February 21, 2012 at 6:28 pm

    had sceral buckle on 19 feb. along with gas bubble. i do yoga 6 times a week and wondering if inversions or other physical activity (scuba or free diving) contributes to retina issues? ihad lasik 10 yrs ago at age 50 and had nearsight of 7 before that. I am lean and strong, happy and healthy and recovering well. Had 20/25 in eye week after surgery.
    are there ong term physical restrictions? anything i need to be careful of? running etc?
    we travel and i know bubble needs to be gone before any travel on an airplane.
    we have a winery – any issues with drinking moderately?
    Thank you so much, jill

    • Randall V. Wong, M.D. February 22, 2012 at 12:35 pm

      Dear Jill,

      I don’t believe the physical activity you described contributes at all to retinal problems.

      If you were my patient, no physical restrictions. Remember, during REM sleep your eyes move violently.

      Drinking your own wine!!! No issues.

      Randy

  • Bobbie February 23, 2012 at 3:17 pm

    Hi,

    Thank you very much for this forum!

    I have partial retial detachment (have had it for months apparently), and my first doctor tried to cure it with a gas bubble, but one corner of the retina ‘opened’ again. Now I am scheduled for the buckle surgery in mid March and the doctor is optimistic he can fix it. However, reading this forum has endendered some questions that worry me:

    1) How likely am I to have further problems with my retina after this operation? I am 30 and work on a desk job (i.e. heavy computer usage), and worry that would impact my career and lifestyle.

    2) How painful will the first days be after the operation? I don’t trust Tylonol and the gas bubble hurt a lot…

    3) Why do surgeons don’t like general anasthesia? I personally don’t want to know anything about what will be done to my eye, but my doctor said I looked very calm and he’d want to do it with local anasthesia. Of course, he spoke to me for 5 mins only.;) I have quite a bit of anxiety about the operation.

    These were all questions..

    Thank you!
    Bobbie

    • Randall V. Wong, M.D. February 24, 2012 at 9:55 pm

      Dear Bobbie,

      1. Quite likely this can be fixed. Your age and desk job, from what you’ve told me, are not in jeopardy because of the eye.
      2. Shouldn’t be painful at all. Did the gas hurt due to an increase in your eye pressure?
      3. Probably because it takes alot longer to recover, especially after long (with respect to time) anesthesia. Basically a personal preference.

      Good luck to you!

      Randy

  • carl graziano February 24, 2012 at 10:22 am

    I had a scleral buckle put in after a detachment feb 2011. I m 66 now and before the detached retna I had excellent vision and play a lot of golf. While the surgery saved the vision in that eye it also caused that eye to be very nearsighted. I had extreemly blurred double vison. Glasses helped a little and I was told my vision in that eye was as good as I can expect. I dealt with the bad news and bad vison. I recently had a cataract in that eye. The doctor said the removal might give me slightly better vision. I had the catarct surgery and new lens put in. (15 min surgery). I now have perfect vision !!! I was flabbergasted. Im just posting this to give others hope what is possible after I had given up hope.

    • Randall V. Wong, M.D. February 24, 2012 at 10:00 pm

      Dear Carl,

      Well done!

      Thanks for sharing and giving others hope.

      Randy

  • Indranil February 29, 2012 at 7:39 am

    I have undergone Ratinal Detachment .i have sclaral buckle,C3F8 gas and vitrectomy done on my eye. in July 2009. after 3 month in oct 2009 i need to remove sclaral buckle for the infection. Now i think my vision deteriated some amount. what can happen there?

    • Randall V. Wong, M.D. March 6, 2012 at 9:31 am

      Indranil,

      Am I correct in understanding that you had the buckle removed in October 2009. Now, you are experiencing decreased vision?

      I would re-visit your eyedoctors……could be anything from glasses, to cataract, to ERM….please have yourself checked.
      R

  • Amboy J February 29, 2012 at 11:47 pm

    Is it safe to wear contact lenses after having scleral buckle surgery and vitrectomy? I wore them for many years prior to my RD, but have been wearing eyeglasses since the surgery, assuming I could never wear them again, but now I’m hearing from my optometrist that it’s perfectly safe.

  • sarah b March 2, 2012 at 5:44 pm

    Hi Dr Wong,
    I just came across this page think its great that you’ve answered so many questions!
    I’m an 18 year old girl and iv never had any issues with my vision or needed to wear glasses.
    Last week I was diagnosed with a detached retina that has apparantely been there for a few years without me realising! The opthamologist gave me a choice between having the laser or having cryoprexy and a scleral buckle, although he strongly recommended the buckle because it is more effective. I agreed and he has put me through for routine surgery in a few weeks time.
    However, after doing a bit of research on the internet I am having second thoughts.
    My main concern is that the buckle will cause refractive error which will mean I’d need glasses from now on. Is this always the case or is it very common? As well as this I was wondering generally how long the eye takes to look “normal” again?
    If this was an emergency situation I’d happily agree for the surgery but as I am in no rush and my vision appears to be fine I’m just wondering if this surgery is a bit drastic.
    Thanks for taking the time to read this, I hope to hear back from you,

    Sarah

    • Randall V. Wong, M.D. March 6, 2012 at 9:37 am

      Dear Sarah b,

      Yes. Difficult decision. I agree with your surgeon. Refractive error is a small price to pay for a better, more permanent “fix.”

      All the best.

      Oh yes, it’ll take a few weeks to look “normal.” Eventually, even an eye doctor won’t be able to tell the difference between the two eyes.
      r

  • johnd March 9, 2012 at 4:13 pm

    I am a 71 yr old man, and just had the gas and the bubble both put in on Feb. 16, and still have several questions.. is it normal to feel the buckle? I haven’t seen any one else comment that they can. also, how long do you keep your head down, My dr. said i could walk around, but does that mean with head down?? and last.. how soon can one drive after? I have to make a 1200 mile trip home as soon as possible.. thank you for your help

    • Randall V. Wong, M.D. March 19, 2012 at 12:16 pm

      Dear Johnd,

      Yes. Still likely that you are feeling the effects of the surgery. The length of head positioning depends upon the type and % mixture of the gas used. In general, air absorbs faster than SF6 (sulfahexafluoride) and C3F8 takes the longest (most docs use the latter).

      You may drive after your doctor allows you. Usually, with my patients, I allow them to drive after the head positioning is over AND they are comfortable with driving.

      Randy

    • Randall V. Wong, M.D. March 19, 2012 at 12:17 pm

      Dear Johnd,

      I just responded to this on the other article “Scleral Buckle Surgery for Retinal Detachment.”

      All the best.

      Randy

  • Chris March 16, 2012 at 11:38 pm

    Hi there….. I am a 38 yr old female. I had retinal detachment and scleral buckle put on in July 2010 in my left eye. It healed very well, and vision is good considering the detachment was on the macula. Low and behold after a routine eye examine in Sept 2011, my retina was detaching in my right eye now!! So, same day I went in and had a buckle put on my right eye too. That was 6 months ago and I am still experiencing so much eye pain. My eye is constantly red, and painful…..feels like pulling whenever I look certain directions. I have to take 800 mg ibuprofen and put hot compresses on my eye daily to relieve the pain. I have been going back to retinal specialist almost every other week to figure this out. My eye is not infected he says, the retina is attached and the buckle looks just fine. My Dr. Is beside himself stumped, last resort he says is removing the buckle – which he would prefer not to do. I have tried so many drops to see if they help, but nothing seems to. I take artificial tears multiple times a day as well. I am so desperate for this pain to go away, I just can’t function with it. Also the redness is very noticeable – someone says something daily to me about how redmy eye is – I can perhaps live with that if the pain could just go away. Any suggestions?

    Chris

    • Randall V. Wong, M.D. March 19, 2012 at 12:37 pm

      Dear Chris,

      This is unusual. Sometimes removal of a buckle may be helpful. I usually like the buckle to remain for 3 months before considering removal.

      I’d seek a second opinion.

      Randy

  • Chris March 23, 2012 at 6:56 pm

    Dr. Wong,
    Typically, how long after Scleral buckle surgery are you able to wear contacts?

    Thank you

    • Randall V. Wong, M.D. April 4, 2012 at 7:25 am

      Dear Chris,

      This varies from patient to patient and doctor to doctor. I personally like my patients to wait as long as possible;

      1. I use drops after surgery for 1-2 months. The drops may ruin the contact lens.
      2. Patients may be sensitive to contact lens wear after having a buckle. This, too, can take months for the eye to heal enough to “re-acclimate” to lenses.

      Sorry I didn’t give a firmer answer.

      Randy

  • Lisa D March 24, 2012 at 10:27 pm

    Dear Dr.

    I’m a 20 yr old female college student who has a history of colobomia of the retina and optic nerve since birth. In September I had a vitrectomy where silicone oil was placed in my eye and a buckle was put in to fix a retinal detachment of the macula. I understand that I may not see the same ever again, however ever since surgery I have been experiencing a “black cloud” or “total loss of sight” in the effected areas of the eye, or sometimes the whole eye itself. I never did the head down positioning since my doctor was afraid that the added pressure was pushing against the already fragile nerve, and then when I got photos taken a month ago, the nerve seemed as normal as it as ever been, and the retina is completely flat. I’m taking eye drops to lower internal eye pressure, and to prevent inflammation twice a day, but still no change. The black cloud stays for a while, then dissipates, then comes back, then goes away again. I find that when it’s not there i see extremely well (with glasses) considering my prior history and the surgery. I’m so confused as to what could be causing this, and so are my doctors’. It comes and goes frequently enough to impact my daily life greatly. Do you have any ideas? Or possible questions I could ask my doctors?

    Thank you,

    Lisa

    • Randall V. Wong, M.D. March 30, 2012 at 8:24 am

      Dear Lisa,

      1. You have a coloboma of the retina and optic nerve.
      2. My first thought is that the pressure in your eye may be high relative to your blood pressure and blood may be having difficulty flowing through the retina. Just a guess. Make sure to address with your doc.

      Randy

  • Rachel Martin March 28, 2012 at 12:29 am

    Hello! I am glad to have discovered this forum. My poor, unfortunate, 10 year old son has recently experienced a detached retina in his right eye. It was discovered on Valetine’s day. He had surgery with laser treatment and the gas buckle injection that day. He remained in his recommended position and 3 weeks later new tears were discovered. The following day he had the scleral buckle put into his eye. Upon follow up appointments his eye pressure was 26. He has been taking Alphagan 2x daily. We had an appointment again today and his pressure was 30 and the Doctor said there is yet another new tear and he needs yet another surgery tomorrow! I have concerns about these ongoing problems and some reservations about the treatment we’re receiving. Are these issues common? Should I have reasons to be concerned that his Doctor is possibly incompetent? I have had to remind her the last 2 times that we needed drops for his elevated eye pressure. Thanks for any input.
    .Rachel

    • Randall V. Wong, M.D. March 30, 2012 at 8:38 am

      Dear Rachel,

      Hang in there.

      This is very unusual, both the age of onset and the post-operative course. Maybe time for a second opinion.

      r

  • Rachel Martin April 2, 2012 at 11:34 pm

    Thanks so much for taking time out of your busy day to answer questions regarding retinal/eye concerns. That is very kind and gracious of you. My son did undergo a 3rd surgery last week to laser the retinal tear and to remove his cataract. After surgery I was told everything went well, but when we went for a follow up appointment the next day, we were told that the Dr. was unable to finish the procedure. Her explanation for this was because the structure of my son’s eye is very weak and kept collapsing, therefore prohibiting her to complete the lasering process. So, yet again, she wants to do another surgery this week to finish lasering the tear. I feel like this ongoing nightmare of surgery after surgery will never end. I have major concerns about my son being put under anesthesia time after time, in addition to all the scar tissue that’s being created from all these surgeries. That being said, I have an appointment with a pediatric retinal specialist in Michigan in 3 weeks. In the meanwhile, I will have to continue with the current Dr. in hopes of keeping him stable. Again, thanks for all the time and effort you put into your website Dr. Wong.

  • pam nelson April 4, 2012 at 9:08 pm

    Dr Wong,
    I had a retinal datchment in my R eye on Dec 30 2009. I had a victrectomy, laser, gas bubble and a scleral buckle. I had constant pain over the last couple years The pain of the eyelid area continued . My doctor just kept saying give it time. I finally went toget a second opion in Sept 2011. He was well known. He immediately said I had a suture fom the buckle protroding. I had surgery to removing the suture hoping the suture and not buckle was causing pain on Oct 2011. Now my pain not as severe but still a daily consant pain that ranges 2 to 6/10 in the upper eylid. Pain still with reading and looking up. My retinal specilaist says we may want to remove buckle. My concern of course is another detachement. My question is have you removed many buckles with the result not a detachment. Also, my eye will go thru changes of shape and visual acuity? By the way I also need cataract surgery from the bubble so I need to decide before I do this and also does that increase detachment risk.

    Thanks
    Pamela

    • Randall V. Wong, M.D. April 8, 2012 at 5:44 pm

      Dear Pam,

      While usually not necessary, I”ve removed about 2 dozen buckles over almost 20 years. The reason is usually for erosion through the conjunctiva.

      We learn that the buckle needs to be left in place for the first 6-12 weeks after which removal is safe…..I would have to agree. I’ve never removed a buckle and the retina subsequently detaches.

      Randy

  • Cesar Samaniego April 6, 2012 at 2:34 pm

    Dear Dr. Wong

    I hope you are ok, My name is Cesar S. Im 40 Years old, In resume, I had a surgery in 1989 to remove a Cataract and Dr on that time place an intraocular lens in my left eye, in Nov of 2011 I had a surgery because the lense moved (Fall down) and other Dr. decided changethe intraocular lense for othe new lense 12mm Diameter, in Jan 2012 I had a Vitrectomy and in March/2012 I had a small retinal DetachmentI and Dr decided make a Scleral Buckle, from 3 weeks ago I Have an intense pain in my left eye, some Drs said thta was not necessary the Scleral Buckle because was an small detachment and with laser or Endolaser could be repaired, and the 2nd Dr opinion said that the Scleral Buckle must be loose or remove because was not necessary and is too tight that is why the reason of the pain.
    Any pain medicine can eliminate the pain, just is reduced.

    I really will apreciatte your opinion or if you consider necessary remove the Scleral Buckle, mi vision is reduced about 50% from the scleral buckle surgery, I feel dizzy and I lost the balance, I really want to remove the scleral Buckle.

    Regards

    • Randall V. Wong, M.D. April 9, 2012 at 8:37 pm

      Just answered on the other comment/post.

      Basically, wait a bit longer. If still painful, seek an opinion regarding removal.

      Randy

  • Cesar Samaniego April 9, 2012 at 1:04 pm

    Dear Dr

    I hope you are ok, My name is Cesar S. Im 40 Years old, In resume, I had a surgery in 1989 to remove a Cataract and Dr on that time place an intraocular lens in my left eye, in Nov of 2011 I had a surgery because the lense moved (Fall down) and other Dr. decided changethe intraocular lense for othe new lense 12mm Diameter, in Jan 2012 I had a Vitrectomy and in March/2012 I had a small retinal DetachmentI and Dr decided make a Scleral Buckle, from 3 weeks ago I Have an intense pain in my left eye, some Drs said thta was not necessary the Scleral Buckle because was an small detachment and with laser or Endolaser could be repaired, and the 2nd Dr opinion said that the Scleral Buckle must be loose or remove because was not necessary and is too tight that is why the reason of the pain.
    Any pain medicine can eliminate the pain, just is reduced.

    I really will apreciatte your opinion or if you consider necessary remove the Scleral Buckle, mi vision is reduced about 50% from the scleral buckle surgery, I feel dizzy and I lost the balance, I really want to remove the scleral Buckle if is an option, can let me know cost.

    Cesar Samaniego

    • Randall V. Wong, M.D. April 9, 2012 at 8:35 pm

      Dear Cesar,

      If I were given the chance to meet and examine you….perhaps removing the scleral buckle might be helpful.

      I would a wait a few more weeks after your last surgery.

      Let me know.

      Randy

  • Rachel Martin April 9, 2012 at 7:59 pm

    To answer your question Dr. Wong, no my son wasn’t born with any eye problems. His father, however, had multiple eye surgeries as a child which began at the age of 7 with cataracts and then escalated to detached retinas and he now has scleral buckles in both of his eyes. My son had corrective eye surgery 3 years ago for his “lazy eye” but this was his left eye and his detachment was in the right. He is myopic and has had glasses since he was 2. We are going for another surgery this Wednesday to finalize the lasering of his latest retinal tear. I will keep you posted about his post status. God Bless.

  • Cesar Samaniego April 10, 2012 at 12:00 am

    Dear Dr Wong

    I really apreciatte your comments, I feel with more confidence about your comments, I will wait until the week #8, this friday Apr/13 will complete my 4th week, tomorrow will have an apointment for checking because my eye all time is red like irritated all the time, and the last doctor (the third option or suggestion) said that my intraocular lense is moved and is not centered, but when the actualDoctor change my internal lense said that is very difficult center the lense because I dont have capsule and he had to suture or sew the lense to the top of the cornea because before the lense fall down because my eye dont have the capsule to fix the lense, do you have some option to fix this problem or center the lense.

    Before I decide make the scleral bucle remove locally I would like to visit you but with the intention and the desicion taken to make all the necessary with you on my visit, is very important know the aprox cost for Lense centering, remove the scleral buckle and all the necessary and try to avoid future surgery.

    you can send me the necessary information or aprox cost to may email to take the desicion, If I go with you is because I will make all the necessary on my visit because I will go from south California, or I will try to call you tomorrow and speak with you.

    Advice

  • pam nelson April 10, 2012 at 1:34 pm

    Dear Dr Wong,
    Thanks for your info. Its great to get another opinion. I am nervous about the removal of buckle. I hear that it helps prevent future tears by keeping the retina on a more slack position. I also don’t like living with pain too. My doc reassures me we can try to catch future holes with regular exams. And the worse ( if redetached)would be reapplying another buckle.Would you agree with this thinking? Also will my eye shape change along with the vision? I need to get cataract surgery. Sorry so many questions.

    Pam

    • Randall V. Wong, M.D. April 17, 2012 at 10:06 pm

      Dear Pam,

      As you are experiencing, this is very difficult and complex.

      I would recommend trying to digest this one symptom at a time.

      Focus on relieving the pain, then tackle the other issues.

      Randy

  • Rachel Martin April 25, 2012 at 12:16 am

    Greetings,
    I just wanted to fill you in regarding my son’s condition after seeing a specialist today. The doctor advised that my son be tested for stickler’s syndrome. He also mentioned that the vitreous in my son’s left eye (which is currently his “good” eye that hasn’t been operated on) resembles that of an elderly person as opposed to a 10 year old child. He wants to perform a lasering procedure to prevent a retinal detachment in his left eye, as he said there’s about an 80% chance of him developing one in that eye. I am very glad that I made the decision to commute to see this reputable physician and am now a little more hopeful for the future of my child’s vision.

  • Ruth May 9, 2012 at 3:35 pm

    I had gas bubble and a scleral buckle done to my left eye May 3rd 2012 and have been told every thing looks good. I have had bleeding of the eye and pain every since and the doctor said that is ok but all the reading said that bleeding is not. The blood is bright red and the eye fills with in 10-15 mins. and hurts. I have called my doctor and he seems not to be concerned. I’m very worried.

  • Ruth May 10, 2012 at 9:41 pm

    Dear Dr Wong,

    I had Scleral Buckle Surgery with air a week ago and I am still having bleeding not watering with pink but bright red from the eye and pain. I was told not to worry. Shouldn’t the bleeding be stopped by now and less pain. I see color and shapes out of the eye.

    Thank you
    Ruth

    • Randall V. Wong, M.D. May 13, 2012 at 8:50 pm

      It sounds like you are bleeding outside the eye?

      I agree that one week later is somewhat concerning, but I don’t know how much about the surgery you had.

      r

  • Liz Abrams May 11, 2012 at 10:23 pm

    Dear Dr Wong;

    I had retinal detachment surgery almost four years ago and for four years I have been
    miserable. My eyes are dry, so dry, and achy. I have a scleral buckle. Each time I
    see my Retinal doctor, he tells me how great everything looks, but I wish my left eye
    wasn’t causing me such misery. It has taken any joy from my life and because I
    suffer from bipolar disorder, this only exacerbates the problem. I am at my wit’s end.
    The Retinal surgeons are all in the same group, so it would be impossible to find
    someone with a separate opinion. I am miserable and don’t know what to do.

    • Randall V. Wong, M.D. May 13, 2012 at 9:31 pm

      Dear Liz,

      Consider evaluation by either a corneal specialist or an ophthalmic plastic surgeon. Both have significant experience with dry eye, whereas we retinal specialists are only truly worthwhile with retinal related problems :).

      r

  • Darlene May 16, 2012 at 10:47 am

    Dr. Wong I had a retinal detachment when I was about twenty five years old. I am now fifty four years old. I am and was extremely grateful for the surgery. My eye is noticeably smaller than my left eye. I want my eyes the same size. I think its embarrassing to look this way. Is this expensive to fix this problem? What are my options?

    • Randall V. Wong, M.D. May 22, 2012 at 1:36 pm

      Dear Darlene,

      Am I to assume that your vision in that operated eye is the right eye?

      I am also going to assume that your eye is seeing well and therefore not shrinking.

      Most likely, the normal orbital fat (fat within the eye socket) has decreased in volume compared to the left eye giving the appearance of it becoming smaller due to different elevations between the two lids.

      I would consult an ophthalmic plastic surgeon.

      Randy

  • Ruth May 21, 2012 at 6:58 pm

    Dear Dr Wong;
    The bleeding was on the outside and had stopped after a week but the scleral buckle is showing on the outside of the eye on the upper left corner.and I’m still having pain. Is this something that is ok? I was told I could go back to work ( it has been 2 weeks) and I am having a hard time as I am a dental assistant and the vision and headaches (pressure is good in the eye) are more than I can handle so I only work a few hours. I can see better in the eye but still very blurry and watery.

    • Randall V. Wong, M.D. May 22, 2012 at 2:15 pm

      Dear Ruth,

      I am wondering if the scleral buckle is exposes on the outside of the eye? You’d have to confirm with your doctor.

      r

  • JC June 10, 2012 at 2:39 pm

    I had this Scleral Buckle surgery on May 30 in my left eye. That gas bubble is finally down to a dot (thank God!). That was totally distracting and made me virtually blind for looking down. Had to cover that eye to go down steps. My eye feels very uncomfortable, though, and feels heavy. I can’t open it as wide as before the surgery, so it does look noticeably smaller than the right eye, now. What is the total healing time for this?

    • Randall V. Wong, M.D. June 18, 2012 at 9:38 am

      JC,

      Total healing time from a scleral buckle can take weeks to months and depends upon your particular definition or question regarding “healing.”

      Opening your eye and having the lid symmetric with the other eye may take months and I would not be concerned, but to make sure ask your doc this exact question.

      Randy

  • XY June 24, 2012 at 8:16 am

    Dear Dr. Wong,
    I have had scleral buckle surgery with gas bubble on my right eye on 25 May 2012. The gas bubble has gone after two weeks and i have just been to my post operation check-up four weeks after operation. My doctor said that there is still detachment with fluid and advised that I would probably need another surgery if the fluid doesn’t disappear within a month. I am worried and wondering why there is still fluid in my retina. Is this a common issue? (I did ask my doctor but he ignored my question) What is the possibility that the fluid will be gone in a month??? Is that necessary to have another operation???
    Thanks!!!
    XY

    • Randall V. Wong, M.D. June 27, 2012 at 7:52 am

      Dear XY,

      Not too uncommon especially if the retinal detachment, or a portion of the retinal detachment, is old. The older the retinal detachment, the thicker the fluid underneath the retina becomes and is more difficult to remove.

      It is also possible persistent fluid is a sign of redetachment or a new tear.

      You’ll have to rely on your surgeon for this answer!

      Randy

  • fawad June 28, 2012 at 4:06 pm

    Dear sir i have had my left eye surgery in 2005 silicon oil was put in for retina deatachment oil was removed in 2008 due to high pressur now the problem is 1) i have compleatly lost my vision from that particular eye 2) eye colour changed 3) that eye bacame smaller than other one sir i just want now to 1) recover my eye normal colour and size? is it possible plz plz plz help me out i will be very thankful plz

    • Randall V. Wong, M.D. July 10, 2012 at 5:52 am

      Dear Fawad,

      I believe you can be helped by an oculoplastic surgeon who might recommend a prosthesis…if indeed you have lost your left eye to retinal detachment and glaucoma.

      Randy

  • Kerry Summers July 9, 2012 at 3:08 pm

    Dear Doctor,
    I had scleral buckle surgery in my left eye on June 21, 2012. I have been getting an excruciating head ache on my left temporal above my eye. My eye surgeon said the eye looked fine and there would be no cause for the bad head ache. The pain got so bad I went to the hospital. They ran a cat scan and MRI and the imaging results came back normal. They sent me home with pain meds and Gabapentin to take. The doctor is guessing that a nerve might have been irritated since the heath ache is localized in one spot. Can you tell me if there are any complications or side effects that would be causing the debilitating headaches from the scleral buckle surgery? Is there any information you can give me to help me understand what might be going on? I’m nervous to take the Gabapentin which is an anti seizure/anti convulsant drug. Please write back ASAP!

    • Randall V. Wong, M.D. July 19, 2012 at 1:15 pm

      Dear Kerry,

      Pain from scleral buckle surgery is commonly from one of 3 causes;

      1. High pressure
      2. The operation itself (just the trauma of the surgery)
      3. The buckle impinging on a nerve or infection.

      I would ask your doctor to determine which of these is most likely.

      Randy

  • Ailsa July 11, 2012 at 9:03 pm

    I had a sclera buckle 3 weeks ago. After 2 weeks of using Atropine drops I realized I was having an allergic reaction. I was getting excrutiating headaches as soon as I used the drops, my pulse rate was at 50 bpm, I was sleeping all the time etc. I ceased using the drops and for 2 days I was fine then I started getting headaches again. The headache is only on the 1/2 of my head with the scleral buckle. After 3 days of this I went to my ophthalmologist. He said the retina was flat and good, pressure was good as was everything else. He does not know the reason for the pain. This pain is debilitating!!! It is like a toothache with someone poking something into it every few minutes. What could this be from? Is it the after affects of the Atropine? Is the buckle sitting on a nerve? Is my body rejecting the buckle device?
    Ailsa

    • Randall V. Wong, M.D. July 19, 2012 at 12:51 pm

      Dear Alisa,

      Obviously tough to say from my virtual vantage point, but allergy, high intraocular pressure and the buckle can cause pain. Depending upon the situation, buckles can cause pain. It is doubtful that your body is rejecting the device, the material used is inert and should be biocompatible.

      Stay in touch. Removing the buckle is not rare. The buckle really only needs to be there for 4-6 weeks.

      Randy

  • Lauren M July 19, 2012 at 4:05 pm

    Doctor Wong,
    5/6 weeks ago I suddenly could see a black sheet/shadow in my right eye which I left for around a week or two thinking it was a sty or lump in my eye which would go. I went to my opticians Monday the 2nd of July where they referred me to the hospital.. I went the following Thursday & was booked in for surgery Friday the 6th of July. The surgeon told me after looking at my eye the right eyes retina was detached, to the point where it was ‘chronic’ and had been going on for months which id not noticed as I had no symptoms until the black sheet. I had the surgery at around 2:15/2:30 the Friday aft & was taken back to my ward around 5:00/5:30 where the surgeon said he was extremely pleased with how the procedure went. I had cryotherapy & a scleral buckle. I saw the surgeon again the following Friday, the 13th, last week & he said everything looks great. Tuesday just gone I saw 2/3 flashes of white light in the top corner where I saw the shadow, when I was walking up the stairs, then as I put my drops in I saw many more. I went back to the eye clinic yesterday where another doctor saw me & checked the buckle (he dilated my pupils) & checked the pressure & said everything was fine but sometimes flashes can be caused by the buckle as its new and that’s normal but to go straight back if anything changes. Today I have only seen 2/3 again, no more, but my eye today feels heavy. It’s 9 o’clock in the uk and I’ve been awake since 9 this morning, could it be caused by tiredness? Or because the swelling on my face has gone down a great amount therefore I can feel the buckle more maybe? or the swelling in my actual eye? I’m a 17 year old female.
    Thank you. Any replies would be great thank you x

    • Randall V. Wong, M.D. July 31, 2012 at 10:52 am

      Dear Lauren,

      I am sure that you are getting great treatment from your doctors. I can only guess from across the ocean as to what you might be seeing.

      I do want to point out; however, that retinal detachment surgery is difficult and at anytime, if you believe you have re-detached, you should consult your retina surgeon promptly.

      All the best.

      Randy

  • Jacinta Faber July 28, 2012 at 5:23 pm

    Dear Dr. Wong,
    Thank you so much for providing this opportunity to ask a question. On May 28, 2012 I had a retinal detachment followed with a vitrectomy, laser repair, and scleral buckle placement. Two weeks later I had another detachment in the same eye. The detachment was lasered followed with a gas bubble. I am eight weeks post scleral buckle. Here is my problem. I feel that the buckle is to tight. My reasons are: 1) I have to really strain to move my eye side to side. When I do move my eye it seems to put a strain on the buckle. I can feel it tugging at the buckle. There is a spot about 50 degrees off of midline where I see double where the two images are attempting to merge. I feel like the buckle is restraining me from smooth muscle movement. When I scan with my eyes, I get dizzy. 2) My eye feels like it is bulging. Is that normal? 3) I get a headache every day about mid-afternoon. I never got headaches before this.
    My question is can the buckle be loosened to allow for freedom of eye motion? I am feeling desperate. I am 54 years old and my life has changed so dramatically in the past few months. I don’t expect great vision, but if the buckle is too tight, I don’t want to live with it.
    Thank you for your help.
    Jacinta

    • Randall V. Wong, M.D. July 31, 2012 at 11:38 am

      Dear Jacinta,

      Everything you mention might indeed be from the buckle, but I’d give it a few more weeks and keep in close contact with your doctor.

      Placing a scleral buckle can be pretty traumatic and often takes a while to fell normal.

      Randy

  • Laura July 29, 2012 at 1:17 pm

    Hello Dr Wong,
    My husband had a complete macula & retinal detachment 2 months after his cataract surgery. The retina was repaired w/ a vitrectomy, gas bubble and scleral buckle. His vision in the eye now varies from double and a view that is hour glass- like. We have been advised to wait longer to see if there is any improvement. The surgeon is reluctant to remove the scleral buckle but is agreeable considering this is very difficult to live with. Currently my husband keeps the eye closed the majority of the time to avoid the distortion. He is now 4 months post op. Wondering if waiting is the best advise. What is your advise?
    Concerned,
    Laura

    • Randall V. Wong, M.D. July 31, 2012 at 11:53 am

      Dear Laura,

      Buckles, at times, can be removed. I’d defer to your retina specialist for now, but I wouldn’t mind hearing about someone else’s opinion 🙂

      Randy

  • Teri July 31, 2012 at 9:24 pm

    Hi Dr. Wong,
    I was diagnosed with Retinoschisis in 2009 – and had my first detachment in 2011. I had a vitrectomy – gas bubble – and healed nicely. However lost my peripheral vision. I have approximately 20 degrees of sight left. In May 2012 I had my second detachment treated with a vitrectomy – gas bubble and scleral buckle. Now I have 20/300 in my eye – and they are telling me that I need Cataract surgery. How soon is TOO soon to have this done. I have double vision, light sensitivity, flashed, floaters… the works. Also what are the risked of additional surgery. From what I am reading – there is a chance for another detachment. What are your thoughts?

    • Randall V. Wong, M.D. August 13, 2012 at 2:10 pm

      Teri,

      There is always a slight chance of retinal tears/retinal detachment with any intraocular surgery. If your retina is stable (according to your doc), then I would have no issue with cataract surgery.

      The chance of redetachment…in my opinion is the same now versus six months from now or later.

      Randy

  • Ivan Helfand August 2, 2012 at 10:49 am

    I has buckle surgery 6/8. Blood accumulated in the eye after surgery. My Dr. said a blood vessel might have ruptured. In any case. recovery is very slow. My vision is still very blurry, with black floaters. How long can it take before my vision is restored and is there anything I can do to speed the process? Might I need a surgical procedure to remove the blood? Thanks very much.
    Ivan

    • Randall V. Wong, M.D. August 17, 2012 at 11:34 am

      Dear Ivan,

      Blood does not always absorb. You may need a vitrectomy to clear the blood..and let your dr. get a better examination of your eye.

      Randy

  • Elizabeth Ruiz August 12, 2012 at 12:32 am

    Dr. Wong,
    Thank you so much for giving us the opportunity to ask a question.
    My mother had Scleral buckle surgery done on one eye 3 years ago . She recovered quickly and didn’t have any immediate problems. She has slowly developed a cataract on that eye. She had a visit with her eye doctor last week and he is going to remove the cataract next week. He mentioned that he would like to go ahead and remove the glue that was applied to her eye from her Scleral buckle surgery. He said it wasn’t neccessary, but he would like to remove it. I haven’t been able to find any information online regarding this procedure(removing glue after having this surgery). Why would he want to do that? Should she agree to have it removed? She is concerned about the risks.

    Thank you for your time,
    Liz

    • Randall V. Wong, M.D. August 17, 2012 at 10:34 am

      Dear Elizabeth,

      Doesn’t make sense to me. Buckles rarely need to be removed. The usual cause is that it chronically irritates the overlying tissue or “erodes” through the covering tissue. I don’t know why one would remove a buckle at the time of cataract surgery….cataract surgeons usually don’t place/remove buckles. Regardless, usually not a dangerous procedure.

      Randy

  • Tim August 19, 2012 at 8:22 pm

    Dear Dr. Wong,
    I had a scleral buckle placed about 3 weeks ago due to a detached retina. So far it looks like everything is healing well albeit slow. My question lies in the outlook for my vision correction. Both eyes were the same diopter for near-sightedness prior to the surgery. After surgery there is now a -3.5 to -4.5 difference between my two eyes. I’ve been told I will no longer be able to wear glasses but will require contact lenses. My concern is that I have tried contacts in the past (3 years ago) and I could not tolerate them. I have astigmatism in both eyes and had the appropriate toric lenses, but I still could not get comfortable with them. As I get ready to attempt contacts again out of necessity, I have been looking at other options. Specifically IOL implants. Please lend your opinion on these as I am in my 40s, have worn glasses since an early age, and have been unsuccessful with contacts in the not to distant past. Would having IOL implants increase my risk for cataracts or another detached retina? Thanks for your help.

    • Randall V. Wong, M.D. August 28, 2012 at 9:05 am

      Dear Tim,

      Your condition is called anisometropia. Your two eyes differ too much in the prescription required to let each eye see well.

      The obvious solution is the contact. Your brain can tolerate a larger difference in refraction between the two eyes due to the fact that there is less size disparity between each eye (inherent to large changes in prescription is a change in size of the image you are seeing).

      Regardless, if you can’t tolerate contact lenses (and I see no reason why you would if you never had);

      1. IOL implants or even cataract surgery might be helpful. (So called implantable contact lenses, or if cataract surgery were done, an IOL could used to even the out the myopia.)
      2. Laser vision correction?

      Randy

  • Deb Beagle August 21, 2012 at 9:46 pm

    I had a scleral buckle surgery December, 2011 for detached retina. I last saw my doctor in April. I left very frustrated as he told me my eye seems fine. It is not. I feel it has handicapped my performance at work. I want to cover it with my hand constantly and my vision is distorted. I feel like I’m looking through a glob of vaseline. I don’t know what to do. Any suggestions?
    Thank you,
    Deb

    • Randall V. Wong, M.D. August 28, 2012 at 7:56 am

      Dear Deb,

      Probably your doc means that the retina is attached and there is nothing more that can be done.

      Your vision, however, is not what you’d like.

      1. Get a refraction (measured for glasses) and see if there is too much of an imbalance (anisometropia) in the prescription of the two eyes. This may be part of the problem.

      2. Distortion: Likely causes from retinal detachment: macular edema, epiretinal membrane or perhaps your macula was detached originally.

      Good luck!

      Randy

  • Sherice August 28, 2012 at 5:37 pm

    Hi there! I’m getting ready to have a retina detachment corrected by use of a buckle + silicone oil. It’s in an eye that has poor vision anyway due to ROP. My question is, lately I’ve been having pain near the top of the eyeball itself, and seeing what I can only describe as “liquid light” — as if you spilled something thick on the floor and it all sort of formed together. Another opthamologist, not my regular doctor, took a look inside the eye and didn’t see any inflammation or infection – but what could be causing that pain and those odd shapes?

  • Joseph September 15, 2012 at 2:19 pm

    Dear Doctor Wong,
    I had a detached retina due to getting bumped in the eye about a year ago. I didn’t know I had a detachment until I started seeing lots of floaters about 4 months ago. I think my doctor said it was a chronic, slow-progressing detachment in bottom part of my eye. A scleral buckle was put on approximately 3 months ago. My question is will having my scleral buckle removed increase my chances for future detachments or any other complications? My buckle has been on for 3 months now and my Doc says retina is healed. Also, I still have some degree of dilated pupil in my operated eye. I’ve been told the eye drops I took after surgery to dilate my pupil would have worn off by now. I’m wondering if the pupil will go back to normal after buckle is removed. Thanks. You have a great website. Very informative.

    • Randall V. Wong, M.D. September 25, 2012 at 9:03 pm

      Dear Joseph,

      I don’t think the bump in your eye one year ago caused the retinal detachment preceded by floaters 4 months ago.

      Regardless, if your retina remains attached…removing the buckle shouldn’t be a problem. The buckle needs to be in place for about 6-12 weeks.

      If you had a vitrectomy in association with the buckle there is even less chance of “complications” or future detachments.

      The dilated pupil does occur from time to time…may be related to complications during surgery, but I’m just guessing. I agree, drops shouldn’t fit in the equation right now. Doubt pupil will change with/without buckle removal.

      Thanks for the plaudits.

      r

  • pradip September 18, 2012 at 10:29 am

    Dear Dr. Wong,
    I had a buckle implanted in my right eye when i was 15. I lost the vision in my left eye around the same time. Now after some 10 years it is gradually migrating and is slightly coming outside. My doctor says that it is fine and there is no infection but also tells me that if it comes out surgery will be done again. Pls tell me if at all it has to be removed, will it be necessary to plant again and what will be the condition of my retina? Will I need this buckle throughout my life?

    • Randall V. Wong, M.D. September 25, 2012 at 9:09 pm

      Pradip,

      “Now after some 10 years it is gradually migrating and is slightly coming outside.”

      What exactly are you talking about?

      I am moderately confused.

      Can you rephrase?

      r

  • W.M. September 24, 2012 at 9:32 am

    Dr. Wong – I had a sceral buckle surgery performed on my right eye in 2010 and even with new presecription lense, the vision in my right eye is always a bit distorted. If I close my left (good/better) eye and look at something with only my right eye, the word/image is twisty/warped. Is this common? Will it ever stop/go away – the distortion???

    • Randall V. Wong, M.D. September 25, 2012 at 9:51 pm

      W.M.,

      It may not go away if it’s related to your original detachment.

      It could be related to the subsequent development of an ERM (epiretinal membrane or macular pucker) which is not uncommon following a retinal detachment. The ERM can be removed….if it’s there.

      r

  • Joseph September 26, 2012 at 9:51 pm

    Doctor Wong,
    After my buckle is removed will my eye/vision return to pre-buckle status? In other words, is the eye like a balloon filled with air (when squeezed it changes shape but rebounds after pressure is released) or like balloon filled with sand (when squeezed it permanently assumes new shape even after pressure is removed)? Also, given my lasting partially dilated pupil, is it safe to have my pupil dilated further with drops when I go for my check-ups? Will this make my pupil even more dilated permanently? Thanks again for your help.

  • Paula Longshore October 2, 2012 at 7:15 pm

    Hello Dr. Wong,

    I have severe myopia and now have a tear in my retina. My doctor tried to fix it with a laser but there was fluid and blood in my eye so that was ineffective. I am scheduled for surgery this Friday to have a buckle put in. I have heard so many negative outcomes that it scares me. Have you done this surgery and had positive results ?

    What should I expect post op and what type of limitations will I have ?

    Thank you,

    Paula

    • Randall V. Wong, M.D. October 3, 2012 at 12:02 pm

      Dear Paula,

      I’ve done this many, many times over twenty years. In the right hands, a very good procedure.

      Basically, you have retinal detachment.

      I’m sure you will do well.

      All the best,

      Randy

  • Andy October 5, 2012 at 11:23 pm

    Doctor Wong,
    I’m a 20 year old male from Argentina, and I had a retinal detachment in my right eye one year ago. A buckle was placed in the eye to stop the detachment. Although I haven’t had so many problems with the surgery, my eye can still get a little red if I put my lense on. I asked my doctor if this was normal, and he told me that it was, and that I should be patient.
    The same goes for the methamorphopsy, or distorted vision, which has been improving since the surgery, but I don’t know whether I should keep waiting further improvement. And last, my upper lid is still not like it used to be, although it has also improved, and I would like to know if I should keep waiting for it to be exactly like before the surgery.
    I asked my doctor if the buckle could be removed so that the lid got better, but he says that it’s still helping the retina to hold in place. Is that possible? From what I read here, it’s only necessary for up to 3 months…
    Thank you in advance.

    • Randall V. Wong, M.D. October 14, 2012 at 7:08 pm

      Dear Andy,

      1. Redness caused by contact lenses/smoky environments may take at least a year to settle out.
      2. Metamorphopsia can improve, get worse…depending upon cause. Don’t expect it to go away…depends on cause.
      3. Lid: May not really be due to the buckle. Could be due to the operation. Can’t tell from where I sit 🙂
      4. Scleral buckle removal: In my opinion, can be safely removed after about 6-8 weeks.

      Randy

  • Shana October 11, 2012 at 2:01 pm

    Dr. Wong,

    My husband had a buckle placed on his left eye approximately 5 years ago. The surgery was very difficult for him mentally along with the initial physical recovery. Over the 5 year period, 3 stitches have come from his eye (washed out like any other foreign object in the eye and once with bleeding from the eye). Vision seems to be the same so he will not go back for a check up. I can see the band when he looks to the left, but it is not discussed. A few months ago I noticed a small bubble on the outside of his eye where the eyelids meet along with some discharge. Today, I seen that the bubble has gotten much larger and he still has discharge. Is the eye infected? I am needing info before I can convince him to go back for a check up.

    Thank you so much.

    • Randall V. Wong, M.D. October 15, 2012 at 3:30 pm

      Shana,

      Can’t tell from my seat, but it is common to see a buckle after surgery, and thereafter.

      Vision does not correlate with infection, meaning, he could be infected despite steady vision.

      I can only encourage you/him to have it checked by his doctor.

      r

  • Laila October 12, 2012 at 9:05 am

    I had a scleral buckle put in my left eye almost 2 weeks ago. From the outside my eye seems to be doing well. I can open my lid practically like my normal eye. Even the redness has gone down significantly. I feel no pain or discomfort. My vision is still blurry, understandibly from far away. My fear is that when I look at a piece of lined paper, there is a distortion (squiggle) in the middle of the page. Will this be permanent? Once I get a new eye correction prescription, will this be even more noticeable when I look into the distance? I am so depressed thinking my vision will be abnormal for the rest of my life and i am only 27. I had a partial detachment and unfortunately my macula wet along with it.

    With all the advances in the medical world, why is something like a retinal detachment that seems not uncommon, still ruining peoples lives?

    -L

    • Randall V. Wong, M.D. October 15, 2012 at 3:47 pm

      Dear Laila,

      I am sorry.

      Distortion following a macular detachment is not uncommon, but it may be too early to “give up.”

      I’d ask your doctor for an explanation as there can be so many causes of distortion at this point following an operation.

      Randy

  • John November 21, 2012 at 7:48 pm

    Hi Doctor Wong,

    My name is John, I am 29 years old and from Melbourne Australia and can I just start off from saying what a great opportunity this website provides for indivduals such as myself to gain some guidance and clarification on what they are going through. I am impressed with your commitment to helping people via this website. Well done!

    My particular issue is that I have had a scleral buckle put in place for a peripheral retinal detachment (macula on) for my right eye. My retina was peeling away from the outer peripheral so I was slowly losing my vision from my nasal peripheral side. I am shortsighted and before the operation was at -4.25 for both eyes.

    I had the operation on Monday 22nd of October (4, nearly 5 weeks ago) and my vision is still blurry. It is very hard to read out of that eye and letters appear wavy and distorted. I was wondering if this is normal and how long should I wait before being worried?

    I also find it hard to focus on things (some days are better than others) and this sometimes causes my eye to water. I also suffer sudden shots of pain randomly from the eye and cannot move my head around to focus on different objects too quickly, for eg. a person entering the room. Sometimes if I move my eye inwards towards my nasal side to look to my left without moving my head I can feel a foreign object in the eye that does not necessarily hurt but does feel uncomfortable. Is this normal or will I potentially have to have the buckle removed?

    Thanks again for this opportunity and sorry for the long comment.

    John.

    • Randall V. Wong, M.D. December 3, 2012 at 9:21 pm

      Dear John,

      The focusing issue may indeed be need for glasses or contacts. It is possible, too, that you’ve developed a cataract which may also cause distortion, cause strain and blurry vision.

      The foreign sensation may indeed be the buckle, but it takes months to heal from these things and I don’t necessarily think you’ll need it removed…too early to tell.

      Thanks for the comments.

      r

  • Don Cruise February 3, 2013 at 5:45 pm

    I have had 5 retinal detachment repair surgeries, the last one was scleral buckle with vitrectomy plus removal of the lens. My eye is filled with oil. I have been fairly miserable since the Dec. 29th 2012 surgery. My eye pressure has been high, running in high 30s to low 40s. We are trying various drop combinations to no avail. I have frequent pain, not crushing, but not fun either. Every day in the evening especially I have watering of the eye and pain for hours. I seem to have come down with a head cold virus that will not go away, and the left sinus where the surgery is near is the one that drains the worst. I can hardly keep the surgical eye open at times, I feel there is a force trying to shut it closed, kind of like staring into bright light. None of my previous surgeries have had post-surgery complications like this. I am getting care from a retinal surgeon, but just wonder if any other theories, ideas may be out there? The surgeon said he may have to go back into the eye and drain out some of the oil. Thanks so much for any information that may give me hope.

    • Randall V. Wong, M.D. February 13, 2013 at 12:30 pm

      Don,

      I can’t accurately assess your situation without an exam.

      My thoughts;

      1. Symptoms due to increased pressure
      2. Allergy to some of the drops?

      r

  • mikki February 13, 2013 at 12:37 pm

    Dr Wong
    I have scleral Buckle insert my right eye my sergant says i had develop a early stage cataract. she is rectinal specialist not a cataract specialist i need to go back my eye doctor.
    my eye been red more than 2 months . i used the special eye drop for anti infected , it did not help i went to buy allergy eye drop over walmart. it help less than 30 minute. but on the label said i cannot use more than so many days.during 2 eye specialist with 2 different
    doctor. they never mention my red eyes.yes they can see but they never said a word and i forgot to ask.i have many physical issue my health insurance only pay so much. each time
    i went to see doctor i have to pay copay and a different of health treatment deductible.just have no extra money to pay.what can possible be about 1 of my operated eye alway bloody red . please what might be happen .so i be more aware. and look for right doctor for my issue

    thanks

    • Randall V. Wong, M.D. March 2, 2013 at 11:33 am

      Mikki,

      It’s impossible for me to know why the eye is red. I can’t examine you. Stick with your doctors’ advice.

      Randy

  • Don Cruise February 26, 2013 at 3:14 pm

    Dr. Wong,
    Thanks for your reply. Since writing to you, my retina surgeon removed some of the oil from my eye to relieve pressure. For 3 weeks I was doing great, then yesterday, February 25th, my eye pressure sky-rocketed to 46! My symptoms are exactly as before, very sensitive to light, constant ache accompanied by sharp prickly sensations,and the left sinus runs quite a bit. This in not an allergy to drops, I was not on pressure drops when this happened. Also, I never had any reactions to the post-surgery drops either. Yesterday my doctor looked for unusual things, like enlarged blood vessels, collapsing eye walls, blocked eye drain or blocked sinus. He could find nothing wrong. He has put me back on Combigan and I have been on Lotemax since partial removal of the oil. I fear that a deeper problem remains, my belief is that removal of a little oil only masked the real problem. If you have any ideas from your experiences, I would be most appreciative. This is a wonderful service you provide, thanks for that!
    Don C.

  • Martha March 18, 2013 at 6:29 pm

    Hi Dr Wong,

    I was losing my sight in my right eye and was diagnosed with retinal detachment. On Jan 4th 2013 the surgeon inserted a scleral buckle and did a vitrectomy with a gas bubble. I can see, however my sight is much worse than before. During my last visit the Dr told me that it looked as though I have scarring, which could be corrected with another surgery and that I might develop cataracts in the eye. Is there anything that I can do to avoid this?

    I also notice that if I lean over for too long I feel a pressure in the eye, should I be concerned?

    Thanks,
    Martha

  • Allen Y March 24, 2013 at 3:49 pm

    Dear Dr. Wong,

    Thank you for your informative website. It’s very helpful to patients and families. We are from Atlanta, GA. My 13-year old daughter was just diagnosed with retinal detachment on her left eye this week and a surgery has been scheduled for the coming Thursday. My daughter complained about fuzziness in her left eye in November 2012 and our regular OD didn’t know what the problem was after two visits (in December and February). Then on March 15th, we decided to see another OD who found the RD problem right away because she herself had suffered from RD two years ago. She recommended a retina specialist in our area who has recommended the procedure of scleral buckle plus vitrectomy with gas bubble. Because we didn’t find the RD sooner and our 13-year old’s brain has adapted so quickly to using her right eye only, both the OD and the retina specialist say that our daughter’s macula is currently partially detached, which presents another level of difficulty to gaining vision back.

    We have read up a lot on RD, its treatment and recovery prospect. We have some questions.

    1. In your experience, what is the chance of getting some vision back (say 20/80 with glasses on the left eye) assuming the retinal reattachment surgery is successful? Her right eye sees 20/20 with contact lens.

    2. Scleral buckling has side effects, one of which is increased myopia. Another one is a smaller looking eye size with buckling. What are potential side effects if we were to remove the buckle a few months after retina is reattached? Wouldn’t it be better to remove the buckle after it has done its job?

    3. We still don’t know how our 13-year daughter could have suffered from RD. There is not a family history nor any remote chance of trauma. The retinal specialist believes it has to be sport injury a year ago. Our daughter is a soccer player for her middle school and in one game about 7 or 8 months ago, the soccer ball hit her face causing her mouth to bleed due to dental braces. We don’t think a big size 5 soccer ball could have hit the eye the way a tennis ball or softball would. On the other hand, our OD thinks it might be the CRT lenses (hard contact lenses worn at night to correct vision but don’t wear during the day) that have done some effect to the eye ball over the years which ultimately might have caused RD. In Atlanta there is an OD who is a big proponent of CRT lenses for kids because he says it deters myopia and prevents retinal disease (ironically it doesn’t do so for us). Our daughter started CRT lenses since 3rd grade. The lenses aren’t uncomfortable for her and actually worked very well until last November when she started complaining about the vision fuzziness. We just don’t know. Have you encountered any instance of RD with young patients who use CRT lenses?

    Thank you so much for your help.

    • Randall V. Wong, M.D. April 1, 2013 at 9:05 am

      Allen Y,

      1. I have no idea what vision she has now. Can’t even guess how much she’ll improve. The variables influencing eventual vision; degree and time which macula is detached. On the other hand, I’ve seen anything happen with kids.

      2. If the buckle is done too tightly or too “high” these might be issues. Removing the buckle after 6 weeks is possible, but removing the buckle probably won’t reduce the myopia….there will be scar tissue on the OUTSIDE of the eye preventing the eye from regaining its original shape. Try not to play doctor too much. The whole key is to get the retina attached….that’s the primary goal.

      3. Have no idea about the trauma. Usually there is a history of being knocked out our concussion (ie. pretty severe trauma). RD happens in myopia more often. CRT is used to fix myopia. No known causal effect between CRT and RD. Makes no sense.

      Randy
      Randall V. Wong, M.D.
      Ophthalmologist, Retina Specialist
      Fairfax, Virginia

      http://www.TotalRetina.com
      http://www.RetinaEyeDoctor.com

  • Dana March 30, 2013 at 8:51 am

    I had the buckle procedure only two days ago and understand that my vision will take some time to recover. I wish I had a better idea of what to expect regarding my recovery. I still have the pre-surgery loss of a field of vision due to retinal detachment and the remaining vision is so blurry as to be basically useless. I have been told I can return to work in 3 days so am hopeful that with a decrease in the swelling there will be dramatic improvement, however I am worried this is not realistic, especially after reading some of the prior posts on this site. Would you share a “typical” recovery after the scleral buckle procedure?

  • Peter B April 1, 2013 at 7:18 pm

    Hi. Dr. Wong. I had an RD and scleral buckle 9 weeks ago and still have trouble seeing. I am a 55 year old male, otherwise in good health. My eyes have been nearsighted since I was a child, the left one worse than the right; all of which was corrected to 20/20 with glasses. Here is the history of the RD on my left eye (called here LE). In late November 2012, I noticed some strange light sensations in the corner of my LE. I didn’t think much of them — though for your readers, in retrospect I should have gone right to the doctor. In December there were some odd floaters. In very early January there was a liquid curtain in the lower right of my LE (that’s where it appeared to me through my eye). So I went to the doctor 3 days later and 2 days after that he did a pneumatic retinopexy with cropexy on January 8, 2013. I had to keep my head tilted 2 weeks. It seemed to be working, I recovered to 20/70, but then a liquid curtain appeared in the upper right of the LE. So he said that was another peripheral tear, and this time, given the location in the lower part of the eye he couldn’t do the retinopexy, but that it would require a scleral buckle and vitrectomy. So the latter was done by him on January 28, 2013. This time I had to keep my head down for 2 weeks. As of today, 9 weeks later, the gas bubble has dissipated (it took 8 weeks for this to happen). My eye is still a little red. The retina is fully reattached and holding. Here is the problem: I cannot see well out of the LE. Everything is blurred, and quite distorted like looking in a fun house mirror. For example, if I look at a picture frame instead of being rectangular, the sides are curved and wavy in or out, also irregularly. So today the surgeon had an OCT done of my retina and he said that the macula did not appear to have a physical problem such as scarring. The macula was similar on LE to right eye. Then, I went to an optometrist this afternoon and I could not even see the large E on the chart through my LE with my glasses. And then he tried different lenses and solutions (including things for astigmatism) and nothing worked for my LE to see even the largest E. Instead the white projection around the E looked like a flag occasionally waving. So I am legally blind in my LE and lenses won’t help — at least not today. My question why is this happening and what can be done? Am I at a dead end? Or might the LE improve just with healing over the next months? If so, will that only be minor, or could it improve in a major way? Right now my understanding is that I am stuck with a legally blind LE and that if it gets better over time it will only be by a minor amount (maybe 20/200 and still wavy), and that nothing else can be done since there is no evidence of physical scarring to the macula that would merit further surgery. Any thoughts? My doctor only seems to tell me things very little by little. I didn’t realize the retina could be fully re-attached (as here) but so hopelessly wrecked as to be largely useless except to see blurrily. Luckily I see 20/20 with my right eye, but if that one fails, I will be in big trouble seeing.

    • Randall V. Wong, M.D. April 23, 2013 at 8:46 am

      Dear Peter B,

      Wondering if you’ve developed a cataract?

      A cataract might decrease your vision, especially with two procedures utilizing gas.

      (For subsequent readers, the length of head positioning is determined, in part, by the type of gas used. I prefer a gas that is absorbed quickly and thus usually request my patients maintain head positioning for about 5 days at most.)

      The misleading thing about retinal detachments…”success” refers to anatomic success and not necessarily vision.

      Let us know.

      Randy

  • Bob in Pittsburgh PA April 10, 2013 at 2:46 pm

    Dr. Wong,
    Do you do the Scleral Buckle operation?

  • AbRaR MaRfAnI April 15, 2013 at 12:21 pm

    Hi doctor Wong,
    I am Abrar, from Pakistan. My brother is having retinal detachment before 16 years. We were totaly fall on internet to find the recovery of this infection but Alas we were failed to find it and now this infection has been recover so I want to ask about this that there is any hospital or doctor which can treat this in any country ? please reply me fast! I wanna also ask somthing about this diseases !!

    Regards!

    • Randall V. Wong, M.D. April 23, 2013 at 9:20 am

      AbRaR,

      Please ask your question again, I don’t understand your question.

      Randy

  • Frida Siton April 21, 2013 at 12:41 am

    Dear Dr Wong
    My buckle has come off after two years. The doctor said that they don’t usually do anything unless it protrudes or there is an infection. However , I can feel the buckle on the inner underside of my eye and I have a small cyst there too. I have had five ops to remedy a re-detaching retina in right eye so I understand that it is best not to operate unnecessarily to avoid further stress to this eye.

    History: two gas bubble vitrectomy ops; two oil vitrectomy ops; a buckle during one vitrectomy; a peeling of retina scar tissue around peripheral and new lens during another; fifth op was just to remove oil. Retina is now flat. Vision not very good. There is still traction, macular scarring and some oil bubbles floating around. Now the buckle has come off!

    I know it’s unusual for buckle to come off, but is it harmful to eye?

    Thank you for your time. Bless

    • Randall V. Wong, M.D. April 23, 2013 at 10:25 am

      Dear Frida,

      A scleral buckle can usually be removed…safely after the initial 6 weeks or so. I agree that it is usually unnecessary to be removed unless there is infection or erosion through the conjunctiva.

      It is usually not harmful to remove a buckle.

      Randy

  • CSS April 21, 2013 at 2:56 pm

    Hi Dr. Wong,
    Thanks in advance for your time. I had scleral buckle surgery 5 days ago for a left eye retinal detachment, macula-on. The whole thing has been a terrifying nightmare to me,to say the least. I’m a 38 year old female with 3 young toddlers to care for. My two questions are:
    1. My doc (who had been wonderful) lifted all restrictions on me 3 days post surgery after two post op exams when he observed reattachment, no fluid. Is this too soon? I am being very cautious including wearing safety goggles around my energetic little ones.
    2. I asked what the “failure window” is for scleral buckle surgery, meaning if it is going to fail is it known in a week, a month, 6 months….. My doc answered this 3 days post op with “it’s over. It will not fail. It was a success.” While that gave me enormous relief, can this be known so absolutely so soon?
    Thank you for this service.

    • Randall V. Wong, M.D. April 23, 2013 at 10:29 am

      Dear CSS,

      1. If you are attached and no gas, lifting restrictions is probably fine (I can’t really say because I don’t actually know the condition of your eye, but I generally would agree). No worry about the goggles, won’t really do anything. You’ll redetach with or without goggles. Imagine if every parent were to sustain a retinal detachment every time they were hit by a child (I’d be retired!).

      2. I would say that if there are no issues at 6 weeks, you are probably out of the “failure window.”

      r

  • CSS April 21, 2013 at 2:59 pm

    I meant to say my doc “has” been wonderful, not “had.”

  • Donna Leistner April 23, 2013 at 10:59 am

    You mention crt for myopia what is that. Do you mean it can improve distance vision after a sclera buckle.
    If not is there something else I can have done as I am very short sighted.

    Thanks for all your help with this site. It is invaluable for many people

    • Randall V. Wong, M.D. April 29, 2013 at 4:38 pm

      Donna,

      Could you rephrase your question….”crt”? Where did I mention that?

      r

  • susan mcshane May 2, 2013 at 3:13 pm

    Hello Dr. Wong. I am so happy to have discovered your wonderful forum. I had a scleral buckling done in 1972 at the age of 25. Since then I have had 2 brain MRI’s and around 5 lumbar ones done in the last 4 years. I have mild MS and my neurologist wants me to have a brain and full spine MRI. The MRI center she sent me to is refusing to perform it because they say I have metal in my eye and it could be very dangerous. I was of the understanding that a non-ferrous metal was used if at all. Since I have had so many without problems do you think it is possible that a ferrous metal was used and wouldn’t I have had a problem by now after so many being done? My current Ophthalmologist feels there is no metal in the buckle. Am I taking a chance? I called the hospital where I had it done and they destroyed the records years ago and the Dr. who performed the surgery has been dead for 10 years. What would happen after so many years if in fact a ferrous metal was used?
    thank you, Susan Mcshane

  • Denise May 31, 2013 at 11:56 am

    Dr. Wong,

    My friend has recently been diagnosed with this condition and is scheduled for surgery this coming Tuesday at the Calahan Eye Foundation in Birmingham, Alabama. She is married with two small children and of course we were all quite shocked at hearing this news. After reading this article and seeing the procedure on YouTube we are all much more comfortable with the situation. It is facinating and simply amazing to know that this knowledge and technology is out there! I will be her caretaker the first week after her surgery-any tips or pointers?
    Thank you for helping to calm our nerves

  • Peter B June 4, 2013 at 1:19 am

    Hi Dr. Wong. Further to my post April 1, 2013 and your kind response April 23rd. The latest news is that my LE is still blurry. I am told I have a very minor cataract in that eye which is not thought to be the cause of the blurriness, but I will ask the doctor again about that. I also went to a cornea specialist in case the scleral buckle was causing a warping problem there, but apparently it is not. The surgery was 4 months ago. Can I expect any natural improvement over the next 2 months to year, or is what I have pretty much going to be the best it gets? I am also very curious what percentile I fall into. I gather from reading on line that this all depends a lot on how long the macula was detached (plus lots of other factors). I am assuming an intermediate period of DMD 10 days to 6 weeks. From what I can tell (as an amateur) reading scholarly articles online I had only about a 6% chance of ending up with 20/200 vision or worse. I had about 60% chance of ending up with 20/50 or better. Does that sound approximately right? Was I just one of those in the small percentile who had unlucky results? Also I read your recent section “Success of Retinal Detachment Surgery” where you say the goal is to reattach; the vision improvement is secondary; and to “keep your expectations aligned.” Thank you for this and I wish I had known it. I always knew there was a chance the retina would not reattach, but I had assumed that if it did I would get at least 20/50 vision; so unfortunately even though it remains reattached I remain very disappointed with 20/200. And I keep searching for a reason why I ended up with 20/200 — just bad luck? Finally, from some things I read on your website and others, I gather that experimental regeneration with stem cells or other means is still very early in development, and I shouldn’t count on the availability of that for maybe at least 10-15 years or perhaps longer (or maybe it is even impossible)?

  • Rhonda C June 13, 2013 at 3:39 pm

    Dr. Wong,

    My husband (65 years old) had scleral buckle surgery on his right eye 16 days ago. The bubble is shrinking but his vision does not seem to be improving. One week post op, he was told his “corrected vision” was 20/50. He would like to get interim prescription lenses right away so he does not have to strain his eye so much. He called his surgeon yesterday who told him he would let him know when he was ready for new glasses. My question is, if he goes to an optometrist and gets new glasses, will it cause any damage to his eye to prevent it from healing properly, and/or restoring his vision? Right now, his eye waters constantly and he feels the vision in his good eye is worsening, perhaps from straining to see. Thanks in advance for your reply.

    • Randall V. Wong, M.D. June 22, 2013 at 7:06 am

      Dear Rhonda C,

      Won’t cause any damage…with or without lenses now or later.

      Randy

  • Samantha June 16, 2013 at 8:12 pm

    Hi Dr. Wong,

    I am now three weeks post-op from a vitrectomy and scleral buckle surgery and everything is looking great! My eye is still pretty red from the surgery but other than that I don’t have any negative side effects. My doctor has me down from putting 4 drops in my eye per day to 2 drops per day. So far I’ve been wearing my glasses but I am anxious to be able to start wearing my contacts again. Will it harm my eye at all if I wear my contacts? I asked my doctor about this and he said that I should be able to wear my contacts in around another 2 weeks or so, because it might feel uncomfortable. However I’m not so worried about the comfort I just don’t want to harm my eye at all!

    Sam

  • Kim June 17, 2013 at 9:10 pm

    I had a scleral buckle fitted in June 2012 for a detached retina. Nearly a year on it feels like I have “pulling” in my eye, my vision is still blurry and I also have soreness and the feeling of something being stuck in my eye. I am wondering if it is possible that I am developing a cataract and if I could have the buckle removed?

    • Randall V. Wong, M.D. June 22, 2013 at 8:26 am

      Dear Kim,

      Yes, cataract is quite possible. It is also possible the buckle has become exposed and would give you an irritation. Have someone take a look. Can you go back to the retina specialist?

      Randy

      Dear CK,

      It is my practice to remove an ERM/macular pucker as SOON as the patient notices a change in vision.

      The reason is quite simple, no one can guarantee full restoration of vision after removal. Therefore, I recommend removal as soon as you notice the decreased vision.

      I would recommend Dr. Kenneth Fong

      Consultant Ophthalmologist and Vitreoretinal Surgeon
      Sunway Medical Centre,
      Petaling Jaya, Malaysia

      His website/address is here;

      http://www.eyeretina.my

      Good luck,

      Randy

      Randall V. Wong, M.D.
      Retina Specialist
      Fairfax, Virginia
      http://www.RetinaEyeDoctor.com

  • Scott B June 18, 2013 at 8:10 am

    Hi Dr Wong
    I am a 50 year old male,I had retinal detachments in both eyes 37 years ago, After the scleral bucking in my rt eye I had problem with double vision and had to have the eye muscle operated on during the procedure my retina surgeon removed the buckle and the retina detached again. since then no problems with detachments since then. Two years ago my best corrected VA was 20/30 rt 20/20 left. Six month ago it was 20/20 lft 20/40 rt. I depend on my eyes for my job as a Captain and currently meet vision requirements my concern is that I have cataracts in both eyes and the one seems to be progressing hence the decreased VA in the right eye. I was just wondering how safe is Cataract Surgery for me and can I get a VA under 20/40 for the right eye post surgery. my last eye surgery was 1976. The vision requirements for my job is at least 20/40 both eyes
    Thank you

    • Randall V. Wong, M.D. June 22, 2013 at 8:24 am

      Dear Scott B,

      Based upon your description, you should be able to improve your vision with cataract surgery.

      I don’t feel you are at greater for detaching despite your history.

      Best of luck.

      Let us know how things work out.!!!

      Randy

      Dear CK,

      It is my practice to remove an ERM/macular pucker as SOON as the patient notices a change in vision.

      The reason is quite simple, no one can guarantee full restoration of vision after removal. Therefore, I recommend removal as soon as you notice the decreased vision.

      I would recommend Dr. Kenneth Fong

      Consultant Ophthalmologist and Vitreoretinal Surgeon
      Sunway Medical Centre,
      Petaling Jaya, Malaysia

      His website/address is here;

      http://www.eyeretina.my

      Good luck,

      Randy

      Randall V. Wong, M.D.
      Retina Specialist
      Fairfax, Virginia
      http://www.RetinaEyeDoctor.com

  • Scott B June 23, 2013 at 3:29 pm

    Thanks Dr Wong I will be going to Dr Updegraff in St Pete Fl to evaluate my Cataract I hear he is good

  • Meenal June 26, 2013 at 4:21 am

    Dear Dr. Wong,

    I am a 23 years old female.I had a Retinal Detachment Surgery on May.05,2012 with Macaula being on.The Surgery was successful.My only concern is that probably because of the Scleral Buckle, My eye has become smaller.Is there any way out (Like Removing the Buckle or Cutting it or Loosen it up a little or anything else) that can help me get my eye back to Normal Shape or atleast Close to it.It has really changed my life and I am having Self-Esteem issues.

    Thank you so much Sir.

    • Randall V. Wong, M.D. July 2, 2013 at 2:02 pm

      Dear Meenal,

      I doubt the eyeball is smaller, especially if the vision is good.

      More likely, especially with some scleral buckles, the fat around the eye ball has decreased resulting in the lid dropping slightly. This gives the appearance of a small misshapen eye.

      You should see an oculoplastic surgeon if this is so.

      Randy

  • Meenal July 8, 2013 at 9:37 am

    Thank you so much Dr. Wong. I have had Ptosis Surgery done on the same Eye after Retinal Detachment Surgery.It has been more than six months now (after the Ptosis Surgery). But still it seems that the Eye is smaller and pushed inwards. Is there anything that can bring this Eye a little outwards n bigger?

    Thank you once again

  • jeff August 12, 2013 at 7:58 pm

    Dr. Wong,

    My son, 20 years old, had a scleral buckle operation 4 days ago. His vision went completely black the next day, and still black after 3 days. His surgeon said it is NOT normal, the blood flow to his eye is SO POOR. He said there is nothing we can do except for eye drops and rest. Is he blind at this point? Before operation, he only saw several black spots.

    Your sincerely opinion is greatly appreciated.
    Thank you.

  • Alex August 22, 2013 at 7:59 pm

    Hello Doctor:

    I am a 33 year old male who just had the scleral buckle surgery described above for a detached retina in my right eye. After the surgery, my doctor was able to fix 4 of the 5 tears, but unfortunately 1 (approx. 1-2 microns in size) was remaining with a small amount of fluid behind it. I was instructed to lie on my back for about a week, but the tear still remains. At this point, the doctor has given me the following options: 1) vitrectomy, 2) seal the fluid with laser, 3) adjust/add another scleral buckle, 4) do nothing and monitor. His recommendation is for another buckle, which should eliminate the hole and underlying fluid. Although he isn’t concerned of increased chances of PVR due to the size of the tear, he doesn’t like the idea of having the small amount of fluid (last checkup showed that the size of the fluid did not increase from prior checkup).

    Right now I’m pretty torn of\about what is the best action, especially considering that my left eye has limited vision currently due to retinal detachment/pvr affecting the macula. My question is what would you recommend given this situation? Currently my right eye is at a 20/30+ after the recent surgery, but i’m always worried about complications with a possible future surgery along with the potential that my good eye may get worse?

    Your response will be greatly appreciated.

  • Scott Baker October 9, 2013 at 5:10 am

    Dr. Wong,
    Thought I would let you know that I completed LenSx Cataract Surgery last week UVA is 20/20 left and 20/25 rt
    The rt eye has a slight after cataract so that may go to 20/20 after yag laser the rt eye was my eye that had a macula off rd 37 years ago so the results are amazing. I had the Alcon Toric IOLs implanted so for anyone worried about the long term results of Scleral Bucking Surgery I am proof that the Surgery works I had SB in both Eyes 37 years ago and now have near perfect vision after IOL implants. Thanks for your advice a few months ago. I also have been to a Retinal Specialist Post Op and she says everything is fine

  • John D. Garrett October 21, 2013 at 9:16 pm

    Greetings,
    My daughter recently had a scleral buckling. Following surgery, there is a notable diference in the shape and size of the eye. Also, she appears to have a lazy eye (if that makes any sence at all.) Being a young lady this difference has her and me (Dad) quiote concerned. Me, I would consider my precious dayghter beautiful if she had one eye in the middle of her head, but, she is devestated. Is this something that will be as it is forever or will it improve with time? My daughter has severe nearsightedness and the tear was to significat for laser treatment.
    Any information you could share would be most appreciated.

    Thanks so much….

  • Dr Maria November 2, 2013 at 10:18 am

    Dear Sir,
    I have my buckle surgery done and now it seems the buckle is being pushed out. The doctors have advised for an immediate removal. What are the side effects and risk factors? Also, is there any harm in removal. I had vitrectomy done after buckling.

  • Rael S. November 15, 2013 at 3:59 pm

    i too, had a scleral buckle implanted 30 years ago. it has not cause me any problems, the doctor that did it did advise me that if i saw floaters i needed to have it checked. i see floaters all the time, even right after the surgery took place, and have had it checked every couple years or so, and have had no problems with it at all.

  • mr albert September 2, 2014 at 11:40 am

    Hello, doctor

    Why is that I suffer pressure on my skull after I fail my scleral buckling surgery 3 years ago , ie there has been extrusion as black lined shadow appear on my pupil ???

    and why that pressure kept on affecting my cortical region ,causing me cognitive problems???

    Even my local surgeon know nothing about the pressure???

    Pls advise me.Thanks

    • Randall V. Wong, M.D. September 9, 2014 at 11:39 pm

      mr albert,

      I’m not able to make any constructive comments as I am unable to examine you. It is unusual for you to have the symptoms of pressure in the eye with the scleral buckle. There should not be any cognitive problems.

      Randy

  • Jane Sarver September 10, 2014 at 11:20 am

    My grandson had retinal detachment surgery and had a band placed around his eye last year at the age of 17, he has periodically been suffering eye pain in that eye, is there a reason we should be concerned?

    • Randall V. Wong, M.D. September 21, 2014 at 10:14 pm

      Jane,
      A scleral buckle usually does not cause pain. Bring to the attention of his doctor….sometimes eye pain is not actually from anything wrong with the eye, but sinus disease.

      r

  • Mani22 July 11, 2018 at 2:10 pm

    Hello Dr!
    I am 33yo and just had a Scleral buckle surgery to fix a detachment caused by 1 hole in the retina. It has been 4 weeks now and my vision seems to be improving. The detachment happened very suddenly and not following a trauma I can remember (although I did do some extreme sport a couple years ago including bungee jumping). I had myopia 12 ago but my vision was fixed to 20/20 with laser surgery.

    Would love your help clarifying the following:
    1/ I feel heaviness in my eye, when will it start feeling normal again?
    2/ I am always very concerned and worried about causing a recurrent tear/detachment. How fragile is my eye really? Can I cough, sneeze normally for example? Can I lift luggage during my travels?no gas or oil was inserted in my eye …
    3/ is my retina now more fragile than it was prior to the initial detachment? Or does the buckle play a protective role somehow? In other words, did the buckle decrease the probability of detachment when everything else is held constant?

    Thanks!

    Marwan

    • Randall Wong, M.D. September 23, 2018 at 11:06 am

      Hope you are well. Apologize for the extreme delay.

      1. Heaviness might have been related to swelling or inflammation from the buckle. Just guessing as I can’t examine you.
      2. In my opinion, lifting can not redetach your retina.
      3. In my opinion (deferring to the opinion of your doctor), once healed and reattached, the buckle makes it less likely that you’ll redetach.

      r

  • Deb September 13, 2019 at 1:34 pm

    Dr Wong-
    I had scleral buckle with vitrectomy 8 months ago with many complications including recurrent uveitis (still using Durazol daily), double vision and extreme myopia (prisms in glasses), permanently dilated pupil, droopy eyelid, cataract. Last week I noticed a bump on my eye when I touched my eyelid and lifted my lid and can see the buckle protruding off the surface of my eye. It’s sticking out pretty far and looks pointy on the corner. I’m not sure if it’s exposed, if not, the conjunctiva is very thin because I see what looks like white plastic. I will be having cataract surgery in the next couple months. Should they remove the buckle at that time? I am 60 and I feel like it will poke thorugh eventually, even if it hasn’t already.
    Thank you for your opinion!

    • Randall Wong, M.D. May 20, 2020 at 9:10 pm

      My opinion is that you should listen to the recommendations of your doctor(s). I wouldn’t worry about the presence of a scleral buckle and having cataract surgery. Pretty common.

      Randy

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