There are 3 reasons to have retinal detachment surgery. More than just to restore vision, there are emotional and physical factors that need consideration. There are complications to long term retinal detachments. Your doctor should prepare you for all of them.
The most obvious reason for retinal detachment surgery is to save your vision. A detached retina has no chance of spontaneously fixing itself. An operation is needed.
Remember that retinal detachments cause blindness. Reattaching the retina may not restore your vision completely, but it will prevent blindness.
Usually with proper timing of retinal detachment surgery, the better your visual prognosis and, in most cases, we try to operate within a short period.
On occasion, I’ll see a patient who has had a retinal detachment for a long time. Last month, I operated on a patient with a retinal detachment for about 2 years. The vision was quite poor and unlikely to improve despite successful surgery, but we needed seriously consider surgery.
There are emotional and physical reasons to operate, too.
My patient is relatively young. While I have seen miraculous improvements in similar circumstances, the chance of his regaining useful vision was quite small. We discussed this.
In my experience, the younger patients tend to have more of the “miracles,” that is, given his age, he has a chance of getting some moderate improvement.
I am a big believer in “closing the loop” on something and moving on. This is how I also approach patients with complicated and devasting vision loss. We’ll try everything we possibly can now, if it doesn’t work, we know we’ve tried so that years from now…there are no questions or reservations.
There is value in trying.
It is a healthy approach. I have met too many patients that weren’t properly prepared for the long term possibilities…and can’t move on.
A long standing retinal detachment will lead to blindness.
A long standing retinal detachment can also lead to a shrunken and disfigured eye. The eye is “dying” and can become visually unappealing. This condition is called “phthisis bulbi.” It doesn’t happen to every blind eye, but occurs more often in patient unrepaired retinal detachments.
The long term physical changes occur gradually. Phthisis bulbi can take years to occur. It is not reversible. It is less of a concern with older individuals.
Reattaching the retina can prevent this cosmetic nightmare.
What Does This Mean?
A retinal detachment can have long term complications…and more than just your vision. The emotional trauma that may occur with permanent vision loss can be life changing. I am not discounting the significance of losing vision, but one needs to be aware of this possibility.
A physically disfigured eye can be more traumatic than simply going blind. Complications of long term retinal detachments should be dealt with “up front.” Most of the time, these are only potential issues.
The decision for retinal detachment surgery is usually straightforward as we are often faced with the question of restoring vision. In cases where visual improvement is unlikely, there are still complications that must be faced. Your eye doctor should help you learn about these.