Silicone Oil for Retinal Detachments

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Silicone Oil for Retinal Detachments

Silicone oil can be used to help fix a retinal detachment. While it is not usually used as a first attempt, doctors should use this method earlier to save vision loss from repeated retinal detachments.

Silicone oil can be used to fix retinal detachments.  Using the same principles of intraocular gas to repair a retinal detachment, oil can be thought of as a non-absorbable intraocular gas.  It is a useful “tool” for difficult or recurrent retinal detachments.  Both gas and oil may, or may not, be used in retinal detachment surgery (e.g. vitrectomy and scleral buckle).

Recurrent Retinal Detachments

A recurrent retinal detachment is basically a retinal detachment that can’t be fixed.  An operation is performed, often involving intraocular gas, the gas gets reabsorbed and the retina…detaches again.  Every time the retina redetaches, more vision is lost.

“Rhegmatogenous” Retinal Detachments

“Rhegmatogenous” retinal detachments are all caused by a retinal tear or retinal hole.  By definition, “rhegma,” or a retinal tear, must be present to cause the retinal detachment.  The retinal tear allows communication with the space underneath the retina.  These are the most common type of retinal detachments.

Fluid is able to migrate from the center of the eye, through the tear to the space underneath the retina, thus, causing the retinal detachment.

Intraocular gas and silicone oil work by “plugging the hole” and stop migration of  fluid from the center of the eye to the sub-retinal space.  As long as the oil is pushing against the retinal hole causing the retinal detachment, the detachment will go away.  The oil acts like a cork.

When to Use Silicone Oil

Silicone oil is usually used after other attempts have failed.

Initial attempts at fixing retinal detachments associated with tears usually involve the injection of gas.  The gas is temporary, and will absorb within days to weeks after the operation depending upon the type of gas used.  It does not require an additional operation to remove the gas.

Advantages of Silicone Oil for Retinal Detachments

The best reason to use oil is due to the fact that it does not absorb.  This “permanancy” increases the liklihood of the retina staying attached.  It breaks up the vicious cycle of repeated retinal detachment surgery.   The whole process of having multiple retinal detachment surgeries can be mentally, physically and financially draining.

Now, I use oil earlier in my treatment algorithm.  It allows the retina to become attached, prevents redetachment and therefore saves vision!

Silicone Oil is Safe

The oil is safe and not known to cause any problems elsewhere in the body.  Some doctors feel that the oil can damage the eye directly, but this is controversial.  Many people feel the silicone oil can damage certain tissues of the eye such as the cornea and optic nerve.

I believe the oil to be safe to the eye.  There are no studies by the way, but if doctors wait too long to employ the oil, the same tissues get damaged from recurrent detachment anyway, that is, I think the actual cause of the “damage” is the mere fact of repeated retinal detachments.

What Does This Mean?

Silicone oil is a safe alternative and a good way to fix complicated retinal detachments.  For the time the oil is in place, however, the vision is usually poor, but the oil may increase the visual prognosis in the long term.

Most doctors don’t use silicone oil early enough.  They wait too long.  By then, too much vision may be lost from repeated retinal detachments.

I have found it to be more useful as I have “matured.”  As a younger doc, I was reluctant to turn to silicone oil.  I hadn’t learned that sometimes the disease wins.  My feeling is that docs should be using it earlier and not waiting until the 3rd or 4th redetachment.  It can be a wonderful tool and can buy you time as it interrupts the cycle of reoperation after reoperation.

I recently injected silicone oil into my patient with recurrent detachments in his only eye.  He is presently completely attached and is stable.  We no longer worry (for a long as the oil stays in the eye) about him redetaching.  While he may not be seeing well, we have stabilized him.

Silicone oil gives you stability and piece of mind.

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Comments
  • Bailey Sasser September 29, 2010 at 6:09 pm

    I love reading your blog! I have learned so much. I am a nurse that has had retinal detachments in both eyes and the proud owner of two scleral buckles. My doctor is now talking about a vitrectomy due to scar tissue. He discussed it on my last visit but after waiting so long to see him I did not ask too many questions. I just looked at your website to figure out what he wants to do. (I am 50, like you, and have forgotten most of the eye things I learned about long ago) Keep up the good work.

    • Randall V. Wong, M.D. October 1, 2010 at 12:39 pm

      Dear Bailey,

      Sorry for the delay. Not sure what he means about a vitrectomy for scar tissue. Macular pucker?

      Look forward to hearing from and thanks for the kind comments regarding the blog.

      Here’s to the “Year of the Rat!” (1960)

      Randy

  • Barbara Thomsen October 9, 2010 at 10:45 am

    Thank you for your comments regarding the early use of silicone oil to treat retinal detachments. My first detachments presented on July 3 (holiday weekend) and were treated with pneumatic retinopexy in the doctor’s office; two new detachments occurred and were treated with vitrectomy and gas bubble on August 4; after gas bubble absorbed to 30 percent retina detached again and a scleral buckle with gas bubble performed on September 6; when gas bubble absorbed to 30 percent retina detached again; another vitrectomy performed October 1 and this time silicone oil was used to hold retina on place. I have been told the oil may not be removed for 6 months to a year, if ever. Surgeon noted entire retina was weakly attached on July 3! I had only ever needed reading glasses and after cataract surgery two years ago no longer even needed them. One drop of Timoptic 50% in each eye daily was prescribed to treat my 13 years of glaucoma and has kept that condition very stable. I am a healthy, active 72. I am so happy to have found your blog, it is my lifeline, and I am hoping for the best possible outcome from this latest procedure.

    • Randall V. Wong, M.D. October 10, 2010 at 6:48 am

      Barbara,

      Thanks for sharing about your retinal detachments. Unfortunately, there is no way of telling who is going to have repeated retinal detachments and who is not. You may be a “poster child” for the use of silicone oil.

      I wish you all the best. Please write again and let us know about your progress.

      Randy

  • Michael Dayton October 14, 2010 at 4:32 pm

    Hi Dr. Wong,

    I had a vitrectomy on my left eye on August 31st to repair a detached retina. Initially, about three years ago, I had a small detachment on the nasal side of the retina, and, my surgeon was able to isolate that detachment with laser work. He thought it would remain stable, as the optic nerve was blocking the detached portion from progressing toward the macula. In fact, this summer, it did progress “around” the optic nerve. He then elected to do a full vitrectomy, with a gas bubble. I saw him yesterday (6 weeks after my first procedure), and he told me that the retina has a small hole in it, and has detached again. He explained that the vitreous left behind in the anterior portion of the eye was tugging on the peripheral retina, and thus, caused the hole, and thus, the detachment. I guess my question for you is whether you would recommend a gas bubble or silicone oil in my rapidly approaching surgery this coming Monday the 18th. He explained to me that he would like one of his colleagues to review my situation and render his opinion on oil versus bubble post op, and, whether to do a lensectomy in order to get the remainder of the vitreous out of the eye. Thoughts? He did tell me that for certain, he will be putting in a scleral buckle. Not psyched, as first one was rather painful. Thank you. Michael

    It is a scary time, as I went through all of this 11 years ago, 4 detachments, four surgeries, scleral buckle, two bubbles, two rounds of oil, result, not much useable vision in right eye.

    • Randall V. Wong, M.D. October 16, 2010 at 8:36 am

      Michael,

      I agree with the buckle. Look at it this way, the better your vision in the left eye, the more aggressive you should be.

      I think the buckle is definitely warranted because the first vitrectomy, with gas alone, did not work. I can’t examine you, but silicone oil may not be a bad option at this time. As you know, I favor using oil earlier than later.

      How old are and how good is your vision? When was oil used in the right eye…if you remember, that is, how many times did you detach before oil?

      All the best,

      Randy

  • Susan October 18, 2010 at 11:53 am

    Hi Dr. Wong,
    I just found your blog and website. I recently am two weeks out from my last vitrectomy. I have had a total of 9 procedures on my eye..including cataract and 2 YAGs. I had an initial tear in my retina over 2 years ago which was followed by scleral buckle and silicon oil. Eye was stable for almost 18 months when the detachments started again. I had one vitrectomy 6 weeks ago and now two weeks ago.
    Very frustrating. I have kept some vision. The most recent surgeon (of the practice I go to) is going to mandate oil if it happens again. I am not diabetic, 50 years old. -6.0 in the eye that detached. The very puzzling thing for all the retinals specialists in this practice is why it continues to happen since I am a model patient and follow orders.

    Thanks.

    • Randall V. Wong, M.D. October 18, 2010 at 6:42 pm

      Dear Susan,

      So sorry to hear of all your troubles. I am a bit confused. Are you re-detaching with oil in your eye? It is unusual to be redetaching this far down the road.

      Do they talk about scar tissue on your retina that needs to be peeled away?

      Randy

  • Susan October 19, 2010 at 10:42 am

    Scar tissue caused a couple of the issues. The surgery I had 6 weeks ago cleaned out the scar tissue. this last one two weeks ago was not caused by scar tissue, it was a tear. I am so in tune to the symptoms I catch the detachment very early and it is usually a corner. What they said was if this gas bubble doesn’t work and we have another peel away that they will use silicone oil the next time. Chronologically, here is what happened:

    Tear in retina – vitrectomy with gas
    detachment – buckle with oil
    detachment – vitrectomy, oil remained scar tissue
    removal of oil
    cataract with 2 yags

    15 months stability

    small detachment – scar tissue vitrectomy wiht gas bubble
    redetachment due to tear – vitrectomy with gas bubble

  • colette October 23, 2010 at 6:09 pm

    July 4th retina detached while out of State.
    had gas bubble July 9th.. was never told to position.. 3weeks later gas bubble again with freezing.
    then to surgery for large bubble, had to be face down for 20 hrs aday for 2weeks.. Makes you crazy.Was always being told bubble would go away. first 3-4 weeks then it was 4-6 wks,then told 6-8wks.
    On week 7 at Dr, check-up he then scheduled me for more surgery to be done THAT EVENING he told me I had now a cataract and was going to remove len and put in silicone oil.. It is very upsetting as he also LOVES THE LASAR and does marathone lasar sessions.. on almost every check-up..I feel this is causing alot of damage..
    My puple is soo dialated It takes up my whole eye.. I now have high blood pressure, sick to my stomah everyday and in total discomfort everyday. I’ve asked my Primary care to give me a referral for a second opinion as I feel this guy is distroying my eye totally.. He hurries you thru your appt with hiim ,tells me to just let him do his job.. I never even wore eye glasses, and now wonder if I will ever see again..He says yes but I feel he is running me thru the Mill

    • Randall V. Wong, M.D. October 25, 2010 at 7:34 am

      Colette,

      As I am just an outsider and don’t know the details, some retinal detachments do take several attempts to fix.

      On the other hand, if you need clarity with all that’s going on, I’d recommend a second opinion. It can only help.

      Randy

  • Keri October 27, 2010 at 9:25 pm

    All my eye problems started 21 year ago. I had a detached retina and it was repaired with a scelera buckle. No problems for 18 years and then three years ago he bottom dropped out. I have had macular hole, several detached retinas(even with oil and gas), cataract removed, optic nerve damage and now being referred to a glaucoma specialist. All this and I am 34 years old. My question is how long can my oil stay in? It has been in for two years. I just saw my retina specialist today and was told he retina still looked stable but it looks like a have glaucoma. Pressure was 19. My MD orginally told me that the oil would have to come out because it would change the color of my eye and is now saying if I take the oil out and my pressure goes down my eye can shrival up. Scary! I have enjoyed reading your blog.
    Thank you inadvance foe your thouhts!

    • Randall V. Wong, M.D. October 28, 2010 at 12:48 am

      Dear Keri,

      You have an unusual protracted course.

      The oil can stay indefinitely. As long as your retina remains attached…no worries. Many times you take a chance when removing the oil, hoping/praying that there is no redetachment.

      As long as you are attached, you’ll keep the eye.

      Thanks for your kind remarks.

      r

  • Barbara Thomsen November 4, 2010 at 7:50 pm

    After a pneumatic retinopexy 7/3, vitrectomy with gas bubble 8/4, scleral buckle with gas bubble 9/3 and vitrectomy with silicone oil 8/1, I had my third follow-up visit with the surgeon today. She says there is now scar tissue and she is certain I would have suffered yet another detachment already if the silicone oil was not in place. She says despite the presence now of scar tissue the retina is fully attached and stable but mentioned today the oil may have to remain in the eye permanently. Can detachment reoccur despite the use of silicone oil? That, of course, concerns me. Also, I saw a different doctor in the practice two weeks ago and while he mentioned the presence of “a thin layer of fluid, he didn’t mention scar tissue being present. I also have glaucoma that has been controlled for 15 years with only a daily drop of Timoptic in each eye. Do you think the glaucoma contributes to my retina problems?

    • Randall V. Wong, M.D. November 5, 2010 at 8:31 am

      Barbara,

      Retinal detachment can occur despite the use of silicone oil, but is less common. In my experience, once the retina is attached with oil, it is unusual for it to redetach. The euphamism of “scar tissue” implies a condition called PVR (proliferative vitreoretionpathy) that can lead to recurrent detachment, but it is good news you are attached at this time. Hang in there. It sounds like you are doing well.

      BTW – the glaucoma medications are not contributing to your retinal detachment issues.

      Randy

  • Gillian November 9, 2010 at 8:48 pm

    I have an important decision to make. My left eye was treated with silicone oil at surgery for a retinal detachment 15 months ago. I was traveling in the Middle East and found a good surgeon in Jordan. He told me the oil would have to be removed after 6 to 12 months in order to see normally. Since then my right eye was treated with laser when I started to see floaters. My retinal doctor in the U.S. has discouraged me from removing the oil. But, today, the doctor who specializes in removing cataracts said that I must decide whether to keep the oil or not, before he removes the cataract. The oil makes cataract surgery more complicated with less stable results. I would more likely need glasses and a contact for my left eye if I keep the oil. How do I find a specialist who is experienced in removing silicone oil with safe results?

    • Randall V. Wong, M.D. November 9, 2010 at 9:23 pm

      Gillian,

      Where do you live?

      Most retinal specialists with some experience should have no problems removing the oil

      My preference, and this may be different than your doctor’s, is to laser the retina, again, in anticipation of removing the oil. You must be prepared for the possibility of the retina detaching again.

      I don’t think you should worry about cataract surgery unless your oil is going to be removed.

      Where are you located?

      Look forward to hearing from you.

      Randy

  • colette dickeson November 23, 2010 at 6:42 pm

    How long idoes the silicone oil lef in the eye ?? also Dr removed my lens and now my puple is a large opal shape..I feel miserable everyday.. Well it ever go back to norml size..Having awful panic attaacks since this fiasco becane. Is there any hope ??

    • Randall V. Wong, M.D. November 23, 2010 at 6:59 pm

      Dear Colette,

      The silicone oil may stay indefinitely. Sometimes it must come out if your doctor feels that it is causing some damage to the structures of the eye, but this is uncommon. Vision is usually poor due to repeated detachments and the fact that it is simply hard to see through the oil. The odd shaped pupil may be a result of the actual surgery to remove the lens or perhaps even the oil. I am only guessing as I can’t examine you.

      It is very frustrating, but you should be able to get the answers you need from your doctor.

      Keep your hope!

      Randy

  • Bill December 2, 2010 at 10:02 am

    Doctor,
    Since I last wrote you I have spoken to my Doctor about using Silicon Oil this time in the operation to repair my retina for the third time. He agrees that this may be best. How well will I be able to see through the oil?

    • Randall V. Wong, M.D. December 4, 2010 at 1:27 pm

      Dear Bill,

      Silicone oil has a much different “index of refraction.” This is the property of a substance to pass light. It is much different than water/vitreous and, hence, it is difficult to see through. In other words, you most likely will not be able to see well with the oil especially if you have a lens in place.

      I wish you well. Keep me updated.

      r

  • Will December 8, 2010 at 11:57 pm

    G’day Doctor,
    Greetings from Sydney Australia.

    Since early Sep 2010, I had 3 eye surgeries to repair detached retinal of my left eye – Gas, Heavy Liquid and Oil in that order. It has been almost 2 months since the 3rd surgery (oil).

    The vision now is very murky and distorted (objects appear smaller and squashed). Occasionally, I see ripples of lights at the top corner when I close my eye. My doctor told me the oil is causing cataract, hence the murky vision, and the ripples indicate the retina healing the scar in the lower corner of the eye. He did not explain about the distorted vision.

    He said it will be early 2011 before he will remove the oil.

    Your opinion is appreciated. Also, what should I do about the cataract?

    Thanks

    Cheers
    Will

    • Randall V. Wong, M.D. December 10, 2010 at 11:39 am

      Dear Will,

      G’day!

      Assuming the vision has become worse since your last operation, I would agree that you have a cataract. I generally recommend removing the oil before cataract surgery, but I’d defer to your operating surgeons for their preference. Another possiblity is to have the cataract removed at the same time as the oil. This may give your retina surgeon a perfect view of the retina.

      Sounds like you may have an epiretinal membrane on the surface of your retina leading to the ripples. This may be the same for the distortion.

      On the other hand, the refractive index of oil is much different than water. It is probably responsible for the anisometropic (large difference in refraction) between the two eyes and can give you double vision.

      Stay well. Hope I was helpful.

      Randy

  • Will December 9, 2010 at 12:13 am

    I am having double vision as well.

    Will

  • Barbara Thomsen December 10, 2010 at 3:49 pm

    My previous posts were Oct 9 and Nov. 5. I saw the surgeon 12/9 and this time she didn’t mention the presence of scar tissue but said I now have a large tear at the “bottom.” She still says the retina is stable and says I don’t have to return for three months. Do tears ever heal on their own? And do you feel it is okay to wait three months for another exam? I am not sure I mentioned before that I was diagnosed with glaucoma (mother had also) about 15 years ago. It remains well controlled with one daily drop of Timoptic. I also had cataract surgery two years ago and enjoyed great vision without glasses afterward. The vision in my healthy eye remains excellent. I do drive but not very far and not very comfortably. The headlights from oncoming traffic appear double and almost into my lane of traffic. Dark glasses do seem to help some.

    Thank you so much for your answers and for taking the time to maintain this website. When you experience, particularly numerous times, a detached retina, you are in what seems almost a different world. You provide much support and comfort.

  • Will December 10, 2010 at 6:47 pm

    Thanks Dr. Randy for your advice. My doctor said that for my next surgery to remove oil, he will also do so “repairs”. I assume he meant to fix the epiretinal membrane ? Should I be concerned about the ripples until then ?

    Cheers
    Will

  • Jessica December 21, 2010 at 8:34 am

    Dr. Wong,
    My Mother-in-law is 65 years old and has had a major tear and detached retina and lost per total vision. She went in for emergency surgery to repair the retina and had injection of the gas bubble. She had gone back every week for 2 months and now finds out that the retina has come detached again. She had the second surgery done not knowing what exactly the surgeon was going to do, this was done with silicone oil and a scleral buckle, plus her removed the cataract from that eye . At her follow-up apt with the surgeon he told her that she needed to have a third surgery in about 3 months to have her lens put back in and have the silicone oil bubble removed. My question is this, did the lens have to be removed from her eye for the oil to be placed and does the oil have to come out? At this point is has been 2 weeks since this last procedure and her eye is bloodshot read, swollen, and she has constant headaches.

    Thanks,
    Jessica

    • Randall V. Wong, M.D. December 21, 2010 at 8:52 am

      Dear Jessica,

      It is common practice to remove the lens if silicone oil is going to be removed. There are at least two reasons; first, removal of the lens allows more vitreous to be removed, which at times makes reattachment more likely. Second, everyone has some degree of cataract at age 65 and especially after previous retinal surgery, so, removing the cataract/lens allows better visualization. Third, a cataract is likely to develop rapidly if silicone oil is injected, so, better examination after surgery is afforded with the lens out of the way.

      Silicone oil, in my opinion, usually does not have to come out. I don’t think there is anything golden about waiting 3 months. Perhaps your surgeon is just giving you a heads up (i.e. warning that more surgery may be needed).

      All the best to your mother in law,

      Randy

  • maria January 2, 2011 at 8:27 am

    i just like to ask how long can a heavy silicone oil stay in the eye?

    • Randall V. Wong, M.D. January 2, 2011 at 6:29 pm

      Dear Maria,

      Silicone oil, in a relatively healthy eye, can stay indefinitely. Unfortunately, many times the oil is used after many, many surgeries and the eye is well on it’s way to shutting down…often blamed on the oil.

      Randy

  • colette dickeson January 2, 2011 at 7:34 pm

    I now have a new eye dr.who is just watching the eye,,He said it has to totally heal from all the lasar and trauma to the eye Then he will be sending me to an eye Specialist in Miami,,My Last Dr removed my lens from my eye and filled it wilth silicone oil..so No Vivion..
    Was told old Dr should hve never removed my lens.. after 2 surgeries , gas bubble , freezing. terrrible long lasar sessions .I’m into total meltdown…

    • Randall V. Wong, M.D. January 3, 2011 at 10:32 am

      Dear Colette,

      Shame on the doctor who made the comment about your lens! It is often performed to allow silicone oil to be used.

      Let me know what happens!

      Hang in there and don’t meltdown.

      Randy

  • azlim January 5, 2011 at 6:13 am

    hi, I’m from Malaysia, I had my first ops (vitrectomy) because of retinal detachments and injected the bubble – this was done in july 2010, then 3 months later in october 2010, after there was no more gas, my retinal still detach, but the doctor told me I had Cataract and did the ops, change my lense, and injected another gas (btw this was the 3rd gas, during the 3 months period july-oct, when the first gas had absorp thru my body, the doctor injected 2nd gas, nothing happen. after the 3rd gas still my retinal detach, in december 2010, the doctor told me he wanted to inject silicone oil , because I have a lot of scars and my left eye has shrink, the injection is on 11 january 2011. but during this week, I went for a 2nd and 3rd opinions from two tops Consultant Ophthalmologist in Kuala Lumpur, Malaysia. They all said the same thing, basically my left eye has gone, I lost my vision, because of the condition of my retinal even the silicone oil can only sucsess anatomically but function wise – zero, but my first doctor told me I still has a chance, now all the doctors told me I will has a retinal detachment also in my right eye and they want me to focus on that eye, that I will do. but my question is there any hope or chances (from medical pov) of course I have to be positive!! if silicone oil can attach my retinal and I my left eye can see again off course not 100% but at least I can see. Your opinion is much appreciated, tq. (btw I’m 41 y.o, I had my heart by-pass surgery on july 2008 – is there any connection that cause retinal detachment, but Im not diabetic).

    • Randall V. Wong, M.D. January 9, 2011 at 11:17 pm

      Dear Azlim,

      I wish you well this week. I am not going to add to your anxiety about the left eye, but it doesn’t sound as if the left eye can be helped or salvaged.

      I would agree with every effort to fixing the retinal detachment in your getter eye.

      Good luck!

      Randy

  • Jessica January 27, 2011 at 11:58 am

    Hi Dr – I’m 28 and have had several detachments in my left eye (scleral buckle, 2 times repaired with gas, now have oil in that eye) and had a slight detachment in the right eye which was repaired by laser and has (thankfully) been stable for 4 years. I had a cataract in the left eye as a result of the oil and found a cataract surgeon who was also a retinal specialist to remove the cataract while leaving the oil in the eye. This was 3 months ago and the pressure in my left eye is typically between 18 and as high as 26. Neither my retinal specialist nor my cataract surgeon has mentioned glaucoma, but my optometrist thinks it might be an issue. Can you see the optic nerve through silicone oil? If not, aside from the eye pressure, is there any other way to detect glaucoma without removing the silicone oil? If I had it my way, I’d keep the oil in forever – it’s the only thing that has kept my retina attached (it has been in since January 2008). Thanks!

    • Randall V. Wong, M.D. January 30, 2011 at 11:04 am

      Dear Jessica,

      Be careful about too many “cooks.” In this case, be careful about too many “doctors.”

      The optic nerve can be viewed directly through silicone oil in most cases, especially if cataract surgery has been performed. Sometimes the cataract prevents adequate examination.

      Remember, too, that high pressures are only a risk factor for developing glaucoma. Not everyone who develops increased pressures is necessarily going to get glaucoma. To know for sure, of course, you need to be checked.

      Also, in certain cases, the silicone oil may cause different pressure readings, so the pressures may be unreliable. I’d ask your retina specialist if he/she thinks is possible.

      Last, a more specific test, called a GDx Nerve Fiber Analyzer can be done through the oil to see if there is any glaucomatous damage. I’d ask around to see if you your doc has one of these devices. They are pretty common.

      All the best,

      Randy

  • Virgil Donati January 31, 2011 at 1:55 am

    Hi Dr,

    I am a 38 and had a retinal detachment around 2 years ago. It started with a PVD which when checked out showed no signs of retinal tears and I was told to come back in 3 weeks. About a week later I woke in the middle of the night and noticed he vision seemed to have dropped. I was back to see the opthalmologist the next afternoon who advised that the Retina had detached but the macula was still on.

    He referred me to a Retina specialist who I saw the next day and by this time the Macula was off. There were 8 superior retinal tears. I was operated on the next day and had a vitrectomy with C2F6 gas and a scleral buckle. About 12 days later the Doctor diagnosed another detachment ( not involving the macula this time and I had another vitrectomy this time involving a heavy liquid exchange and doing face up recovery for 14 days. At this time I had another vitrectomy where the Heavy liquid was exchanged for silicone oil.

    A month or so out from the silicone oil exchange the vision was 6/38 improving to 6/12 with pinhole.

    I had about 3 sessions of laser during this time to create a 360 degree band.

    About 2 months after the silicone oil went in I noticed that the vision started to go off and after visiting the retinal specialist he decided to remove the oil in 2 weeks time rather than the 5 weeks that was orginally planned.

    His opinion was that this was just a precaution and that the drop in visual acuity was more likely related to the formation of cataracts.

    After the silicone oil removal the vision dropped to count fingers.

    At this point he was still confident that it was the cataracts causing the low acuity.

    A few months later I had cataract surgery and then a few months after that a yag laser capsulotomy. There was ultimately an improvement and best corrected acuity now is 6/30 ( still not very useful)

    The retina specialist has never really spoken much about why the acuity at one point seemed so promising only to drop other than to say sometimes it happens. I have read other studies relating to the adverse effects of silicone oil however it seems to be a very grey area.

    Is there any hope that the vision could improve over time. The retinal specialist says no however I like to always maintain hope. Meanwhile the Vitreous has started to detach in my other eye.

    • Randall V. Wong, M.D. February 5, 2011 at 1:04 am

      Dear Virgil,

      I would have to agree with your retina specialist. It is unfortunate, but your history of repeated detachments is really the culprit.

      I wish you well.

      r

  • Virgil Donati February 6, 2011 at 7:45 pm

    Thanks Dr,

    What confuses me though is why after the second detachment did the acuity increase to such a promising level , only to go downhill without a further detachment. Was this a delayed result of the first two detachments? When I ask this question it is answered with a shrug of shoulders

    Regards

    Virgil

    • Randall V. Wong, M.D. February 7, 2011 at 4:04 pm

      Dear Virgil,

      I reread your original comment and I can only wonder if you redetached while the oil was inside the eye. It may be related to your getting only a “shrug” for an answer.

      Randy

  • Jim February 8, 2011 at 4:21 am

    Hi Randall,

    I was just diagnosed with retinal detachment in one eye. That eye was already extremely near-sighted. so I’m wondering what are the consequences of leaving it untreated? i.e. are there consequences other than losing what little vision there is in this eye?

    Thanks.
    Jim

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

      Dear Jim,

      In short, get the operation. I have an older article about the reasons for repairing a retinal detachment that may be helpful.

      Unless you know you are on death’s doorstep, I have trouble supporting the choice of not operating.

      Hope this was more helpful than not.

      Randy

  • Barbara Thomsen February 9, 2011 at 3:13 pm

    My first post was Oct. 10, 2010. 7/3/10 – retinopexy with gas bubble; 8/4/10 – vitrectomy with gas bubble; 9/6/10 – scleral buckle with gas bubble; 10/1/10 vitrectomy with silicone oil tamponade. I noticed a change in vision through the oil two weeks ago and when I was examined was told there had been a small bleed but it had stopped and hopefully the blood would be absorbed. Today, 2/8/11, I saw my retina physician/surgeon and she says I now am 40% detached and that it is my decision if I want to continue or should be satisfied to be 60% attached and not have further surgery. I will see another retina specialist for a second opinion on 2/15. What should I do? She says she can remove the oil, repair the detachments and put in another silicone oil tamponade. Should I go to Cleveland Clinic for a third opinion?

    • Randall V. Wong, M.D. February 9, 2011 at 11:49 pm

      Dear Barbara,

      Sorry to hear of your recent news. This is a hard call. On one hand we want to always do as much as we can, but on the other, sometimes enough is enough.

      I think you really have to weigh the practical implications of more surgery…especially the visual potential of your eye at this point. Obviously, I can’t make a recommendation based upon an exam, but I’d go with your gut if you like and trust your present retinal physician.

      Sounds like she has an approach like mine. At times, we have to realize, and accept, that the disease wins sometimes. I doubt there is any “magic” to be found with a third opinion.

      Let me know. I hope this was just a bit helpful.

      Randy

  • Barbara Thomsen February 10, 2011 at 2:32 pm

    Yes, it is helpful. Thank you. One more question, please: Do you feel I will remain 60% attached if I do nothing? My fear is if I do nothing, I will suffer further detachment. I realize you cannot be sure either but I would like to know your thoughts.

    Thank you too for your very prompt answer to my post. I so appreciate your help and time.

  • Bob March 6, 2011 at 10:32 pm

    Randy,

    I am 49 years old. On 10/16/2011, I developed a horse shoe retinal tear with bleeding. I had laser surgery on the 19th of that month, but because of the blood in the eye the ophthalmologist said a week later the surgery was not successful and referred me to a retinal specialist who performed cryosurgery with a gas bubble on the horse shoe tear and repaired a second tear as well. January 5th I saw the tell tale flashes of another detachment and by the time I saw the retinal specialist on Thursday the 6th, I had a shadow in the top quarter of my vision. I am told I had a traction detachment from folded scar tissue. On Monday the 10th, the doctor performed a vitrectomy and reattachment with a buckle and silicon oil. By that point before the surgery I had a shadow in nearly 3/4 of my vision. Now almost 2 months later I am told that the retina looks flat and that the blood behind the retina appears to be gone but I still have a dark shadow that covers almost the same 3/4 of the last detachment. I can only see through this dark region if the is a bright light in that portion of the vision. The bright light will look brown or purplish. I will be having an OCT later next week to hopefully discover what the dark region is. Do you have any guesses what this dark area is?

    • Randall V. Wong, M.D. March 10, 2011 at 12:14 pm

      Dear Bob,

      It sounds as if you have blood underneath your retina. I’d ask specifically if that is the case.

      Randy

  • Dorina March 22, 2011 at 10:55 pm

    Randy, I am 60 years old and I was born with severe myophia (-37 on my right eye and had better vision on my left eye( -18) However I am at the limit to be able to drive. Last week I had a retinal detachment on my right eye and the dr. used a gas bubble. If is happened to my right eye, could it happen to the left eye too? Is there anything I sould do to prevent a detachement to the other eye? (the good eye) I really appreciate your answer,Dorina

    • Randall V. Wong, M.D. March 23, 2011 at 7:41 pm

      Dear Dorina,

      If what your writing is correct, your right eye is at greater risk for retinal detachment compared to that of the left. Although I’ve personally never encountered someone as myopic as -37, but by definition, your eye is longer and larger than your other eye. While -18 is also very myopic, it is less so and physically at less risk for retinal detachment.

      The best thing to do to prevent a retinal detachment in your good eye is to pay attention to any new symptoms of flashes or floaters. I’d also recommend periodic and regular examinations with your doctor if he or she thinks it’s a good idea.

      Best of luck,

      Randy

  • T. Jackson March 24, 2011 at 3:21 pm

    Dear Dr. Wong,

    I experienced a retinal detachment in late December 2010, and late January 2011, neither of which affected the macula. Both led to surgeries; with the first one, the retinal specialist reattached the retina, repaired the holes, removed the vitreous, and injected a gas bubble; the second involved the same repair work, along with a 240 degree scleral buckle and silicon oil injected, which I think he plans to keep in about 6 months. Right now, my vision is poor in this eye, and it seems that my brain has trouble adjusting due to the non-surgery eye having a -7.00 power with little astigmatism, and the surgery eye having a -.50 (used to be approx. -7.00 also) with 3.25 astigmatism. Once the oil is removed, will my eye always have the high astigmatism, and can a contact lens correct the problem in the interim? Or will vision be so distorted with the oil that it won’t be worth it to try to correct it at this time? I just get frustrated because it seems as if I always get double vision, so my left eye takes over and does all the work..

    • Randall V. Wong, M.D. March 29, 2011 at 2:27 pm

      Dear T.,

      It’s tough to predict, but it may be that the astigmatism is due to the buckle. I usually favor 360 buckles for this reason. To be sure, ask your surgeon.

      For now, however, don’t blame all of your visual complaints on the astigmatism. Part of the blame may be the oil. I don’t think a contact lens can help you during the interim.

      Randy

  • ishan kacker March 31, 2011 at 3:14 am

    Dear doctor,
    I am goin in for a surgery today..- had injured my eye which lead to a retina detachment in my right eye..I already have a cataract surgery done in this eye due to an earlier accident so this is goin to be my 4th operation in the same eye..this detachment has not affected my macular area and the doctor said that due to the earlier complications we will decide which procedure to go ahead with on the table itself. Now I have a lot of questions regarding this:
    1.Whether redetachment occurs in cases due to trauma and does the detachment take place at the same spot or different ones on the retina
    2.In your article you said this disease is a viscous cycle of detachments,does that mean I now have this disease or is that another reason for detachments as I tore my retina due to a trauma.
    3.Is there no chance my vision may improve?as I had very low vision in that eye from before.
    4.Does cataract reoccur due to this sometimes?

    I know these are too many questions but I’m freaking out as I’m undergoin my operation in a few hours from now.

    • Randall V. Wong, M.D. March 31, 2011 at 9:15 am

      Dear Ishan,

      1. We are talking about just the right eye? Recurrent detachments usually occur in different areas.
      2. It does not mean you have proliferative retinopathy which is a disease causing recurrent detachments due to “scar” tissue forming repeatedly on the surface of the retina.
      3. Don’t know why you lost vision from trauma, do you?
      4. No cataracts occur once.

      Good luck today.

      Randy

  • chintan gala April 5, 2011 at 5:57 am

    my dad age 55,had a rd last year for which he was operated upon,the doc said it was a complex detachment and chances of redetacment were high after surgery.the doc first gave him a gas injection with other things like scleral buckle,vitrectomy,etc.after the gas surgery his retina got redetached after which he underwent silicon oil treatment ,even that was not succesful…..and then again he was operated upon with a heavy silicon oil called densiron,his retina is stable now but the doc says we should go for oil removal.MY QUESTION IS WHAT IF WE DONT REMOVE IT?WILL IT CAUSE ANY HARM?ONCE THE OIL IS REMOVED WILL HIS VISION IMPROVE? AT PRESENT HIS VISION HIS ONLY 10%. WE HAVE A TIGHT FINANCIAL SITUATION.

    • Randall V. Wong, M.D. April 7, 2011 at 7:53 am

      Dear Chintan,

      Usually oil may remain in the eye indefinitely unless there are some signs that the oil itself is damaging the eye. I would ask your doctor if there is a medical reason to remove the oil, and, if removing the oil would improve the vision. In general, and I don’t know this to be true for your dad, eyes requiring oil have poor visual potential.

      Randy

  • Donald Onyedika April 10, 2011 at 12:12 pm

    Dear Doctor,
    My brother, a 45 year old just had Surgery for Retinal detachment with injection of Silicon oil, and the doctor says oil to be removed in 6months. This is the first detachment he is having, but it has been there for six months. My question is, must the oil be removed and if so can it be left for a longer time?

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

      Dear Donald,

      If there are no signs of toxicity, the oil may remain. Your brother should ask is doctor.

      Randy

  • Clay Fain April 23, 2011 at 10:37 am

    Randy, I have had silicone oil in my left eye for several years. I got CMV Retinitis in 1996 lost vision in my right eye and the left is complicated! I just had surgery last Monday to remove silicone oil from the front of my eye. I had bleeding in the eye and Iritis, my Doctor used a needle to remove the blood and silicone oil got into the front of the eye. My last visit on Thursday April 21,2011, he stated their was a little oil still there but he’s ok with that for now. I’m so worried and scared!!!! Please give me a word of encouragement and do you agree with his decision? He did say he wanted to take me back to the Hospitial in a year to remove the oil. I feel hopeless!

    • Randall V. Wong, M.D. April 27, 2011 at 7:51 am

      Dear Clay,

      Where are you located? I am concerned about your past history and the bleeding and iritis sound worrisome in that something else may be going on. I wonder if there are some other details that may shed some light on this? Oh yes, have you had cataract surgery?

      Look forward to hearing from you. Always use my email if you feel more comfortable.

      Randy
      RWong@RetinaEyeDoctor.com

  • Mr. Lusitano Fernandes April 28, 2011 at 3:13 am

    Dear Doctor,

    I was operated for cataract in year 2008 but while the doctor was operating on removing the cataract the wall where he intended to place the lens was ruptured and so he placed the lens in front which started giving me a problem later. I continued using drops but after a head shower my eyes turned red and swollen and I did not know the reason why. I had a problem with my vision and just before I decided to see a doctor my vision in the right eye was nil. When I went to the doctor, he said I had a retinal detachment from below and immediately he suggested that silicone oil be used. I was operated on 14/4/11 and as instructed by the doctor placed my head in a downward position for 7 days. I am worried now because my vision is still distorted and I am wondering how much vision will come back as I have a job and wish to work. I also have 2 tiny holes in the left eye, I can see well with this eye and the doctor says he can seal these tiny holes by laser. Will this laser treatment diminish my vision as I can see well with my left eye. I am worried because the vision in my right eye is already very poor. Its 12 days now since my operation, should I still keep my head in a downward position?
    What is the best I can do to improve my vision in the right eye which is operated and the diet that will help. Please assist as I am very worried. Lusitano

    • Randall V. Wong, M.D. May 4, 2011 at 7:35 am

      Dear Lusitano,

      You are in the midst of a very difficult course. Good luck!

      With regard to the retinal holes…get them lasered if that’s what is recommended! They will prevent a retinal detachment in that eye and you don’t want to have to go through all of this again!

      With regard to the right eye, I would continue to have high hope for the vision return. In most cases, I don’t expect people to see well with oil in their eye. It does not focus light the same way as water. We were made to have water in our eye, not oil.

      Ask your doctor about the distortion, too. There are many reasons other than just the oil that could lead to distortion. A simple examination will clarify the actual cause very quickly.

      All the best to you.

      Randy

  • Barbara Thomsen May 12, 2011 at 9:01 am

    My last of four posts was Feb 10 when after almost a year of reoccurring detachments in my right eye and 1)pneumatic retinopexy; 2)vitrectomy and membranectomy with gas bubble; 3) scleral buckle with gas bubble; 4) vitrectomy with silicone oil I suffered yet another detachment. After my eye surgeon said it was up to me whether or not to have further surgery I said I would like a second opinion. She suggested a doctor with the Cincinnati Eye Institute and I saw him about five days later. When he examined my eye he said he could certainly tell me what to do. I was now almost totally detached and he said it was no longer about saving vision but about saving my eye. He gave me his first available surgery date and performed “complex retina surgery.” He told me his hope was that the PVR would soon run its course but he could promise nothing. During the surgery he removed the lens placed when I had cataract surgery two years before, did “lots” of work, was able to get the retina flat and fully attached and again used silicone oil. After surgery I positioned for a week and he prescribed Durezol instead of the usual prednisone to, hopefully, better prevent inflammation and I am still using it twice a day. His hope was I would eventually be able to count fingers and see well enough to get through a doorway. The surgery was Feb 23, I remain attached, there is only a tiny bit of scar tissue and for the first time my eye seems to be in a quiescent state. I can count fingers,see all around the room as if looking through murky water and am driving again for the first time since last July. I go back in three months. Regarding the bit of scar tissue, he said he wasn’t worried about it but if it became a problem in the future he would plan to remove it. What do you think of that plan? I have had glaucoma for years. The pressure in my operated eye was 6. He said I should stop using Timoptic in the operated eye and would probably no longer need to use it. Why would that be? I would appreciate your answers. Thank you!

    • Randall V. Wong, M.D. May 16, 2011 at 5:42 pm

      Sounds like you’ve hit a home run. While the vision is not great, you are attached and not having surgery again!!!

      and driving!!

      I can’t answer why you may not need the Timoptic. It may have to do with the PVR and its effect on the ciliary body. Sometimes the scar tissue in PVR pulls on the ciliary body, that tissue in the eye that makes the aqueous fluid.

      Congrats.

      r

  • antonio carlos May 20, 2011 at 7:03 pm

    Boa noite Dr. Randy,

    Sou brasileiro, tenho 48 anos, em 1996 fiz cirurgia para corrigir miopia e astigmatismo. Em 2008
    com 45 anos de idade apareceu catarata em ambos os olhos e progrediu rapidamente, em 6 meses fiz a cirurgia e foi super bem sucedida. Estava enchergando como nunca. Para minha decepção em 2010 tive um descolamento de retina espontaneo no olho direito exatamente o olho retocado com o método Lasik, fiz 2 injeçoes de gaz e por ultimo injeção de oleo de silicone que estou há 10 meses no olho direito. O meu médico pretende retirar o oleo em julho/2011. Estou preoculpado porque minha visão central esta super distorcida, será que é por causa do oleo? percebo que ao redor minha visao está nítida mas não consigo ler nada e nem ver o rosto das pessoas.

    Abraço

    • Randall V. Wong, M.D. May 22, 2011 at 4:38 pm

      Dear Antonio Carlos,

      I translated the above message via Google, to read:

      I am Brazilian, I have 48 years in 1996 did surgery to correct myopia
      and astigmatism. In 2008
      with 45 years of age appeared cataracts in both eyes and progressed
      quickly, within 6 months had the surgery and was very successful. Was
      spotting as ever. To my disappointment in 2010 had a detachment
      Spontaneous retinal detachment in the right eye right eye with the retouched
      Lasik method, I made two injections of gas and last injection of oil
      silicone I’m 10 months in the right eye. My doctor wants
      remove the oil on julho/2011. I am because my vision preoculpado
      this super central distorted, is it because of oil? realize
      around my vision is blurred but I can not read anything or see
      people’s faces.

      The distortion may be due to;

      1. The oil
      2. Epiretinal membranes which have developed on the surface of your retina
      3. Macular edema or a macular hole
      4. Scarring from a detached macula

      Any of these things can cause distortion.

      Randy

  • Bruce Johnston May 24, 2011 at 1:25 pm

    I posed this question directly to your email address, but have not heard back from you: After four [4] surgeries, my retina has remained attached. Per my doctor’s last comments, all looks as expected and the macula looks good. The problem is that I cannot see well due to the oil in my eye. With all of my problems, I plan to leave the oil in there. The question that I have: Is there a way to prescribe a corrective lens to improve vison in that eye? Thanks for any response, Bruce Johnston Easley, SC 24MAY2011

    • Randall V. Wong, M.D. May 28, 2011 at 6:23 pm

      Dear Bruce,

      Sorry, missed this in the email.

      To answer your question, there is no lens that will improve the vision with the oil remaining. The refractive index of the oil, compared to the refractive index of the vitreous is quite different ….. the result will be two lenses (one for each eye) that won’t work well together.

      You could also take the practical approach, ask your eye doctor try…

      Stay in touch. Sorry again for the delay.

      Randy

  • Wayne May 31, 2011 at 6:43 pm

    Year 2011 has been a very difficult year. Started in January with a detached retina, with several large holes. The surgery included a Sclera buckle,vitrectomy, and air bubble and followed doctors orders. In February the retina detached again, so laser treatments and another air bubble placed in eye with a high dosage of prednisone, and followed doctors orders. Then was hospitalzed for herpes simplex encephalitis during this time the retina detached again. I do not know what to do, still recovering from the brain injury and on coumadin for blood clots. There is no vision in the eye and the eye has a cataract. My surgeon suggested doing the cataract surgery, then oil bubble surgery. Not sure what to do, what happens if nothing is done and what are the complications of having the surgery, and will there be any benefits of having the surgery? Prior to all this was a very healthy 52 year old man.
    Please advise…..

    • Randall V. Wong, M.D. June 3, 2011 at 12:11 am

      Dear Wayne,

      Retinal disease can be devastating. You are living it.

      It sounds like your surgeon wants to reattach your retina with oil. Oil can be a great option and interrupt the redetachment and operate again cycle.

      The benefits of keeping your retina attached, regardless of vision loss, is to maintain the physical appearance of the eye.

      Have no idea how well you will see you’ll have to ask the opinion of your doc.

      If your doc recommends oil…without knowing anything else than what you’ve provided…then go for it.

      r

  • Patrice Steffee June 4, 2011 at 2:45 pm

    Dr. Wong,
    I have had laser surgery to repair retinal tears in both eyes in 2009 and in February 2011 I was diagnosed with a retinal attachement in my right eye. I had laser surgery in the retinal specialist’s office to repair the detachment which caused my eye to hemmorhage & I was told that my retina was attached but outpatient surgery in a surgery center would be needed to remove the blood from my eye. I had the surgery, which was extremely painful afterwards, and saw the retinal specialist weekly afterwards and my eye was still very bloodshot & I couldn’t see anything but an orange haze. During one of my doctor visits he used a needle to withdraw blood from around my cornea, which seemed to reduce the orange haze but I still couldn’t see well at all. During my visit with him the 1st week of March 2011 I he seemed concerned about my vision not improving and I heard him say to himself
    ” I should have used a gas bubble” when he was reviewing my chart. After he examined me I was told that I had developed a traumatic cataract which needed to be removed which he did not do but he recommended another physician. He contacted this physician who I saw that day and he said he would do the surgery but wanted to wait until all of the blood was gone from my eye, and give my eye more time to recover from the last surgery, which would take a few weeks. When the blood was gone I had the cataract surgery and a lens implant was put in my right eye at the same surgery center by this physician. I continued to see this physician weekly until the 1st week of April 2011 when I noticed very large swirling lines and dots in front of my left eye. I contacted this physician and his partner, who was on call that week-end, met me at their office and examined me. She said I did have some vitreous hemorrhages which probably caused the floaters but they should go away. The next few days the floaters were still there so I was going to go back to the retinal specialist but after viewing my explanations of benefits from the out patient surgery where it said that he did a retinal attachment with vitrectomy at the surgery center, I realized that he has mislead me in telling me that my retina was attached before that surgery, so I decided to see another retinal specialist who was on my insurance company’s list of providers. I saw this new retinal specialist later that week. He examined my left eye and said he would recommend lasering around the retina, which he did but he also examined my right eye, after reviewing my medical history and said that my retina was not attached. Needless to say I was very upset. after having the the past three surgeries that I had on that eye, and still having a detached retina. He said he would insert a gas bubble in the right eye during the surgery so I would have to be face down for 7-10 days so I made arrangements to have the surgery and take that time off from work. I had that surgery on April 21, 2011 and the doctor also did a vitrectomy and said that he smoothed the edges of the lens implant from my cataract surgery. I rented a chair and pillow to use during the week and a half I was to be face down at home and followed all of the post operative instructions & I have been seeing that physician weekly since then. My vision seemed to be improving as the gas bubble was absorbed but I did tell the doctor during my last two visits that I noticed bubbles of light coming up from the bottom of my right eye and I was told that it was normal to see all sorts of reflections while the gas bubble was still there. I just saw this doctor yesterday and he told me that the retina was partically detached at the bottom right part of my right eye. He also said I had edema in that eye and was going to give me an injection for that then & we would discuss another retinal attachment surgery using silicone oil when he returned from vacation on June 16th. I am quite upset and fearful about another surgery. During my last surgery with this physician the anesthesiologist was unable to put me or keep me under anesthesia so I was awake and in pain during most of the procedure. After reading your articles and comments to other patients about retinal detachments I’m pretty sure this next surgery is probably my last resort but I am terrified about the pain and the outcome as well. What are your thoughts regarding what I have been through and what I should do? I apologize for the length of this comment but didn’t find an e-mail address to contact you .

    • Randall V. Wong, M.D. June 14, 2011 at 7:42 am

      Dear Ms. Steffee,

      I apologize for the delay.

      I would suggest you look forward to the silicone oil as it may put an end to the vicious cycle of repeated operations!

      With regard to the discomfort, I can only guess that it must be horrifying to have to anticipate a painful procedure. I would certainly consider putting you to sleep for the next procedure. This is something you would discuss with both your surgeon and the anesthesiologist.

      Best of luck!

      Randy

  • AlmirSLO June 9, 2011 at 1:27 pm

    Hello!i had a retinal detachment with giant tear from 12 to 6 oclock,the macula waš afected,i was blind!i was operated on 30.4.2011 vitrectomía pars plana,endolaseratio,tamponada cum olei silicum o dex.my vision vas 0.2,now after a month its 0.5 and my doctor is happy,he says it looks good!but i am worried because i am seeing aura like lights and black spots!i have an iol with -9 that is decentered i have glares from it!i am of work now 45 days,how long is a normal healing time in these situations?and what r the ods of redetaching or other complications in these situations?please be open with me!thank you for your answer!hello from europe

    • Randall V. Wong, M.D. June 14, 2011 at 7:45 am

      Dear A,

      The lights and changes in your vision are probably from the different optical properties of the oil. This is usually the case especially if your doctor is happy with your progress.

      In general, patients of mine are pretty stable within 1-2 weeks after putting the oil in place. I would express your concerns with your doctor, that is, ask when you might anticipate going back to work.

      Thank you!

      Randy

  • zack June 16, 2011 at 3:33 am

    My girlfriend is suffering from a retinal detachment. Doctors in singapore advises to do a surgery asap.
    Currently her vision is a little bit wavy. Kindly advise if she can wait 3 more months to do the surgery as only by 3 more months she will have enough money for this surgery.

    • Randall V. Wong, M.D. June 20, 2011 at 10:04 am

      Dear Zack,

      If your friend has a retinal detachment, she should have surgery ASAP. Waiting too long could lead to permanent loss of vision if not blindness.

      Randy

  • zack June 16, 2011 at 7:19 am

    and also, the thai doctors say that it is not retinal detachment.
    Her condition is seeing things wavy and sometimes top vision is shadowed

    Please advise if its retinal detachment usually..

    • Randall V. Wong, M.D. June 20, 2011 at 10:05 am

      Can’t tell without examining. I’d fear the worst. You have nothing to lose if you act as if she has a detachment. I’d get another opinion if there is any question. Again, if she indeed has an RD, she needs immediate care.

      Randy

  • Zack June 16, 2011 at 11:25 pm

    hello? was my post deleted?

  • Kaushik June 19, 2011 at 8:29 am

    Dear Dr Wong, I had RD surgery in my right eye on 7th April due to inferior retinal detachment at 3:30 . 23G cannula was placed + ReBMV+PAX+EL+ C3F8 Gas bubble was inserted and I was advised prone positioning for two weeks. But within 10 days as the gas bubble shank I had a fresh break at 7 oclock position causing partial retina detachment. Immediately second surgery was done as above and silicone oil has been inserted this time. Since vitreous fluid seepage had taken place I have micropsia and the image is distorted (macular edema type). I am adviced with Navanac eye drops for three months and have my IOP checked every week. How long I need to keep the silicone oil? How long does it take for micropsia to get corrected?
    with Regards
    Kaushik

    • Randall V. Wong, M.D. June 20, 2011 at 10:24 am

      Dear Kaushik,

      Ask you doctor if there is any epiretinal tissue. While submacular fluid might cause micropsia, there are other possibilities including the refractive index of the oil or scar tissue forming on top of or underneath the macula.

      Randy

  • AlmirSLO June 19, 2011 at 3:04 pm

    Thank you for your answer!i have a couple of questins on which i cant find an answer on the web!
    1.are the symptoms for redetaching after silicon the same i(flashes,and floaters) maybe we see it differently because of the oil
    2 can doctors see if scar tissue is forming with those intstrument 100% with oil and buble
    3.do vitamins and health food help in healing(because i eat tons of carrots,fish oil,vitamins)
    4 after what time staying atached with oil can we lift heavier stuff etc…
    in my case giant tear,macula off,retina was folded or something like that,lens moved and bllurred!when i look down i see the edge of the lens!will that lens in your opinion detach or something like that!my vision is 50% i feel its to good to be true!you have a great site!thank you

    • Randall V. Wong, M.D. June 20, 2011 at 10:28 am

      Dear A,

      1. symptoms are usually gradual loss of vision. flashes and floaters, in my opinion, occur less often due to the viscosity of the oil and a different mechanism of redetachment.

      2. yes, but you should have only oil OR gas bubble, not both.

      3. No evidence.

      4. Not so sure there is a limit. I usually don’t recommend against lifting, but it depends upon what kind of surgery I performed. In my practice, if I just perform retinal surgery, I have no reason to advise against lifting.

      Randy

  • Ken July 16, 2011 at 6:57 pm

    Dr. Wong,
    I had a retinal detachment (left eye) July 2010, treated with vitrectomy and gas bubble. Redetachment on Aug 2010, treated with scleral buckle and oil. No further redetachment, but two problems. One, I really don’t see well out of left eye; two, for about five years I’ve been developing a cataract in left eye, and my doctor says it’s bad enough to operate now (he also says it will also let him see a little better into the eye). It seems to me there are four scenarios (at least), based on whether we choose to leave the oil, and whether we want to use the “opportunity” of the cataract surgery to “improve” the vision in left eye to close to normal, or whether we should try to make the left eye closer to the right eye. With the oil my prescription is OD: -6.25 – 2.00 x 150; OS: -2.75 – 1.25 x 45. It seems to me, since I don’t really mind wearing glasses (progressives have worked well for me in the past), that it would be best to go for “similar strength scenario” rather than left eye “normal,” right eye -6. Comments?

    • Randall V. Wong, M.D. July 18, 2011 at 2:22 pm

      Dear Ken,

      I’m not too familiar with people having cataract surgery while oil remains in the eye. I’d be amazed if you could see well with the oil. I usually remove the lens/cataract at the time of oil, but that’s my preference.

      Also, calculations for the power of the implant may be altered due to the oil.

      Randy

  • Carole Woodcock July 19, 2011 at 9:31 am

    Is it usual to have “sugarlike/crystal/floaters appear whilst having silicone oil in eye after retinal surgery?

    • Randall V. Wong, M.D. July 22, 2011 at 7:25 am

      Dear Carole,

      No, but the vision with silicone oil is generally poor…and weird. I’ve never actually heard of that particular complaint.

      Randy

  • Lynette Lynch July 24, 2011 at 10:33 pm

    Dear Dr Wong
    I had eye bleed December 2010 – one week later second eye bleed Doctor found a tear in my retina had Vitrectomy mid December with gas bubble – laser around eye perimeter in January 2011 – all good until 2 weeks after Laser – week 7 after Vitrectomy my retina detached. Vitrectomy with heavy silicone Oil and scleral buckle February 2011. Loss of vision with the oil and cataract formed post -op – Surgeon wants to leave cataract for another 4 to 6 months before operating – and will remove silicone oil during cataract surgery replace with Saline – what chance of retina detaching again ?

    • Randall V. Wong, M.D. July 29, 2011 at 8:32 am

      Dear Lynette,

      If you continued to redetache, prior to oil, due to repeated tears, I think you’ve got about a 50/50 chance of redetaching. It really depends, however, upon the reason for the redetachments. The scariest scenario is where you keep redetaching and the actual holes or tears can’t be found. If you are redetaching due to recurrent scar tissue….your prognosis is much, much better.

      Randy

  • Marrisa July 27, 2011 at 8:23 pm

    My Dad had retinal detachment surgery on his left eye on June 6th inwhich they inserted the gas bubble. He went back to the doctor and found out he had a small hole due to scar tissue. For the second surgery they did the buckle with silicone oil. He is VERY worried about the scar tissue forming again. Is there anything you can tell him that can ease his mind about it? Or something they can do. Also he says his vision is blurry and hazy. Some days he says it seems better and then the next day it isn’t. Is this normal with the silicone oil? Thank you.

    • Randall V. Wong, M.D. July 29, 2011 at 8:44 am

      Dear Marrisa,

      Sounds like your dad’s surgeon and I are similar. I think the earlier oil is used, in this setting of “scar” tissue forming, the better. In my opinion, the chance of recurrent scar tissue forming is quite high, but only for a limited time (couple of months?). Thus, the oil potentially can keep him attached while the disease (of recurrent scar tissue forming, called proliferative vitreoretinopathy or PVR) burns itself out.

      Tell him to hang in there!

      Randy

  • Marrisa July 29, 2011 at 12:14 pm

    Thank you so much for your reply. I have another question… His eye is watering really bad. Mostly when he goes outside and comes back in and when he watches TV. Is this something he needs to contact his doctor about or is it pretty normal two weeks after surgery? Also his vision is blurry and hazy… Is that normal with the oil?

  • Frank August 5, 2011 at 12:59 pm

    Hi Dr. Wong,
    I have recently had four retinal detachments. One was treated by freezing and laser and that held, but a small tear developed 3 weeks later next to the original tear. That was treated with a laser in the doctors office. Two weeks later a new detachment occurred from the 6-830 position.I again had surgery. Ten days out after two weeks of a face down position, it re-detached at the same position. (A maculer hole was also noticed) Now my doctor advises another vitrectomy to correct this problem.
    She has given me the option to use gas or oil. At this stage, given my past history, I have decided on the oil. Is the oil clear enough to see through and what are the downfalls? I have 2200 vision now

    • Randall V. Wong, M.D. August 7, 2011 at 10:37 am

      Dear Frank,

      Wow. It seems that you had two tears that were treated with cryotherapy and then a retinal detachment developed. If you have a macular hole, that may be the limiting factor to visual recovery. I think the oil is a good choice. I would think a vitrectomy would be helpful by changing the vector forces within the vitreous…..oil or gas is probably a secondary consideration.

      The only real downfall to oil is that it has to come out. The vision with oil, in my experience, is probably not that great especially if, and I am making an assumption, that your other eye sees well.

      All the best.

      Randy

  • Zac August 9, 2011 at 10:43 pm

    Hi,

    I would like to seek your advise if after fixing retinal detachment with Sceleral Buckling and laser, will it relapse?

    & also, after the operation, eye sight went left -6.00, right -2.00. Is getting a spectacle temporarily advisable as my surgeon said only have 2-3months then get a new spectacle as the degree will still change.

    Regards,
    Zac

    • Randall V. Wong, M.D. August 19, 2011 at 11:38 am

      Zac,

      Sorry, have been on vacation.

      Temporary spectacle changes are fine, in my opinion, but you most likely will need to change them.

      Best of luck.

      r

      BTW – no guarantees about relapse. It does happen.

  • Zac August 19, 2011 at 10:11 pm

    Hi ,

    Thank you for your reply. What’s the chances of relapse? Is it high?

    Regards,
    Zac

  • Andrea August 23, 2011 at 2:55 pm

    Hi,
    I am after some advice and reassurance. I am 26yrs old and developed a retinal detachment early June this year. Was treated with bulking, but diddnt work. Was then treated a month later with the gas bubble and only lasted a week till the same shadow reappeared. My consultant told me I had fibroids and scar tissue in my eye and sent me for a chest xray and immunology bloods all of which are perfect. I was treated under another consultant, mine was away, 5 days ago and he agreed to put the silicone oil in place. Vision was good, shadow had gone, but today it seems strange. My eye at the top seems similar to when the gas bubble was dissolving, as if there is a line at the top of my eye. Could the oil be leaking or has my retina detached again?
    Also, I don’t want to have to have surgery every few weeks, I just want this fixing
    I am a nurse and this is my sixth week off work. Financially I am struggling and feel very low. What other options are there for me?

    Thanks
    Andrea

    • Randall V. Wong, M.D. August 24, 2011 at 7:36 am

      Dear Andrea,

      Sounds like a condition called PVR (hence the terms fibroids/scar tissue) and recurrent detachment. It is a very tough problem to rectify.

      Redetaching with oil can happen, but not very often.

      Repeated surgery, if you are redetached, is probably likely.

      Stay in touch.

      r

  • Nayan Abbot September 3, 2011 at 10:25 am

    Dear Mr. Wong,
    My 13 year old brother had a retinal detachment macula off surgery in July and was injected with Silicone Oil in his left eye. He had to be in the painful head down position for 4 weeks. Prior the retinal detachment he was myopic with -11 power in both eyes. All was fine and the doctor said that the retina has attached. With the Silicone oil his vision is very blurry. He could only read a few “Es” on the eye test chart. Now after three months,the doctor said that a membrane has formed on his retina and he would remove the oil and the membrane in a surgery next week. He said that he would replace the oil bubble with a gas bubble.
    My questions are:
    1. How much are the chances of recovery of his vision.?
    2. Is a gas bubble after the oil bubble removal really needed?
    3. Can these bubbles cause Cataract in the eye.? Can their removal cause another detachment?
    5. Can he have a laser surgery later to remove his -11 power? Will that improve his vision?
    Please help me because I am very much worried..! He is too young.

    • Randall V. Wong, M.D. February 15, 2012 at 9:17 am

      Dear Nayan,

      There were four “comments” that were “lost.” Yours is one of them.

      For the sake of future readers, I’m going to respond to your questions as i am aware your brother has already had the surgery to remove the oil.

      I hope your brother is well after this past 5 months.

      1. Don’t know, depends upon severity of original detachment and severity of the membrane.
      2. Yes, if he wants to have the chance of functional vision.
      3. Yes and yes. Both are possible, but not imminent.
      4. Whoops!
      5. If the visual potential is good and the cornea thick enough, he might be able to get laser.

      Randy

  • Irfan September 7, 2011 at 4:21 am

    Dear Doctor,

    I am wearing high power specs (+7.5,+9) with additional reading +3 from my childhood.I have done Surgery for Retinal detachment with injection of Silicon oil for my right eye in 2006, It was a two step procedure and removed a portion of silicon oil during the second stage after 45 days. When i done eye check up last week my consultant told me that there is a silicon oil emulsification in my right eye (also she added retina is well attached now and pressure also very much normal) and advised me i may have to remove the silicon oil and told me to consult one more senior doctor but he is available only on 11th October 2011.

    I have the following concerns regarding my present condition, kindly share me your opinion.

    1. Is emulsification of silicon oil a serious issue .
    2. The silicon oil is there in my eyes for almost 5 years, can I remove it at this point of time, or it should be there for life time to avoid re-detachment.
    3. Is the vision of the right will improve once I remove the Silicon oil.

    Awaiting for your reply

    • Randall V. Wong, M.D. September 7, 2011 at 5:03 pm

      Dear Irfan,

      1. No. It just means it is breaking down and commonly occurs with longstanding oil.
      2. Was most of the oil removed before? If the oil is keeping the retina attached now, it is possible you could re-detach, but it matters how much oil remains at this time.
      3. Have no way of knowing.

      Randy

  • Suzy Moody September 7, 2011 at 9:16 pm

    Dr. Wong,
    We are working on our second reattachement. First one with buckle and gas. Second a function of scaring and a tear. We now have oil in the eye. Our doctor was not clear on activity. He said don’t read, but we have a patch over the bad eye. Does that include TV also? How long does the oil normally stay in? Lastly, can FML Forte drops increase scarring? Of course that was the last thing we did before the second detachment and worry it is suspect. Thanks!

    • Randall V. Wong, M.D. September 8, 2011 at 8:50 am

      Dear Suzy,

      Without contradicting your doctor, please confirm your activity restrictions with him.

      With my own patients, I don’t restrict reading or watching TV because it doesn’t make sense to me. Here’s why; Every night, when we enter REM (Rapid Eye Movement) sleep, our eyes beat back and forth ferociously….much worse than reading or TV.

      Hope this was helpful.

      r

  • vonda rogers September 10, 2011 at 10:29 am

    Just how long is it possable to keep the silicone oil in ones eye months? years? can it do damage if in for to long?

    • Randall V. Wong, M.D. September 12, 2011 at 4:41 am

      Dear Vonda,

      Silicone can stay in the eye indefinitely. Some feel that it can be damaging to the cornea and/or optic nerve, but the should be examined regularly for signs of toxicity (aka damage).

      Randy

  • Doug Alley September 14, 2011 at 7:55 am

    My wife had several detachments about 10 years ago. In the end, a buckle was used, and silicone oil. Her vision in that eye is limited to shades of light and color, and unrecognizable images. Each follow up brings us no new information. The conclusion is without the oil, the retina will not remain attached. Are there any other options we should discuss with our doctors? There must be something else that canbe done? Or is what she currently sees in her eye the best she can hope for until technology advances? Thank you for your time.

    • Randall V. Wong, M.D. September 19, 2011 at 6:15 am

      Dear Doug,

      Not sure if technology is promising anything “around the corner.”

      I often take out silicone oil if the retina has been attached. If portions of the retina are detached, I am somewhat cautious as redetachment is likely.

      If your wife’s retina is attached, you might inquire if the oil can be removed after additional laser. This would be my approach.

      Randy

  • shelia smith September 19, 2011 at 8:02 pm

    ihad a retina detachment in my left eye the first surgery was a gas bubble put sight came for two weeks then went away, so i had another surgery they put in silcon oil. my eye stay in bad pain everyday I wish I wouldn’t had any surgery because Ican not see out of my eye. my doctor act like there is nothing he can do for my pain. I am in pain everyday. PLEASE HELP

  • Jimmy chen September 26, 2011 at 10:40 am

    Dear Dr.Wong
    I took a air bubble surgery at Aug 21 by Dr. Bhagatne at UMDNJ. For me have not keep the face down whole the day and month. It fail. Tomorrow I will take secondary silicon oil that is Dr. Bhagatne’s idea. She help me not so difficult to get thru the recover. before I get in surgery room . my vision can see golf ball at 190 yards but distorting .I need your advisory during the recover. Thank you

    • Randall V. Wong, M.D. September 27, 2011 at 11:29 pm

      Dear Jimmy,

      Think of silicone oil as a permanent gas bubble…it works the same as gas, but doesn’t get absorbed. Your facedown positioning depends upon the directions your doctor gives you…in my practice, it would be about a week.

      r

  • shelia smith September 26, 2011 at 3:42 pm

    No Dr.Wong I didn’t have scleral buckle place in my eye.

  • shelia smith October 1, 2011 at 11:47 pm

    Hi Dr, Wong, Can you tell me what can I do about my eye pain after I had that silicone oil put in my eye. I did not have that scleral buckle put in my eye it feel like someone keep sticking pinnes in my eye, it even hurt to blink my eye. I put eye drops in from the doctor that don’t work.I am tired of this eye pain, I don’t have vision in it. HELP ME PLEASE DOCTOR WONG. THANK YOU

    • Randall V. Wong, M.D. October 3, 2011 at 11:02 am

      Dear Shelia,

      My first thought was that the buckle was the culprit, but if there is no buckle….how can that be?

      There are so many causes of eye pain other than the buckle. I can only recommend you speak directly to your doctor….or, get a second opinion if he/she is no help.

      I wish I could offer more.

      r

  • Yoko October 3, 2011 at 5:05 am

    Hi Dr Wong
    So glad there is this blog to relieve one’s fears and clear some doubts. I had retinal op – gas and scleral buckle in Jan this year followed by another gas and 2 lasers due to additional tears. Finally Doc put in silicon oil in May- now i am going for its removal and fixing of lens. I thought this is the final operation i have to suffer but i was very upset to hear the bad news that the silicon oil has caused calcium deposits on my cornea, hence i need to go for another operation -scraping of calcium deposits after it. Doc told me that this is the body’s reaction towards alien silicon oil. I wonder how many operations will follow after this-can’t help feeling kinda of disappoinnted and pessimistic . Hope Doctors can empathise poor patient like myself who has to undergo so many operations which cause lots of money and time. Pls clarify whether silicon oil will cause calcium deposits on cornea- does one need to go for operation or they will cause loss of vision in future. Thank you- hope to hear your views, Doc

    • Randall V. Wong, M.D. October 3, 2011 at 11:10 am

      Yoko,

      It’s difficult to know corneal calcification is actually from the silicone oil, or from the operations, both are possible.

      Regardless of the cause, however, it can often be removed, albeit with another operation.

      Best of luck.

      r

  • Maurice October 5, 2011 at 5:36 pm

    Hey I have silicon oiI in my right eye is that the reason why I can’t currently read a book or why things look like there in shade? When the oil is removed will that enhance my vision some? Last I going to be fitted for a lens will this help my vision?

    • Randall V. Wong, M.D. October 15, 2011 at 10:34 am

      Dear Maurice,

      Most people do not see well with oil….but it does not necessarily mean that removing the oil will be helpful. Often, I use an instrument, called PAM (Potential Acuity Meter) to assess possible retinal function in patients with oil…but this is only an approximation.

      r

  • jenny October 7, 2011 at 11:21 pm

    dr wong

    can the patient who just had oil injection take an airplane flight ? if not how long does she have to wait …?

    • Randall V. Wong, M.D. October 15, 2011 at 10:36 am

      Dear Jenny,

      Should not be a problem. There are potential problems with changes in atmospheric pressure in patients who have gas in their eye. The gas may expand too fast for the eye to compensate and cause the eye pressure to increase. Oil doesn’t expand in this way.

      Randy

  • Maurice October 12, 2011 at 9:49 am

    Hello. if I have silicon oil in my eye how will the vision look? Currently It’s seems like I’m looking threw water or the oil it self. Im also going to be fitted for a lense because mine was removed during surgery what is the lense suppose to do? My sight seems very well so once the oil is removed will that clear vision up?

    • Randall V. Wong, M.D. October 15, 2011 at 10:42 am

      Dear Maurice,

      Sounds as if you have no lens and oil in your eye?

      The oil itself as an index of refraction (that property which focuses light) that approximates your own natural lens. So, removing the oil will also remove the oil related focusing…which will be replaced by the intraocular lens.

      My guess is that you’ll see pretty well if you are seeing well now.

      Randy

  • Mohammad Swell October 14, 2011 at 2:03 am

    Hi Doctor Wong.

    I have gone through Retina detachment surgery- R/E VR Surgery + SOI+ Endolaser done in mid of july. then after 15 days my doctor done laser then after 10 days again laser was done. my vision was improving. doctor did second sergury after 3 month of inserting oil for removal of silicon oil on 11th octorber’11. at that day before removal my vision is 6/9 from 6/36 at the time of detachment and I was able to see through the glass put infront of my eye. Now after one day of removal i have blurred vision not able to see just like cloudiness images are not clear. so doctor advise us to keep eye pad for 48 hours more and use 2eye drop(1. homatropine hydrobromide- tds: 2. Gatifloxacin & Prednisolone Acetate 6 times in 24 hrs) + ciprofloxicin tab. Please advise how much time it will take to clear my vision. what should be the precaution we should take so that retina detachment cant happen in future again.

    waiting for your respnse. Thanks!
    MS

    • Randall V. Wong, M.D. October 15, 2011 at 10:45 am

      Dear Mohammad,

      Your best bet to prevent re-detachment is to make sure you see your doctor regularly.

      In theory, you’d like the detachment to be noticed before it affects your vision.

      Randy

  • john October 17, 2011 at 8:09 pm

    Had oil put in eye after 2nd retinal surgery. Vision in eye is blurred as expected. When driving or
    reading get headaches. Tried wearing eye patch over eye seemed to help. Is this ok? Have crystalite
    lens in eye. Will that have to be replaced when oil removed?

    • Randall V. Wong, M.D. October 18, 2011 at 11:16 am

      Dear John,

      Vision should be blurry after oil injection…and as you said, as expected.

      Wearing patch over the eye, in an adult, is fine, especially if it makes you more comfortable and more confident driving.

      Your implant should not have to be replaced.

      Randy

  • Barbara Thomsen October 26, 2011 at 10:19 pm

    My last surgery was my fifth in a year for reoccurring retina detachment. My retina was totally detached and a new surgeon performed complex retina surgery and once again silicone oil was used. At the time of my last surgery the lens implanted two years earlier during cataract surgery was removed. My surgeon tells me he has no plans to ever remove the oil and that I wouldn’t have any better vision if it was removed. I guess my vision in that eye might be termed ambulatory. It has been 7 months and retina remains attached. Surgeon says I must continue to sleep only on my side. Do you agree? My total vision seems distorted, a bit double and as if a flashlight is shining in my face. Any ideas of what might help?

  • Zahid Syed October 29, 2011 at 11:07 am

    Dear Dr. Wong
    I am high myopic and wearing glasses of (L -10, R -14). 4 years back I had put silicon oil in my right eye due to retina detachment. The following 30 days I felt a gradual better vision but all of a sudden loss of vision started and I lost my complete vision. Now just darkness is there and nothing else. Have visited 2many doctors but they says ” now after such a long period nothing can be done now” After reading the above article and your good response towards general ppl asking you, I once again became hopeful for getting back my vision. Silicon oil is still there in my eye. Can I have a kind advise, if it is possible?
    Regards

    • Randall V. Wong, M.D. November 5, 2011 at 10:35 am

      Dear Zahid,

      I don’t know why you lost vision. Do you? I think something else must have happend with the silicone oil in the eye. Did you detach again?

      Randy

  • Almir October 30, 2011 at 10:22 am

    Hi!i had a retinal detachment with giant tear!silicone oil was in for 5 months and i had it removed 10days ago!i had 70% vision with oil but one month before silicone removal it droped to 20% and my iop was 30!on my hospital papires says lavage cameram,aspiratio olei siliconi,peeling membran,endolaseratio!my vision is still 20%!and i see a lot of black spots more than first operation!i see strange light on my pheriphery vision and flashing vision on my central,it was there even when silicone was in!when will it stop?and why did i lose so much vision?my lens is also dislocate from my first operation!has anyone had experiences with these lights which last up to 20 min.!when i seetle down it stops!thank you for your answer!

    • Randall V. Wong, M.D. November 5, 2011 at 10:36 am

      Dear Almir,

      Lots of things going on here. Did your doctor remove the oil and replace it with gas? If so, that could be one answer.

      r

  • Wendi November 1, 2011 at 6:57 pm

    Hi Dr Wong,

    I have just had a vitrectomy to remove the silicon oil from my eye after a retinal detachment seven months ago. Now that the vitreous jelly has been replenished, my sight is far worse than it was with the oil. With the oil there was a lot of refraction, as to be expected, but now it is as though I am looking through a smear of vaseline, in addition to many floaters which I am told are due to a small amount of oil in the eye which they were unable to remove. There is a speckling of oil droplets covering my lens implant that I am afraid is causing this extreme blurriness. In your experience, is this oil on the lens something that could be causing this, and can be removed with yet another surgery? Thank you so much.

    • Randall V. Wong, M.D. November 5, 2011 at 10:44 am

      Dear Wendi,

      It is possible that oil droplets remain on the implant…do you have one? If so, at times it is possible to remove them, but requiring another surgery.

      r

  • Deedee Jones November 6, 2011 at 5:56 pm

    I have had lazier on both eyes for the past 10 years. Then in June I was rushed for emergency surgery on the right eye for retinal detachment. I had a cataract surgery done in Jan. 2011. They did the gas first. Didn’t work. They did a slecarl buckle waited on my left side for 2 weeks. Didn’t work.
    Got another gas and it didn’t work.
    Finally got he silicone oil on June 24th and will have it out on Dec. 1.

    Can I fly after that surgery and if I have to wait when would I be able to.
    I know when I had the gas ones done I could not even drive on an elevated highway.

    If this doesn’t work for the detachment what am I to expect.?
    Blindness like i was before the surgery?

    • Randall V. Wong, M.D. November 15, 2011 at 9:52 am

      Dear Deedee,

      You can fly after removal of the oil if gas is not put in again (it might be).

      Unfortunately, blindness is a possibility with retinal detachments….but it doesn’t happen often.

      Randy

  • Jose November 7, 2011 at 5:12 pm

    Hello doctor
    I had a upper left eye retinal detachment in 2009 gas and scleral buckle used then developed cataract which was removed then another lower detachment occurred in 2010 which oil is still in. Retina attached and need to have iol lens put in. The doctor says he wants to remove oil asked how long is recovery he says he may laser and may use gas bubble again to insure no recurring detachment. He will know if he will use bubble again when he goes in. I really want the oil removed since it will improve vision but don’t want bubble again since this is what caused the cateract. How long does the oil removal procedure last also how long is recovery? Is there pain or vision loss during procedure does most of the oil come out I Plan to take 2 wks off.

    • Randall V. Wong, M.D. November 15, 2011 at 9:55 am

      Dear Jose,

      Your recovery will depend upon the type of gas used, if any.

      If no gas, then quickest recovery. I use SF6 at a mixture of 16%. I keep my patients head positioned for 5-6 days only and then the gas should be absorbed completely within about 10-14 days.

      Most doctors use C3F8 and this gas tends to last much longer due to its chemical structure (much larger molecule).

      TMI?

      Randy

  • wee November 8, 2011 at 12:51 am

    I just had retina detachment done. The doctor used silicone oil instead of gas as I am from outstation and have to fly back home. I was asked to apply “Vigamox” & Pred Forte. Can you tell me how long I have to use the eye drops?

    The doctor also said I have slight cataract in both eyes. I am thinking of have them removed. Is it possible to have them done 4-6 weeks after my retina detachment surgery with the silicone oil still inside.

    • Randall V. Wong, M.D. November 15, 2011 at 10:06 am

      Dear Wee,

      Duration of use of the drops varies from surgeon to surgeon.

      I use an antibiotic, like Vigamox, for about a week. On the other hand, I use Pred Forte sometimes for months.

      I don’t think cataract surgery is very easily done with silicone oil in the eye.

      Randy

  • sal mazzone November 21, 2011 at 9:53 pm

    please adivise me as to why in some people the retnia does not stay attached? I had two surgurys, first gas bubble, second gas bubble and buckle, and finally oil. I am afraid to go or do anything in fear of it falling again. I live in Pa. and have to drive almost an hour to my doctor, and he trys to get the surgery done that night or next morning. I feel so depressed with this. Not sure when to just give up. Is there a time when enough is enough? My wife and I usally go away for most of the winter, but can not even think about going far from my doctor. this has put my life on hold, and just need to know when to say no more. thanks

    • Randall V. Wong, M.D. November 26, 2011 at 8:13 am

      Dear Sal,

      Repeated surgery for retinal detachment is not uncommon. Certainly, it can overtake life for a few months. It has happened to many of my patients, too. About 5-10% of retinal detachments recur. About 2-3% have complications.

      Sounds like you are finally stable.

      The real test, in my book, is how much vision do you have now and what does your doctor realistically feel about your visual potential?

      Randy

  • carol mazzone November 21, 2011 at 11:42 pm

    Dr. Wang, My husband posted above, I also wanted to know what can be done about scar tissue, the Doctor mentioned that he builds scar tissue that cause the retnia to detach. But when we asked if he could rid of it before detachment, he said no. So every time he has a procedure, will he not get more? Ok he just had his third surgery, and the oil was put in. I must say, neither one of us are at all possitive, and my husband is walking around waiting for the retnia to fall again. This is no way to live, I am shocked that modern medicine has not found a way to permantly hold the retnia up. When asking if it could drop even with the oil? He said yes. We are both wondering if after this he should go furthur, as there is really little hope, or at least thats how we both feel. We live in Pa, and are making a trip to manhatten to see another retnia specialist next week for a consult, sure for nothing, but this is so ugly. My husband retnia came down like wall paper, floating in his eye, wonder if thats why its not taking. Please can you advise what he does if this does not work. Oh and the doctor mentioned removing the oil after 6 monthes, ok, then what? It comes down, like the way it did after gas dissolved? Help thanks Sad wife.

    • Randall V. Wong, M.D. November 26, 2011 at 8:17 am

      Dear Sad Wife,

      I answered some of your questions addressed to your husband.

      According to your description, he has a condition called PVR and is classically a condition where recurrent scar tissue forms on the surface of the retina and “pulls” the retina off.

      It can be very troubling. I have learned that using silicone oil early in the process leads to better outcomes as the oil often decreases the number re-operations needed. Oil can be left in the eye for indefinitely as long as the eye can tolerate the oil.

      Randy

  • Kristen November 23, 2011 at 11:45 am

    My 6yo son had surgery for a complete retinal detachment OS 3 weeks ago. Scleral buckle, silicone oil, endolaser, cryo…..1 day post-op his occular pressure was 34. 6 days post-op it was down to 26. That day however, he started vomitting and complained of a headache. There was a virus “going around” so we chalked it up to that. He continued to vomit daily and ended up in the ER for what we thought was dehydration. He was lethargic also. We discovered he was bradycardic due to the use of Alphagan a/o Timoptic gtts so both drops were ceased. He felt better 24 hours later, but when I took him to have his pressure checked to be on the safe side, his pressures went up to 55 and he started complaining of headaches and vomitting again. He was again started on Timoptic, Diomox orally and Lumigan. His pressures went down from 55 to 46 one day after, then 36 a day after that and today 38. His opthalmologist believes it may be the silicone oil. Do you have any input? I am very concerned.

    • Randall V. Wong, M.D. November 26, 2011 at 8:29 am

      Dear Kristen,

      Hopefully the eye pressure problems have improved since you first commented 11/23.

      I think you are quite right that possibly all of his problem are eye pressure related. What method is being used to test his pressure?

      Randy

  • kiran November 24, 2011 at 11:09 am

    Dear Dr.,
    I Emulsification happened in the eye after veterectomy + SOI. then silicone oil removed.After silocone oil removal from my eye, the blurness has increased (silicone oil removal done on 10 th november 2011) ,when i am steady without moving my head, the blurrness is decreased and my vision is clear to some extent, when i move my head it is becoming blur.
    My Dr. said That it slowly get cleard.
    Please advise, how can i get rid of the blurness, and does the Dr.’s word correct?
    PLEASE HELP ME OUT.

    • Randall V. Wong, M.D. November 26, 2011 at 8:30 am

      Dear Kiran,

      Unfortunately, I can’t answer you because I do not have the luxury of examining you and can not tell anything from the little information you provided.

      I’m sorry!

      Randy

  • kiran November 26, 2011 at 8:44 am

    Dear Sir,
    After Veteroctomy + SOI surgery( done on July 11/2011) , some babools happend in the silicone oil, and they said emulsification, and removed the oil on November 10/2011,after the removal of oil i feel some oil is still inside.In the event of my movement , i see the oil floating b4 my vision,in other times when i take rest, that flyers?blurrness is settling down.
    Pleaseenlighten me my condition and the remedy, if possible.

    Thanking you
    KIRAN

  • carol mazzone November 26, 2011 at 3:25 pm

    Thank you for your responce to sal and I. Please just want to know, now that husband had oil put in after two surgurys and two detachments, What to do after this? If it comes down again, should he stop with the surgury? And if he does get more scar tissue with the oil!!! Is it worth going furthur? He now is so convinced that this will not take, that any kind of sight is better than none. I would assume that seeing with oil blocks vision? One more thing, Can he fly with the oil in? Thanks. Yup, sad wife.

  • carol mazzone November 27, 2011 at 10:02 pm

    Dr wong, If scar tissue pulls the retnia down, is there a way to catch it in time and scrape it off before it pulls down the retnia. We did ask the dr. and he said no. I can not beleive there is no way to stop this. And the more surgurys, the more scar tissue? It seems so hopeless at this point. They can transplant corneas, and yet, can do nothing for alot of people with detached retnia. Mean time without it, your blind. Really sad.

  • Kristen November 30, 2011 at 8:58 am

    My son is taking oral Diomox 125mg BID, Lumigan 2.5ml qhs and Timolol 0.5% bid and yesterday when he saw his retinal surgeon his pressure OD was 24, but his macula was detaching again so he is scheduled for another surgery 12/28. The plan is to remove his lens (he has a SPC cataract) with the hope that this helps with the pressure, and to insert more silicone oil to reattach the macula. His oil bubble was at 75% yesterday.

    Do you have any comments on this? I am considering a second opinion, not second guessing his surgeon, but for my own peace of mind.

    • Randall V. Wong, M.D. December 6, 2011 at 8:59 am

      Kristen,

      Sorry for the delay. Hope surgery went well last week.

      I am curious as to how the retinal detachment occurred? I am guessing trauma.

      I would suggest a second opinion if nothing more than to validate the original surgeon’s opinions.

      Randy

  • Kristen November 30, 2011 at 11:06 am

    His pressure is being testing using the applination method

  • Kristen December 6, 2011 at 1:33 pm

    My son had a head trauma (small skull fracture) almost 3 years ago. That is what we are guessing this stems from since he has had no other injuries. He was premature, 36 weeks and on CPAP , O2, but has not had any complications.

    He is scheduled to have the surgery Dec 28th. The area around the scleral buckle is still in tact, just need to attach the center by inserting more silicone oil and also removing the lens.

  • Karen December 12, 2011 at 2:34 am

    Hi Randy,
    My grandfather has had 2 detached retina surgeries and is going in for his third. He is going to be getting the Oil put in this time. My question is he has a cateract in his eye now also. Can they take the cateract out at the same time when they do the oil precedure or does he have to go back and have surgery later to remove the cateract.? If so, why cant the cateract be taken out at the same time as the retina surgery instead of having to under go another surgery? Also with the oil treatment does he have to have surgery to remove the oil as well? After the oil treatment and it doesnt work what would be the next step if any? thank you Karen

    • Randall V. Wong, M.D. December 12, 2011 at 11:17 am

      Dear Karen,

      I hope I answered your questions in your email. I’m glad you posted this on the site, however.

      I usually would elect to take out the cataract at the same time as placing the oil. This would be my suggestion, but your grandfather’s doctor may believe differently.

      Oil can usually stay in the eye indefinitely. While there is some controversy regarding silicone oil causing toxicity, I don’t believe that to be true. Traditionally, silicone oil was used in the sickest of eyes, those that have undergone multiple surgeries. I believe the damage blamed on the oil is actually due to previous surgery. I personally don’t really recall ever having to remove oil due to “damage” or “toxicity.”

      There isn’t a great “next step.” Oil is generally very often successful.

      Randy

  • Karen December 12, 2011 at 4:53 pm

    Hi Randy,

    Thank you for your reply. My grandfather is going for his third surgery this Thursday Dec 15th. His Doc hadnt told him as of yet whether he was going to remove the cateract at the same time or not that was why I was wondering if they could do it or not instead of having to undergo another surgery to remove the cateract. I will be speaking with him on Thurs morning in regards of the removal of the cateract, but I just wanted to know from you whether it could be done or not. Thank you for your thoughts on the matter. For my grandfathers sake I hope they will remove it, he is getting very frustrated with all this and would hate for him to have to endure another surgery once his eye heals from all this. I hope that the oil will be the last of it all and it works for him. thank you Karen

  • CHRIS CESAL December 20, 2011 at 1:43 am

    HI RANDY,

    I’VE JUST FOUND YOUR VERY HELPFUL SITE. I’VE BEEN SEVERELY MYOPIC SINCE BIRTH, AND UNABLE TO DRIVE UNTIL MY MID TWENTIES, WHEN GAS PERMEABLE CONTACTS CAME OUT. THINGS REMAINED RELATIVELY STABLE FOR THE NEXT 25 YEARS.

    BACF IN 2003, MY VISION WORSENED, MAINLY DUE TO ADVANCEMENT OF MYOPIA, AND AT THAT TIME MY SURGEON SAID I ALSO HAD EARLY STAGE CATARACTS, SO HE GAME IOL IMPLANTS, AND I BELIEVE HE DID MILD LASER ON SOME SMALL PLACES ON MY RETINA.

    IN AUGUST I BEGAN TO HAVE CLOUDY PERIPHERAL VISION IN MY LEFT I, AND ENDED UP WITH A VITRECTOMY WITH LASER REATTACHMENT On 9/14/11.AFTER SUBSTANTIAL TIME SPENT FACE DOWN, MY VISION WAS CLEAR WITH 20% OF THE BUBBLE LEFT BY LATE OCT. ON 11/4 A TINY SCRATCH IN THE RETINAAPPEARED, SO MY EYE WAS DRAINED OUT OF FLUID, AND REFILLED WITH GAS. TO MAKE A LONG STORY SHORT I AM SCHEDULED FOR SILICONE OIL WITH A BUCKLE ON WE’D. 12/21 . I JUST FOUND OUT TODAY ABOUT THE BUCKLE, SO I’M MORE CONCERNED THAN I WAS INITIALLY.

    MY VISION NOW ABOVE THE BUBBLE IS VERY BLURRY, SO I CAN’T SEE ANY WAY AROUND HAVING IT DONE. ONE OF MY CONCERNS IS HOW IS IT GOING TO AFFECT MY IMPLANTS, AND IS GOING THROUGH ALL THE EXTRA DISCOMFORT OF THE BUCKLE WORTH IT, AS FAR AS KEEPING THINGS ATTACHED, AND OVERALL VISUAL ACCUITY? I HAVE NO DOUBT THAT I’M DEALING WITH A COMPETENT RETINOLOGIST, BUT I GUESS WHEN I FOUND THE SITE, I COULD USE A LITTLE REASSURANCE, AND ADVICE, IT WILL LIKELY BE OVER BEFORE YOU CAN GET BACK TO ME, BUT YOUR THOUGHTS WILL BE GREATLY APPRECIATED. THANK YOU. CHRIS

    • Randall V. Wong, M.D. December 21, 2011 at 2:30 pm

      Dear Chris,

      Good luck tomorrow. Buckle and oil should do nothing to the implants.

      The buckle can only help….that’s the way I’d look at this.

      Randy

  • carol mazzone December 20, 2011 at 4:18 pm

    Hi again Dr. wong, My husband now has the oil in his eye after 2 unsuccesful procedures with gas, and buckle. But the pressure in his eye is down, What if anything can bring that pressure up? Actually his pressure in eye was down when it was determined that huge caterac had to come off, but he had and emergency with retnia, so they had to remove the caterac before the last procedure so that the doctor could see. please reply. thanks still sad

    • Randall V. Wong, M.D. December 21, 2011 at 2:26 pm

      Dear Carol,

      How low is the pressure? If it is too low, it is probably related to the repeated detachments.

      Randy

  • david December 22, 2011 at 12:21 pm

    When reattaching a detached retina should the retina be reattached to scar tissue? Or should it be reattached to fresh tissue? Is it possible that my retina keeps detaching because the Dr. keeps trying to attach it to scar tissue. After 3 detachments this summer I am ready to go to a different Dr. And should I be in constant pain, [ Scale: 3 to 7 on a 1 to 10], from the oil in my eye?

    • Randall V. Wong, M.D. December 30, 2011 at 7:43 am

      Dear David,

      Don’t know what to make of your comment about reattaching a retina to scar tissue.

      You should not be in pain from the oil.

      Randy

  • carol mazzone December 22, 2011 at 12:58 pm

    Ok, Dr wong, My husband has the oil in his eye. But his vision is doubled, and sees from the bottom of the effected eye. Not good. dr. does not seem to give any options to correct this. He sais it was due to the buckle under the muscles. This is as bad as no vision at all. In other words, he sees the tv, but at the bottom of the eye, not centered. The doctor says that if the vision was clear, it would really annoy him. Ok, if this is the result of three procedures!!! Not good. He does not suggest another surgury to correct this. Have you encountered this with your patients? and is there a way to correct the double vision? thanks sad sad sad wife

    • Randall V. Wong, M.D. December 30, 2011 at 7:45 am

      Dear Carol,

      Double vision can occur from a variety of reasons…one of which could be the scleral buckle. A pediatric ophthalmologist might have some suggestions.

      Randy

  • hazel February 2, 2012 at 5:41 pm

    dear dr wong. i left message last year about my concern after surgey to repair the retinal tears and holes with silicone oil and laser treatment as the silicone oil had been in for a year. your reassurance was a great help. the operation to remove oil and cataract is finally done and my eye is healing well. my only problem is that i seem to have lost a lot of colour and red either disappears or turns a dull brown and white and blue is ultra violet .and looking into the distance still looks like i have the cataract. i hope that this changes as time goes on but in the grand scheme of things i am so grateful that i have most of my peripheral vision back even if the centre is still a bit off.. i do have lots of floaters but surgeon says that is just oil that cant be removed. my question is i have lattice degeneration in my ‘good ‘ eye that has been repaired with laser treatment. is that likely to be sufficient or will it be likely to tear like the other?. And will the weird colour effects i have in the repaired eye eventually stop and i’m just being impatient [it is only two weeks since op]. thank you so much for your time. hazel

  • Lori Blea February 8, 2012 at 9:56 pm

    Hello Randy,

    My name is Lori I am a 29 year old female, having much difficulty with my decision on what I should do, one doctor tells me to take the oil out and possibly a laser treatment for glaucoma at the same time, that oil will make me lose me eye, and my main doctor tells me he’s really not sure doesn’t give me a straight out answer. I have had cataract surgery as a child, this retinal surgery back in June of 2011, and I suffered big time from it and hate to go through any other kind of surgery, and have glaucoma also, my eye has been feeling really enlarged and weird lately, and it’s been 8 months since the retinal surgery, what do you think I should do? Is it worth it to get any laser surgery for the glaucoma, can it harm my eye? I do not see through this eye, just blurr, don’t have a lense in it since a child, it is congenital glaucoma I have and was born with the cataract? Please help with any advice, I am really feeling lost of what to do, and really depressed.

    • Randall V. Wong, M.D. February 14, 2012 at 12:07 pm

      Dear Lori,

      Yours is very difficult to address accurately as there seem to be many things going on simultaneously.

      My only advice is to make a decision and stick with it. Ask your doctor the true likelihood of eventually seeing better. If the answer is vague, find another doctor who will answer in a way that satisfies you.

      All the best.

      Randy

  • Lori Blea February 24, 2012 at 9:13 pm

    Hello Randy,

    Thanks for getting back with the previous message. One more, if the retina comes detached again with this oil in the eye and or while getting it removed what are the chances that any other operation is going to keep the retina attached, I just do not want to go through another surgery again if it is going to come detached again and again like I see alot of people go through on this site! I will never see good in this eye just light not clearly or am I able to read, I just want it to feel good and normal, seeing out of it really don’t matter to me at this time because I don’t.

    • Randall V. Wong, M.D. February 24, 2012 at 10:01 pm

      Dear Lori,

      Sometimes the goal is to just keep the eye comfortable….as you stated.

      Randy

  • Meki February 27, 2012 at 3:11 pm

    Hello Dr,

    I had retinal detachment surgry with oil on Feb 7, 2012 and am scheduled to see the surgeon tomorrow for a follow up. He stated that if all is well we will schedule to have the oil removed. I noticed several comments regarding not having to remove the oil. I am very nearsighted (-8.0) so I cannot see very well at all without my contacts, which I am curently unable to wear with the oil. What is considered to be a good timeframe to have the oil removed and are there any complications and/or restrictions after the removal? Thank you for your time as this has all been very helpful for me.

    • Randall V. Wong, M.D. February 28, 2012 at 6:16 pm

      Dear Meki,

      1. When the oil is removed, there is always the chance of redetachment. That is really the only “risk.”
      2. Often, though this may not be true in your case, the oil is put in after several failed attempts. Hence, the eye may have already had several surgeries before the oil and the eye is is poor shape with a poor visual prognosis. Many times this is due to a condition called PVR.

      Randy

  • Lori Blea February 28, 2012 at 12:48 am

    Hello Randy,

    I just keep thinking of more questions sorry, I’ve asked the doctors this over and over they don’t know, after the retinal surgery and me using, brimonidine, derzolomide, xalatan, timilol, everyday I’ve noticed my left bad eye is changing color, to really light and my eyes are dark brown, have you ever experienced that with any of your patients, and what do you think the eye looking lighter to me is from eye drops or the oil? Is that a bad indication also?

  • DKY March 9, 2012 at 7:14 pm

    Just want to share my story:

    1) In April 2011, diagnosed with rhegmatogenous detachment in the left eye. Apparently it had gone on for a while before I noticed it (things looked distorted), as subretinal strand had formed (in inferotemporal arcade, away from macula). Macula was on but a lot of subretinal fluid.
    2) Underwent scleral buckle surgery. Was a disaster. Surgeon failed to find the tears (strongly believe he didn’t look thoroughly) and caused massive subretinal hemorrhage when he drained the subretinal fluid through the sclera. Sutured me up and sent me on my way. Developed secondary vitreous hemorrhage causing my vision in that eye to go down to light perception only. Worse, some parts of the retina was left detached anterior to the buckle. It was basically a blind buckle, very big one and very high.
    3) Obviously changed doctors. Was monitored closely over five months by two surgeons. New surgeons advised not to do a vitrectomy right away but to wait for the vitreous blood to be absorbed, then perhaps 360 laser would do the trick as long as retina was reattached where it mattered. Blood did get absorbed over time. Monitoring was difficult given the vitreous haze and doctors relied on a lot of ultrasound scans. Visual acuity improved. Went from light perception to counting fingers then actually to 20/25 corrected! Major downside was -7 diopters caused by the large buckle, and some parts of the retina detached anterior to the buckle.
    4) Unfortunately buckle failed to keep retina attached before vitreous blood completely cleared up and laser could be administered. Surgeon intervened with vitrectomy and 360 endolaser plus silicone oil. Three retinal tears were found and sealed. The vitrectomy happened around 5 months from first surgery.
    5) Immediately after the vitrectomy, noticed a defect in the central vision of the eye. The defect appeared like a stain, a blotch, kind of like glue stuck on a glass when you peel off the sticker. What was weirder was that when I closed my eye, the blotch would flare up into a bright white area (called it an after image). The vitrectomy was supposedly uncomplicated and OCTs revealed nothing unusual about the macula. So the defect was never explained. I was worried damage had been done to the macula during the surgery but could not do anything but wait and with the silicone oil in the eye vision was blurry anyway.
    6) Over the next six months, things were stable, and VA was at best 20/30 with pinhole. Experienced a lot of shimmering on the periphery which was explained as likely caused by the laser, and certain parts of the peripheral visual field has blind spots — either due to the laser or the subretinal blood from the first surgery being there for a long time.
    7) Deveoped a cataract over the six months. When oil was removed, had phaco done at the same time and a monofocal IOL implanted.
    8) As I had worried, after oil removal, the defect in the central vision of the eye although faded had resulted in a blurry area that prevents me from seeing small details. Can’t read newsprint sized text. VA is at best 20/50 at this time (about 4 weeks since oil removal). The VA is low quality since I am able to semi guess and recognize the snellan chart letters, but this is not useful vision.

    To this day, it’s not clear what caused the defect in my central vision. My only hope is that the macula can regain some of its function over time. This implies regeneration of certain cells. Have heard anecdotal stories of how some people have regained macular function over multiple years. Wish there were more things I could do to treat the condition.

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

      Dear DKY,

      I would agree that there is not much of a clue as to why the central vision is so poor in that eye….especially since the surgery was uneventful.

      If the fluorescein angiography and the OCT is normal….Not much else to do but wait and see.

      Sorry, but nothing else I can think of.

      Randy

  • Lori Blea March 13, 2012 at 3:06 am

    Hello Dr,

    Are you able to say than if I got the oil in my first surgery which I did and it fails, if it is more than likely to fail with any other procedure because how you say Dr’s usually place oil after failed attemps with other procedures which leads me to believe oil is the last and best resort if nothing else works and I already have the oil in so I am guessing any other procedures won’t work if I am understanding right!! So if I get the oil taken out I am not going to let the Dr place anything else in my eye because I went through hell and back the last surgery I got! I just wish there was a answer Dr?

    • Randall V. Wong, M.D. March 19, 2012 at 12:21 pm

      Dear Lori,

      Oil is used for either severe retinal detachments or repeated retinal detachments. In either case, the prognosis is not always very good. At times a retinal detachment is so severe that oil is needed for the initial surgery.

      I would ask your doctor if this is/was indeed your case.

      Randy

  • A. A. Shaikh March 15, 2012 at 3:23 pm

    Hello Dr. Wong
    I am 59 year male and had my left eye IOL implant in 2010 and so far doing fine with it, BUT unfortunately developed endopthamitis in Rt.Eye after 2 month of IOL implant in Dec 2011. I was given four intravitreal injections: two antibacterial, two anti fungal along with one steroid injection and heavy oral medicines, tube& drops, resulted in Soft n Small Eye with complete vision Loss. The ophthalmologist saying Sorry, ask me to consult Vireo-Retina Surgeon, who hoping against hope did vitrectomy and made silicone oil exchange which have bubbled out in anterior chamber.
    It is 7th post vitrectomy week and my eye presently is quiet, clean with finger/hand movement vision and light reflexes with night like back ground. Eye look, color n contour is normal size is still small but little soft.
    Dr Wong, what I expect more and what else can be done more… beside silicone bubble or entire oil removal ?

    • Randall V. Wong, M.D. March 19, 2012 at 12:30 pm

      Dear A.A. Shaikh,

      I would ask you to ask your doctor. If the oil is keeping your retina attached, it’s doing all that it can do.

      Randy

  • Marie March 16, 2012 at 2:06 pm

    Dr randy,
    Is there a cure for hypotony, I have oil in the eye, on my 3 rd surgery there’s an oil globule on ,y anterior chamber and I can’t really see clearly , is it bec of the globule for my dr says the oil globule is in the center, and does it cause low pressure bec I can’t see well ? Thank u
    Do u have an email add doc where I can keep in touch with u ? I plan to go to US and have my eye check

    • Randall V. Wong, M.D. March 19, 2012 at 12:35 pm

      Dear Marie,

      The oil globule might be the reason for the decreased vision. I don’t know the cause of the hypotony, but two reasons can be chronic retinal detachment or detachment of the ciliary body.

      Chronically sick eyes may begin to lose pressure.

      Randy

  • Radhika March 18, 2012 at 7:51 am

    Hi Randall,

    My father had an emergency retinal reattachment surgery 2 years back. His doctor was of the opinion that the cause for the detachment is severe myopia in his right eye. After a complicated surgery, they put in silicon oil to prevent further detachment. They decided to leave the oil in and not remove it at all, because he has no vision in his right eye anyway. They said he can live with it.

    Now, almost 2.5 years after the surgery, he has started having irritation in his eye. It has become red and is watering a lot. Now his doctor has decided to remove the oil because he thinks the oil is entering the back chamber which is what is causing the irritation.. I am worried about this surgery as my father has already been through a lot in that eye. I was wondering if you thought this oil removal was necessary because he has no vision in that eye anyway. Is there something else that can be done to stop the irritation and watering in the eye. Please advise.

    Thanks a lot in advance.

    Regards,

    Radhika

    • Randall V. Wong, M.D. March 19, 2012 at 12:40 pm

      Dear Radhika,

      Tough question because I can’t examine your dad, but it sounds as if his cornea is decompensating due to the oil. There could be many reasons for this. Sometimes the cornea can be treated for “band keratopathy,” but, again, I don’t know if this is the exact problem.

      Randy

  • wee-Victor March 30, 2012 at 8:05 am

    I just got the silicon oil removed from my eye after my retina detachment surgery 4 months ago. At the same time the doctor also removed the catarach and implant a new len in the same eye. Its been less than a week but I keep seeing a lot of floaters – I don’t have the floaters before the oil removal. Is this a normal occurance of the silicone oil removal?

    • Randall V. Wong, M.D. April 4, 2012 at 7:45 am

      Dear wee-Victor,

      This is not necessarily related to the oil except that now your vitreous is filled with liquid and is more fluid. As long as you don’t have any new retinal tears then you are mostly likely okay.

      Make sure your doctor is aware of the floaters.
      Randy

  • vinay April 13, 2012 at 11:36 pm

    Respected Sir,
    i m Vinay gupta age 35 from Gwalior M.P. sir i want to know about your opinion about my case
    i was suffer with myopia (-10 right eye and -11 in left eye) but after having Lasik laser in year 2003 i get rid off specs.
    on 03 Fab. 2012 i went local eye hospital at gwalior with complaint of Right eye diminution of vision. where i come to know that it was retinal detachment and same day Scleral Buckling was done. on 1st march 2012 it is Re detachment of Retina in same eye than on same day ( pars plana vitrectomy + endo laser +Silicon oil) injection was done.
    Right now (26/03/2012) my vision of right eye is very blear and i m not able to read also. and again i m feeling very tiny black spot in same eye while i have under go two laser for retina attachment after second surgery.
    and following drops i m using in my eye
    1. Refresh liquigel
    2. Pred Forte
    3. Vigamox
    4. Combigan
    5. Careprost
    6. Azopt
    sir please suggest me that i should come to Chennai for further checkup
    i will very great full to you
    thanks

  • hazel April 22, 2012 at 5:40 am

    hi dr wong. i have left several messages on your site but think they get lost somehow. i recently had the silicone oil removed from my right eye after treatment for giant retinal tears and several holes. the oil was inplace for a year and since its removal all was well to begin with but now my sight is fading in that eye with loss of red colour centrally and i’m now finding i have loss of peripheral vision again. the retina is still firmly attached but i feel like i’m looking through a thick plastic bag with the bad eye. i’ve now read reports that say that silicone oil for macula on detachments isn’t good and more people are reporting loss of sight. could you say if the damage is permanent or can get worse. i’m so upset that i’ve gone through all that work for nothing. will i get used to it as its driving me mad . my eye is very dry and inflamed even with the comfort drops and i wonder if the eye vitamins on the market will be of any use. i hope you get to read this and would greatly appreciate any advice you have. thank you . hazel

    • Randall V. Wong, M.D. April 22, 2012 at 9:56 am

      Dear Hazel,

      Sorry for the confusion. Your comments were published as best I can tell.

      Regardless, there are so many reasons why your vision could be worse, it would be unfair to you for me to “guess” without an examination. I don’t agree that in cases where silicone oil were used, yet the macula was attached, the vision is going to get worse.

      If you are still attached, ask for reasons from your doctor: macular pucker, macular hole, swelling in the cornea, macular edema, etc.

      Randy

  • hazel April 22, 2012 at 3:18 pm

    dr Dr Wong. thank you so much for your reply. I know the surgeon i’ve seen has done a great job on a mess of an eye and i know i’m lucky to have sight in it at all. I think because i have so many floaters from the silicone oil thats left and the central vision is getting so poor and the eye is so uncomfortable its all a bit disheartening. as you suggest i will talk to specialist again at next appointment. many thanks again for a wonderful site. hazel

  • Annette April 28, 2012 at 1:21 am

    Dr. Wong,
    I have just suffered my 3rd RD only 10 days post vitrectomy with gas and photcoagulation. Surgeon performed emergency retinopexy, laser in three days. I had scleral buckle two years ago for first detachment. Oil will be the next step.

    Can you please give me and the general audience an idea of what the recovery from vitrectomy with oil is like? What are the limitations on activities? Can you fly? Can you go on roller coasters? What is not safe and what is safe? And what is the time frame to be able to do these things? I have a trip to Disney scheduled later this summer and want to know how it will be affected? My kids and I spend a lot of time at amusement parks in the summer. It is very important to us as a family. I am so accustomed to not having vision in the eye, I am not as concerned about that aspect of it. (My macula is attached and unaffected at this point though the last rd covered 80% of periphery.)

    I have not been able to find this information and would greatly appreciate an answer.

    Thank you.

    • Randall V. Wong, M.D. May 3, 2012 at 11:35 am

      Dear Annette,

      Silicone oil is very similar to intraocular gas, except it is not absorbed. Both are lighter than water, hence, the head positioning should be the same between gas and oil. The only difference is that oil needs to be surgically removed.

      Once the retina is attached;

      1. No limitations, perhaps except lying flat on your back looking at the sky.
      2. You can fly.
      3. You can do roller coasters (I personally hate them) although some docs don’t advise this (ask your doctor), but there should be no reason why you shouldn’t.
      4. Lying flat on your back with NO LENS is not safe.

      Have fun!

      Randy

  • wee-Victor April 28, 2012 at 1:38 am

    Thank you so much for the reply. As my retinal detachment surgery and oil removal is done out of state I am seeing another eye specialist in town who referred me in the first place. He examined the eye and said the many floaters and bubbles could be due to some residual oil which is not removed completely. I was wondering if I shd go back to the dr who did the surgery and see whether he can do anything about it but my dr advised me to leave it for the time being as I will slowly get used to it. Will the remaining residual oil eventually disappear or could it cause harm to leave it in the eye. Anyone ever had silicone oil removed twice?

    By the way, can I start weight training exercise (its been a month after the removal).

    Victor

    • Randall V. Wong, M.D. May 3, 2012 at 11:39 am

      Dear wee-Victor,

      I personally have no reason why you can not resume weight training.

      r

  • carol mazzone May 10, 2012 at 1:55 pm

    Please Dr. can you let us know if the oil in eye must be removed and the retnia falls, which is what is believed will happen according to our Dr. If the eye has to be removed? this is husbands third procedure, and has lost vision which will not return. We have gone to three different doctors, and they all seem to think the vision loss is from retnia falling two times, and scar tissue. Ok well, just wondering if his eye ball would be removed if no more attachments after oil. thanks

    • Randall V. Wong, M.D. May 13, 2012 at 8:48 pm

      Dear Carol,

      Eye does not have to be removed just because the oil is removed. Sometimes, with chronically detached retinas, the eye shrinks (the fancy term is phthisis bulbi) and might need to be removed if it becomes painful or for cosmetic reasons.

      Randy

  • Shirley R.Araza June 1, 2012 at 2:04 am

    I appreciate how you explained silicone oil in retinal detachments.I can picture myself to your descriptions.im 54 years old and for the past 6 months I had 4x vitrectomy surgeries.the first surgery started with gas bubble but eventually I created retinal tears and silicone oil had been replaced.after 10 wks,he removed the oil but it didn’t work,my vision got worst and almost gone when he did the 4 th surgery,leaving the silicone again and this time it needs to stay there for 6 months.youre very right of saying multiple retinal surgeries can drain me out mentally,physically and financially.I am an RN and still in the height of my career.

    Thank you so much,Dr.Randall,for your postings…at least you make me feel at ease in heart and mind that I have to cross this ordeal… A long journey indeed!

    • Randall V. Wong, M.D. June 4, 2012 at 2:51 pm

      Dear Shirley,

      Many thanks for writing and sharing. I’ve learned that there is an art to employing oil. I used to think it was like giving up, but I have realized that it can now control a vicious disease….PVR. I have several patients who have maintained excellent vision who I might otherwise have “blinded” years ago.

      Experience?

      Best of luck.

      Randy

  • Jordi Rea June 4, 2012 at 6:36 pm

    Thanks for this information. I’m only 14 years old so I don’t have to worry about any of these thing but it has really helped my research.
    Thanks very much 🙂
    Jordi.

  • ahemd June 17, 2012 at 3:39 am

    dr’s ,, i think so that not work on sugar patents bcoz my father 52 years old and thy have 10 to 15 years old dibetic thy also used insulin but thy can not controled them so he damaged the eye , and he do opration for the Retinal Detachments of ratina doctors using silicon oil for detatached its earlier 2 or 3 years but my father still not seeing on left eye , he only see blank after that now he also doing kidney transplant but i have a question can my father improve his left eye ? doctor cannot remove the silicon oil he said thare is not any problem !

    • Randall V. Wong, M.D. June 18, 2012 at 10:41 am

      Dear Ahemd,

      I am having trouble understanding the nature of your question.

      Sounds like your father has kidney disease and proliferative diabetic retinopathy?

      Randy

  • Cole McLaughlin June 21, 2012 at 10:13 am

    hi i am 23 years old and about four years ago i had a piece of shrapnel steel go through my left eye. it has been one problem after another since that day i have had 5 diferent surguries and was diagnose with epithelial down growth and went through a series of methaltrexate injections to try and stop the cell growth wich six months after the injections the growth is dormant but now i have had 2 rentinal tears that were treated with a gas bubble and during an appointment yesterday at Mayo clinic in Rochester the have fond another and want to treat it with silicone oil and a buckle i am just looking for any other opinions and advice for the simple fact that i dont want to keep going through these procedures

    • Randall V. Wong, M.D. June 26, 2012 at 1:26 pm

      Dear Cole,

      As you have read, I favor use of silicone oil earlier in the retinal detachment process than later. It is impossible for me to give an opinion as to what I would suggest for you as I can’t examine you.

      All the best! Keep in touch.

      Randy

  • fawad June 28, 2012 at 3:55 pm

    sir i am 25 and i have gone trogh silicon oil surgery of my left eye in 2005 oil was removed in 2008 and now i have lost all of my vision from that particular eye. now my eye have changed its colour and it is now much smaller than other one . plz guide me sir is it possible for me just to be look my left eye normal as other one . just want to recover its size and colour. i will be many many many thankful for ur guidence plz sir help me plz

    • Randall V. Wong, M.D. July 10, 2012 at 5:51 am

      Dear Fawad,

      If indeed your eye has become completely blind and has changed color, the result may be permanent.

      I would confirm this with your doctor. A prosthesis or scleral shell can help you look completely normal, but the loss of vision is permanent.

      Randy

  • NT July 8, 2012 at 12:16 pm

    Hello,

    Can there be any complications if the silicone oil is left in for too long? Can this cause vision loss? If the patient is diabetic how much does that change things?

    • Randall V. Wong, M.D. July 19, 2012 at 1:00 pm

      Dear NT,

      Yes, silicone oil can cause complications if left too long, but usually it is due to too much oil. The oil itself shouldn’t cause any problems. Remember, oil is usually used TOO LATE and “damage” seen after the oil may indeed be damage due to the surgeries leading up to the oil insertion.

      OIl can be used safely in a diabetic.

      In all cases, frequent monitoring by the surgeon is suggested by this doctor 🙂

      Randy

  • fawad July 11, 2012 at 10:32 am

    dear sir
    eye can not move by using scleral shell
    is it possible to recover eye coloure and size trough medicins waiting plz sir

  • fawad July 11, 2012 at 10:50 am

    Dear sir
    firstly i forgot to ask u many many Thanks u will be always in my prayers
    2ndly sir my doctor have prescribed me these medicins for coloure recovery please tell me that if it will be helpful for coloure and size recovery
    Fortipred (prednisolone) 2 times
    Tears gel (polyacrylic acid) 4 times

  • fawad July 13, 2012 at 11:38 am

    sir
    EYE SITUATION is
    Eye has been decreassed to 80% of origional size while
    Coloure has turned to yellowish in center. and origional coloure of eye is dark brown yellowish coloure is only in center of iris not entire iris. I can say 60% of iris have changed coloure from center is recovery like normal eye is possible trough above said medicines thnx w8ing for ur reply sir

    • Randall V. Wong, M.D. July 19, 2012 at 1:25 pm

      Fawad,

      It really sounds as if you have phthisis bulbi.

      Your eye is blind and may be shrinking and becoming discolored.

      I am sorry.

      Randy

  • PRATEEK kAPOOR July 27, 2012 at 10:45 am

    Hello Doctor
    Greetings !
    its been more than a year since my father was operated upon for retinal detachment.
    The doctor used silicon oil and it is placed in the eye since then.
    Should it be placed there forever or we need to remove it as soon as possible?
    What are the repercussions of the oil being there for this long?
    Waiting for your reply.
    Thanks.

    • Randall V. Wong, M.D. July 31, 2012 at 11:25 am

      Dear Prateek,

      As long as he receives periodic check-ups, the oil does not necessarily need to be removed.

      Randy

  • Ashley August 2, 2012 at 9:36 pm

    I’ve had two gas bubbles, a buckle, vitrectomy, cataract lens removel with implant, and silicone oil. I’ve had four operations and nothing has worked. Right now my eye is filled with silicone oil which has gone to the front of the eye and making cornia swollen. I also have chronic inflamtion. I am forming scar tissue which is making it hard for me to see out of. My doctor has given me lots of options of what we could do but its up to me. My eye hurts and really what I would like is what would be best just to save the eye itself? I”ve came to terms with not being able to see out of it. Can you please help me and give some advice? I am so scared and confussed and need help??? Can you give me any advice of what you think would be best? Thank you for your time.
    Ashley
    p.s. I’m only 30 so I would like for it to look some what normal

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

      Dear Ashley,

      It is possible the silicone oil is the real culprit. It is possible that the oil is touching the inside surface of the cornea. This could be causing swelling of the cornea and then scarring/calcification.

      This is just my best guess as I can not examine you.

      Get a second opinion to see if what else can be done. You shouldn’t have to be miserable with/without good vision.

      Randy

  • Melissa August 3, 2012 at 4:01 am

    Dear Sir,
    My husband needs to have the oil removed after being in for a little over 4 months for a retina detachment. He had a buckle done and gas bubble. Ive watched how the procedure is done online to remove the oil and it looks terrible. He was put under general Anesthesia orginally because the surgery took over 3 hours and he is 6’6″ and 250 lbs. How long does the oil removal typically take? What do you suggest he should recieve for sediation. Versed and fentanyl conscious sediation? Or something less? He is very anxious about this procedure and does not like his eyes touched. He does not want to know whats going on during the Oil removal but we also dont want general again. Recommendations.
    Thank you 🙂

    • Randall V. Wong, M.D. August 13, 2012 at 2:23 pm

      Dear Melissa,

      Straight removal of oil, regardless of viscosity (there are two grades) should take no more than 30 minutes with a 25 gauge set up or even less time with a 20 gauge vitrectomy system.

      Randy

  • mukesh September 3, 2012 at 10:54 am

    my father have an operation of total retine detechment for left eye and full of sillicon oil now afterchecking the eye it found that the eye have some sequeze and parda fall again please advise what to do now
    and right have an operation of iol surgery but have no vision clearly but vision as milky usg done found partial pvd temp memb 56db localised rd please advise what to do now

    tha nk
    mukesh

    • Randall V. Wong, M.D. September 11, 2012 at 9:46 am

      Dear Mukesh,

      I am really having difficulty understanding your complete question. Could you please reword and resend? Not sure what’s going on after your father had an operation for a retinal detachment.

      I’ve had good luck with the Google translator!

      Randy

  • Sue McDonald September 4, 2012 at 12:35 pm

    I had a retina detachment, and a gas bubble inserted 7-5-12. The retina detached again and the doctor inserted silicone gel on 8-15-12. It was in the right eye, and it is very blrry. I don’t know how long the gel should remain in the eye, and if the vision will get better after the gel is removed. I don’t care if I have to wear glasses , I just would like to be able to see out of the eye again. I can read the large E at the doctor office from about 6 feet away, nothing else. All I hear at the office is that my vision will not be the same as it was. Please let me knw what to expect, and when it should be removed. We are moving from MI. to FL in four months, so will have to find a new doctor.

    Thanks so much!
    Sue

    • Randall V. Wong, M.D. September 12, 2012 at 1:17 pm

      Dear Sue,

      I just published a post this morning regarding decreased vision and silicone oil. Perhaps it will be helpful.

      Basically, with the oil in your eye, it’s very difficult to figure out your actual vision.

      Read the article. Let me know if it helps.

      Randy

  • John Rawlings September 6, 2012 at 1:11 pm

    You made a very strong case for using silicone oil. How safe is removing the silicone oil after the retina has been reattached?

    • Randall V. Wong, M.D. September 12, 2012 at 8:51 pm

      Dear John,

      Very easy and safe to remove oil. The real question becomes, will the retina detach after oil removal?

      Randy

  • Skaria Varghese September 8, 2012 at 3:17 am

    Dear Sir,

    I just had a retina detachment surgery on my right eye. After 10 days of surgery I checked the vision and it seems my right eye vision turned to plus 2.4 from minus 5.5. Left eye is still minus 5.5. Doctor said, this is due to silicon oil and vision will come back to minus once the oil is removed. Is it correct that the procedure can change the power like this? If yes will it go back to old power? Is there any complications for wearing spectacle with one minus power and one plus power?

    Thank you

  • Keith Dormer September 12, 2012 at 5:34 pm

    Dear Dr. Wong,
    Thank you for a most useful and informative website.
    Could you please tell me what fluid is used to replace silicon oil in the eye after it has been removed?
    Also, does the replacement fluid stay in the eye permanently or is it eventually replaced by something produced by the body?

    Thank you very much for your help in this matter.

    Yours sincerely,

    Keith

    • Randall V. Wong, M.D. September 12, 2012 at 9:08 pm

      Dear Keith,

      Artificial saline replaces the oil at the time of the operation. Natural saline replaces the artificial stuff within a day or two.

      r

  • Anna September 22, 2012 at 1:21 pm

    My husband has just experienced an expulsive hemorrhage having his silicone oil removed and has lost his vision. Is this really as rare as we have been told?

    • Randall V. Wong, M.D. September 25, 2012 at 9:48 pm

      Dear Anna,

      Yes. A very unfortunate and rare event.

      Expulsive hemorrhage is very unusual but is horrible.

      So sorry.

      r

  • DR.P.R.KANANI September 25, 2012 at 6:00 am

    Dear Dr.Randy,
    Let me thank you for the information on R.D. of an eye
    Sir, let me draw your kind attention that my right eye was affected by R.D on 5th JUNE 12 Which was operated by Dr Sanjay Gadre from Rajkot famous eye specialist in our area with using gas therapy.But unfotunately which occurred hole on 18th july 12
    Again the same operation was done on 27th july 12 with silicon oil and the followup is going on I got about 60 percent vision now.Condion is good pressure is 13 which is under control.would you pl tell me the precutions which i shuold follow.Dr. told that it may take 4-6 months to get cent percent vision
    My humble question is that may i get 100 per cent vision ? How loger time may require to get it sir?

    • Randall V. Wong, M.D. September 25, 2012 at 9:57 pm

      Dear Dr. P.R. Kanani,

      1. I am sure you had a great doctor.
      2. “which occurred hole on 18th july 12” I don’t understand this.
      3. If you have redetached, including macular detachment, it is unlikely your vision will recover 100%.

      Let me know.

      r

  • DR.P.R.KANANI September 26, 2012 at 11:27 pm

    Dear Dr.Randy,
    Thank you very much for prompt and +response
    I know we have gr8doctor
    He did 2 operation on 6th june and on 27th july.
    First operation was fail as he told due to hole occured while screen(ratina layer? i do not know exact term sorry)
    Again he did 2nd operation on 27th july with silicon oil and the followup is going on I got about 60 percent vision now.Condion is good pressure is 13 which is under control.He also checked the eye no which is 4 and 10 cy but i could not see the picture clear Would you pl tell me the precutions which i shuold follow.?Dr. told that it may take 4-6 months to get cent percent vision
    My humble question is that may i get 100 per cent vision ? How loger time may require to get it sir?
    WITH KIND REGARDS

  • DR.P.R.KANANI October 1, 2012 at 1:24 am

    Dear Dr.Randy,
    Thank you very much for prompt and +response and salute you sir for humble work for the patient like me.
    I know we have gr8doctor
    He did 2 operation on 6th june and on 27th july.
    First operation was fail as he told due to hole occured while screen(ratina layer? i do not know exact term sorry)
    Again he did 2nd operation on 27th july with silicon oil and the followup is going on I got about 60 percent vision now.Condion is good pressure is 13 which is under control.He also checked the eye no which is 4 and 10 cy but i could not see the picture clear Would you pl tell me the precutions which i shuold follow.?Dr. told that it may take 4-6 months to get cent percent vision
    Sir, one more complex I got today that one vibrating point (may be bubble)occurred in my operated eye and passing from middle to right side and remain in the corner My Dr. advised not to be worried but I am afraid so far. So you are kindly requested to guide me pl. pl
    My humble question is that may i get 100 per cent vision ? How loger time may require to get it sir?
    WITH KIND REGARDS

    • Randall V. Wong, M.D. October 2, 2012 at 1:10 pm

      Dear Dr. P.R.Kanani,

      It is hard for me to predict your outcome. In general, eyes that receive oil have a poorer visual prognosis than those that do not.

      Randy

  • DR.P.R.KANANI October 2, 2012 at 11:43 pm

    Thank you Dr Randy
    my humble request is that may I get vision as per the condition is facing by me?
    How longer time may required for 100% vision sir?
    pl sir guide me
    with regards
    Salute for your free service sir.

    • Randall V. Wong, M.D. October 3, 2012 at 12:03 pm

      Dear PRK,

      You are welcome.
      Your vision may never improve, but my point has been that it’s very difficult to assess your vision with oil in place.

      Randy

  • Stephanie Moore October 3, 2012 at 1:50 pm

    Dr. Randy – your blog is very helpful. I had schleral buckle put in Jan 10, 2012. All was well until Feb 14, when scar tissue built up and I re-detached. I had oil put in on Feb 28. The oil was removed on July 17. I had a traumatic cataract removed during my Feb 28 surgery. It is now time for my lens implant, surgery is Oct 24. My cornea is quite damaged but a corneal transplant is being ruled out for now, too risky. My pressure went up in that eye after the July surgery, but is now controlled with 3 different drops. I am scheduled to get a secondary IOL/suctured PC IOL for my lens implant. My prognosis is 20/70 in that eye post lens implant. So here’ s my question: after doing research, I am concerned of my chances of another retinal detachment due to my history of scar tissue, detachments, cornea problems,and pressure problems. Should I be concerned? If so, how concerned??

    Thank you so much for your help,

    • Randall V. Wong, M.D. October 10, 2012 at 10:29 pm

      Dear Stephanie,

      Tough, but easy recommendation.

      If you don’t try the surgery, you won’t have a chance of 20/70.

      What is your vision now? Probably nowhere close to 20/70.

      There is the chance of re-detaching with oil removal, but it can be replaced.

      Randy

  • DR P.R.KANANI October 3, 2012 at 11:15 pm

    Sir,
    would you pl suggest the eye specialist in India or Gujarat to whom I shoud go for folowup and other treatment to get vision pl?
    Is there any hope for this condition ?
    I am really frusteted for vision.
    sorry for inconveniency caused in this matter pl be regretted
    PR KANANI

    • Randall V. Wong, M.D. October 14, 2012 at 7:01 pm

      Dear Dr. PRK,

      Indeed, I wish I could give you a name, but am not aware of anyone in your locale.

      I am sorry.

      Randy

  • Vishal October 5, 2012 at 12:30 am

    Hi Randy,
    !st of all very much thank for such a grate guidance.
    My father 52 years old has under gone retinal detachment surgery in which Si oil was used.
    After around 6 Months of this surgery Cataract got developed in same eye.
    So while doing cataract surgery Dr. removed Si oil also.
    So now when he went for regular check up Doctor is saying that again Si Oil need to put in eye.
    I mean re putting of Si oil, is it fine or will ir cause any more complications?
    Please guide me so that vision can be maintained as it is.
    Thanks in advanced.

    • Randall V. Wong, M.D. October 15, 2012 at 3:12 pm

      Dear Vishal,

      My best guess is that the retina detached again following cataract surgery and (1st) oil removal.

      It’s okay to put the oil back in….again. Cataract can’t come back.

      r

  • Vishal October 5, 2012 at 12:39 am

    And more thing for how much time Oil should be kept in eye?
    For long time or for short time bcozs i read some oil should not kept in eye for long time

    • Randall V. Wong, M.D. October 15, 2012 at 3:17 pm

      Vishal,

      Oil may be left in the eye indefinitely.

      There may be reasons to remove oil due, but there is no hard and fast rule.

      r

  • vinay October 11, 2012 at 11:22 pm

    sir i am 36 and i have gone trough silicon oil surgery of my right eye in 3/10/2012 oil was removed and cataract is also removed and fold-able lens is implanted in same eye. but sir now i feel very tiny black points floated in my vision and few bubble of oil is also visible even after surgery. my doctor said it not possible to removed complete oil from eye is it true? will is got my 100% vision back after using specks.
    i will be many many many thankful for ur guidance plz sir help me plz

    • Randall V. Wong, M.D. October 15, 2012 at 3:33 pm

      Vinay,

      Can’t tell from this angle if you’ll get your vision back…too many things I don’t know about you.

      Randy

  • mj October 13, 2012 at 1:49 am

    Dear Dr. Randall:

    Thank you for maintaining this post and offering practical explanations. I had surgeries for retinal detachments in both eyes in August. The scleral buckle procedure worked for he left eye, but I required regiment of gas and then silicon oil implants procedures for the right eye. I currently have the oil in my right eye. Using corrected eye-glasses, I have mostly adapted well to the impact on vision through the gel (though I look forward to having the gel removed and hope for recovery–notwithstanding likely increased nearsightedness). I have been happy with the care of my surgeon, though in hindsight I agree with you and wish I could skipped the gas procedure.

    If a patient is physically fit and active, do you typically recommend that a patient can return to a physically active lifestyle when the silicon oil is still in the eye? Specifically, would running and swimming (with goggles) do harm?
    My Dr has said it is okay to run and walk after about 1 month, but did not recommend swimming in chlorinated pools.

    I am very cautious because I do not want to repeat the surgery, but I am extremely anxious to get back to running and swimming.

    (I am 46 years old male, physically fit long distance runner.)
    Thank you. M.J.

    • Randall V. Wong, M.D. October 15, 2012 at 3:53 pm

      Dear MJ,

      I prefer that all my patients resume full activity once able. In my practice patients with successful oil injection need a special head positioning for usually < one week. Once the head positioning has been sufficient, they should return to full activity. If you were my patient, you should be running and swimming. (Great idea for another article! Thanks!). r

  • Benyamin Prasetyo October 14, 2012 at 11:05 am

    Dear Dr. Wong,

    After almost 2 month of treatments for inflamation on my right eye, later known caused by uveitis, my doctor found out that the retina detached on July 23, 2012, and on July 24, 2012 I’ve gone through an operation using gas.
     
    After 10 days, my doctor told me that there are some part on the upper right of the retina isn’t attach so well, so on Aug 7, 2012 I had the 2nd operation using silicon oil.
    Since then, my right eye which used to be -5, now becomes +4, the vision is still blurry & distorted, and eye pressure is constantly at 7. 
     
    The uveitis thankfully have been under control since I’ve been having treatment of MTX shoots 5 times for rheumatism.  At this moment I’m still using Prednisolone Acetate twice a day.
     
    On Oct 13, 2012, my doctor told me that he see some shrinking on the retina on its bottom left part, which he said cause by the floating silicon oil didn’t give pressure on that part, could it possibly the cause?  He would see in 1 month, and then remove the silicon oil and use gas to fix it, and if that doesn’t work, he said he have to use silicon oil again or buckle.
     
    My question are :
    1. Is it a common case that retina could possibly shrink even though there’s still silicon oil in it?
    2. Is it a proper procedure to fix this case with gas, while from your writing the best way to re-attached retina is using silicon oil.  How about buckle, could it solve this problem?
    3. Since I had surgery with silicon oil until this moment my vision on the upper right is look like I saw a shadow of crescent when I see forward.  My doctor said it’s a meniscus of the silicon, is it true? Or is it actually a sign that from the beginning my  bottom left part retina has not attached well. 
     
    Looking forward for your response.
    Thank you in advanced.
     

    • Randall V. Wong, M.D. October 15, 2012 at 3:57 pm

      Dear Benyamin,

      1. No. I think you may have epiretinal fibrosis/PVR? Ask your doctor for a description other than “shrink.” Not clear from my seat.

      2. Depending upon the answer to #1, just using gas in a already silicone filled eye is not accomplishing anything. Ask if there are membranes which need to be removed, or peeled, off the surface of the retina (likely).

      3. Could be, but then that means you don’t have much oil in the eye.

      Hmmmm…

      r

  • DR P.R.KANANI October 16, 2012 at 2:11 am

    Respected Dr Randy
    yesterdy i went for followup of my RD which i told you that i got 2 operation one by gas another by silicon oil vision is not as per mark about 70 pc
    our dr told he will do the spa/masaz in the next followup on 17th Nov 12
    The problem he told is that there is creeze/rinkle in the RD in front of retina which prevents your vision. He is right cause i got 2.75 no and 7.5 cy no in eye
    i can see if i see indirectly to the object but straight it is not visible
    pl i need your advise sir
    pl help me i frusteted
    inconveniency caused pl bre regretted
    pr kanani

  • vinay October 16, 2012 at 2:16 am

    ok sir,
    one more doubt i have that “are the floaters first signal of re-detachment?”
    if it is what i should do?

    • Randall V. Wong, M.D. October 17, 2012 at 7:26 am

      Vinay,

      It can be. You should always have new floaters examined.

      If you are indeed re-detached, talk with your surgeon about fixing it….you have nothing to lose. You can only save your sight and your eye.

      Randy

  • Benyamin Prasetyo October 16, 2012 at 4:59 pm

    Dear Dr. Wong,

    Yesterday I went to another doctor, and he said that he saw my bottom part of retina is detached again could be caused by the wrinkle, but he didn’t mention about epiretinal fibrosis/PVR, and he suggest me to have scleral buckle and silicon oil surgery again.

    After twice of operation, actually I’m not so sure that those action would solve the problem, after I read your writing about PVR, I’d rather believe that Epiretinal Membrane has alredy grow on my retina, because I’d just realized my right eye vision is distorted.

    So what is your suggestion, is the scleral buckle & silicon oil surgery without peeling off the membrane would solve the problem? Or else actually the peeling off process is the most important thing to do?

    Fyi, I’m from Jakarta, Indonesia, do you have any recommended doctor within the region such in Singapore, Malaysia, China, or Indonesia itself, which most probably have the same minds, thoughts, and opinion with yours?

    Your forum for sharing information has been very helpful for me, I really appreciate it.

    Thank you & regards,
    Benyamin

    • Randall V. Wong, M.D. October 17, 2012 at 7:30 am

      Dear Benyamin,

      Obviously, without examining you, I have to defer to the your doctor.

      Scleral buckle, silicone oil and removal of epiretinal tissue are often used in combination to treat PVR.

      I do have a recommendation for Kuala Lumpur, Malaysia.

      Dr. Kenneth Fong

      I hope you are well.

      Randy

  • DR P.R.KANANI October 17, 2012 at 1:13 am

    Dear Dr. Randy
    As you asked that”are the floaters first signal of re-detachment?
    I do not know but it was my 2nd operation of RD with PVR.
    As per our Dr.told is that there is creeze/rinkle in the RD in front of retina which prevents your vision.He also cleried that silicon oil will be brought out after 6 month i.e.27/7/12/ + 6 month =27/1/13
    My query is that can the rinkle or creeze be rectified and vision can be brought or return
    sorry for inconveniency sir
    pl help me and give me some tip for vision

    with regards
    P.R.KANANI

    • Randall V. Wong, M.D. October 17, 2012 at 7:22 am

      Dr. PRK,

      You really need an evaluation with someone experienced with PVR. We all deal with it differently. If the “fold” is due to epiretinal tissue pulling on the retina, then removing the tissue creating the retinal detachment is paramount.

      Without an examination, I have no way to intelligently suggest to you anything different.

      Randy

  • MJ October 19, 2012 at 5:46 am

    Doctor,
    Thank you for your response. Your response indicates medical approach that cares for the whole person, not just the eye.

    I see a recent osting from someone in Indonesia. Though I had my surgeries in USA, I am also living in Asia (Sri Lanka) and would be interested to know if there is a professional organization or some way of knowing if doctors and facilities in the region are well trained in retinal care and surgery. I have referrals to surgeons in India and Singapore, who have come highly recommended, but I am looking for periodic care and follow-up observation now. I realize the challenges here in Sri Lanka, but would be interested to know what have you heard of the quality care available in India and Singapore? I have to decide if I should have the gel removed in Asia or travel back to the USA. Thank you.

    • Randall V. Wong, M.D. October 22, 2012 at 8:17 am

      Dear MJ,

      I really don’t have any useful information. Sorry.

      My only personal contact is in Indonesia.

      r

  • Benyamin Prasetyo November 2, 2012 at 1:08 pm

    Dear Dr. Wong,

    I’ve already done the combined surgery of membranectomy, silicon oil, and scleral buckle, last week in Kuala Lumpur with Dr. Kenneth Fong, as you recommended and I’m quite sure he’s expert in his job and I think he handles me very well.

    Now I’m in recovery and hoping the best result. You’d be the first I’ll updates.

    Thanks again for your recommendation & discussion.

    Regards,
    Benyamin

    • Randall V. Wong, M.D. November 11, 2012 at 10:48 am

      Dear Benyamin,

      I am so happy it worked out. Thanks for keeping in touch. Look forward to hearing about your progress.

      r

  • Hans December 19, 2012 at 2:35 pm

    Dear sir,

    A relative of mine (female, 24.. High myopia in the eye, -10) recently diagnosed with retinal detachment in left eye. Upon evaluation it was discovered to be an old detachment and was quickly operated upon as it had come very close to macula. The surgery involved infusing silicone oil plus head posture, which all lasted for 10wks. After tht, the doc removed the oil as it had begun to emulsify and replaced it with a gas and hasnt rquired her to lie on her face anymore. Monthly checks during the past 3 mths have indicated reattachment Ok, and the doc says that once the gas is absorbed vision should improve. Currently she can only see around the edges as the gas was infused only 13 days ago.

    Questions:
    1. As an independent opinion, do you think it is progressing well?
    2. Usually what are the chances or recurrence here?
    3. What precautions are required to ensure this doesnt recur?
    4. How to detect recurrence?

    Thanks, Hans

    • Randall V. Wong, M.D. December 25, 2012 at 11:43 pm

      Dear Hans,

      1. Presumably the vision is poor due to the remaining gas. I agree that vision should be poor with retained gas.
      2. Varies, but the odds are favorable, but each case varies and is different. Also, there is a huge variation in surgeons and there decision making process…meaning we operate differently.
      3. Can’t
      4. Frequent examination.

      Good luck,

      r

  • Eyad Al Anani December 22, 2012 at 10:38 am

    Dear Doctor
    I had first RD operation before 4 month in my right eye, and under go another surgery to remove the silicon oil. After removing the silicon oil for 3 weeks it detached again and i had a catarct in my lens,before 4 days i donrle another operation and the doctor implant a lens and injict a silicon oil again. The doctor told me it might stay in my eye the silicon oil for the rest of my life, Am 32 years old male. And am having in my left eye (Amblyopia) or lazy eye case. Is there any sude effict for leaving the silicon oil for the rest of my life in my eye ?! And is there anyway to make my vision clear cuz while the silicon oil inside my eye i see wavy pictures and blurred vision ! Is there a special eye glass or anything to make vision more clear ? Another thing about my left eye is there any way to bring it back to normal and fix the Amblyopia ?!.
    I hope i didnt ask too much quastions and thank you for allowing ppl to post there experiance with RD cases to disscuss it here and to share opinions.

    Kind Regards

    Eyad Al Anani

    Jordan

    • Randall V. Wong, M.D. December 26, 2012 at 12:42 am

      Dear Eyad,

      1. Oil may indeed stay indefinitely in the eye. It, too, may cause some damage, but you’ll need regular eye exams.

      2. The oil may not be the reason for the wavy and blurred vision. It may be due to the retinal detachment.

      3. There is no special eye glass.

      4. No fix for amblyopia.

      Randy

  • Lori January 24, 2013 at 5:58 pm

    I am a 48 y.o. woman who lived in Las Vegas, Nevada in 2006 and had a detached retina. Caused by illness w/ severe vomiting, woke up next morning with detached retina. Was treated with a vitrectomy, scleral buckle, laser, with a gas bubble. Redetached same year and reattached with silicone oil. The following year, oil removed and redetached a 3rd time. Repaired, lensectomy and silicone oil once again. Dr. said she’d never remove oil ever again, only exchange!

    As of 2010 living in Salem, Oregon with a different Retina Dr. IOP went up from 18 to 24 immediately after moving (much lower elevation -2,000 comparison, feet plus higher barometric pressure) compared to Vegas.

    Oregon Dr. wants to remove silicone oil. I’m afraid because Vegas Dr. said, “No more eye surgeries, the eye could die, it could also redetach.” Also under the care of Ophthalmologist for secondary glaucoma.
    1. Could barometric pressure and elevation cause a change in eye pressure?
    2. Is it safe to remove the silicone oil without risk to another detachment?
    Thank you.

    • Randall V. Wong, M.D. February 2, 2013 at 4:24 am

      Dear Lori,

      1. Barometric pressure should affect gases only, so I don’t think so.

      2. There is always a chance that removing the oil could lead to redetachment. I really can’t offer more without the advantage of an exam.

      Randy

  • Melinda February 9, 2013 at 1:08 am

    Dr. Wong
    I have had three rd surgeries. The last one is with silicone oil and buckle. My eye is half the size as the good eye and I was wondering how long it take for my eye to get back to the normal size.

    • Randall V. Wong, M.D. February 13, 2013 at 12:34 pm

      Melinda,

      It may not. How is the vision? Are you looking at a droopy lid or is the eyeball itself smaller?

      r

  • Melinda February 17, 2013 at 2:11 pm

    My vision has improved some. I can make out large objects pretty well but can’t see up close at all. I don’t really notice droopy eyelids and my eyeball is smaller but my concern I guess will be the muscle have stretch because of all of the surgeries. I would just like for both eyes not particularly eyeballs be the same size at some point.

    • Randall V. Wong, M.D. March 2, 2013 at 11:50 am

      Melinda,

      Best of luck. Time will tell. Ask your doc if you have specific concerns.

      r

  • gelanie February 21, 2013 at 4:02 am

    Dear Dr. Randy,

    I am from the country of Philippines, I had my operation last July 2011. My doctor put a silicone oil on my right eye, because of retinal detachment. my left eye is no longer have a vision., I did not go back to my doctor anymore because of financial problem. My doctor told me that he still needs to remove the silicone oil.
    My left eye retina is already broken, I just want to know if there will be a chance to have a vision again?

    Thanks,

    gelanie

    • Randall V. Wong, M.D. March 2, 2013 at 12:18 pm

      Dear Gelanie,

      I really don’t know the present status of either eye as I can NOT examine you.

      So sorry.

      r

  • Dominic Cusumano March 6, 2013 at 7:16 pm

    Dear Dr. Wong
    In March 2012 I had a cataract Surgery with an implant, In June my vitreous detached, On September 6 they told me that I had a detached retina. The retina specialist told me I had three tears , And that about 50% of the retina had detached. The next day I had retina surgery And a vitrectomy With a short acting gas bubble. At the end of three weeks The gas bubble disappeared and my vision was almost perfect. Two weeks after that The Retina Detached again. Surgery was done again, this time with the Scalera buckle and a long term acting gas, This time I was told that the Macula had detached. Four weeks after that the retina we detached again , I was told the macula had detached again. Surgery was performed for the third time but this time they put in silicone oil. Two weeks after that the retina detached For the fourth time but it was caught really early. And again silicone oil was put In the eye. That was done on December 6 of 2012 It has now been 16 weeks since I had the surgery At 12 weeks I became allergic to the atropine eyedrops . I still have the oil in my eye, vision is 20-200 I still have full vision no Dark areas. But objects seem to have an hourglass Effect. And I have double vision. So my questions are, Does the oil create the Hourglass affect, or is my macula deformed. And how much will the eye vision improve after the surgery to remove the oil. My surgeon won’t answer these questions, she keeps telling me it is what it is. I read the double vision can be in muscle cause by the scleral buckle., On my brain won’t comprehend two images. What’s the chances of it correcting itself.
    Thank you Dominic Cusumano

  • Dr Gerard Chuah April 19, 2013 at 2:04 pm

    Hi Randall
    I am a retina surgeon in Singapore and my private practice is at Camden Medical Center.
    congratulations on such an excellent informative blog on retinal detachments!
    I wrote a book for such patients and would like to send you a complimentary copy. my retina website http://www.retina.com.sg
    please let me know your mailing address
    best regards
    Gerard

    • Randall V. Wong, M.D. April 23, 2013 at 10:57 am

      Dr. Gerard Chuah,

      Thanks!

      3025 Hamaker Court
      Suite 101
      Fairfax, VA 22031
      USA

  • Sarvagya April 22, 2013 at 10:44 am

    Dear Dr. Wong,

    my 60 years old mother undergone Retinal detachment surgery— vitrectomy + trans scleral cryo + silicon oil injection (1300cs) + partial sclerectomy.

    it has been 6 weeks now. Her doctor says he will keep oil permanently on her eye. but she is having blurred vision (as if oil is interfering vision). Will that blurred vision improve with time?

    • Randall V. Wong, M.D. April 23, 2013 at 10:31 am

      Sarvagya,

      Blurry vision may be due to the silicone oil and/or retinal detachment if the macula were detached.

      Most eyes with silicone oil do not see maximally due to the mere presence of the oil.

      Randy

  • Alex K April 24, 2013 at 11:02 am

    What if I have silicone implant for cataract surgery?
    I’m going maybe for a 4th surgery

    Will silicone bubble will still help?

    • Randall V. Wong, M.D. May 11, 2013 at 3:14 pm

      Alex K,

      Help me. I’m a little confused over your question. Silicone implant? Do you mean IOL made from silicone?

      Randy

  • mmartin May 24, 2013 at 8:15 pm

    hi I have been reading your site over the last year and thought I would ask a question..

    I had DR surgry, vitrectomy with gas , 2 operations and a 3rd which oil was put in over a period of 3 months.. now I have virtually no vision but IN outdoors light I see blurry figures, I can see how many fingers for example but not able to see any detail but i only get this brief vision in day light not indoors.

    I have had the oil in for a year now… is there any hope for someone thats had oil in for that length og time..

  • Deepak Nagewadia May 28, 2013 at 3:56 pm

    Dear Dr.Randall

    My mother had her Retinal detachment surgery— vitrectomy (macular-hole) in March end 2013,in India.
    She has been told that she would need to go back to India for removal of silicone oil by end June 2013.

    My question is how long is the period in which the silicone oil can be in the eye? And can the removal surgery be done by any eye specialist? I mention this because the travel arrangement need to be made and if the Doctor who initially did the operation has many patients and the time period for advance booking is quite difficult, however, he has emphasised that my mother will need to be back for oil removal and that there will be a cataract progression, which will be worked on when she returns.

    Please advise me on my mother’s situation as it stands.

    Best regards

    Deepak Nagewadia

  • Sarvagya June 19, 2013 at 12:31 pm

    Dear Dr. Wong,

    my 60 years old mother undergone Retinal detachment surgery— vitrectomy + trans scleral cryo + silicon oil injection (1300cs) + partial sclerectomy.

    It has been 3 months now… what she sees is some white spot traveling from left to right in eye followed by complete blackout for 30 seconds before sight regains slowly… this happens every 5 minutes… i’m worried if this is not common post surgery… can u help me on this please

  • saurabh July 2, 2013 at 11:23 am

    Dear sir,
    I am 29 year old male.i had giant retinal tear in my right eye due to accident.which was cured by buckle with oil folowed by cataract removal with IOL implant.however vision was poor and now have PCO too. Recently I had grt in my left eye too again due to accident on 28 apr,this time cured by buckling and oil process. After six week my vision is upto 6/18 from left eye.
    I would like to know that as oil was not removed from my right eye yet and now I have it in my left eye too…what precaution should I take? Also can oil remain in eye for ever?

    Thanks for promoting such a use ful information in a great way and help the patients like me to clear their doubts and fear.

    Rgds
    Saurabh

  • Sarvagya July 25, 2013 at 8:19 am

    Dr. Wong,

    Her eye pressure is 2 only. And Doctor says he can not identify problem

  • Sarvagya August 3, 2013 at 10:44 am

    Sir,

    Oh.. that looks scary as this is the only eye she has… Could you please guide me on how can I get it verified that she has phthisis bulbi or not… and if at all, is there any cure for this.

    Thanks,
    Sarvagya

  • Grace August 13, 2013 at 8:58 am

    Is positioning needed when silicone oil is used? My 10 year old boy just had RD Surgery today, surgeon did oil, buckle & PPV , probably coz he lost the left eye 3 years back even after 3 progressive attempts with silicone oil last. My boy is autistic and hyperactive, so post-op care is difficult.

  • Loundeann September 4, 2013 at 8:22 pm

    In May this year, my husband had surgery for retinal detachment in 3 spots in one eye. The surgeon used oil instead of gas as he felt it would be more stable. My husband was able to see (20/30 in that eye) if he used a contact lens +5 and his regular eye glasses. 3 months later (Aug this year) he went back in for removal of the oil. He is unable to see out of that eye at all other than colors, blurred images. It makes no difference if he is wearing glasses or not. Will his vision improve with time? It has only been a month since his surgery but he is very concerned as it doesn’t seem to be getting better. His employer won’t let him come back to work until his vision is 20/40 with correction. What would be the reason his vision is so poor after removal of the oil when he was able to see with the oil in?

  • Phillip Luzzi September 14, 2013 at 7:35 pm

    Thanks Doc for this great overview of your thoughts on silicone use in retinal detachment.

    My wife rRbyn had a haemorrage in her (R) eye 13 years ago which left her clinically blind as there was no treatment with lazer in Australia at the time that we were aware of.

    6 weeks ago she suffered a retinal detacment in her (L) eye and had lazer surgery to rectify the problem.

    After 5 weeks she developed another tear in the same eye however in a different spot. As a consequence she was rushed off to a private clinic and was operated on by a retinal surgeon who used silicone as the prognosis was very poor given that this was her only functioning eye.

    Like most doctors they have a busy schedule and the full details of the long term effects were not explained to us. It has now been six days post operatively and she has no vision at long distances, however she can see her hand about 6 inches from her face.
    We will be asking her doctor how long before she gains her vision as she is only 61 and basically blind.

    We have been told by the retinal surgeon that the silicone could be permanent as she is not a good candidate to have it removed. I hope through your experience with this procedure there are no long term effects that add further complications to her (L) eye. Thank you for the article on behalf of myself and Robyn

  • Tony September 21, 2013 at 3:55 am

    The Dr. put silicon oil put in my eye after retina detachment and my eye is now starting to skrenk. My cornea was effected, and I asked my doctor to remove the silicon gel or oil and he would not do it. My cornea Dr. said the silicon gel is what cause my cornea to fail. I want the gel out of my eye and my cornea replaced. I had sight and now I have none. I had this surgery three years age and you can see how much my eye has skrank.

  • Marsha Hubbard November 20, 2013 at 9:08 pm

    In April 2013, I had a retinal tear and received laser surgery. Eventually, a second laser surgery was performed (deeper into my eye) in case the doctor missed anything on the first surgery. This situation held for 4 months until August, 2013, at which time my retina detached. I had surgery to remove the vitreous gel, and gas was injected, and the scleral buckle was added. Exactly one month later, Sept 2013, my retina detached again. The doctor injected the Silicone oil. In my recent follow-up visit in November, 2013, the doctor took one look inside my eye and announced we could not remove the oil or I would detach again. He wants to leave things alone until Jan/Feb 2014. Two symptoms that have occurred during this journey is that my eye has shrunk some, and my upper eyelid has not returned to its original shape. People take one look and know there is something physically wrong with my eye. My two questions are: First, have you experienced, with any of your other patients, this side effect that the eyelid is misshapen and doesn’t appear to be returning to its normal form? And, secondly, from what you’ve read about my journey, do you project that I might need Silicone Oil forever, in order to avoid future detachments. Do you have some patients that will require the Oil forever? I currently can see colors, but images are blurry and I cannot make out facial features. I cannot see anything up close.

    • Randall V. Wong, M.D. November 26, 2013 at 6:49 am

      Dear Marsha,

      My best guess is that your eye “looks” smaller, but is not. This would be consistent with your eyelid drooping, too.

      Often, especially with protracted surgery or repeated surgery involving a scleral buckle, there is loss of the orbital fat behind the eyeball. Basically, there is less volume to fill the eye socket. The eyeball doesn’t push outward as much giving the appearance of a shrunken eye and droopy lid.

      Randy
      Randall V. Wong, M.D.
      Retina Specialist
      Fairfax, VA 22030

      http://www.TotalRetina.com

  • aamir ali January 18, 2014 at 9:10 am

    my Father got retinal detachment problem then the doctor in karachi Pakistan done following procedures
    1. he used silicon oil for detachment and my father hace clear vision
    2. then after two years dr said because of the silicon oil cornea will be damaged so they have decided to remove it known as ROSO(romoval of silicon oil )
    3. with in a week of ROSO procedure again retina detached , and then same procedure repeats but now my father doesnt have a vision

  • Yeoun Jin Kim January 28, 2014 at 2:48 pm

    Dear Randy
    My 16 yr old son got retina detachment and had a surgery 5 days ago. The choice was silicone oil since the retina tear happened long time ago and the macula region was off. I have some questions.
    Doctor did not mentioned any special head position after surgery. Is it normal for silicone oil option?
    He still sees distortion in his vision and black area. His doctor explained that it is due to the many optical changes in the eye such as stitches, laser, scar etc…and it may improve. But the info from internet were very discouraging and scary. Is it still possible to fix the distorted vision even in the case of macula off as my son’s?
    Also he is now very sensitive to the light….is it common post surgery symptom?

    Thank you very much.
    YeounJin

    • Randall V. Wong, M.D. February 4, 2014 at 7:08 am

      YeounJin,

      I usually recommend head positioning with both gas and silicone oil (think of silicone oil as a non-absorbable gas, both are lighter than water). Head positioning, however, is dictated by the location of the retinal tear/hole which caused the retinal detachment.

      With regard to the distortion, I really don’t know all the factors and lack the ability to examine your son. It may be too early to know if the distortion is permanent. If the macular was indeed involved, and for a long time, the distortion may be a problem.

      Best of luck and thanks for commenting.

      Randy

      Randall V. Wong, M.D.
      Retina Specialist
      Northern Virginia
      Fairfax, VA. 22030

      http://www.vitrectomyforfloaters.com

  • kapil January 31, 2014 at 11:24 pm

    Dear Dr. Wong
    I am 22 years old.around 4 years ago i got an eye surgery for filling silicone oil in it.and till now oil is in my eye.i am comfortable with that but some time my eye get red due to continuesly watching tv or computer.and some time due to not sleeping timely.So i just want to ask that,is it normal or should i go to the doctor for this.
    Thanks in advance

  • Phil Angel April 30, 2014 at 2:20 am

    Dear Dr. Wong,
    I have amblyopia in my left eye. My right eye has started having retinal detachment problems. On 2/3/14 I had surgery to reattach my retina. Then on March 29, I noticed a spot, and the spot grew to complete darkness. On 4/1, I had a 2nd surgery with a buckle put in. I still see a gas bubble, and now the surgeon is seeing fluid around the scar tissue. He is contplating a silicon oil surgery. Are ther alternatives? I only have vision in my right eye.

    • Randall V. Wong, M.D. May 10, 2014 at 8:48 am

      Dear Phil,

      Really difficult for me to say anything constructive without the ability to examine you. I would encourage you to follow your doctor’s recommendations.

      In my opinion, oil reduces the chances of re-detachment, especially if you’ve got PVR (you need to ask). Doctors overuse the word “scar” so I don’t know how it may be used in your context.

      Randy

  • Workneh July 15, 2014 at 9:05 am

    I had undergone a retinal Detachment surgery had PPV operation with silicon oil implant. In india my doctor advices me to have a laser treatment back home & the oil should be removed after six month time .my home eye specialist recommends that the oil should stay in my eye at least one year time because the retina will redetach again .I donot have a laser treat so far & I am of the opinion to travel to India for the oil removal after nine months time .what do U pse advise me?thank U so much

    • Randall V. Wong, M.D. July 27, 2014 at 2:11 pm

      Workneh,

      Very difficult to say. I usually consider removing oil after 3 months…if I feel the vision may improve substantially.

      I always treat with laser. I disagree that you have a greater chance of detaching at 3 mos vs. 6 mos. I say you have the same chance.

      Hope this helps.
      Randy

  • Leonard August 26, 2014 at 2:47 pm

    I had retinal detachment and re-detachment in both eyes. My vision is now okay, but not as good as before the detachments. The silicone oil was removed after about four months. My problem is that some silicone oil adhered to an implant in my left eye. This causes hazy vision in that eye and limits my sight, especially in certain lights. I received the implant some 25 years ago. Is there anyway to safely correct this?

    • Randall V. Wong, M.D. September 2, 2014 at 9:17 am

      Leonard,

      Your options are limited. “Vacuuming” the silicone oil off the implant is very difficult and sometimes can work, but compared to removing the IOL, is safer.

      Randy

    • Randall V. Wong, M.D. September 2, 2014 at 9:20 am

      Leonard,

      Removing the implant is very difficult and more dangerous than trying to “vacuum” off the oil with a vitrectomy instrument.

      Those are the only two options I can think of.

      Randy

  • Cindy Lee August 27, 2014 at 6:40 am

    Dr Wong,

    My 14 year old son got hit by a soccer ball about 3 weeks ago. He was initially diagnosed as berlins edema but now it has developed into macular hole. One Dr wanted to wait and see if it will heal on it’s own. I took him to see another Dr for a second opinion, and she said the macular hole is big enough that it will not heal on it’s own and that we should go ahead and do the surgery. She suggested air or oil bubbles and maybe though oil bubble might be easier on him. Is there any benefit from waiting? I don’t want to rush to the surgery. For his situation, would air bubble or oil bubbles give him better end results? (better vision). Would would you recommend? Thanks in advance for your advice.

    • Randall V. Wong, M.D. September 2, 2014 at 9:01 am

      Cindy,

      Macular holes due to inflammation and trauma generally do not close on their own. It might be wise for you to wait (a few weeks?) for the retinal swelling to calm down – this may be why someone suggested waiting. It is unlikely the hole will close by just waiting.

      The standard is to use gas; C3F8 is most common. I like SF6 because it is absorbed faster. At issue is keeping a 14 year old boy face down. C3F8 requires a longer face down position without any difference in results. I don’t use at all.

      Silicone oil might work, but will require a second surgery to remove.

      This probably didn’t help but to throw fuel on the fire.

      Randy

  • Wajid February 13, 2019 at 7:39 am

    Hello Dr.
    I have chronic detached retina in my left eye performed surgery on 18-01-2019 with partial macula off and distorted and blurry vision. Doctor used silicon oil and I am instructed to face down for 6 weeks. 1week post-op visit my VA was +5.0 and 6/21. Now it is about 1month to surgery gradually recovering my vision back. Still blurry and distorted vision though. I am concerned about that I noticed a transparent bleb in white area of eye right beneath the stich near my nose. It look like oil leakage to me. I have scheduled next visit to my doctor after two weeks. Plz tellvme that this bleb is danger or not?

    • Randall Wong, M.D. February 28, 2019 at 2:57 am

      Wajid,

      No way for me to tell without examining you. I wish you well, please follow your doctor’s advice. r

  • S. Larson March 8, 2020 at 4:24 am

    I had retinal tears after pars plano vit by cataract surgeon; – had retina surgery with cryo, partial buckle and gas; had scaring – 2nd sx full buckle, gas – scarring again treated w/ air bubble and laser, – then another scarring air bubble again x2 then did laser 20 mins had shadows at top – 3 sx next day injected silicone oil. At wk 7 I noticed like a bubble light that comes up and goes away… it was mostly bottom left corner but now it seems pop in bottom right or side left — like a bubble that comes out of perpherial and goes away (but it’s lighted)comes up a little then goes away. My surgeon doesn’t say much. He doesn’t seem worried – says the retina scar is stretching out very well, is flat … is this normal? Could this be a reflection off the oil moving? I’m nervous… Thx!

    • Randall Wong, M.D. April 1, 2020 at 10:33 pm

      I’m sorry that your surgeon isn’t able to better explain your situation, but I can only encourage you to follow the directions and recommendations of your doctor…I can’t examine you.

      Randy

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