Why Vision is Poor with Silicone Oil

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Why Vision is Poor with Silicone Oil

Why your vision is poor following silicone oil for retinal detachment surgery.

There are many reasons why you may not see well after silicone oil is used for your retinal detachment eye surgery.  Remember, retinal detachments are potentially blinding conditions and silicone oil is often used for repeated detachments.

Did Your Macula Detach?

One major concern with every retinal detachment is whether or not the macula becomes detached.  The macula is the most sensitive part of your retina.  It provides central vision, reading ability, color vision, etc.

One goal of retinal detachment surgery, if possible, is to fix a retinal detachment before it spreads large enough to detach the macula.

If the macula detaches, you my lose permanent central vision and/or develop distortion regardless if the surgery is successful.  Thus, if the macula detached at any time, there may be some permanent loss of vision.

Was Your Lens/Cataract Removed?

Silicone oil is rarely used during “primary” retinal detachment surgery, meaning we usually don’t use silicone oil unless the retina repeatedly detaches.  So, too, is the necessity to remove the cataract, or your natural lens, during retinal detachment surgery.

If your lens was removed, this might impact your vision, too.

Index of Refraction

This is a fancy term referring to the ability of light to be focused in oil versus water.  Light is focused differently depending upon the medium, or liquid in the eye.  For instance, replacing the natural saline solution and the vitreous (i.e. during a vitrectomy) with oil would change the power of your glasses or contacts.

Too Much Oil

Oil and water focus light differently, therefore, your vision will change simply because the medium (water/vitreous exchanged for oil).

Filling an eye with silicone oil can be tricky.  Eyes come in all sizes and therefore require different volumes of oil.   We have to use our best judgement when filling the eye with oil.

The perfect amount of oil fills the entire back of the eye and stays behind the iris.  In patients where there is no lens, too much oil can move forward through the pupil and decrease the clarity of the cornea.

Too Many Retinal Detachments

Many times eyes lose vision due to damage to the retina or cornea simply from repeated detachments and surgery.  That is, while oil may be used to prevent complete loss of the eye (often the case), there has already been permanent damage to some of the ocular tissues and, thus, poor resulting vision.

What Does This Mean?

Retinal detachments are difficult to understand.  Communication with your doctor is essential, though I realize we doctors vary in our ability communicate effectively.

Silicone oil is often used as a last resort to prevent further operations.  As you can see from the list above, just by putting oil in the eye, the vision is reduced.  This fact, coupled with the necessity for future surgery to remove the oil, prevents most of us from using oil during the initial surgery.

There is a difference between successful surgery, i.e. getting the retina fixed, and seeing well.  They don’t always go hand in hand, especially in cases where there have been repeated retinal detachments….the most common use of oil.

In the end, ask your doctor why she thinks you are not seeing.  If the answer you are receiving does not make sense to you, seek a second opinion.  You have a right to understand.

 

 

158 Comments

  1. Sid says:

    Hello,
    If the oil is removed, say a year from the time it was put, can there be any damage that occurs because of the oil being there for the year? For example, does the weight of the oil pushing on the retina when you lying down face up cause retinal damage?

    thanks
    Sid.

    • Dear Sid,

      No such thing. If you are face up, the oil “rises” away from the retina. Regardless of positioning, no additional risks for damage.

      r

    • Judy Gilde says:

      Saturday,October 6, 2018 had vitreal hemorrhage in my left eyenand left me with a little blurry vision. The next day, had another gush of streaking/bleeding across my vision. Saw my optometrist immediately on an emergency visit to his office. He was not able to see anything in the eye.
      The following noon saw my opthamologist who is about 60 miles away. He couldn’t see into the eye either. Did a B-scan and didn’t think the retina was detached. Sent me home saying it was a “vitreal hemorrhage” and recheck in 4 weeks. Vision worsened over the next 3 days. Went back to him and was immediat sent to the retina specialist. They did surgery the next day as it was late in the day at that point. They did laser to the 10 tears, inserted long acting gas and kept very close watch. At 5 weeks post-op scar tissue forced new tears and detachment. Surgery again with scleral buckle, new gas, vitrectomy just before Thanksgiving. Now at my 7 week post-op last Thursday had my 3rd surgery and they used silicone oil as scar tissue again caused the full detachment. So I’m absolutely frightened to think what happens if this happens to my good eye which is also 20/15. My past eye history is bilateral Lasik in 2004. Bilateral enhanced cataract surgeries in October and November 2017 followed by YAG in January 2018. Also have been diagnosed with bilateral lattice degeneration many years ago and am nearsighted. I use my eyes for very detailed work for photography. I can’t afford to lose vision in two eyes. Would you recommend any preventative laser treatment to the lattice areas of the right/good eye? Or will that create scar tissue which my cause tearing and detachments sooner? The previous gas bubbles have caused a film also. My vision 6 days post op with oil is very blurry. Can the film be cleared by the laser treatment as I’ve already had the YAG? Thank you for your input. I am scared for my other eye as it sounds like I might be at risk for the second eye to do the same.

      • Randall Wong, M.D. says:

        Judy,

        You have a very delicate, but no uncommon situation, please follow the advice of your docs. I’d be happy to examine you and offer some advice, but I’d need to see you. All the best. r

  2. Shukri says:

    Dear Randall, Last December 2011 I had a retina detachment operation in Ankara Turkey. I was told that they do the operation with gas, but after the operation was done the Doctor told me that the operation was not quite successful (there is a small detachment of 2.5 mm), and they did not remove the cataract. I am still waiting to have my second operation of retina detachment so I have applied again to The Ministry of Health in Kosovo and I am still waiting for the response from them. Even though they told me that they are short of finances. I am an English Language teacher and I have no financial means to pay for the operation. What to do? Will it be too late?
    With friendly regards!
    Shukri

  3. cheri says:

    Should a physician request previous information from previous eye surgeries before doing a surery on a patient? I had a detatched retina and had surgery to repair it. I have had a cataract surgery with silicone IOL implant, The physician first used gas with buckle. The buckle caused me much pain. He removed the buckle and used silicone oil. This caused me much trouble. The physician had not requested previous history and was not aware I had a silicone IOL implant. He new I had cataract surgery but did not know I had the silicone IOL. After the oil was used and I had trouble he said he thought I probrably had a silicone IOL and asked me to find out. Sure enough I did. I did not know anything about possible interaction between the oil injected and the silicone IOL to make an imformed decission about this surgery. When the physician tried to remove the oil was when he suspected the silocone IOL. He took me in for surgery to remove oil and was unable to get much of it because it had adheared to IOL. and he did not have the right tools at hand to remove oil. This lack of having previous history caused me to have another surgery and I would have never signed to use oil if I would have been told the possible risks with using oil with silicone IOL. I follow your website and respect your opinion. Please let me know your opinion on this Thank You, Cheri LeMay

    • Dear Cheri,

      1. Perhaps there is some confusion regarding silicone oil. It is a very, very useful tool and can dramatically reduce the chances of your losing vision or even going blind from retinal detachment. There really is no alternative. I think you should feel fortunate that your retina was saved and, in my view, having oil stick to your implant is a small issue…but not negligence.

      2. Regarding special tools. Not sure I would know what they could be other than instruments to remove the entire IOL.

      3. Basically, you were given the choice of going blind vs. saving your vision with silicone oil. I rarely inquire about type of implant because it would be, in my opinion, negligent to move forward with the oil.

      Good luck. I hope this was helpful.

      Randy

  4. cheri says:

    Dear Dr. Randall Wong, The above post is for you. I am a healthcare provider (RN) and feel I was not given proper information to make a decision and that if this physician would have taken the time to request previous history I could have avoided problems including an extra surgery. This DR. did not even have the proper tools to work with seeing that he did not have my history. Thanks again for your opinion.

  5. Pat Steffee says:

    Hello Dr. Wong, I have had repeated surgeries for recurring retinal detachments in my right eye. The last surgery was done with silicone oil and was sucessful. My retina has stayed attached since 04/25/12 however my field of vision in that eye is quite small, distorted and blurry. I also have had cataract surgery in that eye in the midst of the detachments and I have an implanted lense. I am using Prednisolone Acetate 1% eye drops Q2H but haven’t noticed much improvement. The pressure in that eye is 8 and there is some corneal edema. Do you think I have a chance of my vision improving? Should I just be thankful that my retina is staying attached and that I some vision?

    • Dear Pat,

      I agree. Overall you should be thankful you’ve not gone blind nor lost the eye.

      I can’t know, however, the status of your retina. Corneal edema may decrease vision, too, and with time might improve. I’d ask your doc;

      1. Do you think the cornea will improve?
      2. Is there any macular edema from the retinal detachment(s)?

      r

  6. cheri says:

    Dear Dr. Wong, I did not understand what you was saying in your answer related to using silicone oil with silicone IOL. You said you do not request information aboiut IOL related to knowing would make it meglagent to more forward with use of the oil. I have had a total of 3 detatchments. 1 in the left eye and 2 in the right. I fear if I would have another one in my left and they use oil that I would be blind. I can only see the large E on the eye chart with my right eye. Gas was used with my previous surgeries and I never had any trouble. My left eye and vision is great. My right eye vision is very poor. Should I not use oil on my left eye should it detatch Now there are about 3. I still have pain in my right eye and have had ever since they put oil in it back in may. Just wanting to make the right choices. I appreciate your imput so I will have a better understanding. Thank you for your time. Cheri

  7. cheri says:

    Dear Dr. Wong, I did not understand what you was saying in your answer related to using silicone oil with silicone IOL. You said you do not request information aboiut IOL related to knowing would make it meglagent to more forward with use of the oil. I have had a total of 3 detatchments. 1 in the left eye and 2 in the right. I fear if I would have another one in my left and they use oil that I would be blind. I can only see the large E on the eye chart with my right eye. Gas was used with my previous surgeries and I never had any trouble. My left eye and vision is great. My right eye vision is very poor. Should I not use oil on my left eye should it detatch Now there are about 3 oil.bubbles in my vision. There had been 20. Other than that my vision in my right eye is very poor. I still have pain in my right eye and have had ever since they put oil in it back in may. Just wanting to make the right choices. I appreciate your imput so I will have a better understanding. Thank you for your time. Cheri

  8. Elena says:

    Dear Dr. Wong, thanks for your excellent and easy-to-understand information on retina detachment surgery. I had retina detachment in the end of May and initial operation in the beginning of June. It didn’t last as we had a “leakage” so I had a few more operations that included the gas treatment, with strict positioning orders, which re-attached the retina except for a “suspicious” spot. To deal with that my surgeons decided to have a silicone oil infection (in the end of Aug). I’m doing much better almost a month later now, but my vision is too blurry to consider it useful and most of the time I have to keep the operated eye closed as it obscures the “total” vision (it’s like I see double as if I was cross-eyed). Is this normal? And will my vision improve after a while? The retina has been re-attached and I’m being watched closely by my surgeon but he isn’t speaking yet about my vision and I meed to know if things will improve. Thank you for your help.

    • Dear Elena,

      I don’t understand if your retinal detached again after silicone oil or if you had an actual infection (that would be really rare). Realize that silicone oil usually is not associated with good vision and your eventual vision may be unrelated to the vision you have now with the oil.

      I simply don’t know enough about your condition to remark constructively.

      r

  9. Elena says:

    Dear Dr. Wong,

    Thanks very much for your response.
    I meant to type “injection” (as in “silicone oil injection”, not “infection”), sorry about that. The retina remains attached since the silicone treatment.
    I understand and have read in your articles that silicone is associated with poor vision. When you are saying “my eventual vision”, do you mean it may actually improve even before the silicone is removed? Apparently my surgeon isn’t in a hurry to remove it since it keeps the retina attached, but does this mean I have to endure the same poor vision until the removal occurs? Are there any chances of (even slightly) improved vision while the silicone is still in?
    I have to say that I *do* see, I mean I have a picture, it is just very blurry in some parts and many details are obscured. Light is very hard to manipulate by the eye. For instance, in plain daylight everything is a blur. I seem to see more when the sunlight is down but not in complete darkness. But I can see color, and shapes. Almost like seeing under water. Isn’t the fact that I see color a good sign for the health of the macula (I don’t know if it got detached in the initial detachment)? If it did, it didn’t remain detached for longer than a few days.
    Thank you very much. I truly appreciate your service through these pages.

    • Elena,

      “Eventual vision” means when/if the oil is removed.

      Likely to have poor vision with oil remaining.

      The timing of surgery with respect to macular detachment is pretty important. There is really no way of my giving you a prognosis as I can’t examine you and don’t know much about the details of the previous detachments.

      Hope you understand.

      r

  10. Elena says:

    Dear Dr. Wong,

    I do understand and thank you again very much for your response.
    I asked more persistently my questions to my surgeon today (he’s a wonderful doctor but always so busy) and he seems to not want to give any more news about my vision (beyond what I already know, that is, that it’s poor) and he seems to prefer to leave the silicone in for as long as possible. Today I also heard that my natural lens was removed during one of my surgeries, and that the macula had indeed been detached. As for the timing of the surgery, the detachment became total on a Friday and by Tue morning I had my 1st operation. All subsequent “detachments” seemed to be mostly “tears” and none of them was left to progress to full detachment again (that’s a kudos to my surgeon and his team); we operated before it reached that point.
    My doc said that the double vision is due to the lens we removed and if I got that right, this ought to improve with time. But the blurriness, again if I understood right, is due to the silicone and so no more improvement is expected on that front. Please correct me if that sounds wrong.
    A more general question is whether glasses can be fitted to help with vision after silicone oil injection. One of my doctors had told me that after the silicone surgery I can adjust my glasses. Today my surgeon said this isn’t going to change and so no change in the prescription for my glasses would help. Do you think this is due to the silicone oil or due to the lack of natural lens?
    I would love to read more about the lens removal and how the new lens affects the health of the eye and vision acuity in particular, in case you are thinking of adding articles to your site. Could the surgeon proceed with lens removal to prevent cataract too (since it’s very likely for cataract to develop after retina detachment surgery according to my readings)?
    Also, a question that might seem a bit naive to a retinal specialist: why do we care to re-attach the retina if vision is not going to be “fixed”? I mean in cases like with the silicone oil injection -which might also stay in forever- when vision is poor and mostly not useful for day to day “seeing”, especially if there is no hope of vision improvement whatsoever, what do we gain by saving the retina? If the retina was left to die, would the eye die too?
    Last question: would supplements help strengthen a re-attached retina and which ones would you recommend?
    Thanks again very much for the invaluable service that you offer through this site to patients like me.

  11. joyce lau says:

    I have been following up issues like these shared by valued patients. I understand the agony of not seeing. I can identified my cases with Elena.
    From my understanding, once the rectina is detached and not able to be re-attached, the patient is classified blind permanently.
    Surgery using silicone oil is to give the patient the best quality of sight possible, no doubt in some cases (unfortunate one if macular detachment is involved), vision may not be improved, but at least there is some hope that some sight is still there.
    I am also suffering from some of these and trusting God , my vision oneday can be improved.

  12. Lynette says:

    I have had one operation on my detached retina and torn macula and then a second operation for two small cataracts. Now my retina has detached again and the doctor is going to use silicone oil that will have to stay in for three months. The problem is I cannot have the operation for another 2 weeks. Will this hurt my recovery. I do not have any diseases of the eye and I am hoping that when the silicone is removed I will gain some sight. But then I have to have an artificial lens inserted. My doctor says this is the last chance to reattach my retina. Is this true?

  13. slovenian says:

    Hi!i had a retinal detachment with giant tear wich was repaired with silicone!when was silicone in the eye i had 70 % visione,after silicone removal i had 30 % vision!doctor says to much silicone stayed in side!now after a year i have another surgery to cleam the eye from remaining silicone!is that a sirious operation,are the risks higher then the benefits?thank you for your answer

  14. 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

  15. Elena says:

    Dear Doctor,

    Any answers to my questions above? I know it’s lengthy but I asked more general questions. Thanks.

  16. Jason says:

    Dear Dr. Wong,

    I am due for surgery soon for detached retina. I understand oil will be used

    As I understand from your columns, even after successful surgery and oil removal, only limited and often blurry vision is restored, as opposed to total blindness without surgery.

    My question is: is the surgery worth it?

    What I mean is this. I can either see with one good eye (no surgery) or I can see with one good eye and a poor eye (perhaps with constant pain or irritation).

    Many thanks in anticipation.

    Jason

    • Jason,

      You aren’t reading correctly. Depending upon the health of the retina when the oil is first used seems to be the best predictor of vision.

      When oil is in the eye…vision is expected to be poor. We can’t really tell how good the vision will be after oil removal.

      Hope this was helpful.

      r

  17. Elena says:

    Dear Dr. Wong,

    I hope you kindly respond to my questions about double vision.
    Double vision seems unrelated to the silicon oil injection (the blurriness is a different issue and I understand it is due to the oil).
    In reading some other articles and comments from others (and your responses) in this site, it seems glasses MAY correct double vision and that DV is not normal.
    As I explained, my surgeon said no glasses will fix the problem and that all I have to do is wait until the brain adapts.
    Is this right to say about DV? How do I know that there has been no damage to the muscles (I still have a droopy eyelid 6 wks after the last surgery), or stravism or something else going wrong that needs to be fixed?
    I hope to get some response or guidance from you specifically on the DV issue. I wonder specifically if it is right to “wait it out” or should I seek help elsewhere. Thanks.

    • Elena,

      Double vision is not normal following retinal detachment surgery. Double vision, however, means different things to different people.

      I don’t believe about the brain adapting. Never happened in my personal case.

      Droopiness of the eyelid following any retinal surgery is not uncommon and may last weeks, but, of course, I must defer to your doctor if this is actually the case.

      I am concerned you really don’t know why you have DV. Can you get a second opinion? I’d recommend a pediatric ophthalmologist.

      Randy

  18. Jason says:

    Thank you, Dr for your quick response. Much appreciated.

    Jason

  19. Kathy says:

    Mt daughter got a detached retina 6 years ago. The first surgery was an injection of oil, I suppose because the detachment was big. However, the oil was not dense enough, so six months later a heavier oil was put in. A couple of years later, the oil starts to crystallize so that oil was taken out and more oil put in. At that time, the Dr. said the detachment was very close to center of macula. Her vision has always been very poor with no prognosis of any vision returning. So we were under the understanding that her eye may have to have new oil very two to three years just to keep her eye from “dying”. Last Dec. she had the oil replaced again. The Dr. said he thought her retina was finally starting to lie down…a little hope! Then she developed a cataract which she had removed. However the pressure in her eye is always high. . The present issue is that she is wanting to get pregnant and the doctor says he wants to take the oil out and maybe put gas in, if the retina is indeed reattaching. How will pregnancy and delivery of a child affect her eye…the pressure…possible redetachment? Are we risking a slight chance of her retina attaching if we take the oil out now? Could there be other procedures that might be attempted instead of repeated oil? Thanks so much for your information.

    • Dear Kathy,

      It is not my habit nor my understanding that oil needs to be replaced in this manner. I’d ask someone else (get a second opinion).

      There is no inherent therapy by just changing the oil.

      r

  20. Elena says:

    Dear Randy,

    Thanks much for your response.

    When I asked my surgeon about the reason for my double vision, he said it’s because he has removed my natural lens. However, he didn’t explain why or how this would bring about DV. What do u think?

    DV in my case means I see two different pictures when I have both eyes open. I do not have DV when I have only one eye open. But because of the different picture I get with both eyes open, I often end up closing the operated eye so I can safely see one picture (from the good eye) and successfully navigate in my environment.
    As you can see, I can’t live with this. I can’t believe there is no fix with glasses as my surgeon said.
    I will ask him again and let you know if I have any clearer response. If you have an idea how the removal of the natural lens may be cause for DV, please let me know. I have learned a lot through your site and it would be fantastic if I could learn one more thing.

  21. Kathy says:

    Thank you for your info. I believe the oil was for maintenance, holding down the retina in hopes the retina would attach. Is there another treatment you would suggest if the retina does not attach? What happens to the eye when the retina detachment cannot be repaired?

    We sought a second and third opinion after the first surgery but there was not any suggestion for a different treatment. I live in Oklahoma and have considered taking my daughter to a better facility somewhere but am not sure where. I m afraid that since it has been 6 years, it might be too late.

    Thank you.
    Kathy

  22. Elena says:

    Kathy,

    If you allow me, what I think Dr. Wong is saying is that this is not how oil replacement is used. I too had RD and a silicone oil injection and unless there is a reason my surgeon is thinking NOT to remove the oil. That’s what they usually do: they leave it in the eye for as long as possible in order to secure the re-attachment of the retina. Since the risk for re-detachment is high once the oil is removed, no surgeon in his/her right mind would be in a hurry to remove it (unless there is a real harm in the eye of course).
    That is why your post describes a rather unusual practice. Is it possible that the surgeon hasn’t explained himself well to you or that some other type of mis-communication has occurred?
    From my understanding (I’m just a RD patient like your daughter), the retina needs to be attached anyway or there is a real risk of blindness and/or losing the eye. So, it’d be good to get a second opinion as Dr. Wong suggested and prevent the worst.

  23. Kathy says:

    Thanks for responding. My understanding from doctor was that after a couple of years of having the oil in the eye, the oil crystallizes and must be replaced. Since her retina has not totally attached, the oil then is replaced. So is crystallization of the oil in the eye not common? She has another surgery on the 25th to remove the oil and put in gas…..if the retina appears to be attaching…if not, Dr. says he will put in more oil. We will seek another opinion again if oil is replaced again. Just wondering if there was any other procedure to try to get her retina to reattach. I so appreciate your comments.

  24. Elena says:

    Hi Kathy,

    Dr. Wong is the one to speak of “crystallization” of the silicone oil, as I haven’t heard (or read) anything about it.
    Regarding your question about “other procedures to keep the retina attached”, I’m only a patient, but I will tell you what my own surgeon has told me: the use of the silicone oil is the last tool in their disposal, kind of like -as I understand it- their last resort. This means, as in my case, they have tried other methods (like gas) and they failed to yield a stable result.
    Now, if the removal of the oil causes a new re-detachment, I guess the surgeon has to use oil again or gas depending on the case. RD is so individualized. Only the doctor who examines the eye is in the position to offer the best advice/suggestion.
    That is why, if I were you, I would try to see a new surgeon as soon as possible and get his/her opinion before anything else is done on the eye.
    My two cents.
    Wishing you and your daughter the best!

    • Dear Elena,

      Much of what you write is correct.

      I really have never heard of crystallization or silicone oil. It can breakdown at times. Probably the reason why you haven’t read much about it.

      Oil is usually used as a last resort.

      Unfortunately, sometimes the disease does win.

      Remember, we (docs) are usually very successful at what we do….but we are not 100%. Due to recurrent retinal detachments and PVR, I estimate about 1-2% of all retinal detachments are not “fixable,” despite many attempt at surgery.

      Randy

  25. Elena says:

    A short update from me, Dr. Wong.
    I found a place where I can see a pediatric ophthalmologist for my diplopia. (Yay! It’s not as easy as it sounds as I’m no longer in the DC area or even in the States. If I were still in DC, I would have loved to meet you in person; I used to work in Fairfax!)
    Also, the ptosis of the eyelid is doing better every day. I think since there is improvement, it’s safe to say that there is no permanent damage on the elevator eyelid muscle (which would require surgery to correct). That’s a big relief. (I really am not in a hurry for any more surgeries…)
    The operated eye ball is still redish/pink though. Compared to the first days, I can see it’s much better now (7wks after my last RD surgery) but compared to the right (good) eye, it’s still not looking normal, not so white and “natural” looking.
    Do you think this “discoloration” might improve with time? Or is it due to the silicone oil in the eye and will keep looking this way until the oil is removed?

    Thanks!

  26. Elena says:

    One more question, doctor.
    When might I resume applying eye makeup? I haven’t touched my eyes since this whole adventure started (only using sterilized gauzes and sterile solution to clean the operated eye and always covering it when showering etc.).
    At some point I had an infection in the operated eye but that is now cleared according to my doctor (I only have to use the antibiotic drops twice per week now).
    I will ask my own surgeon too but I wonder if you might have an idea about when it is safe to apply eye makeup again on the operated eye.
    I know surgeons mostly care for the “back” side of the eye and not so much about “the looks” of it but it is so important for resuming normal life again that we know what is going on with the “front” of the eye too!

  27. savita Luka says:

    Dear Sir

    I am from New Delhi India, and would like to seek your advise regarding my nephew who is 15yrs old boy and recently been diagnosed with vitreomacular Adhesion when he realized loss of in his right eye suddenly while playing match in massorie boarding school. he has never complaint of any problem before as he was already wearing specticals for the last three years. we have consulted many private & govt doctors and dint get any good advise yet. we are very confused at the moment and dont know where to go and what to do. Doctors from private hospitals have advised for surgery but none of us told the correct that this is very complicated surgery except one of the SR from Guru Nanak gave us the right information and he only told us that during surgery he may loose 5% from his current vision also.

    I need you advice regarding this surgery that what are the chances to improve his vision post surgery.

    Looking forward to hear from you soon.
    >
    >
    > I need your advised as early as possible.

    > Thanks in advanced
    > Regards
    > Savita.
    > +91-9818447782

    • Dear Savita,

      VMT – vitreomacular traction is not a rare condition. Surgery is usually very, very successful…if that’s what he has.

      If that is the cause, I’d recommend operating sooner than later.

      Randy

  28. Elena says:

    Dear Randy,

    Are my posts above ignored or did they not post?
    I don’t want to bother posting if you are going to ignore my posts.
    I am sure my questions can help many others. If you think my posts are inappropriate, please let me know. I do not wish to waste my time or yours.
    Thanks.

    • Elena,

      I can not possibly answer each post in real time…too many.

      I have to manually read each post before “publishing” them…trying to avoid as much spam as possible. For instance, if your comments were automatically posted, then a spammer could “comment” and include some blackhat links to their site.

      You aren’t being ignored, I try to answer weekly.

      You aren’t wasting anyone’s time…you are a great asset.

      As always, many thanks for contributing.

      r

  29. Maher Boubess says:

    Dear Dr Randall
    I had a retinal detachment on 21/7/2011 ,and my doctor decided since my detachment was big to operate on it using silicone oil ,instead of gaz,which he did successfully on 23/7/2011.I reoperated on to remove the silicone oil end of november 2011 . I had a cataract operation in the same eye to improve the vision february 2012 .My vision now is eight over ten ,but unfortunately I see hundreds of silicon oil bubbles in my vision ,some times very small and sometimes of medium size .I talked to my doctor about this issue ,and he says he flushed the silicone oil as much as it was humanly possible , and the only possible solution is to be operated on again to flush any remains .In addition to this he states that he is not sure what percentage of the silicone oil can be removed .
    Please advice if this right ,and whether there are other solutions to my problem which is really bothersome ,and should I take this chance of getting another retinal detachment (5% according to my doctor) while operating to flush the silicone oil .
    Thanking you in advance

    Maher

    • Dear Maher,

      I don’t think there is much risk of retinal detachment by removing residual oil. I would agree that the risk is likely less than 5% (perhaps 1%) at this time.

      Obviously you and your surgeon will be on “alert” for a detachment were to occur again and the damage from a subsequent detachment would theoretically be limited.

      If it were me, I’d try and have it removed.

      r

  30. priyanka says:

    dear wong
    I need an advise from you.i am in a very confused state.i am priyanka from india hyderabad
    my husband(29 years old) has a retina detachment in his right eye.only one quarter of the retina is only attached.rest has been detached.he can still see larger images and objects from long distance.but not like fingers and small objects.he also he can see like this jus because only of the rest of the attached retina
    he has this detachment from past 2-3 years(as said by the doc we consulted)our doctor said there is no treatment for his eye.
    I am still wondering is there is any treatment to cure his eye condition or any other alternatives to treat his eye

    please help us.

    your reply will be of great help to us

    • Dear priyanka,

      There is always treatment for portions of the retina still detached. The visual prognosis, however, is generally poor with longstanding detachments.

      I can’t really comment without examining your husband. His doctors may have meant that further treatment would no be worthwhile.

      r

  31. priyanka says:

    if you are able to advise us i am more happy to provide with his medical reports.i am hoping some kind of good news from your reply.

    thanking you and waiting for your quicker reply

    • priyanka,

      Unfortunately, I can not review your husband’s records without becoming his consultant. This would allow me to ethically and legally render an opinion specific to his case.

      If you are interested in doing this, please email Chrissy or myself.

      Randy

  32. priyanka says:

    dear randy

    thank u so much for ur reply.

    vl contact through mail

    regards

    priyanka

  33. Maher Boubess says:

    Dear Randall

    Thanks a lot for your reply , I will take your advice,and most probably do the operation in Dec 2012 .I will keep you posted ,and hopefully with good news .
    Maher

  34. Maher Boubess says:

    Dear Randall
    Sorry to bother you again ,but if a detachment was to occur because of the operation, will it be instant ,or after some time of the operation .
    Thanks a lot
    Maher

    • Dear Maher,

      If instant, say during the operation, your doctor can address it at that point.

      Usually, if you redetach, it’ll happen days to weeks after surgery. Sorry, I’m sure you didn’t want to hear that.

      r

  35. Elena says:

    Thanks, Randy.

    Not looking for real-time responses of course!
    But I noticed that you responded to some posts and not to others, so I’m not sure if you’ve seen them at all.
    I posted two posts on Oct 17th that have remained unanswered.
    It would be great if you could respond to them however briefly or late.
    Thanks again.

    • Elena,

      I’ve cleared the “inbox” completely and have nothing pending.

      I could have lost them somehow.

      Why don’t you just re-post. That’s my best suggestion.

      Looking forward to hearing from you … and sorry for the inconvenience.

      r

  36. Todd Nguyen says:

    Hi Dr.
    My son got retina detachment in May 2012. With in 48 hrs He get surgery at Ivey eye clinic in London hosp.Ontario Canada by Dr. Tom Sheidow. After that his eye built up a lots of scar tissue so he end up with 5 time surgeries. The last time Dr. inject sillicone oil and steroid in to his eye to try to keep it stable and it does. From that day July 3,2012 up to now my son eye does not get any detachment at all and the Dr. happied with the result but the last time we saw him on Oct.12,2012 after check my son eye he not quite happy and he told me that my son eye pressure really good and stable could be the sillicone block the hole so the fluid could not get into his eye and the vision almost zero. My son could not see at all from that eye . The Dr. gave us 2 choice to consider and think over and give him a call when we ready to make the decision
    1/ Keep the sillicone oil in the eye until it brake down then remove the oil & eye together ( the Dr. not sure when is the oil brake down )
    2/ Remove the oil now and hope everything will be ok. If the eye pressure go down to much will create a lot of pain then he will send my son to another eye ‘s Dr. and if the eye shrinking then the eye should be remove.
    My son is only 19 yrs old and I do not want his eye remove so I would like you to HELP us what should we do please ? I hope with my broken English you will understand the problem we face and guide us to make the right decision for my son life
    Thanks

    • Dear Todd,

      I am sorry to hear about your son.

      There may be no easy solution. It sounds as if the doctor feels that removing the oil will reduce the eye pressure, but in doing so will lead to retinal detachment and loss of the eye, whereas, leaving the oil in the eye keeps the retina attached, but the high pressure is causing pain.

      Is this correct?

      My suggestion would be to seek a second opinion because either way a tough decision needs to be made. Keep in mind that it doesn’t sound as if restoration of vision is possible nor likely.

      It is also likely that an oculoplastic surgeon could offer options, too, if the eye were lost.

      r

  37. Elena says:

    Dear Randy,

    I knew they somehow fell through the cracks, no worries.
    They can be summed up in the following three questions:

    1. How soon after the last RD surgery is it safe to use eye makeup?
    [I’m in the end of month #3 after my last silicone injection surgery and I wonder if it is OK to use an eye-pencil and an eye-shadow. Because the eye is still a bit red and the white area not quite as white as in the other eye, I would not overdo it but it would be nice to do some light touch-up when I go out.]

    2. Is it normal for the eye to be red(dish) and the white part (cornea?) still a bit discolored 3 months after the silicone-injection surgery? Will it ever recovered its initial bright color?

    3. Could diplopia be due to the lack of lens in my operated eye? If so, after we put a lens in it, diplopia ought to disappear, right?

    Thanks again,
    Elena

    • Elena,

      1. Immediately, unless you are allergic.
      2. The white part is the sclera. The cornea is clear. It is usual for this to be red for months after surgery, especially with a scleral buckle. I advise most of patient in whom I place a scleral buckle to expect redness to develop for up to a year. At some point in time, your eye should look completely normal.
      3. Yes. Don’t know for sure. Separate testing needs to be done.

      r

  38. Todd Nguyen says:

    Dear Dr. Randall
    Thanks for reply my email and I think on my email I did not explained well on my son’s eye problems.
    The last suregy the Dr.using oil silicond and steroid inject into his eye and keep his retina attached. After 5 months my son fell really good with no pain no head ache but he could not see at all on that eye. After suregy we went to see the Dr.every month and he check my son eye pressure always stay the same about 7 so he said may be the oil blocked the fluid get in and out his eye that why his pressure always the same and the vision not improve over time. My son retina is attached and he fell really good right now except he could not see on that eye So the Dr. now gave us two choice to make
    1. Do nothing which mean keep the silicond in his eye until the oil break down (did not know how long ) then remove oil and his eye together.That mean my son will lost his eye for ever.
    2.Remove the oil now which mean if his eye pressure stable and he will be fine but if the pressure come down will create a lot of pain then his eye will be remove
    As per your experienced what option I should choose ? and have you ever see or know the person whoever get retina problems have to remove the eye ?
    Thanks you very much
    Todd

    • Todd,

      I think your first email explained the situation quite clearly.

      Which situation will give your son the best vision? If the answer is neither, then if it were my son, I’d want him to be comfortable.

      r

  39. Mark Bussard says:

    Hello Dr. Randall,
    I am writing for my friends 21 year old son who lives in Central China. They have been to specialists in Wuhan and Beijing. But the doctors say there is nothing more that can be done for his vision. They can bring him to the US if it is possible to receive more advanced treatment here. I am copying a translation of his eye problem below:

    Four years ago, First time surgery (right eye).
    About two years after the surgery, the eye had uveitis, and the pupillary membrane closed and anterior chamber disappeared. The vision only visible light. and then second surgery to remove the crystals and refilled silicone oil. Now vision only see light and outline of objects; the eye is a little red and there is added hyperplasia on surface of the retina. Could it be cured? Or at least maintain healthy appearance of the eyes, Will not blindness?

    Thank you in advance for your help and comments. I have found it very difficult to find a doctor to talk with about this.

    Regards,
    Mark

    • Mark,

      Not sure what the original problem is/was, but the description does not bode well. Sounds like recurrent detachments, uveitis and the eye is shutting down.

      Just my best guess from what you sent.

      r

  40. nirav says:

    sir i m from india my left eye ratina has gone and the ratina becomes 2 much blunt vthe time has spend 3 years so sir can u do the operation plz mail sir it is my life que

  41. Maher Boubess says:

    DEAR RANDALL

    I WOULD LIKE TO KNOW IN YOUR OPINION WHICH HAS MORE RISKS ,AND WHICH HAS BETTER RESULTS ?
    1-REMOVAL OF FLOATERS BY USING FLOATERS ONLY VITRECTOMY.
    2-REMOVAL OF SILICON GEL REMAINS USING VITRECTOMY.

    MERRY XMAS

    MAHER BOUBESS

  42. Todd Nguyen says:

    Dear Dr. Randall
    My son just get surgery done yesterday in St Joseph Hospital London Ontario. Like I told you before the Dr. drain all the silicone oil out of my son eye which he injected in before. During surgery the Doctor told us he is able to see a lot of scars tissue grow undernedth of the retina and push the retina out of location and a cloud cover front and back of cornea . It could be reason why my son could not see any thru. that eye. Now he give us 3 scenario to choice what to do next
    1- Do nothing and hopefully the eye’s pressure will maitain the same
    2-He will transfer my son to Toronto to get cornea transplan ( he not recommend)
    3- Transfer my son to Toronto to see Dr.Wong who will do surgery using telescope method to remove a scars tissue , flat the retina and apply silicone again.
    All these scenerio are not guarante my son’s eye will able to see or improve his vision
    I am really don’t know what to do but I don’t want to give up any hope that my son will be able see a little bit thru. that eye because I am scare if the other eye get the same problem. Is it the other eye get more chance to get retina detachment ?
    As per your expetise please give me help
    Merry Chrismax and Happy New Year
    Thanks
    Todd

    • Todd,

      Your choices describe a very guarded situation. It sounds as if the eye has had multiple surgeries and, I am just guessing, that the eye has not survived the multiple retinal detachments.

      I am not hopeful there is a great alternative, but I don’t think simply transplanting the cornea only will be worthwhile, especially since one of the alternatives is to perform surgery to reattach the retina.

      My best to you and your difficult situation.

      Randy

  43. Frans Andrea says:

    Looking for second opinion and your site has impressed me.
    I had a detach left eye was 15 years ago. – buckle no bubble used
    This year I had a detachment in my right eye. Buckle and gas bubble used and seem to hold.
    However left eye detached as well! And it did not “stick”
    Had two surgeries each using gas bubble and now third surgery using silicone fill. Doctor suggest to wait 6 month for the removal of the oil
    FYI this Retina facility has many doctors and up till now a different doctor has performed each surgery,

    Question:
    1) Will my retina stay attached as long as the silicone is in place?
    2) Changing doctors?
    I live in the Houston area, and my wife in North Port Florida (Cancer ailment)
    Do you have any recommendation on Retina Specialist. To avoid preference I like to withhold whom I am using now

    • Dear Frans,

      1. If the retina is attached now, likely to remain so.

      2. I don’t believe in multiple doctors operating….but at this point, I’d recommend getting a second opinion. Unfortunately, skills vary and so are the communication skills.

      You’ve obviously retained a lot of information (impressed with your use of terms correctly).

      I don’t personally know anyone in Houston who I could recommend…you are safe, but your courtesy is professional.

      Good luck. Sorry I’m of limited help.

      r

  44. Frans Andrea says:

    Thank you Randall,
    Here lye the issue.
    The institute I am with consists of about 8 to 10 Retina Specialists.
    One main location directly accross from the hospital where they operate (Houston Medical Center)
    Some of them have dedicated days to operate at the hospital.
    Each rotate through about 8 or 9 locations as visiting office for follow procedures etc.
    There for the follow up doctor is not always the doctor that operated on you.
    I have never seen the first doctor after he operated on my right eye.
    I stayed mostly with the same doctor for the first two operation follow ups. She diagnosed the first detach and got me the next day in the operation room. I liked her and tried to schedule visits in her office as much as possible.
    She also saw the detach on my right eye and got me in the same day.
    You cannot choose your operating doctor when you go in either the same day or next day. So every time it was a different doctor operating.
    The second detach on my left I had the same doctor through out. He stated we better wait an extra day so that he whom had the in depth sight would be doing the operation.
    He also found the third detach in my left eye and I went in the following Monday – different doctor operated.
    He recommended to use the silicone fill and keep it in for close to 6 month. Which the operating doctor did.
    The follow up doc (different from the operating doc, whom took a week off) has seen me know three times – he is stayed available during this holiday season.
    He recommended I go back with the rest of my visits to the doc whom did the last operation.
    He really took his time and kept me at ease and explained everything real well and said: The retina is fully attached and nice and flat also showed me the area with the most damage to explain why a certain head position was better than the regular face-down.
    Next appointment 2 weeks from now.

    So in principal I had at least 7 different doctors look at my Retinas.
    4 different doctors did the (4) operations.
    4 to 7 opinions?
    Or you could see it as one opinion from one institute.
    However I will check around next year and see whom I may ask for possible second opinion, not quite sure.
    Added obstacle: Due to all this I also got laid off (And at 63 this is not going to be helping much) changing insurance (to Cobra and different company) So got to take care of a lot of other …. as well

    Your answer has lowered my stress level drastically as well, which of course is real helpful.

    Thank you

  45. joy says:

    hello doc,

    my sister just had silicon oil removed from her eye following a rectinal correction surgery and she has complained of loss of vision in the eye. after the first surgery, she could see not not very clearly and the doc told her that the vision would get better after the silicon was removed but that isnt the case, the vision infact got worse.
    what could be wrong and what do u advice we do to correct this abnormally?

    • Dear Joy,

      There are several possibilities why your sister may not be seeing. The first question is how much damage may have been caused by the retinal detachment? There is a likely explanation for the disappointing results after oil removal, but her doctor would have to advise her.

      Randy

  46. zahra says:

    Hi Doctor,

    My brother done a retina surgery by 31th of Jan 2013 on his left eye.On that surgery dr insert gas into his eye after a while dr said that retina detached in sides.it seems retina attched in center part but it detached in sides thereby dr advice him to do another surgery.this time (18th feb) they insert oil into his eye and a belt to keep it fix.

    the first day,he was quite alright and his vision was good but once days goes he has too much headacke and pain in his eye,he cannot open his eye alot.

    I would like to know when he is ready to back to his normal life and how long the pain is with him?

    Please reply me.

    thank you in advance!

  47. Felicia says:

    My uncle had a retinal detach in 2000 and I am nearsighted and he has no lens in his eye. Is there any devices that would help him.

  48. Deborah says:

    Good morning Doctor,

    My son was glassed in the eye 31/12/2013, he had emergency op to stitch eye up on our asking instead of removing the eye.
    We flew him to England to an eye hospital where he had an operation for the cleaning up of the eye and general assessment. The pressure afterwards wa 4. The surgeon said there maybe some holes so they operated again attached the retina and filled his eye with silicon oil and he had to posture for 2 weeks.
    He went for aa other assessment this week, and although the retina is now attached and he has some blind spots , he can see letters objects and colour thought the eye, although blurred because his lens was removed.
    The pressure this week is down to 2. They have checked for any small holes, there are none.
    Can you tell me why the eye is losing pressure,? How long the oil can stay in the eye ? Can they top up the oil ?And….if they remove the oil what replaces it ?
    He is 23 years old…I am desperate for him not to lose his eye..I would really appreciate you advice and help.

    Many Thanks

  49. joswa says:

    Hi Dr.

    my left eye was totaly blind, during my 7 years of age, hard object was bump to my left eye,and at that day,my vision was going blurred and i did not consult to a doctor since i was less fortunate,i mean no money to pay for the cost,and then during my college day i noticed that my left eye vision was totally deminished or totally blind, the question is that, is any posibilty that my left eye will be back to its original vision or what percentage that my left eye back to its vision even not 20/20.thanks

  50. Todd Nguyen says:

    Dear Dr. Randall
    I would like to let you know that the Doctor in London Hospital decided to remove my son eye because after removed the oil inject into his eye the pressure came down to zero and the oil cause the damage of his cornea. We went to see another specialist Dr. and get the same advise.We would like to have a another surgery but he said the percent of sucess after surgery to replace the cornea,remove scar tissiue and flatten the retina again are very small. The few days later the eye start shrink and cause a lot of pain so the Doctor decide to take it out. Now my son have only one eye so I would like to know what should we can do to prevent the retina fail in future. He got retina dettatch before so he will get more chance to get on the other eye. Could he do some heavy liftting like work out in the gym ? Please advise
    Thanks

  51. AnKhan says:

    My mother recently underwent Silicon Oil Vitrectomy due to macular hole and retinal tear. Silicon oil was especially used because she had an important travel planned. She had regular post-op visits and with the satisfactory OCT results she finally travelled by air 2 months post op. The travel went fine and she felt no pain or anything in the eye. However, the is a slightly protruding whitish-shiny spot in the white portion of the eye observed during travel and its still there. After 4-5 days of travel, her eye also sometimes become pinkish-reddish. This change in color is on and off. It sometimes appears and at other times of the day disappears. What exactly is going on?

  52. Tim says:

    recently I underwent Silicon Oil Vitrectomy due to macular hole and retinal tear ( 2 different surgery’s1 month apart the retinal tears was do to scare tissue after macular surgery )my dr says that I can never sleep or lay in a reclainer or I will go blind is this true my dr is not very good at explaining things please help Tim

  53. tim says:

    Tim here, thank you for the oil Info really helped. My dr is not telling me much about my prognosis . He says the macular looks good since my retinal detachment surgery with P V R. After three months vision is still not useable. if you can give more info please do. Thanks again your help is a BIG BIG help. Tim

  54. Elena says:

    Hello Dr. Wong!

    Long time no write (from me).
    I had some developments.
    To remind you my case, I had silicone injected in my left eye in Aug 2012.
    I have been doing OK (no remarkable events on the eye front although I did still have a droopy eyelid and wondered why) since then and up to June 16th this year.
    A conjunctivitis on the operated eye led one of the less experienced doctors (who report to my surgeon) to prescribe Dexachlor, cortisone-based drops for the swelling of the conjunctivitis to go down.
    Well Dexachlor worked and the eye got back in its original size (it was really swollen and painful) but in following doctor’s orders I kept taking it for a week after the episode every 4hrs.
    By the middle of the week, I noticed severe pain on the left side of the left eye and inside the eye. It was not a migraine or a headache. A very different short of pain. Very acute too.
    I had no clue what it was about and tried some Advil-type of med, but it didn’t help at all.
    Well, a few days later that pain had grown to be excruciating. I ended up in the emergency room where they measured my IOP and it was found to be 38!! I knew that normal was 20.
    My doctor doesn’t know what set off the IOP.
    I saw a glaucoma specialist and he didn’t think the cortisone had anything to do with it. But the fact of the matter is that only after I took Dexachlor did I present high IOP. All these previous months with silicone in the eye I had normal IOP (and of course no pain).
    Do you think that cortisone in the drops affected the silicone-filled eye to the point of causing high IOP?
    The other thing is: I am overdue for silicone oil removal op (the surgeon had wanted to do it since May 2013) but this is a public hospital and things aren’t working as they should. They keep postponing my surgery. During the same surgery, they have to insert a lens in my eye too, and also remove the stitches from my cornea (I don’t know why they were put there, nobody informed me, I found out that they exist accidentally!).
    Do you think it’s dangerous at this point to delay the removal of the silicone?
    Since the June 16th episode I’m taking drops for the IOP and a pill (acetazolamide). Without these the IOP would be out of control as long as the silicone and the stitches are in the eye.
    My retina was stable last time I was examined. I’m mostly worries about the condition of my eye. It’s very frequently red, I can barely open it, feels irritated and “dehydrated”, my eye can’t stand the sun or bright light, and in general I fear about its condition.
    My question is: is it safe given the above to keep delaying the op? (As I said, it’s not a question by my surgeon whether the retina will detach, it’s more to do with how disorganized the hospital is -all medical reasons show that I’m over-due for that surgery mainly due to high IOP!).

    Thanks and sorry for the length of this. Hope it reads quick.
    Elena

  55. Elena says:

    Hello Randy!

    Hahaha, I understand!
    I had my silicone oil removal surgery this week.
    Also my lense got replaced and the cornea stitches removed (new added to be removed soon again).
    Recovery time after this surgery was remarkably quicker than in the case of the previous op’s.
    I’m focusing on healing now.
    Fingers X’ed.

  56. BC says:

    Dr. Wong,

    I live in Michigan and have had 3 surgeries thus far. I was initially diagnosed with a detached (macular off) retina tear and closed angle glaucoma in my left eye at 37 years of age due to a sports injury.

    The 1st surgery, I had laser and an gas bubble. Roughly a month later during a followup appointment, the surgeon discovered Posterior PVR and a the retina starting to redetach, plus the formation of a cataract.

    My eye pressure was extremely high after the 1st vitrectomy ranging from 40-60. A couple weeks later, I had surgery to remove the cataract and a lser procedure to shrink the ciliary bodies in my eye. This reduced the eye pressure below 20 and into the lower teens.

    A week and a half after that, I had a second vitrectomy with laser, cyro and another gas bubble. I was going on 2 months where things were looking good, then today I had another followup and the PVR returned and the retina is starting to redetach where the PVR is recurring.

    The surgeons suggestion is to do another vitrectomy with a sclera buckle and silicone oil. I know this surgeon is trying his best, but he does not necessarily answer my questions. He side steps the questions and give me a generic answer.

    I take mental notes on what he tells his assitant that she logs into my chart. When I go back for a follow up I ask some pinpoint questions which rarely ever get answered. I am hesitant to go back in for a 4th surgery without knowing the risks involved with the new procedure.

    The glaucoma specialist was surprised how well my vision is responding after multiple surgeries. My eyesight riht now is at 20/100 I believe. Though my sight is blurry and a little distorted in the eye, I can still read and see see object with some clarity.

    I am wondering if I should go get a 2nd opinion. My wife is almost demanding that I get another opinion before we spend any more money on surgery. Last year, my out of pocket costs for the 3 surgeries, tests, prescriptions…etc was about $7,500 and I though I had good insurance. Now, the doctor’s office insurance claims person quoted me another $1,600 since my deductible and out-of-pocket costs reset for 2014.

  57. Marco says:

    Hi doc why did I developed floaters after a focal laser macular edema treatment my doc said that they will eventually go away but I’m not sure now these is my left eye and the only I eye I can see good from I’m 29 years old and I’ve being diabetic for 15 years now on December 25 2013 I woke up with some blocking my right eye vision and I rushed my self to the e.r and was told I had a vitreous hemorrhage so they reffered to a retinal especialist I got injection treatment in both eyes and the laser treatment in my left eye my doc wanted to wait for my blood from my right eye to absorve it self but then on my next visit I told him that I felt that the bleeding was increasing so he did a scan and agreed there was a lot more blood so he scheduled me for a vitrectomy surgery the morning after the surgery he explained to me that he had problem removing the blood because it was really orgaanize and stuck to my retinah he said it was a rare case and ask if some one had punch me in the face my answer was no .so he said do to that he had to bring part of my retina with him and injected sillicon oil I only had to face down one day I got a follow up two weeks after and he checked and it was a good start up and wanted to see me in one month that month came yesterday with a bad news he said my retina is lifting up and most likely I will have to go for a second surgery but he wants to monitor it for one more week now I’m clue less and live day by day thinking what’s going to happend ……what’s is more likely for him to do in this new coming surgery????? Now I dont think his paying much attention to my left eye anymore I keep telling him I still have floaters its being two months since I developed them …will they ever go away or is it a sing of something else?? plz help

    • Marco,

      I really can’t help you with your questions as I can’t examine you. The floaters could be blood or be related to a retinal detachment. I have no idea. I would ask your doctor if he/she feels your retina is detaching and is the cause for additional surgery.

      I wish I could help more!

      Randy

  58. Marco says:

    Thanx doc Wong unlucky the next day I posted my questions I was watching tv and I started to see really foggy from my left eye we’re I have the floters and since my wife was cooking I ask her to open the doors and windows but she said it looks normal in here so I got worried and went out while her saying r ok I said i dont now something is not right so I ask her to take me to a store since they have more bright lights so I walked in n out and I told her take me to the e.r im sure something is going on so we went and I was told iwas a new hemorrhage and they made an appointment with a random optomologist the next morning so she checked and said theirs deffecnetly new blood floating in there she only suggested me to follow up with my normal optomologist doc and that he will decide what to do but that most likely I was going to get a new operation now when I notice this chance the blood seen really darker than right I will say it decrease a lol bit but im not sure I just have to wait to see my doc .I also have to say that the of my last visit with my optomologist I told him to check my left eye but it wasn’t dilated so he said lets do it on ur next visit and the next day its when this happen now I think that maybe if he would had checked ill be doing ok right now ..thx for ur reply

  59. omololu says:

    can I see with silicon oil on my eye and when can i start having sex after the retinal discharge operation

  60. Eliza says:

    Hello, Dr. Wong,

    I had a vitrectomy a month ago…There were numerous complications, because the trocar popped out from my eye toward the end of surgery, which caused a tear the surgeon didn’t see at the time. This lead to hypotony and choroidal detachment (treated successfully with atropine) then a retinal tear at one site (treated successfully with a gas bubble.) Then just three days ago, I noticed huge scotomas developing. I returned to the retina specialist, and learned I had a detached retina, resulting from a tear at the site of the trocar insertion (a different site from the previously treated tear.)

    The ophthalmologist initially attempted to treat it with a gas bubble, but the detachment continued to progress to my central vision. I had emergency surgery yesterday, using silicone. The retina was detached for 4 days before the surgery.

    My questions, and I know it’s impossible for you to answer without seeing me but I’d appreciate any thoughts you might have:
    First, how often does a trocar pop out from the eye? Is this a result of faulty equipment? Or my eye? Or surgical technique?
    Second, I have started to develop a cataract from all the surgery, the gas and oil. Do surgeons ever remove cataracts at the same time they remove silicone, or would this have to be two separate operations?
    Third, obviously my vision is very blurry now from the silicone and swelling, but I can no longer see the scotomas, my color perception seems decent, and I can count fingers in front of my face. Do you think this is an encouraging sign that the tear might be healing and I have not permanently lost much central vision in that eye?

    Thank you so much for your expertise!

    • Eliza,

      Wow – difficult course.

      1. Trocars popping out happen regularly, but I don’t now how this would lead to a retinal tear.

      2. I would prefer two separate operations – just my preference.

      3. Yes, I think encouraging, but no way to really tell until oil is out.

      Randy

  61. Eliza says:

    Sorry, one more question. Since the vitrectomy, I’ve been waking with black blotchy shadows in my peripheral vision and leaking into my central vision. They last for several minutes, the blotch across the top lasting even longer…I also get the blotches for a shorter time when I close my eye for more than a few seconds. They stay there till I look at a bright light, so I guess are only there when my eyes are dilated (or maybe when pressure is placed on them from my eyelid.) What could this be, and will it improve? It’s making me scared to sleep, I worry it’s a circulation issue due to the extensive laser and cryotherapy, and that by closing my eyes I’m actually causing more damage.

  62. amit malhotra says:

    I have a retina detachment surgery two month before after that the silicon oil is removed from my eye .now I have a problem of multi photo that is during the night I can see 4 to 5 light of a single light is there is some problem

  63. Eliza says:

    Thanks so much for your response, much appreciated! I’ve learned that I now have an inferior detachment, and my ophthalmologist wants to perform a scleral buckle, which terrifies me. I’ve read some research that indicates a membrane peel and vitrectomy with gas or oil may be almost as effective for inferior breaks with PVR. In your opinion, is it hopeless to think this might work, since we’ve already done one vitrectomy and the scarring will just recur?

    Also, the doctor has said several times that the buckle will be a difficult procedure because my eye is very small. Does this mean there’s more potential for complications, or complete failure? If so, I’m actually contemplating not putting my body through this, awful as it sounds to give up. The macula is attached now, but was detached for several hours during the first RD, so my prognosis is reasonably poor anyway. I’ve been dealing with issues for many months, basically living one-eyed, and if there’s not much chance of success it’s starting to not seem worth it.

    Thank you again so much. You’re so wonderful to spend your time replying to patients on this forum.

    • Eliza,

      I’m wondering if you shouldn’t get a second opinion. If you do have PVR, a buckle may be useful. It really depends upon the amount of traction and location. There is also differences in physicians’ opinions.

      Randy

  64. Mega D says:

    Hi Doc, I got vitrectomy after vitreous haemorrhage in my right eye, then my doctor removed silicone oil 3months afterward. It happened june 10th 2014. Now my vision is not really good, still blurry. There’re many floaters like sand. My doctor said that it doesn’t matter but I really want to know can my vision getting better, how long it takes? Tq

  65. Madan Bhuju says:

    Hi Doc,

    I had retinal detachment 4 months ago and my Doc use Silicon Oil to attach retina also use buckle. After 3 months Silicon Oil is removed, now it’s been 3 week after Silicon Oil remove. My vision is not clear. It is very poor.Also what i notice is object also shrink. I ask with Doc he said it can’t be improve the vision. Is they any way to improve vision? Please help me.

    Thanks

    • Madan,

      Usually the vision with oil is poor, either due to the oil itself and/or the nature of the retinal detachment. There’s generally nothing to improve your vision with the oil remaining in the eye.

      r

    • Poonam Bhatt says:

      Dear Dr. Wong, I live in Dubai & I had my surgery to fix Retina detachment with silicon oil I n August 2018 in India as the treatment in Dubai is bery expensive, however now i’m In Dubai. Now my eye is having white big spot at center which makes me worried if something is wrong, before surgery I had a curtain drop cover through which I had partial blindness but after surgery that curtain is removed but vision is still blurred which I understand due to oil. Please advise what would be that white big spot in my eye… you immediate response will be highly appreciated

  66. Madan Bhuju says:

    Thanks for reply.

    Now there is no Oil, It was removed before 3 weeks.

  67. Vijay yadav says:

    Hello sir
    I am from Nepal and am having my treatment in India
    We had exchanged email couple of weeks ago.
    I have complicated retina detachment surgery with silicone oil injected into my eyes, they also used pfcl, they also did relaxing retinotomy or something like this, i don’t know the exact term..
    TToday was my first follow up and so far is good.
    Next follow up is dated on 28th of August.
    MMy doctor said i can go home.
    SSo my question is can i take flight?
    IIt will be approx of 5 hours flight.
    OOr should I take train? It will take 3days to reach my place.
    Please tell if flight is safe or not.
    OPlease reply soon if possible
    Thank you

  68. William D says:

    Hi Dr. Wong,

    I’ve had three retinal detachment surgeries in the past four months, most recently three weeks ago, this time with silicone oil and lens removed. So basically, I can only see blurred color fields. I’m scheduled to have the oil removed and lens replaced in three months.

    Two questions:
    1. Given the fact that I’ve had 3 surgeries now, what are the likely chances of retinal detachment occurring while the oil remains in the eye during these three months?
    2. Though my lens was also removed, my vision tends to be slightly hazier than it was a week ago. Should vision normally remain constant during this time?

    thank you,
    William

    • William D,

      1. If the oil is presently in the eye and the retina is attached, low chance of detaching with oil.

      2. Agreed, but really can’t say why it may have changed. Make sure to keep up with your doctor. I’d be cautious about re-detaching.

      Randy

  69. Megan P says:

    Hi Dr! I’m a 30-year-old female and had a retinal detachment on the lower right side of my right eye. My dr said it was a complex detachment with multiple tears and holes. He suggested we do a scleral buckle only surgery. So far the surgery has attached my retina back with no new tears or holes (he did laser therapy the day after surgery to make sure the former tears and holes were sealed), but now there is subretinal fluid plus he said retinoschisis. The next step he wants to take is vitrectomy with silicone oil. We’re waiting as long as possible to see if and when I really need this next surgery.

    In your opinion, does subretinal fluid and retinoschisis resolve on its own? Also, I have great vision after the scleral buckle, just some flashers. Will my vision greatly decline after the silicone oil is removed? I know it will be blurry while the oil is in the eye.

    Thanks so much!

    • Megan,

      In my experience, I’ve never seen retinoschisis develop after retinal detachment surgery. Maybe you had it previous to the retinal detachment surgery.

      Subretinal fluid can resolve if there are no new holes or tears causing new fluid to accumulate underneath the retina.

      You really have to depend on your doc for this one.

      r

  70. Megan P says:

    Also, I wanted to add that I had my surgery July 2nd and it’s been almost 8 weeks since.

  71. Megan P says:

    Thank you for responding. I spoke with my doctor again and he said after looking at the pictures of my eye, there were not any new holes that would allow fluid to be under my retina. He thinks it could be a stable subclinical detachment, but again we just have to wait and see if the fluid absorbs. It’s in a position where it does not affect my peripheral vision.

    How long can it usually take for the subretinal fluid to absorb? Have you encountered subclinical detachments that are stable and never progress?

    Thank you!

  72. Mary F says:

    Back in Nov 2013, I had a membrane pucker removed. I had cloudy, distorted central sight but had sight around the peripheral of my left eye. There was also left over blood from an earlier laser surgery. The surgeon, while removing the membrane, detached my retina. She said there were a couple of tears, and that she “bonded” the retina back and lasered the tears during surgery. She placed silicone oil in and said she overflowed the eye with it because she “likes to make sure”. I have had no sight with little light and movement for months. She said it was because the oil covered the lenses. In early 2014, I was told a cataract formed. I was also told the oil probably damaged the lenses. I was told after ultrasounds that the retina is still attached. The surgeon said there was some pieces of the membrane she could not remove but it was off of the retina and will not grow back. In May 2014, the surgeon removed the oil and referred me to a cataract surgeon. The cataract surgeon is refusing to remove the cataract and put in plastic lenses because he claims I have no sight behind the cataract. I failed a red light test apparently. My argument is if my lenses are destroyed by the silicone oil, how can I see anything? He then claims he will not do the surgery because I have expectations of seeing again. I am not sure how he came to that conclusion because I never discussed that with him, nor do I have any expectations. I believe he just doesn’t want to do it. I am not understanding how a doctor(s) can just let an eye deteriorate without giving it a chance. I am in the middle of a second opinion, but it seems once I say to this new doctor that the surgeon detached my retina during surgery, everyone seems to backs away without giving me an opportunity to see if cataract surgery will at least give me shadows, lights, and movement. If the lenses has been destroyed by the silicone oil, and with the cataract matured, is it correct to say that could be the cause of not seeing behind the cataract? I mean, wouldn’t the two combine caused the 100% vision loss at this time? The retina surgeon kept saying for many months that the reason I was not able to see was because the oil was covering the lenses. Now that the oil is out, couldn’t it be destroyed lenses and the cataract causing to fail that red light test? Thanks!

  73. Janek says:

    I am highly myopic and recently went through a retinal detachment surgery. They induced a gas bubble inside my eye to hold the retina. Gas bubble was complete deflated in 3 weeks. However, after 6 weeks of surgery, I suddenly observed that my vision has a rippling water effect which started from corner and now it is all over my operated eye. After a day, I was not able to see anything apart from very blur and wavy vision in front of bright light. I immediately consulted a retina specialist and he informed that there is a scar tissue developed which detached my retina again and he is suggesting a second retinal detachment surgery with silicon oil treatment. Is it safe to go with the same?

    My right eye is also more myopic the. Left operated eye. I don’t want to happen the same in my right eye. Are there any preventive measures to control the same situation in my right eye??

    • Randall Wong, M.D. says:

      Redetachments are not uncommon. Scar tissue causing redetachments are more difficult to fix. I apologize for the delay in responding. I hope you are doing well and that you followed your doctor’s advice.

      Randy

  74. Janek says:

    Thanks your articles are very helpful.

  75. Amit says:

    Dear Randy
    Had a left Vitrectomy done yesterday. Silicone oil was inserted as this was my 3rd detachment in same eye. Previous 2 had C3F8 and SF6 gas inserted.

    I am seeing a black spot towards the left of my eye. When I move my to far righ or far left the spot goes away.

    I don’t want to panic as my surgery was done just yesterday but would like your opinion. Could this be my blind spot? Is it because of silicone oil or sutures?

    Please advise.

    • Randall Wong, M.D. says:

      I can’t advise medically over the Internet and without an examination. It is possible that air bubbles remained after the operation which absorb quickly, but I’d advise you (and subsequent readers) to alert the operating physician. All the best. Randy

      • Amit says:

        Dear Dr. Randall
        Thank you for your comments. Historically IOP in my both eyes has been 15. I have advanced glaucoma in both eyes. Since the Vitrectomy with silione oil the pressure in my left eye has gone from 15 to 18 to 24 today. It’s been a month since the surgery – Is it okay to have this IOP in the left eye? I am assuming that the oil would be removed in another 2-3 months – will removal of the oil reduce the pressure?
        Thanks.

        • SAlman says:

          SIr tell me will my vivsion improve after silicone oil removal .my retina was detach and now attacheed but vision nnt improved1 silicone oil use in my eye and anterior chamber tel me plz sir

  76. Jim says:

    Dr Wong,

    Thanks for starting this blog; it really helps understand the issues in complex retinal surgeries.

    I have a highly myopic eye (length 32 mm) with silicone oil in my eye and would like to understand how different will be the vision ones it’s taken out? (If at all its taken out). I am aphakaic with second corneal graft.

    I suffered from a Supra coroidal hemorrhage during an AC IOL explant surgery. As per my surgeons, there was little to no risk involved in this surgery. I was on blood thinners but they forgot to stop the blood thinners and operated with INR=2.0. This resulted in heavy bleeding during the surgery which caused the supracorodial hemorrhage and full retinal detachment. The detachment could have also been caused due to removal of iOL which was in the eye for the last 25 years or so.

    During the vitreoretinal surgery, silicone oil was placed in the eyes to reattach a fully detached retina. I can now see but have multiple issues including fixed pupils, poor light perception, and limited field of vision. My light perception is very poor and the vision is just enough to be able to type this and do some minimal work.

    I would like to know what vision issues are caused due to the presence of the silicone oil in the eye? I understand that the refractive index changes but what does it actually cause and how does the vision change?? I would like to get some details and possibly a picture to see how others see with silicone oil. I am sure some of the issues that I am facing presently are duue to the retinal detachment and it’s weakness rather than the silicone oil.

    I appreciate your answer.

    Thank you,
    Jim

    • Randall Wong, M.D. says:

      Jim,

      This is embarrassingly tardy. I lost a couple dozen comments.

      To answer your question (and also for the benefit of others) silicone oil changes the refraction or prescription of the eye. If you are talking about just one eye – silicone oil might yield 20/40 vision in the best of circumstances, but since we usually have 2 eyes, the prescription in the two eyes become too dissimilar. You also have added considerations such as retinal detachment and grafts.

      Hope you are well.

      r

  77. I had my first retina detachment surgery last Sept it was only partial detachment so they went in did surgery with gas bubbleafter I got my full vision back and even more. So on July they found that it was reading agian from the scar tissue at the time was o my effecting the perhial vision . So one of my floow opt i was told it waa detaching again but ftom the right side if the scar tissue this time i didnt nitice the drapping because 40 percent of the gas buubble was in my eye i was only starting to get my vusuon back. So i went for my third surgery this time tjey took out the gas,bubble and put in oil. They told me thrre onky planinng on leaving ot in for4 to 5 weeks so my question is how likely will i get my vision back. I also had catracts surgery in both eyes long before this was happening and im 40 years old.

    • Randall Wong, M.D. says:

      Tricky question about how likely you’ll get your vision back – it correlates to the quality of the vision the day the oil was used.

      All the best,

      Randy

  78. Jesse Smith says:

    I had surgery a month ago. With the Silicone Oil, it’s been impossible to read, due to being very blurry. I found that in diopter 6 reading glasses, I can read through just the top half centimeter of the glasses. Post surgery instructions included sleeping on my side. I found that if I end up sleeping on my back too much, or if I don’t keep changing the side I sleep on through out the night, it’s then harder to read through the top part of the reading glasses. Is there anything I can do to get rid of the blurriness, or just make it easior to read? Would getting a new prescription for classes get rid of the blurriness? Silicone Oil totally destroyed my current glasses, it’s *way* more blurry!

    • Randall Wong, M.D. says:

      Oil is tough to see through. That’s all I can say. I usually don’t expect much useful vision after operating with silicone oil. I assume your other eye is in good shape? Hang in there. Randy

  79. David says:

    Dear Dr. Wong, I am 3 weeks post-op after Vitrectomy using silicone oil. My question is, is it possible to get corrective lens while oil is in the eye and correct to a point that functional vision is possible? Have you seen cases like this where very blurry with oil and correct to functional vision?

    • Randall Wong, M.D. says:

      David,

      Very unusual to have oil and correct lenses with normal vision. Optical clarity of oil is not that of water/aqueous. Most importantly, make sure your retina is attached. Randy

  80. Ewaldo says:

    Dear dr Wong,

    Im ewaldo from Indonesia.
    My left retina got 5 times surgery from professor retina in Singapore. Severe PVR. My natural lens was off from the first surgery.
    Now, already 5 months from my last surgery.
    After my last surgery with silicone oil, my eye got better and i can see far (with several complicated but said it better). Doctor said the retina already attached.
    But after month by month until going this 5 months, my eye is getting worse.
    More blurry and i cannot see far like before especially when its dark.
    May i ask, how long usually the eye’s sight is decreasing? What sign i should worry so its not too late to get surgery again?
    Can it better if i practice use this eye?because before got surgery my left eye become lazy eye.
    My left eye before surgery minus 13 and my right eye now is minus 11. All of my doctors did not say much. So im worried.
    Your answer is very valuable for me. Because its far from my country to USA.

    Regard,
    Ewaldo.

    • Randall Wong, M.D. says:

      PVR is not good and is horrible. It is a very difficult situation and you must follow the advice of your surgeon.

      I wish I could be more helpful over the Internet.

      Randy

  81. Ewaldo says:

    Oh ya, i forgot to say, im 29 years old.
    I will do whatever i can, to safe my eye because im still young. I already sleep head down for 2 years more. Because if i sleep heads up, i cannot see far (just white).
    Thank you.

  82. Lydia says:

    I had my retina surgery on December 2019, I was at the age of 51 and I still had silicon that was put till to date but my vision is still blurry , my question is if the doctor take out that silicon out can I be able to gain more vision?

    • Randall Wong, M.D. says:

      Difficult to say. Depends on health of the retina at the time silicone oil was injected. Randy

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