Eyeball sunken in after operation

[katika29]

I got a detached retina due to accidental force of water shooting out of garden hose into my eye.  Went to retinal specialist, had unsucessful laser surgery. Then he did a combined operation of a buckle and vitrechtomy, and put in silicone and then retina was re-attached.  I can not see out of this eye at all (however, this was a lazy eye before, and I was never really able to see well), I have extremely blurry vision and straight lines are wavy and I cannot make out what I see, I see out of the other eye, but it is mixing up my brain because I see different things out of each eye. The Dr. says I now have scar tissue forming in the center of eye, which will have to be removed with an operation, and at the same time he will take out the silicone.  I am delaying this because the operation was very difficult and painful to recover from, and I have other unrelated medical problems that I am suffering with. The main problem right now is that the eyeball has sunken in a lot and my eyelid tends to droop.  Is there anything I can do about this, another operation, or medicine? I would like to go to a different Dr. but don't know if I can be helped with the sunken eye, it is disfiguring and I see people staring at my eye.  I still have the silicone in the eye, how long can that be kept in for? I had this combined operation about two and a half years ago. Any reply will be greatly appreciated.

[John C Hagan III, MD, FACS]

You have two problems:
1. distorted vision from the eye being amblyopia, having a macula off detachment and now a macular pucker.
2. The sunken eye and droopy lid.

You need to attend to problem 1 first. The surgery is very very taxing and difficult. You can use the search feature on this page and search "macular pucker surgery" and read about it. You should probably also get a second opinion.

Only after you have the operation OR decide not to have it should you address problem 2. For that see an oculoplastic surgeon. You can ask your retina surgeon for a referral. There are operations to correct your cosmetic problems.

JCH MD

[berrywoo]

Where to begin....as a patient of RD's I'd like to add my two cents.

First off, the sunken eye m not be able to be fixed depending on the cause, which may be that the eye has atrophied considerably. The drooping lid, which was more than likely caused by the buckle surgery, can be fixed w/ surgery but like any surgery carries risks. If the eye is considerably painful and otc or rx meds are not working consider pure alcohol injections and as a last resort there is enucleation.

Next, your vision may improve w/ the removal of the scar tissue from the retina and the removal of the silicone oil. This would probably help your binocular vision out. The pain that you experienced w/ the initial surgery was more than likely due to the scleral buckle as that procedure is more complex and involves sewing a piece of silicone to your eye. The removal of scar tissue and oil does not involve muscle manipulation so recovery should not be painful. Also, the silicone oil can be left in the eye indefinitely if it is deemed necessary. Depending on age and other factors this may be a good option. However, most doctors prefer to remove the oil at some point b/c doing so not only improves vision but avoids some of the complications that can arise w/ silicone oil.

Lastly, it is important to talk to your doctor and assess all the risks and benefits associated w/ any surgery. Remember to always keep your other eye safe.

Hope things go well for you and that this was at least minimally helpful.

[John C Hagan III, MD, FACS]

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[katika29]

Dear Dr. Hagan: Thank you so much for your prompt answer.  The distorted vision from the eye being amblyopia is much worse than it was before I had this operation.  Prior to the operation my lazy eye did not interfere at all with my sight, as my other eye was 20/20.  I did not have this blurry double vision coming out of my lazy eye, it somehow worked alongside the good eye and I had some peripheral vision, which I no longer have. The lazy eye did not interfere with my vision, did not "mix" me up by seeing differently from both eyes at the same time. Would having this Macular pucker surgery enable me to get back to what I had -- which basically wasn't so great because I had 20/200 but it did not bother me because I didn't have the blurry or wavy vision coming out of the bad eye. The buckle and vitrectomy which I had done at the same time was not an easy operation either.  Is this Macular pucker Surgery also just as difficult, will I have to lay face down like with the Vitrectomy?  Also what are the benefits of having this surgery and do they usually take out the scarring which occured in the center of the eye at the same time? Also if I don't have this surgery, how long can I keep the silicone in, because it has been in for 2 and a half years, and I have other medical problems I am dealing with right now.  With regard to the sunken eye is there any medicine I can take instead of having the surgery.  If not, would I do all the procedures at the same time during the same surgery -- taking out the scar tissue, macular pucker surgery, silicone removal and fixing the sunken eye and droopy lid. Thank you for your patience in answering all of my questions.

[katika29]

Thank you for your response.  The eye is not extremely painful.  The main problem is that I see differently from each eye at the same time - is that what you were referring to when you wrote "binocular vision out".  It bothers me a lot and I am probably contributing to my droopy lid because I tend to close the bad eye a lot so that I can focus better with my good eye, and my brain doesn't get mixed up.  The other main problem is mostly cosmetic, the sunken eye