A lot happened since my last update, but the outcomes were too uncertain to write about; and I did not want to bore you with Too Much Information.

Still, I hope this post will be useful to people with similar conditions. So here’s a detailed graphic of the eye’s anatomy:

After the vitrectomy in late April, everything seemed to be reasonably OK. The octafluoropropane gas bubble the surgeon used to replace the vitreous humor took longer than expected to dissipate and a small part of it unexpectedly migrated into the eye’s anterior chamber, in front of the pupil, where it blocked the normal fluid flow and raised the internal pressure.

Graphic by Rhcastilhos. And Jmarchn.

Both bubbles were almost gone on a Friday evening in late June when, once again, I noticed the shadows and sparkles of a retinal detachment. Unfortunate timing and circumstances conspired to push out the necessary surgery to the next Tuesday. Because of the detachment’s location on the lower part of the retina — past detachments were all on the sides or upper part — it was necessary to fill the posterior chamber with silicone oil and place a scleral buckle around the eyeball.

The consequences were not comfortable. The replacement fluid — this time, the silicon oil — leaked into the anterior chamber again, possibly following the duct opened by the gas used in the previous surgery. Pressure inside the eye increased dangerously and had to be controlled with several eyedrops designed to reduce fluid production inside the eye. The oil also painfully pressed on the iris muscles which contract or dilate the pupil.

It was all quite uncomfortable. The eyedrops messed up the fluid balance, the painkillers messed up the stomach — I lost 3 kg in the process — and the enforced inactivity messed up everything else. The eye pressure didn’t quite come down to normal levels and would damage the optic nerve in the long run. Accordingly, one month after the operation, it was decided to do yet another vitrectomy to remove the silicone oil: something which would normally have been necessary only several months later.

The scleral buckle, unfortunately, will be left in place indefinitely. As it encircles the eyeball in the back, around the muscles, every eye movement was initially painful and it’s still quite uncomfortable; I’m told it will take several months to get used to that.

So the last operation was in early August, two months ago now, and it mostly went well: all medications were slowly discontinued, the side-effects went mostly away and for a few weeks I’ve been able to resume normal activities. I have another evaluation coming up in late October, when I’ll have a comprehensive OCT exam of the retina, as well as new lens prescription info for that eye.

However preliminary examination revealed that eyesight has fallen to 20/50 (from 20/15 last year), grid distortion has worsened, and there are two dark scotomas — one at the lower left and one at the upper right — just at the edges of vision. Also, the iris muscles were damaged, so the eye was left somewhat dilated and (in photographical terms) with a fixed aperture, not useful at night or in direct sunlight. None of these conditions is expected to improve in the future, so I’m glad to have enough 3D-vision left for driving and table tennis…