Anonymous said...
i had an eye surgery with the gaseous bubble and was told by my doctor to remain face-down for 7 days. then i'll return to another appointment, when i assume he'll check that the hole is healed and, if so, i assume i can raise my head.
is it at this point that the bubble starts dissipating?
also, i've noticed that on the occasions when i do raise my head - for eye drops, for example - that i feel dizzy and light-headed. has anyone else experienced this? when did it start going away?
also, i've noticed a lot of very lengthy recovery times, which i assume are affected by diabetes or other, additional medical issues. has anyone recovered in 7 days and what was the recovery experience after that? i'm trying to figure out (a little ahead of time) whether i should plan to go back to work or not - and whether i should park my car for a month.
i would really appreciate anyone's experience. thanks
February 9, 2009 10:12 PM
Dear Anonymous:
The gas bubble initially grows over the first few days then gradually dissipates. Depending upon the type of gas used, the bubble will disappear in approximately 2-6 weeks. When to raise your head is variable among surgeons and your particular case, just as you inferred. Your ability to drive once you are released to raise your head will largely be your call. The resisdual bubble may interfere with your depth perception so you will need to be careful. The lightheaded feeling you have experienced when raising your head is not uncommon, especially if you have done a very good job of keeping your face down.
Toni
Tuesday, February 17, 2009
Long Standing Macular Hole
Anonymous said...
is it possible to repair a long-standing full-thickness macular hole? my daughter injured her eye at age 2 (she's 26 now). there was a macular pucker to begin; the opthamologist had her see a retinal specialist at age 3; she was uncooperative and specialist didn't get a good look. then by age 6 the opthamologist suggested she see the retinal specialist again, who then confirmed she had a full-thickness retinal hole. I've always hoped that the technology would improve to the point that repair would be possible.
February 9, 2009 11:41 PM
Dear Anonymous:
I believe it would be highly unlikely to achieve much improvement in vision after such a great length of time. Generally surgeons want to repair a macular hole within 6 months, a year at most. There may be a surgeon out there who would perform the surgery but unfortunately the prognosis is not good. Toni
is it possible to repair a long-standing full-thickness macular hole? my daughter injured her eye at age 2 (she's 26 now). there was a macular pucker to begin; the opthamologist had her see a retinal specialist at age 3; she was uncooperative and specialist didn't get a good look. then by age 6 the opthamologist suggested she see the retinal specialist again, who then confirmed she had a full-thickness retinal hole. I've always hoped that the technology would improve to the point that repair would be possible.
February 9, 2009 11:41 PM
Dear Anonymous:
I believe it would be highly unlikely to achieve much improvement in vision after such a great length of time. Generally surgeons want to repair a macular hole within 6 months, a year at most. There may be a surgeon out there who would perform the surgery but unfortunately the prognosis is not good. Toni
Saturday, December 6, 2008
Anonymous said...
My husband cancelled his surgery yesterday. He thinks he has had a MH for over 4 years. He only just realized he had distorted vision when after many pairs of glasses didn't help. He actually had to tell the eye Dr that the print in emails where distorted over and over again, and that is when the Dr looked even deeper into his eye and suspected MH. He was then referred to a specialist. We went for another opinion and the same bad news was given so he chose to have surgery. The night before surgery he realized that after 4 years the hole or should I say his distorted vision hasn't gotten worse, so why should he risk having surgery that may or may not work, or could even make it worse, and that it will eventually lead to cataract surgery and lens replacement with in a year or two. He also feels that it may be getting better after using steroid drops for only 30 days. (Recommended by Dr before electing to get surgery) Do you think that after this many years his hole will not enlarge and that another round of steroid drops will help, or even stop the hole from enlarging? I've read all the good and bad responses in many blogs and quite frankly it seems sometimes it may be better to just wait it out. He see's quite well out of that eye now, only a little distortion. Can't he just be monitored monthly to see if the hole is enlarging? He is really struggling with this. We shipped your equipement back today, which seemed to be the answer if he had gone through with the surgery. Do you have any cases where the hole edges healed and the patient is doing fine and maintaining the same vision for many years? Thank you in advance for your responce.
November 25, 2008 1:38 PM
My husband cancelled his surgery yesterday. He thinks he has had a MH for over 4 years. He only just realized he had distorted vision when after many pairs of glasses didn't help. He actually had to tell the eye Dr that the print in emails where distorted over and over again, and that is when the Dr looked even deeper into his eye and suspected MH. He was then referred to a specialist. We went for another opinion and the same bad news was given so he chose to have surgery. The night before surgery he realized that after 4 years the hole or should I say his distorted vision hasn't gotten worse, so why should he risk having surgery that may or may not work, or could even make it worse, and that it will eventually lead to cataract surgery and lens replacement with in a year or two. He also feels that it may be getting better after using steroid drops for only 30 days. (Recommended by Dr before electing to get surgery) Do you think that after this many years his hole will not enlarge and that another round of steroid drops will help, or even stop the hole from enlarging? I've read all the good and bad responses in many blogs and quite frankly it seems sometimes it may be better to just wait it out. He see's quite well out of that eye now, only a little distortion. Can't he just be monitored monthly to see if the hole is enlarging? He is really struggling with this. We shipped your equipement back today, which seemed to be the answer if he had gone through with the surgery. Do you have any cases where the hole edges healed and the patient is doing fine and maintaining the same vision for many years? Thank you in advance for your responce.
November 25, 2008 1:38 PM
Sunday, November 16, 2008
Recommended surgeons for macular hole repair
Anonymous said...
Hello,
I am in Italy and need an advice. If you had your child with a macular hole due to a thrauma, and have to go to the best specialists in US to have him operated, where would you bring him?
Thank you so much, it's crucial for us to know the right places-names.
November 16, 2008 10:43 AM
Whew-I am truly flattered, yet humbled, by your question.
I am very proud that you believe coming to the United States of America for medical treatment is the right first step. I believe it too. However, I am afraid it would be inappropriate for me give a particular name or practice; I am personally not qualified to make a determination of any particular surgeons abilities. I can recommend choosing a Board Certified Retinal Surgeon; all have ideally reached a minimal level of competance in order to attain their title.
I have personally seen the expertise and outcomes of several retinal surgeons, but only in the Pittsburgh, PA area. Of the surgeons I have had the experience of working with, I can say with sincerity I would trust a couple of them with my own child. There are several surgeons and practices in other regions that have achieved world wide reputations for their research and prominent journal contributions but the truth of the matter is what you want and need is experience and ability in the operating room.
And now I am going to stick my neck out, just a little. I advise that you be sure the surgeon you choose to treat your child is the same surgeon who actually performs the surgery, this is particularly important if you are being seen in a teaching hospital facility.
Good luck to you and your child.
Toni
Hello,
I am in Italy and need an advice. If you had your child with a macular hole due to a thrauma, and have to go to the best specialists in US to have him operated, where would you bring him?
Thank you so much, it's crucial for us to know the right places-names.
November 16, 2008 10:43 AM
Whew-I am truly flattered, yet humbled, by your question.
I am very proud that you believe coming to the United States of America for medical treatment is the right first step. I believe it too. However, I am afraid it would be inappropriate for me give a particular name or practice; I am personally not qualified to make a determination of any particular surgeons abilities. I can recommend choosing a Board Certified Retinal Surgeon; all have ideally reached a minimal level of competance in order to attain their title.
I have personally seen the expertise and outcomes of several retinal surgeons, but only in the Pittsburgh, PA area. Of the surgeons I have had the experience of working with, I can say with sincerity I would trust a couple of them with my own child. There are several surgeons and practices in other regions that have achieved world wide reputations for their research and prominent journal contributions but the truth of the matter is what you want and need is experience and ability in the operating room.
And now I am going to stick my neck out, just a little. I advise that you be sure the surgeon you choose to treat your child is the same surgeon who actually performs the surgery, this is particularly important if you are being seen in a teaching hospital facility.
Good luck to you and your child.
Toni
Monday, October 27, 2008
Good informative website...
This Retina-Vitreous Center in NJ does a great job of explaining macular and retinal diseases. If you are interested in macular degeneration treatment trials be sure to look at their Retina scope newsletter from January 2008. Cut and paste the following link:
http://www.retinavitreouscenter.com/patient_education_macular.html#macular_hole
http://www.retinavitreouscenter.com/patient_education_macular.html#macular_hole
Wednesday, October 8, 2008
American Society of Retina Specialists Convention
I am excited to be attending the American Society of Retinal Specialists convention next week. Five years out of the clinical setting makes it essential I attend conventions to try and freshen up on the new and exciting progress in the retinal world. It doesn't hurt that the convention is being held on the island of Maui! This is my first tip back to Hawaii since holding my very first position in an ophthalmology practice. I was an ophthalmic assistant at the Hawaiian Eye Center under the direction of John M. Corboy, MD. He was a pioneer in cataract surgery and used the phacoemusification technique and refractive nuances to achieve an extraordinary percentage of naked visions under 20/40. And that was in 1989! Not to mention he was quite the business man. He encouraged me to get certified as an assistant, I was a youngster of 23 at the time. Later I certified as a technician and learned the skill of fluorescein angiography.
As I mentioned after a convention in New Orleans earlier in the year, there doesn't seem to be a great amount of change happening in the surgery for macular holes, but whatever is happening I aim to keep up with. A recent customer was involved in a study in California using some new techniques I hope to learn more about.
One of the few surgeons most adamant about the lack of a need to position face down after macular hole surgery will be there, Paul Tornambe, MD. When I met Dr. Tornambe at the ASRS convention in New York in 2003 he told me I would probably be in business for about five more years before face down positioning would be obsolete. Certainly the standard two weeks of positioning has fallen to more like 7- 10 days, but by far, most retinal surgeons continue to require patient compliance with the face down recovery process. Some retinal surgeons, even while requiring their patients to position, feel the positioning equipment my business revolves around is unnecessary or too costly. It is true some patients get through the recovery successfully without assistance, but no one is going to say it is easy. I cannot please everyone every time, but I continue to stay in business because many people are served well by Kelly Comfort and by me.
Undoubtedly, I will have much to learn next week about the progress being made in the treatment of macular degeneration. Really exciting things are happening there. When I left clinical work in 2003 I was actively involved with the latest treatment for exudative macular degeration at the time, Photodynamic Therapy or PDT. The practice I worked for in Pittsburgh, PA was involved in the clinical trials before it became FDA approved. It was an exciting time, but wow, the stuff they are doing now...I'll be taking lots of notes.
I look forward to sharing whatever I learn with you!
As I mentioned after a convention in New Orleans earlier in the year, there doesn't seem to be a great amount of change happening in the surgery for macular holes, but whatever is happening I aim to keep up with. A recent customer was involved in a study in California using some new techniques I hope to learn more about.
One of the few surgeons most adamant about the lack of a need to position face down after macular hole surgery will be there, Paul Tornambe, MD. When I met Dr. Tornambe at the ASRS convention in New York in 2003 he told me I would probably be in business for about five more years before face down positioning would be obsolete. Certainly the standard two weeks of positioning has fallen to more like 7- 10 days, but by far, most retinal surgeons continue to require patient compliance with the face down recovery process. Some retinal surgeons, even while requiring their patients to position, feel the positioning equipment my business revolves around is unnecessary or too costly. It is true some patients get through the recovery successfully without assistance, but no one is going to say it is easy. I cannot please everyone every time, but I continue to stay in business because many people are served well by Kelly Comfort and by me.
Undoubtedly, I will have much to learn next week about the progress being made in the treatment of macular degeneration. Really exciting things are happening there. When I left clinical work in 2003 I was actively involved with the latest treatment for exudative macular degeration at the time, Photodynamic Therapy or PDT. The practice I worked for in Pittsburgh, PA was involved in the clinical trials before it became FDA approved. It was an exciting time, but wow, the stuff they are doing now...I'll be taking lots of notes.
I look forward to sharing whatever I learn with you!
Saturday, September 27, 2008
Reader Questions and Suggestions
Hi Kelly;
I have been referred to a vitreoretinal surgeon for a macular hole in
my left eye. However, I have this strong feeling that I have it in my
right eye as well. (I was diagnosed with macular puckers in both eyes
earlier this year). The vision problems in each eye are different --
left eye is blurry central vision spot; right eye is difficulty
focusing and what appears to be a "central floater".
I see a surgeon next Friday, but am curious. When both eyes are
involved, is surgery generally performed on both eyes at the same time,
or are they typically done at different times? Just curious. This
waiting to see the surgeon next week is difficult.
Linda
Hi Linda:
Vitrectomy surgery is done one eye at a time. The risk of post
operative infection is very, very small but if infection occurs it can
be devastating. It would be difficult to contain an infection to one
eye therefore, the benefits of doing a bilateral surgery, if there are
any, are far and away outweighed by the risks.
Linda, this is a very good question and one in which others may be
interested. May I post your question on my blog:
vitrectomy.blogspot.com ?
Toni Kelly
I have been referred to a vitreoretinal surgeon for a macular hole in
my left eye. However, I have this strong feeling that I have it in my
right eye as well. (I was diagnosed with macular puckers in both eyes
earlier this year). The vision problems in each eye are different --
left eye is blurry central vision spot; right eye is difficulty
focusing and what appears to be a "central floater".
I see a surgeon next Friday, but am curious. When both eyes are
involved, is surgery generally performed on both eyes at the same time,
or are they typically done at different times? Just curious. This
waiting to see the surgeon next week is difficult.
Linda
Hi Linda:
Vitrectomy surgery is done one eye at a time. The risk of post
operative infection is very, very small but if infection occurs it can
be devastating. It would be difficult to contain an infection to one
eye therefore, the benefits of doing a bilateral surgery, if there are
any, are far and away outweighed by the risks.
Linda, this is a very good question and one in which others may be
interested. May I post your question on my blog:
vitrectomy.blogspot.com ?
Toni Kelly
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