Retinal Detachment w/ Gel Vitrectomy: My experience so far, Positive

Just a record for the curious / worried.

Tl;dr: Retinal detachment. Vitrectomy. Nothing much to do, just buckle up and git r dun. So far, working well with me and my contition.

Three years ago, tears in my right eye, laser surgery to fix. At the same time, they noted lattice degeneration in my left eye, and hit it with the laser pro-actively.

Four months ago, first: Hemorrhagic posterior Vitreous detachment in that left eye, doc said to chill out, it'll fix itself. A week later though: Inferior retinal detachment with a horseshoe tear. I saw: Lots of black dots, "Film Grain" I called it. A fair number of floaters. Same as I saw for the right eye years ago, so I knew what was up. Difference: Flashes, and slowly, a dark veil. The dark veil was not pronounced: it was sort of like if you were wearing a hat, and the brim was kinda just outside your vision, but you knew it was there. Like that.

So I knew what was up, and things happened fast. Buckle up! Optometrist at 9am, local specialist at 5pm, and Regional centre surgery with a vitreoretinal surgeon next morning 9am. Surgery was mostly straightforward, indeed kind of interesting. I say "mostly" because I was nearly mis-operated on. When you go in, they are very particular about confirming the surgical eye. You're asked many, many times which eye, you point to the eye, and they put a sticky dot over your eye. Then: English intervened. Pre-op, the nurse came in to give me drops, IIRC, she said, "Ok, we're working on your left eye today", and I recall saying "Right". So she put the drops in my right eye (ignoring the sticky dot over my left eye). I said, "Umm... are we doing procedures on both eyes"? She was taken aback, and left, I could then hear a very long discussion laying out what happened. It actually sounded like a very big deal. Anyway, it got sorted out. Left eye vitrectomy.

A little foggy as I was under happy anesthesia. That's where the 'interesting' part started. You're awake and reasonably lucid the entire time. You won't worry abut having to keep your eye open or still, it's surgically neutralized. It was determined that I would get the gel. So you sort of see swirling stuff as I guess the vitreous is removed, and more neat lava-lamp action when the gel gets put in. It was neat. Then, that was it. Time was timey-wimey, I'd guess 10 or 15 minutes? There was no pain at any point in the procedure.

Day surgery. I was lucid after 10 or 15 minutes. An hour recovering a bit, then released. NO MATTER WHAT YOU THINK OR HOW TOUGH YOU THINK YOU ARE YOU WILL NEED A RIDE HOME. Your eye is literally flopping around. Take photos, they're funny.

I was in a way grateful to receive the gel. Three weeks face down with gas would have been more than just uncomfortable: I likely would have lost my business and my livelihood (small business owner).

You will see shapes, colours and contrasts, and it's for lack of a better word, 'blurry'. Like looking through frosted glass, or a poor prescription, like a -5 or 6 diopter. This is from the gel, which is behind your lens obvi, so it is uncorrectable. One thing I did note: pre-op I did wear glasses, about -2.5 diopter. I found my acuity was slightly better WITHOUT my lens, so I removed it from the left eye of my glasses. Looked a little weird. Sometimes I could see the shadow of a ceiling fan in my vision. Outside. That's the gel. You'll wear a night guard over your eye for a number of weeks (so you don't scratch at night). You may be sad, I was: Aging, health failing, looming different-ability, I was away from my activities so was somewhat lonely and isolated. Discouragement. Talk to someone if you feel this way, and remember that this too shall pass. That said...

Important: DON'T PANIC! Especially early on, you're going to see some weird stuff. In the beginning you'll still see dots and floaters, and they may come and go in intensity. Weird light effects through the gel too. I was told, monitor it, if you get a LOT of floaters, or the veil returns (it should be gone), then go to Emerg. / doctor.

Time passes. I, personally, was very conservative. I religiously took my drops (initially four different ones... for infections I'd guess, and to control pressure, which will be an ongoing thing likely). I stopped my physical activities, other than walking. I followed the instructions (no lifting, flying etc.) Daily functions were fine. I could drive after a number of days, but avoid it. I was never fully comfortable with it. You'll have good days and not so good days: Heat and humidity seemed to make my eye gooey and gross, or sharp and not too bad. It's a spectrum of acuity and grottiness. My vision got somewhat better as time went on, I'd guess as some of the gel was maybe absorbed? Could have been neuroadaptation too. You won't forget that you're in the middle of a procedure though.

Three months later, the gel was to be removed. That's the downside to the gel option (as opposed to Gas which, I'm to understand, simply gets absorbed). Surgery was essentially the same as before (but with the correct eye! I wondered if my experience actually changed their procedures, there were many more checks this time around). It was actually a fantastic experience: I didn't wait longer than five minutes for anything. I was greeted by name and everyone was very thorough and took the time to ask if I had any questions. I was rolled down the hall and there was a guy standing there, he introduced himself as the anesthesiologist, we yapped for a bit. Into the OR, everyone greeted me by name, 70's and 80's rock was playing. 10 or 15 minutes of lava-lamp action, then recovery, then discharge. It seriously felt like private health care at the fanciest hospital, but nope: Canadian healthcare at it's finest (ymmv). Cost for the entire course of treatment, surgeries, follow-ups: $32 for eye drops, and gas money. Humble-brag, but I was extremely pleased with the treatment and (as of five weeks post-op) the result.

The result: I was disappointed that I couldn't see "perfectly" right away. But it was much better. No pain really. Just two drops, four times a day. I put my lens back in my glasses and was disappointed that it wasn't much better. That's brings us to the biggest PITA (and that I'm still going through): My prescription changed, quite a lot: from -2.5 or something, to over -6. I was told that it would be some months before things are settled, and that I could expect prescription changing. But, I gotta see, so to the optometrist I went. Exam. New lens and... still blurry :/ Much better: 80-90%. And that's where I am: it gets better and worse, no one prescription would work it seems. I see rainbows around bright lights at night. I'll need cataract surgery eventually, guaranteed. It is settling down to consistency, but pretty sure it'll be a lot different than before. I was told that 10-15% of cases can result in re-detachment.

Five weeks on now. It's not perfect, probably 85-90% vs. pre-op. I feel I've plateaued a little, and I'm a little disappointed that this might be "it". But then I slap myself upside the head (right side!) and feel extreme gratitude that I received excellent, timely treatment for a condition that not too long ago would have left me blind in one eye. And that said, I am hopeful that over time it'll get even better, and my brain will adapt, and, well, here I am.

Hopeful, and grateful.

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u/schmal — 3 days ago

Prescription change post-vitrectomy?

I've just had my second procedure to remove the gel following a detachment. I'm six days post-op, things are clearing up, acuity is improving as expected, except it appears that my distance prescription has changed.

My standard prescription (2.25, to correct for distance vision (myopia?)) now shows as blurry in distance, but clear(ish) close up. From what I've read here, this may be because of cataracts, or because my retina has changed? Just curious if others have seen changes, and whether they are temporary during recovery, or if I need to replace all my glasses!

Practically (and economically) speaking, I need to decide whether to get new glasses (I need progressives for my work, so $$$), and if so, when, in your experience, things have stabilized to what they will be (ie. 'healed') I will need cataract surgery, I may elect to proceed with that this fall/winter, but in the meantime, trying to decide whether to spend the money for what will likely be a temporary need - cataract surgery will presumably negate the need for distance correction, expensive glasses that would be no longer needed.

I will of course be working with my health care team, but looking for your experiences.

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u/schmal — 1 month ago

A Non-Complaint Drone Post

We gripe and grouse about this and that, but yesterday a Chad drove up in his raised pickup truck as I was flying the drone and I steeled myself for some "educating". Instead, he gave me an ice cream cone (a very hot day!). What unexpected goodness has come your way lately?

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u/schmal — 2 months ago

AME creates .m4v, and: splits files when restarting renders?

Something changed with AME recently: When exporting, it creates separate .m4v files that are 0 kb in size. It didn't used to. And it still exports the expected MP4 as well. I'm fairly confident I didn't make this change anywhere. Muliplexer is set to MP4, so why the separate M4V sidecar file? The only thing I can think of is that AME can't delete the temp sidecar file for some reason, I'm unable to find a pref for this.

The other issue I have is: I sometimes have to stop a render for some reason. I do what I have to do, then Reset Status in AME, and start it again. But it keeps the section of the original file... it didn't used to, if I cancelled an AME render it would just get rid of everything, and it would start the render afresh.

Thinking about it... I'm rendering to a Dropbox folder (for workflow reasons)... I wonder if it's not a pref, but DB failing to remove temp files because it sees DB as reserving them or something...?

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u/schmal — 3 months ago

Ok I'm knocking myself out (and using up all my credits) trying to achieve this look. (Instagram post)

The parts where the house / buildings / subdivision get built. I'm having a hard time trying to figure out the proper model to use, and the most effective prompts. And a specific question: Does the best model use a video clip as the source, or a first frame (still) / last frame (still)? TIA.

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u/schmal — 4 months ago