My health story: detached retina

In mid-April of 2017, I was in a meeting at the hospital where I work when I noticed some flashing lights at the periphery of my vision. I remember thinking, ‘That’s strange’. But they only happened that once and although, as an optometrist, I was aware that flashes can be a sign of a detached retina, I also knew that in most cases they are harmless. I had had cataract surgery a year before, but had no other risk factors for retinal detachment, so didn’t pay too much attention.

Two weeks later, I noticed what I now realise were floaters. But rather than the classic floaters that look like little lacy blobs or spidery webs, it was more like I had a bit of water in my eye. As we get older there are natural changes in the vitreous gel inside the eye that can cause an increase in floaters and flashes, so again I didn’t think too much of it.

However, after a couple of days, the symptoms became unmistakable. I couldn’t see my hand as I moved it up from the right, meaning that the lower right part of my visual field had become restricted. I knew for certain that it must be a retinal detachment – a condition that affects about one in 300 people with normal eyesight; one in 20 with short-sightedness – and that, without an operation to restore the retina to its proper place, I could lose the sight of my right eye.

The next day, by 8.15am, I was waiting in the Emergency Department of the Nottingham Eye Hospital, where the surgeon confirmed my suspicions. As a keen runner, cyclist, golfer and tennis player, I couldn’t bear the thought of losing my sight, even in one eye, as this would affect my perception of distances. An operation was essential – and it had to be immediate.

Thankfully I was admitted at once – I’d taken the precaution of not having anything to eat since the night before – and by 12.30pm was in the operating theatre undergoing a vitrectomy. This involves the surgeon making two tiny incisions in the white of the eye, sucking out the vitreous gel from the middle layer of the eye, and draining fluid away from beneath the retina. A small gas bubble is then injected into the space; it presses against the retina, restoring it to its proper position.

The whole procedure takes about 40 minutes and the incisions are made at an angle so the pressure of the gas causes the wounds to close without stitches. Over the next one to two weeks, the gas bubble is gradually absorbed and replaced with natural fluids produced inside the eye.

The operation can be done under a local anaesthetic, but I had a general, so the next thing I knew I was in the recovery room with a big pad over my eye. After a couple of hours, I went home. I returned next day for a post-operative check and had a first peek at my eye, which was incredibly red. The lids were swollen and my eye black, but it wasn’t at all painful. Now it was down to me.

To keep the gas bubble in the right position to encourage the retina to stay attached, I had to lie on my front with my head down for 50 minutes out of every hour, day and night, for two weeks. You can hire a headrest to keep your head in the correct position.

Although uncomfortable and boring, the thought that it was essential for my vision kept me going – that and lots of books and films on my iPad. As the gas is gradually absorbed and fluid produced, a line appears that gradually moves down. Above the line everything is clear; below it is blurry. I remember a moment in the garden about two weeks after the operation when I realised I could see the plants and trees clearly. Things were going to be OK.

Three weeks later, I was back at work and by six weeks I was running, cycling, golfing and playing tennis. It took a while to regain my confidence, however, as I knew a detached retina can recur, and I did get one or two flashes as things settled down. I was not allowed to fly until the gas bubble was absorbed, so we had to cancel a holiday to Corfu.

A year later, however, I’m completely recovered. We still haven’t made it to Corfu, but we have been to New Zealand and Portugal. My message? If you get symptoms, seek medical help without delay. I didn’t and could have lost my sight.

David Cartwright is chair of Eye Health UK

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