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Best of luck to your sister, but, I'm afraid that retinas are VERY prone to permanent damage, and, once damaged, will never work again (So says the Voice of Experience).

I was born with the congenital disorder of being very near-sighted. Most people that need glasses usually need about -1.5 to -3.0 diopters of correction. Very near-sighted people may need somewhere between -3.0 and -5.0 diopters of correction. The prototypical nerd with "coke bottle" glasses may be up around -6.0 to -7.0 diopters of correction. I was at -19.00 diopters! According to my ophthalmologist, the strongest contact lens made is -20.00 diopters, so I was right up against the limit of what could be corrected. That extreme near-sightedness was due to me having a very long eyeball.

My ophthalmologist warned me, probably 15 to 20 years ago, that I was at a significantly increased risk of retina problems, due to the strain that the shape of my eyeballs were putting on the retinas. However, there wasn't any corrective procedures that could be done. I just had to be aware of the symptoms of retina problems, and take immediate action to correct any problems that might develop.

Five years ago, I noticed a bunch of floaters in my right eye. While investigating those, I noticed a blind spot at the bottom of my peripheral vision. My first thought was "Ohoh!". So, I made an emergency appointment with my ophthalmologist.

When I showed up the next day, at 9 AM, she dilated my eyes, peered into them, and diagnosed a torn/detached retina. So, she referred me to a retina specialist at 11 AM. And, at 11 AM, I visited the retina specialist at her office. She dilated my eyes again, and peered into them, whereupon she confirmed the diagnosis of a torn and detached retina. Then, she asked that infamous question, "Have you had anything to eat today?". Having been worried about what was going on, I hadn't eaten. When I confirmed this, she replied "Good. I'll see you over at the hospital at 3 PM, and we'll do surgery on that eye.".

That gave me just enough time to contact family and cow-orkers, to tell them of my imminent/emergency surgery. Then, at 3 PM, I was wheeled into the operating room, where my retina specialist did surgery on my right eye. This surgery consisted of a Vitrectomy [1], and laser surgery to reattach/seal the torn/detached retina [2].

[1] Look it up if you dare! But, be warned that there are certain images, which, once implanted into the human mind, cannot be removed, no matter how much the desire. If you're familiar with that childhood saying "Cross my heart, and hope to die...", well, the next phrase perfectly describes a Vitrectomy.

[2] I have some wonderful retinal photographs showing the laser stitching. It sort of resembles a sci-fi photo of a planet that has been extensively blasted.

Everything healed up just fine from that surgery, after about three months, and I only lost about 20 percent of my peripheral vision. It seems that, once a retina is detached, damaged, or torn, it stops working, permanently. However, it is necessary to receive immediate surgery. If the tear/detachment isn't fixed immediately, it allows fluid to flow behind the retina, which pushes more and more of it off of the inside of the eye. And, that rapidly degenerates into total, permanent blindness, unless the torn/detached area is sealed/reattached, usually via laser surgery. Oh, yeah, lasers were only invented in the early 1960s, and laser eye surgery wasn't developed until the 1970s. Before that, people who developed a torn/detached retina faced total, permanent blindness (Thank you Ted Maiman!).

Ok, flash forward to May of 2014. On the way home from work one night, I noticed a bunch of new floaters in my other (left) eye. My first thought was "Ohoh! Not again!". So, I made an emergency appointment with my ophthalmologist, at 8:30 AM the next morning. Again, she dilated my eye, peered into it, and diagnosed a torn/detached retina in my other eye. So, she referred me to my retina specialist [3], whom I set an appointment up with at 1 PM.

[3] There are certain phrases in the English language which one never wants to hear. "My retina specialist" is one of those.

I showed up at my retina specialist's office at 1 PM, whereupon she dilated my eye, peered into it, and confirmed the diagnosis of a torn/detached retina in my left eye. Then, she asked that infamous question, "Have you had anything to eat today?". Again, having had a really bad feeling about what was going on, I had intentionally skipped breakfast/lunch. When I confirmed this, she told me to go immediately to the hospital when I left her office, and that she'd be over momentarily to perform surgery.

At 3 PM, I was wheeled into surgery, where my retina specialist (There's that phrase again!) installed a Scleral Buckle on my left eye. A Scleral Buckle is a Silicone Rubber strap that goes around the eye-ball, and under the muscles/tendons that attach to the eye-ball, and is sutured/stitched into place. The idea is that a wedge is inserted under the Silicone Rubber strap, which pushes the wall of the eye inwards towards the detached retina.

Somewhat interestingly, the Scleral Buckle was developed by Dr. Charles Schepens, who was a Belgian-American doctor. Dr. Schepens other claim to fame is that he was active with the French Resistance during World War II, when he smuggled people and documents across the Pyrenees Mountains out of France and into Spain. He was twice stopped by the Gestapo, but his cover, as an employee of a sawmill, held both times, and the Gestapo released him both times.

Oh, if you happen to look up a Scleral Buckle, and, there are some wonderful descriptions of it on the web, as well as some excellent videos of one being installed on YouTube, please realize that you haven't seen anything until you've seen one installed from the inside! Yeah, I was fully conscious as she was sewing that Scleral Buckle to my eye-ball. I was even laying there on the operating room table and talking to her, as she was putting the stitches in place. All I have to say is that there are some very wonderful drugs, such as Morphine and GHB.

Yeah, the same GHB that's notorious for street abuse. However, the anesthesiologist's nurse promised me that I didn't have anything to worry about, since the hospital was a completely different environment than that where GHB is abused. My only thought was, "Darn! And, she's cute, too!".

A few days, later, my retina specialist did laser surgery to reattach/seal the detached retina back to the inside wall of my eye.

Everything was healing up just fine. I had a bit of trouble with double vision, due to the distortion/displacement of the muscles/tendons of the left eye, causing it to be slightly misaligned, but my brain gradually learned to converge the vision again after a few weeks. The rest of May was uneventful, as was all of June. I was set to be cleared by my retina specialist on the 7th of July. Only, I didn't make it.

We had a relaxing Independence Day (4th of July) holiday. I fired up the Propane grill, and grilled up a few hamburgers. Then, we watched the fireworks off in the distance. Following that, we went to bed at a reasonable time. I got up to use the bathroom at 4:30 AM, and noticed a problem with the light. The floor was illuminated, as was the wall, but the bulb was dark. My sleep addled mind chalked it up to one more thing to fix. Then, as I thought about it a bit more, I couldn't figure out how the wall and floor could be illuminated, yet the bulb could be dark. Then, it suddenly dawned on me. That wasn't a problem with the light; that was a problem with my eye. I'd developed another blind spot. OHOH!

So, for lack of anything better to do, I grabbed my blue medical bag [4], and looked up the number of my retina specialist. I called the number at 4:30 AM on the Saturday of a holiday weekend, fully expecting to get an answering machine saying that the office was closed for the weekend. Instead, I was pleasantly surprised when I got an answering service. The lady at the answering service took my name and a list of my symptoms, and said that she'd page the doctor. Thirty minutes later, my retina specialist called me back (Isn't that lady great!), and said that it sounded like I was having another retinal detachment, and that she'd see me in her office at 9 AM.

At 9 AM, I arrived at her office, which was deserted except for the three of us. She escorted me into the examining room, dilated my eye, peered into it, and confirmed the diagnosis of another retinal detachment, which was just outside the area that had been laser stitched two months prior. Then, she asked that infamous question again, "Have you had anything to eat today?". By this time, I had a pretty good idea of what the symptoms meant, so I had intentionally not eaten. After informing her of this, she stepped out of the examining room momentarily. When she returned, she indicated that the hospital's operating room was currently occupied with an emergency appendectomy, but that we were next on the schedule, and that I should go immediately to the hospital when I left the office. She indicated that, as soon as the operating room was available, they'd call her, and she'd be over to do more emergency surgery.

She then said "We have to get that jelly out of there.". I responded with "A Vitrectomy? Let's do it."

The center of the eye is filled with Vitreous Humor material, which is a clear, jelly-like material. As a person gets older, this material thickens and shrinks. Ideally, it's supposed to pull cleanly away from the retina, and be replaced by fresh material. Unfortunately, for people who are extremely near-sighted, the retina is under tension as it wraps around the inside of the eye. And, as the Vitreous Humor gets thicker and shrinks, it can sometimes stick to the retina just a little too well, well enough to cause the retina to be torn away from the wall of the eye.

I went over to the hospital, and entered via the emergency entrance, since it was a holiday weekend, and the front entrance was closed. I got checked in, and spent about an hour laying in the pre-op area, where I chatted, joked, and flirted with the pre-op nurses. I'm afraid my jovial manner completely baffled them. They're quite used to panicked and terrified patients. Oh, make no mistake about it. I was terrified. But, I'd been through the procedure before, and knew that, without the surgery, the prognosis was catastrophic. My thought was, "Why should I make life difficult for these wonderful nurses?".

At 11 AM, the operating room was freed, and they called my retina specialist over. She spent the next four and a half hours operating on me. I'm afraid I completely ruined her holiday weekend. Isn't she great! The surgery included the installation of a second Scleral Buckle. This was followed by a bit of cryogenic treatment, a bit of laser surgery, and a Vitrectomy procedure. The huge needle they use for Vitrectomy procedures really does look sort of like a miniature vacuum cleaner hose, or, at least the silhouette of it does. Yeah, I was conscious for this surgery, too, and got to see the silhouette of that huge needle as it went into my eye.

As part of the Vitrectomy procedure, the Vitreous Humor material, which is the clear, jelly-like stuff that fills the center of the eye, was removed. In place of it, a gas bubble, consisting of Octafluoropropane (C3F8) gas was inserted. This gas bubble functions as a retinal tamponade, which serves to push the retina back towards the wall of the eye, such that it can heal. Over a period of about three weeks to six weeks, the gas is gradually absorbed by the body, and replaced with fresh Vitreous Humor.

In order for the gas bubble to function, I had to maintain a face-down posture for 24 hours per day, for the following three days. I don't know if anyone has ever tried to do this, but it makes sleeping almost impossible (It's hard to breathe when your nose is pressed directly into a pillow.), and eating isn't all that much fun, either.

Having a gas bubble in one's eye is a rather unique and interesting experience. It's impossible to focus the eye, since the index of refraction between the normal Vitreous Humor and the gas is quite great. And, as fresh Vitreous Humor replaces the absorbed gas, the fresh Vitreous Humor sloshed around, and light reflects in strange ways. Plus, it seems that the interface between the gas and the fresh Vitreous Humor mechanical excites the retina, such that one can "see" the interface, even in completely darkness. In some ways, it sort of functions like the "artificial horizon" in an airplane. As one rides around in a vehicle, the fluid/gas interface moves around. As you go around a corner, it sort of leans up at an angle. As you accelerate, it moves one way, and moves the other way as you slow down.

I was thoroughly enjoying the gas bubble, as I was healing up during July. Everything was going well for several weeks. Then, my retina specialist noticed a bit of fluid accumulating behind my retina. Ohoh, that's not good! That normally indicates that a hole has formed in the retina, which is admitting the fluid to behind it. That's very bad, since the presence of the fluid behind the retina will cause portions of it to detach. OHOH! However, she couldn't find a hole.

Since she couldn't find a hole, she referred me to her colleague for a second opinion. He couldn't find a hole, either. But, he diagnosed me with something called Proliferative vitreoretinopathy. Now, if you look up the description of this, it will, almost certainly, scare one silly. At least, it scared me silly. They type I had was where the scar tissue, which had formed as a result of the extensive laser stitching that had been performed, was healing. But, as it was healing, it was shrinking, crinkling, and folding. The theory was that, under one of those folds, a hole had opened up that was admitting fluid behind the retina. But, without being able to see where the hole was, there was no way to do laser stitching on it. So, my second retina specialist [5] concurred with my first retina specialist that the recommended treatment was a retinectomy.

[5] There are some words that one never wants to hear used together; "Second" and "retina specialist" are some of those words.

A retinectomy basically involves "opening up" one's eye-ball, and removing the diseased retinal tissue. Theoretically, the scar tissue should simply peel away from the rest of the eye. So, on the 26th of August, I was wheeled into the operating room again, for the retinectomy procedure. And, I had not one, but two retina specialists operating on me (I'm not really sure what the record is for the number of specialists operating on a single patient at one time is, but I'd really rather not try for that particular record.).

For this surgery, since I have such an amount of scar tissue on that eye now, it was recommended that I be "put under" with a general anesthesia, rather than the local anesthesias that were used for the previous surgeries. Plus, since the specialists would be operating directly on my retina, where any flinching could have catastrophic consequences, the general anesthesia was preferred. So, the anesthesiologist chose Propofol, which is also now known as "The Michael Jackson Drug". I will say that it is highly effective. As the nurse administered the Propofol into the IV that was attached to my hand [6], I remarked to her that I felt a warm, although not altogether unpleasant, sensation as it flowed through the veins in my arm. I remember that she replied "Good.". The next thing I remember is someone gently shaking my shoulder and saying that I was in recovery.

[6] I have very hard to find/hit veins in my arms, so the nurses/phlebotomists/etc., usually opt to go for the veins in my hands. OUCH!

My second retina specialist had promised that the retinectomy would take about an hour. Well, of course, there were complications (Did anyone expect any less?), and the surgery took three hours. It seems that the scar tissue wouldn't simply peel off, so he had to go in and actually excise the tissue.

They also performed another Vitrectomy procedure, where the remains of the C3F8 gas bubble was removed, along with the fresh Vitreous Humor material that my eye had regenerated. They replaced this with Silicone Oil. The Silicone Oil also acts as a retinal tamponade, and holds the retina (or, what's left of it) in place as it heals. There was also quite a bit of laser stitching involved, too. The advantage that the Silicone Oil bubble has is that it's not absorbed by the body, so remains in place much longer than the gas bubble, so much so that it will have to be removed with yet another Vitrectomy procedure (which is yet to be scheduled).

Following the surgery, I had to maintain a laying on my left side posture, for 24 hours per day, for two weeks. That's a bit easier than maintaining a face down posture, but only a bit.

Of course, I've developed more complications, in that I have persistent retina swelling. Unfortunately, I'm the first patient either of my retina specialists [7] have seen which has exhibited this complications. The Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), and the Steroidial Anti-Inflammatory Drugs haven't been decreasing the swelling. However, just recently (Five and a half months after the surgery), the swelling is beginning to show signs of decreasing. So, we're in a wait-and-see holding pattern for the moment. My second retina specialist is unwilling to remove the Silicone Oil bubble until all of the swelling is gone. The presence of any swelling indicates that the retina is in a tender state, and the mechanical disturbance of removing the oil could cause yet another detachment (and, at this point, I don't want to lose any more vision!). So, we're going to give it a few more months. Meanwhile, due to the difference in the index of refraction between the normal Vitreous Humor and the Silicone Oil, I can't focus the eye.

[7] Darned plurals!

As it is, I have numerous blind spots in my left eye (in addition to the 20 percent or so vision loss in my right eye from the episode five years ago), most of which affect the peripheral vision. Unfortunately, I have a small strip of blindness right through the center of the my vision, which is going to make it difficult, if not impossible, to ever read with that eye again (even when I do regain the ability to focus the eye, once the Silicone Oil bubble has been removed). My only hope, at this point, is that I'll be able to retain enough of the remaining vision that I will have some depth perception.

As it is at the moment, I'm functionally blind in my left eye, which leaves me with no depth perception. Unless you've tried living with the vision in only one eye, you probably haven't realized how nice it is to have depth perception. One wouldn't believe how many drinks I've knocked over by misjudging the distance to them, and under/over-reaching. One wouldn't believe how many things I've tried to throw into the trash can and missed horribly. Fortunately, I haven't had to operate a motor vehicle since early July. I'm rather terrified to, given that I have no depth perception. Legally, I'm allowed to drive with only one eye, but, practically, I'd really prefer not to run into something because I misjudged the distance to it.

So, yeah, I think one could safely say that I know all about eye problems, although I hope to eventually recover a bit of vision in my left eye. Eventually.. But, in any case, best of luck to your sister, even though the prognosis isn't good.

Dave

P.S. Feel free to have her contact me, if she'd like to communicate about the situation. I'm not a doctor, but I seem to have become a professional patient.