Retianal Tear

[peeba7]

All my research indicates this is a medical emercency.

 

I saw Dr. Patcharaporn Wangvoraht at Sirikit and wants to operate asap in patient.

 

 Research indicates there are at least three procedures done as out patient.  She wants to keep my head in one position.

 

She did reccomend some other opthomalic surgeons at sri racha and bangok hospital.

 

My head was swimming with the shock of  eye surgery, possible side effects, or blindness untreated or even treated.  I have many options including going back to the states, suggested treatment at Sirikit or let nature take it's course.  If I could take the emotions and fear out of the equation I could make the best descision.

 

Advice on the best Dr in Thailand, most succesful treatment, doing nothing, etc.  I have a med. Certificate with diagnosis, partially blocked vision and paralizing fear.

Thank you

[uhuh]

Nature's course is not an option. 

Going back to the states is most probably not an option, either. 

Ask your doctor whether you are fit to travel to Bangkok. 

Rutnin Hospital has a good reputation. 

Dr Chairat at Bangkok Hospital in Bangkok is very good,  works only on tuesday, that's probably a bit late. 

 

Otherwise I would follow  your doctors advice.

[Sheryl]

You need immediate treatment to preserve your eyesight.

 

Flying back to the US first is not a safe option

 

 

Not should you waste time looking for other doctors. Have the procedure done at once at Sirikit. While Rutnin is excellent the time it would take to set that up would be dangerous.

 

Immediately schedule the surgery as the doctor recommended.

 

It is common in Thailand to admit people for things done as outpatients in the West.

 

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

 

 

 

 

[steve187]

a retina tear is a medical emergency, ans as such requires surgery as an impatient, i had the same thing happen to me while staying at kilosip, i was under Bangkok hospital at rayong, they wanted to do the operation at Bangkok hospital at pattaya, i wasn't aware that queen sirikit hospital had the equipment, i had the operation at EENT hospital Bangkok, ( https://eent.co.th/) half the price of Bangkok hospital Rayong, My doctor was very good, spoke good English, the stay and food in the hospital was very good. now 8 years later there have been no problems, other than to have a cataract operation a bit earlier than is normal. i would not travel abroad to have the operation, as there are plenty of suitable in Thailand, my doctor is also at Bumrungrad as well as others and Government hospital in Bangkok - https://www.bumrungrad.com/doctors/Somsiri-Sukavatcharin

 

edit 

i didn't see the bit about letting nature take its course, that thought should not be entertained, you will lose the sight in that eye.

[mike787]

The vast majority of retinal tears are treated with laser photocoagulation. Ophthalmologists occasionally perform cryotherapy if the location of the tear makes it difficult to perform laser photocoagulation.

Laser photocoagulation and cryotherapy can also be used to treat a retinal detachment and prevent it from becoming bigger. 

Surgery is an option if a retinal detachment is big enough that it can’t be treated with laser photocoagulation and cryotherapy alone. Laser photocoagulation and cryotherapy may also be used in conjunction with surgery for complete treatment.

https://nyulangone.org/conditions/retinal-detachment/treatments/procedures-to-treat-retinal-tears-retinal-detachments

[uhuh]

30 minutes ago, uhuh said:

Nature's course is not an option. 

Going back to the states is most probably not an option, either. 

Ask your doctor whether you are fit to travel to Bangkok. 

Rutnin Hospital has a good reputation. 

Dr Chairat at Bangkok Hospital in Bangkok is very good,  works only on tuesday, that's probably a bit late. 

 

Otherwise I would follow  your doctors advice.

Dr Chairat works at Phayathai 2 hospital tomorrow and is available at noon.

That's a good option IF you are fit to travel and IF your doctor doesn't think that's too late (see Sheryl's post).

[peeba7]

Thanks all!

[peeba7]

The required procedure is ppv+fax+edl+c3f8 le/la *no asa*

 

I must be prone on my stomach 12 hours a day for a month.

 

1-Who is the best retinal surgeon in thailand mentioned above or not?

 

2-Is there a more successful and tolerable procedure for highly detached retina?

 

3-Pardon my ignorance.

Where is the best place to research besides google and wiki?

 

Cheers.

[simon43]

Hey - you posted on Sunday about this retinal tear and now it is Friday (6 days later).  As Sheryl and others have commented, this is an emergency!  You can lose your sight permanently if you do not get immediate medical/surical treatment.

[uhuh]

Exactly.

You wasted a whole week,  unbelievable!

It is your eye, and if you want to lose it it's your decision. 

Not smart.

 

You are under care of an eye doctor at Sirikit so follow their advice!

 

In theory you can make an appointment with Dr Chairat in Phayathai 2 Hospital, he works tomorrow 17:00, call 1772. But I don't recommend to do this without first consulting your Dr at Sirikit.

 

[LosLobo]

1 hour ago, peeba7 said:

The required procedure is ppv+fax+edl+c3f8 le/la *no asa*

 

I must be prone on my stomach 12 hours a day for a month.

 

1-Who is the best retinal surgeon in thailand mentioned above or not?

 

2-Is there a more successful and tolerable procedure for highly detached retina?

 

3-Pardon my ignorance.

Where is the best place to research besides google and wiki?

 

Cheers.

I had the same procedure in the same eye 10 years ago after waiting only 3 days and I lost 50 percent of my vision.

 

By your prone positioning I assume your tear is in the critical macular area.

 

Time is of the essence unless you want to lose 100 percent of your vision.

 

NB *no asa* means do not take any aspirin!

[Sheryl]

STOP researching and delaying.

You risk permanent blindness.

Get the surgery AT once.

Yes, there are limitations on movement afterwards.

There is no easy out for this. Stop delaying.

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

[peeba7]

Thanks again.

Most all are correct.

The soonest is monday.

I posted about the prone posotion.

 

Today she said 50% chance.

And i hadnt lost more retina since yesterday but i am sure i did.

 

Here goes monday unless a miracle.

[peeba7]

Oddly a bit better vision today especially in day light.  Weird.   Most likely will proceed thanks.

[moe666]

How hard headed are you these things do not fix themselves,get either the cold laser or the hot laser and fix the thing. It isn't that big of a deal to have it done. I drove home after my surgery holding my head to the side really wird but eye healed up and no lose of vision.

[uhuh]

Everybody contributing to this thread hopes that tomorrow you see your doctor and get treatment. 

Don't wait!

[peeba7]

I now know what a medical emergency is.

 

Got a gas bubble apparantly caustic to lens creating a cateract and complications not being able to adhere strictly to 12 hours for a month face down.  She wants to remove the lens put in silcone oil with 6 month 90% chance of site return. She told me prior the gas bubble only 50%.  There must be a reason they dont use a non caustic agent. So many unanswered questions so i am thinking this is so important and go out of pocket to private hospital. She originally said oil not covered pay 10k then later 15k plus. She only has five years experience and little time or patience for all my farang questions.  Its a mixed bag who you get. Some great docs some not. Long story and would like to share my insights but still focusing on time consuming face down as it couldnt hurt to keep up a while longer.

 

Good news is light is getting to a good deal of retina and macula though she said retina is pulling away.  I read the gas will disapate but not sure outcome if left alone. The bubble size has not significantly decreased over one month.

 

 Will research options mentioned here and open to gentle suggestions and advice.

I might try (somchai at) bkk pattaya.  I was also told pat city hosp has great docs.  However most all research points to outside pattaya.

 

Thanks to most all here once again.

[uzynkotak]

Op, I wish you speedy recovery.

I'm not sure if you mentioned it before, but how exactly did you tear your retina? Could you tell us so that other people avoid these situations?

[Sheryl]

9 hours ago, uzynkotak said:

Op, I wish you speedy recovery.

I'm not sure if you mentioned it before, but how exactly did you tear your retina? Could you tell us so that other people avoid these situations?

 

Most retinal tears occur spontaneously.

 

"There are three different types of retinal detachment:

• Rhegmatogenous (reg-ma-TODGE-uh-nus). These types of retinal detachments are the most common. Rhegmatogenous detachments are caused by a hole or tear in the retina that allows fluid to pass through and collect underneath the retina, pulling the retina away from underlying tissues. The areas where the retina detaches lose their blood supply and stop working, causing you to lose vision.

  The most common cause of rhegmatogenous detachment is aging. As you age, the gel-like material that fills the inside of your eye, known as the vitreous (VIT-ree-us), may change in consistency and shrink or become more liquid. Normally, the vitreous separates from the surface of the retina without any complications — a common condition called posterior vitreous detachment (PVD). One complication of this separation is a tear.

  As the vitreous separates or peels off the retina, it may tug on the retina with enough force to create a retinal tear. Left untreated, the liquid vitreous can pass through the tear into the space behind the retina, causing the retina to become detached.

• Tractional. This type of detachment can occur when scar tissue grows on the retina's surface, causing the retina to pull away from the back of the eye. Tractional detachment is typically seen in people who have poorly controlled diabetes or other conditions.
• Exudative. In this type of detachment, fluid accumulates beneath the retina, but there are no holes or tears in the retina. Exudative detachment can be caused by age-related macular degeneration, injury to the eye, tumors or inflammatory disorders.

Risk factors

The following factors increase your risk of retinal detachment:

• Aging — retinal detachment is more common in people over age 50
• Previous retinal detachment in one eye
• Family history of retinal detachment
• Extreme nearsightedness (myopia)
• Previous eye surgery, such as cataract removal
• Previous severe eye injury
• Previous other eye disease or disorder, including retinoschisis, uveitis or thinning of the peripheral retina (lattice degeneration)"

https://www.mayoclinic.org/diseases-conditions/retinal-detachment/symptoms-causes/syc-20351344

[LosLobo]

Sorry to hear that your procedure wasn't entirely successful.

 

When I had the PPV procedure the gas took 6 to 8 weeks to dissipate.

 

Vitrectomy surgery using the gas bubble is high risk for developing cataracts. I would have thought your surgeon would have explained this to you. But thai doctors are not usually into bilateral consultation and english being a second language for both of you would add to the problem.

 

Seems like you are still playing the waiting game and you lack confidence in your existing doctor.

 

My advice would be

 1) go to Rutnin for a second opinion ASAP
 2) don't worry about the money, worry about your precious sight
 3) stop procrastinating.

[Sheryl]

3 hours ago, LosLobo said:

Sorry to hear that your procedure wasn't entirely successful.

 

When I had the PPV procedure the gas took 6 to 8 weeks to dissipate.

 

Vitrectomy surgery using the gas bubble is high risk for developing cataracts. I would have thought your surgeon would have explained this to you. But thai doctors are not usually into bilateral consultation and english being a second language for both of you would add to the problem.

 

Seems like you are still playing the waiting game and you lack confidence in your existing doctor.

 

My advice would be

 1) go to Rutnin for a second opinion ASAP
 2) don't worry about the money, worry about your precious sight
 3) stop procrastinating.

 

+1 to the abive especially the 3rd.

[LosLobo]

Addendum :

   4) start thinking smart and rationally here, don't live up to your forum member name.

 

[peeba7]

Rutin it is.  Thanks.  Oddly prior to reading this i called them today and they were the only people who could answer the q: who is the best with the most retina experience! Decision made. Vision not better or worse but i wonder if at some point its too late.  Lens removal silcon oil (toxic?) Scheduled for wed.  Rutin before.  Surgery: Set PE(no IOL)+PPV+FAX+EDL+ heavy SO LE/RBB

mostly greek to me. Translation?

[peeba7]

Contributing factors, unanswered questions, and young Thai doctors.

 

Please excuse spelling, grammar, and errors in perception, character, over generalities or opinion.
I am far below perfect.

 

Most research agrees with sherly's excellent reference post.

 

After extensive research some little known factors also may contribute:

 

Besides the dangers of severe myopia (over +5 in left eye,) and age, these probably contributed in hindsight:

 

-previous severe eye infection
-a drastic increase in floaters 
-(despite docs opinion) over exposure to sun
-untreated dry eyes, dehydration, medications, previous alchohol abuse leading to malnutrition (doc said after first procedure retina very thin)
-over exertion

-avoiding medical attention

 

Number one advice:  keep extremely well hydrated, so your pee is clear (unless you include supplements.)  Use saline and/or lubricating eye drops liberaly to dry eyes.  Air con and fans exasperate them.

 

Eat well and stay well nourished and fit.

 

Avoid alchol, drugs, smoking, and medications if possible.

 

Keep it simple.

 

Some unanswered questions:
1-Why is the incision still irritated after one month?
2-Who is the best practicing retinal specialist(s) in the country?
3-Is there a good specialist in si racha?
4-how to (ALWAYS) get thai price as farang.
5-Best retina specialists at govt hospitals?
6!!!!!!BEST ENGLISH RETINA FORUM(s.)

7-Why a thin retina or did i answer this myself?
8-Is there a pattaya eye clinic?havnt researched.
9-Is continuing face down a waste of time or advisable?
10-What each of the four eye drops target? ( can research or list later.)

 

I now have a decent amount of experience navigating queen sirikit with many young docs and very young students.
My advice, if possible, avoid after hours emercency entrance unless necessary.
Go extremely early or later if you have an appt window.  
If possible dont go on monday or tuesday.  Friday might be great but might have less physicians, maybe no if you might be admitted.

 

I found two great docs/seurgeons, two difficult ones, some bad and medocre ones.
Even the great ones make errors.  
What is usually treated has negative side or after effects.
They can usually only focus on one thing, problem or issue.  
The symtom is treated and not the cause which may be universal.  
They are afraid of asparin in general not just this case.  My origin of culture swears by it.

 

The most shocking occurences despite the fact i was never rude or impolite, is two young surgeons being rude, impolite and openly angry with me.  
A Thailand very different than the one I originally arrived at many years ago when this was an absolute no-no.

[LosLobo]

16 hours ago, peeba7 said:

Surgery: Set PE(no IOL)+PPV+FAX+EDL+ heavy SO LE/RBB 

mostly greek to me. Translation?

I wish you good luck with Wednesday's operation, and hope you have a satisfactory outcome down the line.

 

I am curious to know why you weren't "able to adhere strictly to 12 hours a day for a month face down."

 

PhacoEmulsification(no InterOcular lens) + Pars Plana Vitrectomy + Fluid Air EXchange + EnDophotocoaguLation + heavy Silicon Oil Left Eye/RetroBulbar Block.

 

[Bournville]

Upps. Old post. Nevermind. Happened to me too. Yes it's a medical emergency. 3 days after symptoms of detached retina permanent blindness begins. My retina was "spot welded" in place with a laser.. But not in Thailand. It wasn't that expensive even in USA.

 

Good luck

 

Sent from my SM-G935F using Tapatalk

 

 

 

 

[peeba7]

Contributing factors, unanswered questions, and young Thai doctors.

 

Please excuse spelling, grammar, and errors in perception, character, over generalities or opinion.
I am far below perfect.

 

Most research agrees with sherly's excellent reference post.

 

After extensive research some little known factors also may contribute:

 

Besides the dangers of severe myopia (over +5 in left eye,) and age, these probably contributed in hindsight:

 

-previous severe eye infection
-a drastic increase in floaters 
-(despite docs opinion) over exposure to sun
-untreated dry eyes, dehydration, medications, previous alchohol abuse leading to malnutrition (doc said after first procedure retina very thin)
-over exertion

-avoiding medical attention

 

Number one advice:  keep extremely well hydrated, so your pee is clear (unless you include supplements.)  Use saline and/or lubricating eye drops liberaly to dry eyes.  Air con and fans exasperate them.

 

Eat well and stay well nourished and fit.

 

Avoid alchol, drugs, smoking, and medications if possible.

 

Keep it simple.

 

Some unanswered questions:
1-Why is the incision still irritated after one month?
2-Who is the best practicing retinal specialist(s) in the country?
3-Is there a good specialist in si racha?
4-how to (ALWAYS) get thai price as farang.
5-Best retina specialists at govt hospitals?
6!!!!!!BEST ENGLISH RETINA FORUM(s.)

7-Why a thin retina or did i answer this myself?
8-Is there a pattaya eye clinic?havnt researched.
9-Is continuing face down a waste of time or advisable?
10-What each of the four eye drops target? ( can research or list later.)

 

I now have a decent amount of experience navigating queen sirikit with many young docs and very young students.
My advice, if possible, avoid after hours emercency entrance unless necessary.
Go extremely early or later if you have an appt window.  
If possible dont go on monday or tuesday.  Friday might be great but might have less physicians, maybe no if you might be admitted.

 

I found two great docs/seurgeons, two difficult ones, some bad and medocre ones.
Even the great ones make errors.  
What is usually treated has negative side or after effects.
They can usually only focus on one thing, problem or issue.  
The symtom is treated and not the cause which may be universal.  
They are afraid of asparin in general not just this case.  My origin of culture swears by it.

 

The most shocking occurences despite the fact i was never rude or impolite, is two young surgeons being rude, impolite and openly angry with me.  
A Thailand very different than the one I originally arrived at many years ago when this was an absolute no-no.

[peeba7]

Hats off to well wishes and informaive posts.

Thank you very much.

I tried to call my doc today.

To my surprise she called me right back, did her best to answer my qs, but pressed for time.

I need her in my corner and she was pleasant (long weekend coming monday closed.)

All in all they run a pretty tight ship-pun intended.