Do we have an Ophthalmic Doctor here?

[ali_kat]

My Mother was taken into hospital yesterday with a detached retina, and is having an emergency operation on it this morning.

Is there anyone with experience of this that can tell me what to expect in the way of after treatment etc? As although the hospital is a good one, my Father cannot understand what the heavily accented Dr is saying.

All we know is that it will be a dangerous operation, as it has become detached close to the centre......

Many thanks in anticipation

Ali

[angusfaldo]

I've a friend who suffered the same thing. His was repaired by the insertion of an inflatable balloon into the eye which forced the retina back into position so it could heal. But it meant him lying down on the same side for several weeks so that the balloon stayed in the right position. I think he was allowed to stand upright for something like 10 mins every two hours or so - enough to make a sandwich, go to toilet etc. I stayed with him for the first few days to help administer eye drops - about 4 different types every few hours or so.

I think he was off work for about 4 weeks and it took a bit longer than that to get behind the wheel of a car again.

Good luck.

[alexkp]

968 is your man - but he doesn't seem to be around so much lately.

[968]

ali_kat said:

My Mother was taken into hospital yesterday with a detached retina, and is having an emergency operation on it this morning. Is there anyone with experience of this that can tell me what to expect in the way of after treatment etc? As although the hospital is a good one, my Father cannot understand what the heavily accented Dr is saying. All we know is that it will be a dangerous operation, as it has become detached close to the centre...... Many thanks in anticipation Ali

Hi there

It sounds like your mother has had what we call a Macula-off retinal detachment. In english, that means that the retina (which is a lining of the inside of your eyeball) has developed a hole or a tear in it. Fluid can get in under that hole or tear and start to peel away the retina from its attachments to the inside of the eyeball, rather like peeling a stamp off an envelope.

Now the very centre of the retina is called the macula, and this region has the highest concentration of cells for colour vision and detailed central vision that allows you to read and see details. If the retina detaches but the macula hasn't peeled off, then operations to re-attach the retina have an excellent prognosis, after a few months of recovery.

However, if the macula has peeled off, then the outcome of the surgery is less predictable. It will certainly be better than what it is presently, but probably wont be as good as it was before the detachment. It's not a particularly dangerous operation. It is complex, but retinal surgeons do these operations very routinely.

Depending on how they fix it, depends on what the post-op recovery will be. Sometimes the remove the fluid from under the retina, then spot weld the hole, but then fill the eye with a bubble of gas, which effectively pushes the retina and keeps it in place. Sometimes that involves lying in certain positions, ie face down, or to the side, to make sure the bubble remains pressed against the area where the hole was. Sometimes they stitch the retina to a sponge, which sits on the outer coat of the eye.......

Let me know if there are any questions you have about it.

[ali_kat]

Many thanks indeed!!

I'm off to the hospital now for the rest of the day, so will probably have more questions tomorrow.

[968]

ali_kat said:

Many thanks indeed!! I'm off to the hospital now for the rest of the day, so will probably have more questions tomorrow.

Which hospital?

[ali_kat]

968 said:

ali_kat said: Many thanks indeed!! I'm off to the hospital now for the rest of the day, so will probably have more questions tomorrow. Which hospital?

City Hospital, Birmingham

[968]

ali_kat said:

968 said: ali_kat said: Many thanks indeed!! I'm off to the hospital now for the rest of the day, so will probably have more questions tomorrow. Which hospital? City Hospital, Birmingham

Aha. I don't know any of the VR surgeons there, although it's an excellent unit, so I'm sure she's in good hands.

[yertis]

Nice to see you back 968.

[968]

yertis said:

Nice to see you back 968.

Why thank you.

[ali_kat]

The operation was a success , so we're not getting a puppy

The Dr that we saw before the operation yesterday was great, really helpful, clear and consise in telling us what he was going to do, and what was going to happen to her afterwards.

She's had a comfortable night, the bandages are off, and I'm going to pick her up later this morning. Other than having to put drops in her eyes, there is no aftercare that she has been told about yet......

Thanks for your support and help!

Ali

[968]

ali_kat said:

The operation was a success , so we're not getting a puppy The Dr that we saw before the operation yesterday was great, really helpful, clear and consise in telling us what he was going to do, and what was going to happen to her afterwards. She's had a comfortable night, the bandages are off, and I'm going to pick her up later this morning. Other than having to put drops in her eyes, there is no aftercare that she has been told about yet...... Thanks for your support and help! Ali

That's good news. Make sure she doesn't rub the eye, and try to keep water out of it, for a few days at least. If she develops any pain, make sure you take her back to the unit.....

Any questions or probs, feel free to email.

[SiH]

Hang on a second, you mean we've had a thread about healthcare within the NHS and there hasn't been a load of mudslinging?! Surely someone's going to come along and say that opthalmologists get paid too much (which we all know they do !!!

[968]

SiH said:

Hang on a second, you mean we've had a thread about healthcare within the NHS and there hasn't been a load of mudslinging?! Surely someone's going to come along and say that opthalmologists get paid too much (which we all know they do !!!

Er not anymore.

There's little or no private work available now, unless one sells ones soul to the LASIK devil. Average Consultant salary is £120K now. Used to be a lot more, but now it's a very distant behind Orthopaedics, which is by far the best paid speciality now.

[SiH]

968, the comment about earning too much was entirely tongue in cheek, hence the . A couple of years ago I did an anatomy demonstrator job and part of that was being the RMO at the local Nuff. There were a few eye guys there who would do a Saturday cataract list. There was a chap called Mr Brittain (who we didn't really see all that much) and another guy called Chris Liu who was a nice chap but a bit quiet. I remember bumping into him at lunch one Saturday around the time that all the crap about 'Surgical Nurse specialists' (God give me strength!) and Independant Treatment Centres staffed by "Johnny Foreigner and their gypsy attitude" (i.e. we'll do the ops, take the cash and will be long gone when the complications come rolling in), and he was telling me about how the opthalmologists were being shafted from all sides. For a man who was normally quite reserved he was quite animated about the whole affair and at the time I thought his point of view was a bit pessimistic. Hmmmm.... looks like he was right. Dark times ahead indeed.

[968]

SiH said:

968, the comment about earning too much was entirely tongue in cheek, hence the . A couple of years ago I did an anatomy demonstrator job and part of that was being the RMO at the local Nuff. There were a few eye guys there who would do a Saturday cataract list. There was a chap called Mr Brittain (who we didn't really see all that much) and another guy called Chris Liu who was a nice chap but a bit quiet. I remember bumping into him at lunch one Saturday around the time that all the crap about 'Surgical Nurse specialists' (God give me strength!) and Independant Treatment Centres staffed by "Johnny Foreigner and their gypsy attitude" (i.e. we'll do the ops, take the cash and will be long gone when the complications come rolling in), and he was telling me about how the opthalmologists were being shafted from all sides. For a man who was normally quite reserved he was quite animated about the whole affair and at the time I thought his point of view was a bit pessimistic. Hmmmm.... looks like he was right. Dark times ahead indeed.

I know it was a tongue in cheek comment........

I know Chris Liu, Consultant in Brighton, I believe. Very nice guy......

I can imagine he probably has seen the government selling off cataract waiting list, to private South African companies, (for kickbacks no doubt) with, as you describe, a gypsy attitude, of making as much money as possible, then buggering off. Each surgeon, employed by Netcare earn £500k a year. Please tell me how one surgeon can possibly do more work than 5 NHS Consultants, paid £100k a year?

It's a joke. But the worst thing is the Royal College of Ophthalmologists who essentially bent over for the government, and offered no resistance. Why? Because they said (I quote) "We are a charity organisation, lobbying is not in our remit"

FFS

And now we have a job crisis in Ophthalmology, in that there are no new Consultant's posts available, hence a huge number of post CCST SpRs earning less than minimum wage doing fellowships, to kill time. Added to that, we've got MMC coming in, hence the loss of 60% of SHOs nationally, to be replaced by HOs with 3 months experience.

It's a disaster.......

[wedg1e]

Oh aye.

[SiH]

I know exactly what you mean about the MMC thing and also about the colleges bending over. I'm on the RCSEng MRCS revision course at the mo for my Viva (in a couple of weeks but that's another story!) and one particular Professor who shall remain nameless was absent one day because he was teaching surgical nurse practitioners the anatomy for inguinal hernia repair! We ganged up on him a little and asked him to justify his actions because in our view he is a senior member of the college essentially shafting junior staff by teaching nurses to perform ops that have always been SHO fodder. He was, to put it mildly, a little shocked by our reaction and I'd like to think he won't be doing that again. We were a little pissed off though at the fact that the institution that we are striving to join and that is supposed to represent our best interests is actively training others to do the work. It's a total disgrace and whoever let it get this far should be shot at dawn. If nurses want to go on a course to operate on someone that's fair enough. It's generally 5 years long and happens at a place called medical school!

Just as a matter of interest to others reading this thread, are you aware (and are you happy about) the fact that if you go into hospital for an operation such as a hernia repair there is a strong, and growing, chance that the operation will be performed by a nurse who has been on a course lasting a few days? Or would you rather have a doctor perform the operation who has trained for at least 5 years before they are let anywhere near you with a knife?!