Update and Double Vision Query

[Mimi987]

Hi

Thanks for all the replies I have received.

My update: I had a trabulectomy revision on my right eye in May 2024.

Eye sight has been restored in my right eye - however the right eye lid was always droopy but is now worse and if I try to open the eyelid up I get double vision or ghost vision - the left eye is dominant. . and the right eye vision is not lined up and is a nuisance! If I push my right eyelid up the vision in my right eye gets better but the double vision gets worse. If I turn my head to the right the image from the right eye almost coincides with the image from the left! I have to go to orthoptics to see if the ptosis (eyelid droop) operation would improve my sight overall....I somehow doubt it!

Has anybody had similar experiences? One argument is that I should go ahead with the ptosis op - if I lost sight in my good left eye I would then still have the right eye vision - but I am not so sure about that argument!

Thanks for any advice!

Paul

[Sorshup]

Glad the revision went well, Paul. About the diplopia: Have you been told by the docs that it is incomitant - the image separation always varies with gaze direction? If yes, this is difficult to resolve. If no, it is possible that the weight of the droopy lid pushes the eye down, and the controlling muscles have adapted which explains the doubling when the lid is lifted. Have you tried using micropore tape to lift the lid and sustaining that for several hours? If the diplopia disappears or at least the images get closer the prognosis for the ptosis op looks good, but you must try this and report the result to the orthoptist and the doc.

[Mimi987 in reply to Sorshup]

Thanks Sorshup for your reply. One extra factor is my right eye was always much weaker than my right eye, it has Fuch's heterocyclic syndrome and has had a new lens put in some time ago.

My right eyelid is so low -about halfway down the eye - so that it is easy usually to ignore the 'ghost' image. I tried taping the eye-lid up but the same pattern occurs but more intrusively - the ghost image of the right eye matches up better with the stronger left eye image when I turn my head or body to the right. Turn my head back to straight ahead and the ghost image moves separately downward.

I have not been to orthoptics yet I seem to be with the surgeons!

Do I need to use the right eye vision in some way to keep it going so to speak? Do the left and right parts of my brain behind the eyes have any role in helping to synchronise the two images in the future?

Thanks again

[Sorshup in reply to Mimi987]

Gosh Paul, it's not easy for you is it? As I understand it the ghost imaging description of the RE sight is caused by the Fuchs and what used to be your better eye, the LE, has cataract which the docs are reluctant to remove because of the delicacy of the cornea, needing a graft. And from your description the diplopia is incomitant so reconciling the images of the two eyes will always be difficult. At this distance from your situation I hesitate to offer anything other than suggest that you ensure that the docs and the orthoptists are fully coordinating with each other in their assessment of the best course of action with the separate conditions the overall resolution of which will determine your future sight. The one thing I can repy to is that the coordination of the two eyes is a combination of eye rotation muscle control and brain processing. At your age the RE vision should not be affected by the droop. Good luck with it all !

[Mimi987 in reply to Sorshup]

Sorry my second sentence should have read 'One extra factor is my right eye is much weaker than my 'left' eye, which has Fuch's and had a new lens put in some time ago'.

So my left eye is pretty good! It is only starting to have a cataract and hopefully nothing wrong with the cornea. My right eye vision is worse but I don't use it most of the time because of the droopy eyelid which covers half the eye. The right eye vision is a ghost vision which I can ignore at the moment! But when I lift the right eyelid the right eye vision improves presumably because more light gets in! But it is then a ghost image which significantly interferes with my good left eye image unless I turn my head significantly to the right!

Thanks so much for your help!

[Mimi987 in reply to Sorshup]

Sorry I am finding it difficult to express this accurately!

So my second sentence should have read 'One extra factor is my right eye is much weaker than my left eye, the right eye has Fuch's and had a new lens put in some time ago'. The left eye is just 'coming up' now to need a new lens, hopefully no cornea problem.

[Sorshup in reply to Mimi987]

Ah, I think I have confused two contributors! I thought you had a low IOP problem requiring a corneal patching but that was not you !

Yes, look forward to the LE cat op. That eye seeing even better will help you ignore the other and the diplopia. You still have the cosmetic aspect of the ptosis but I guess you have got used to that. Sorry for my previous confusing references to the cornea!

[Nonswimmer]

Please forgive my ignorance, what is a trabulectomy revision? A relative of mine with MD was given botox injection to lift a droppy eyelid before that he had to use cellotape to lift the eyelid.

I had a trab on my left eye in 2010 which worked well for 9 years with a constant pressure of 8-9 then it opened and the pressure has dropped to 3/4. Has anyone experience of this please?

[Sorshup in reply to Nonswimmer]

When a trab fails, either by scarring or healing of the tissue around the drainage area causing the IOP to rise, or less commonly as yours did, ,further surgery is necessary to restore the desired rate of aqueous drainage. Such a procedure is known as a "revision".

[Nonswimmer in reply to Sorshup]

Thank you. With NTG I had a trab on left eye in 2010 unfortunately the pressure rose from 18 to 26 within a month the trab was needled which brought down the pressure to a constant 8/9 but the op caused scarring on the Macular which caused further sight loss in the left eye, now the pressure has dropped to 3/4 a cornea patch has been sugested but I understand this to be a 2 hour operation using a donor patch under general anesthetic. Has anyone experienced this procedure please?

Aged 78 with asthma I am loathe to risk the sight of my good right eye

[Sorshup in reply to Nonswimmer]

Hmm, tricky, requiring a corneal graft, but without getting that pressure up there could be serious consequences for the left eye. But what leads you to fear that there is a risk to your right eye? Unless I have missed something, you have not mentioned the situation with that eye before.

[Nonswimmer in reply to Sorshup]

Good Morning, I had a cataract operation on my good right eye in September 2012 with SLT in March 2013 this improved the sight and lowered the pressurer to a constant 12/14 with the aid if drops.

My consulatant says dramatic changes to my poor left eye can affect the right, question do I try to save the sight of my poor left eye with a cataract which cannot be removed because of the scar tissue?

The first trab was done under a general anesthetic which the consultant says caused my blood pressure to drop causing further sight loss to the left eye.

[Sorshup in reply to Nonswimmer]

Thank you for explaining your apprehension over possible consequences of LE surgery. I imagine the consultant is referring to sympathetic ophthalmia, which is a rare complication of surgery or other trauma. Only you and he/her can resolve this dilemma, and perhaps a second opinion could be a help? Sorry, I can't suggest anything more helpful.

[PeterRabbit62]

Hi I just had an operation on my left eye because my pressure was 30 and not going down it was shunt, it was called Gonioscopy-assisted transluminal trabeculotomy, it took me 8 weeks to recover and I could not drive either for those 8 weeks, also it was not done near my home I have to travel and 80 miles around trip to get to Hereford eye clinic so my brother and sister have to help out, my sister to look after my mum who I care for and brother to take me. I had the operation in June and I was discharged recently on the 13 of August and my pressure were stable at 12. I still using the same drops as I was before the operation but my consultant in Hereford says that I may eventually get down to using just one drop in that eye instead of 4 which will be good. Best of luck with your operation.