Well, my cataract surgery went okay save for one fairly serious complication: a suprachoroidal hemorrhage, characterized by Google search as this:
A suprachoroidal hemorrhage is a serious eye condition where blood pools in the space between the choroid (the middle layer of the eye containing blood vessels) and the slcera (the white outer wall of the eye).Causes and Risk Factors
- Eye Surgery: It most often happens during or after eye operations like glaucoma or cataract surgery.
During the operation, which was quick, the doctor noticed that the pressure inside my eye increased. That was serious, for if it stayed high and was untreated, it could permanently damage my vision. Immediately after I was discharged from the hospital, I was sent to the surgeon’s office where he joined me and did a gazillion things, including giving me multiple doses of eyedrops and pills, as well as POKING INTO MY EYEBALL WITH TWEEZERS to let the fluid out. It hurt! It was so gross that my friend who accompanied me, the diehard neurobiologist Peggy Mason, had to leave the room.
Finally, the doctor noticed that I may have had blood inside my eye, so he sent me downstairs to a crack retinal specialist who verified that I had a localized suprachoroidal hemorrhage on the side of my eye. The bleeding had stopped and it was not in a critical area. And I had none of the three signs that it might be serious: increasing pain, increasing eye pressure, and intrusion of the clotted blood into other layers of the eye. He was confident that the clotted blood would disappear (its presence as a liquid was apparently responsible for my increased eye pressure during the operation), and all would eventually be well. I see him again next Thursday, and am taking an armamentarium of pills and eyedrops to keep my eye pressure low (it was below normal this morning).
The upshot is that although my vision will eventually be that intended by this surgery, recovery will be slow. And the operation on my second eye is postponed until the first one heals fully.
I have to say that my surgeon/ophthamologist, one of the most highly regarded in Chicago, had never seen this happen before in his cataract surgeries, and he’s done a gazillion of them. It reminds me of my hernia surgery in days of yore: despite reparative surgery, my hernia recurred, something that the experienced surgeon had also never seen before (he didn’t put the mesh far enough to the side, so the bloody hernia snuck around it). Yes, I’m a one-off, but not in a good way!
Blogging will resume when I feel better mentally and physically. I have a lot to say, and not about my eyes.
By the way, I was also unusual in that despite being doped up with two types of anesthesia, I remember everything that happened during surgery—something, I’m told, that is almost unique. I could feel them cutting into my eye, pulverizing my lens and sucking it out, and putting in the artificial lens. And yes, there was considerable pain at times.
Well done for being able to type this so eloquently after all that! Also crazy about the anaesthesia. I don’t think that’s supposed to happen. The whole point is that you’re not supposed to feel any pain.
Sorry about the complications, and speedy recovery! More selfishly, thank you for your report, for I’ll eventually be a candidate for this procedure, should I live long enough.
Sorry for your troubles, Professor. I’ll have to get cataract work done too, probably next year, so this is not good to hear. The good news is that supposedly one’s eyesight should be noticeably improved with the artificial lenses.
Re the anesthesia, I was semi conscious for a little while during a pacemaker implant, but was in a blissful state and felt no pain.
It’s very rare so I didn’t want to scare people who are gonna have this procedure. The incidence of this kind of hemorrhage in cataract surgery is between 0.03% and 0.01%.
Yikes! Good luck with your recovery, and glad to hear there’s no pain 🤞
We all knew you were a special person; but sorry to hear you are one-in-a-million (or whatever the number is) to have this cataract surgery complication. Good to hear the prognosis is positive. I hope you have a speedy recovery.
All us readers of WEIT wish you a full and speedy recovery. —from Cransdale
Wishing you a solid recovery from this and it sounds like it’s headed in the right direction thankfully.
Gracious! I’m terribly sorry you had these complications.
This persuades me to postpone cataract surgery as long as feasible
Speedy recovery!
Well rats. Here’s hoping for a complication-free recovery from your complications! I hope you’re at least comfortable now.
Oh my god. You were conscious and felt the pain and even remember it?? And then the tweezers. What a nightmare. Hang in there Jerry! I’m just on my way out of town for a week or I would bring you some cookies.
What an experience! It sounds like the blood will be resolved over time, which is the good news.
Sorry to hear about the complication. Get well soon!
Well, so much for all of us readers who assured you that cataract surgery was a piece of cake, me included. Sorry this happened to you.
I’m so sorry to hear about your complications. It does sound like your team of ophthalmologists were on the case immediately, thank goodness. Get plenty of eyes-closed rest.
I was thinking about your surgery, hoping it went OK.
I’m glad you had somebody to accompany you. Its …kinda a big deal even if routine so a friend nearby is important, if only to take notes on what you’re learning about your condition.
One of my close friends is an eye surgeon (of your age!), I’ll ask him about your case. Don’t be a yenta, you’ll be fine!
Get well soon, PCC(E)
D.A.
NYC
How awful to experience that. Thank goodness it’s under control.
So sorry to hear of your experience. It sounds absolutely awful all the way through. Wishing you kinder days ahead.
It must have been really serious since you mention “blogging” instead of writing! Sorry to hear about the complications. Get well soon.
That’s exactly what I was thinking!
OW!! I’d say ‘Oi vei,’ but I’m a goy. Best wishes. This is not an experience you want to repeat. Long life, good vision.
Ray Little
I will be rooting for full recovery for you. (My retinal detachment surgery a few years ago was an unusual case as well. So I felt a surge of personal anxiety as I was reading your report. I will be rooting for you very much!)
I had cataract surgery in one eye and retinal detachment surgery in the other. The cataract surgery was fantastic but the retina surgery ruined the ability of my two eyes to aim at the same spot, doubling my vision. It is two years later and I still see double.
I trust your cataract surgery will end well. But I hope you can avoid retinal surgery if possible! The problem, of course, is that retinal surgery is usually not something you can put off or avoid. I hope you never need it.
I’ve had cataract surgery in both eyes. No problems, no anaesthesia, no pain, slight discomfort.
Also had a retina detachment. I agree, your vision is not the same, a lot of seeing double. I no longer drive.
Jerry: I hope that you have a rapid, uneventful recovery!
Yikes! I hope that you get well soon. I’m queasy about anything to do with my eyes and even struggle with eye drops.
I hope you have an unusually fast recovery. Thank you for sharing your experience.
Thanks for this report – So glad to hear the team took care of bidness – though, pretty much traumatizing.
Anything with eyes … it’s Freaksville.
This one time I went for a jog, after a few passes by a mirror I saw a bloody spot in my eye. Freaked me the F out. Went to the doc – said let Nature take its course.
Eventually absorbed away.
Freak-out level stuff! And that was minor!
/WaterCoolerStories
Hopefully, these experiences will…
1. Inform the surgeon about special considerations for your next surgery. This patient needs to be put under deep. Give them the good stuff!
2. NOT put people off of their related surgery. What happened here being very rare and all that.
The problem with being put under deep is that you have to follow with your eyes a constantly moving shape as they vaporize the old lens and put in the new one. That would preclude deep anaesthesia.
Same with some phases of retinal surgery. The surgeon had to inject my eye with an air bubble; no anaesthia at all, because I had to look straight up. It was horrible to see a big blurry needle coming into my eye.
I had vitrectomy and laser treatment for a retinal detachment a few years ago. They use Propofol to briefly put you under and then inject a local anesthetic called a “block”. They then titrate the Propofol so you are in a “twilight” state. The vitrectomy, laser “welding” and gas injection was completed in the “twilight” state. I took no active part in the procedure, but did experience some pain when the laser was used.
Yes that is correct for cataract surgery. They use Propofol to briefly put you under and then inject a local anesthetic called a “block”. Propofol is amazing. You lose consciousness for the injection and then wake up as if nothing has happened. People will sometimes be speaking to the anesthetist, be in mid sentence and continue the sentence when they regain consciousness! They then titrate the Propofol so you are fully conscious and simply relaxed, so you can follow any instructions from the ophthalmic surgeon.
I had both eyes done 6 weeks apart, thankfully without any adverse effects. I did huge research on adverse effects risks and never heard of suprachoroidal hemorrhage, probably because it is so rare – less than 1 in 10,000 surgeries.
Looks like you did get the best possible and rapid treatment, so I hope you will eventually get the expected vision result.
It’s sad to read that you’ve had any complications. I hope the rest of your recovery will be smooth and speedy.
UGH. Was hard to even read about. Hope you’re all better soon.
“It was so gross that my friend… had to leave the room.”
Just reading about it made me want to leave the room! Glad that Prof Coyne was made of sterner stuff!
Sorry about the complications, and especially the pain. Tough hand to be dealt.
A speedy and painless recovery!
So sorry to hear this happened to you! doesn’t sound like an experience any of the physicians want to provide. regarding anesthesia — there are 2 kinds provided for this procedure. primary one would be the topical anesthesia ophthalmologist provides directly on your eye (or injecting local anesthetic near it). in addition, anesthesiologist may provide a conscious sedation, some anti-anxiety medication to allow you to relax or take a nap during the procedure. its not uncommon to have no sedation at all, just topical one. sound like your topical anesthetic did not take, was not effective or wore out. you should communicate with the surgeon and let him know you are uncomfortable so they can reapply. for the second eye surgery, let your surgeon and anesthesiologist know exactly what happen so they can avoid addition discomfort
Here’s hoping for a great final outcome in spite of the present complications. Mallard friends should look even more beautiful through fresh new lenses.
Oy. Truly sorry to read all that you had to go through. I realize that we are both atheists, but I will say a mi sheberach for you next time I am in synagogue. If nothing else, it has the placebo effect of making you feel good when I tell you.
Incidentally, I agree with Mark that your experience should not deter anyone from getting cataract surgery. Many if not most people, including my wife and me, wait too long. Our surgeries were trivial, and we ended up with good, clear vision (tho, oddly, I still have progressive myopia, and no one knows why).
I hope your recovery goes well. I experienced no pain or complications from my 2 cataract surgeries though a funny thing happened. When I took off the eye patch after the first surgery I saw everything slanted. What have they done I wondered? Then a nurse called to see how I was doing. She explained that the muscles allowing eye movement – up, down, left, right, etc- are paralyzed by the anesthetic and as it wears off different muscles start contracting at different times.
Sorry to hear about your setback. I hope you have a speedy recovery.
You have my deepest sympathy re: the follow up. Rare, unfortunately, doesn’t mean never. Fortunately, eyes tend to heal fairly quickly for many classes of trauma, if treated properly.
I have not had cataract surgery, yet, but I have had several eye surgeries, the worst being projectile removal (a metal sliver penetrated maybe 5 or 6mm nearly straight into sclera, but the safety glasses took most of the energy out) and a corneal reattachment a few years later. There is NOTHING fun about eye surgery, and being able to feel everything is pretty normal, in my experience. Consider that it would hurt a lot worse without the anesthetic, even if it is less than perfect.
I too am so sorry that you had complications, but very glad that you had such a competent surgical team and available facilities to deal with it.
My wife the nurse used to say that sure you can deliver a baby at home if all goes well, but when an anomaly happens, you want the best obstetrician in the best hospital you can find.
Whoa! Hope it all goes well from here on then, because that was abit of an, eh, groan… eye-opener. Tweezers!
Rest well, all the best for the recoup stage.
Take care, get well – and take the time you need, Jerry. We’ll miss the blog – but not as much as we’d miss you altogether! So, take it easy and let nature and biology work their magic/science 🙂
All the best for your recovery!
I was a tad perturbed as my wife is getting bilateral lens replacements in a couple of weeks – although I’ve had totally uncomplicated and trouble free Lasik surgery in both eyes over a decade ago and I know you’ve reported your experiences before now.
I hope you get back to your superlative writing and reporting promptly!
Best wishes from a cold and chilly South Island, NZ.
I hope you heal quickly and comfortably, Dr. Duck Whisperer.
Oh my goodness, Jerry! I’m so sorry your unique experience was not the fun kind of uniqueness! You may end up in a medical journal or two….
Thanks, as always, for teaching me something new. I now know what an armamentarium is.
May you heal quickly! The world will be more bright & beautiful when both your eyes are done & healed.
Take good care,
Margaret
Best of luck with your recovery, and here’s hoping that there are no further complications.
I’m so sorry for your awful experience! But hopefully all will be well.
Take care.
I am sure that Jerry is getting excellent advice about when to do this surgery. But I had come across this item about when is the best time to get the surgery, and the downsides of many common kinds of lenses that are used. Upshot: One should not get it so early when any gains are relatively small, and you should carefully choose what kind of lens you get. If you are still doing well with your natural lenses that you have, you should consider waiting. https://www.youtube.com/watch?v=jOj5Hxj-sBw
Quick and best recovery from Vienna, Austria
One small correction:
“… the three signs that it might be serious: increasing pain, increasing eye pressure, and intrusion of the clotted blood into other layers of the eye.” The problem is not intrusion of the hemorrhage into other LAYERS. It is intrusion into the MACULA of the eye, the part of the eye that serves central vision and is needed for high acuity vision such as we use for reading.
Then a couple of comments.
It is a hemorrhage. It is serious. It doesn’t happen often (a search told me 1 in a 1000 to 1 in 3300). Jerry was a trooper. Luckily the high ocular pressure served as a tamponade, or pressure that stopped the bleed. The blood will slowly be absorbed but slow is the operative word. This morning Jerry was much better and I think he will see well in the future.
Thanks for the news, sounds quite awful. I hope everything goes well from now on, and with your other eye. Take it easy – we’ll be waiting patiently for when you are ready to write.
As my grandfather used to say, ouch already!
Sorry to hear about the complication. It’s no fun being a statistical outlier. But best wishes for a speedy recovery!
Oh no! All the best wishes for the recovery!
What an unexpected ordeal. And knowing/feeling the procedure even after anesthesia? No thanks! Sounds like you’ll be ok, but not cool- just adds anxiety for the other eye. Thanks for the report, too bad that prayer doesn’t work, or I’d send you one.
Best wishes for a speedy recovery.
Hopefully, you will make a full recovery!
Get well soon professor! Sending my best wishes to you.
Jerry – I hope you get better soon…
Holy shit! Get well soon, Jerry!
So unlucky, I hope you heal soon and are back and swinging.
It still doesn’t put me off, so when the time comes I shall still have the op!
I wish you a speedy recovery and I hope your eye heals quickly without any further complications.
We’ve always known you were one of a kind, but this is a bit much. i’m so sorry that you are going trough this, and I do hope you recover quickly and that all future surgeries and procedures go well. All the best. I’ll be thinking of you.
Oh, bloody hell.
Best wishes for a swift recovery.
I’m so sorry about your surgical complications, PCCE. I wish you a speedy recovery.
I had a serious complication after my surgery to repair a detached retina. I had a deep corneal abrasion. It was painful as hell. Srsly. I had to return to my surgeon’s office for opioids because the pain was severe. The problem was that opioids interfere with healing, so I had to stop them.
At my surgeon’s office, I had my abrasion scraped with the wooden end of a Q-tip to remove overgrown cells. My surgeon used analgesic eye drops, but this procedure was excruciating.
After about 2 months post-surgery, my corneal abrasion finally healed. My cornea still has a scar from the abrasion.
I empathize with you about surgical complications. Fortunately my cataract surgeries went extremely well, but the retinal surgery was something else.