2022 was the third year for the two of us to be friendly with retinal ablation. Medically, the doctor has stated the condition of the eyes of Zauji will theoretically continue to decline as an effect of silicon. God willing, we will not be tired of keeping trying. The experience of retinal ablation surgery made us learn to understand the beauty behind this scenario of God.
Retinal
ablation is the release of the retina so that it causes sudden vision
disorders. The trigger for the retinal ablation suffered by Zauji was
likely due to high minus, the habit of lifting heavy weights (people in our
homes often had difficulty in water, so Zauji was in charge of lifting
water jerry cans to the reservoir in our house), and severe shocks as
well as motor accidents that we experienced 2 weeks before symptoms of
retinal ablation appeared.
Medical Ins, Medical
The
series of efforts has been done at Mata Cicendo Bandung Hospital, starting with the installation of 1300 cSt silicon oil, silicone with the
lightest viscosity, silicone oil 5000 cSt, injection of CF6 gas, scleral
buckling, and silicon HD, silicone with the heaviest viscosity.
The
last silicone HD installation operation, carried out in June 2020,
became the seventh action that Zauji had undergone. In theory, the
silicone that has been installed will be evacuated after 3–6 months
post-surgery, but doctors recommend maintaining silicone Oxanas HD as
long as possible for the retina to stick perfectly.
Evacuation
(lifting) of HD oxaline silicon will only be done when an emulsion has
formed or other things that interfere with the condition of the retina
or the eye in general. Until the end of 2021, control is carried out
every month with various stories up and down. Some of the examinations
were carried out at the pavilion clinic of Cicendo Bandung Hospital to
make it easier for us to ask and discuss with the doctor. Zauji's own
activity is still as usual except limited to riding a motorcycle at night
and avoiding basic ambulations such as being exposed to shocks or lifting
items too heavily.
Control at the Pavilion Clinic
With the condition of the right eye that is always stable, Alhamdulillah, at the beginning of 2022,
Dr. Made Indra Widyanatha, SpM (K), gives the green light for routine
control every 3–6 months. We returned to the Cicendo clinic 6 months
later, and this time we were reunited with Dr. Rova Virgana, Sp.M.K., at
the pavilion clinic, exactly 2 days before the control schedule at the
BPJS clinic.
Based
on Zauji's medical record, Rova's doctor saw something unusual:
Zauji's visibility decreased dramatically during these 6 months. Six
months ago, Zauji could still see a shadow from a distance of 1 meter.
This time, only a faint shadow from a very close distance. Because we
had not seen each other for a long time, we also explained the
condition of Zauji during consultation with Dr. Made Indra Widyanatha.
SpM (K) 6 months earlier included HD silicone that had not been
evacuated.
Doctor
Rova again explained the situation that Zauji experienced. When
silicone is evacuated, there is a possibility of the retina being torn again, while when not evacuated, there is a possibility that the eye nerves
become damaged, which means a slow decrease in vision.
Under
normal conditions, he himself prefers to evacuate silicone HD with a note that if there is a tear of the retina again, it will be re-inserted into new
silicon, which of course has a heavy viscosity, such as HD silicon.
Because in theory, silicon with low viscosity (silicon oil 1300 cSt and
silicon oil 5000 cSt), such as silicon, is less effective for retinal
tearing at the bottom.
Silicon
HD will not be evacuated if the patient feels comfortable with the
current stable condition, considering the continuous installation of
silicone, because the tear that occurs repeatedly will certainly affect the
patient's psyche. Zauji himself stated that the decision was returned
to the doctor as the person who understood his knowledge better.
Decline in vision
In
Zauji conditions, with the risk of the retina being re-released
repeatedly if the HD silicon is evacuated, as long as this stable
condition is still maintained, alias, no HD evacuation is done.
The
decline in the condition of the right eye of Zauji should be seen,
whether because the HD silicon is damaged or there are other factors.
Doctor Rova also explained that the papilla, in theory, will be damaged if
the silicone is not evacuated, so that when the papilla pales, it becomes a
natural thing.
After another examination, the Rova doctor conveyed two things:
- Silicon HD is still in good condition, but the retina on the edge looks like a pull, so it is feared that there will be a tear when HD silicon is evacuated because during this time the tear does not occur due to the resistance of silicon. Even if there is a tear, the silicone will still tear it with its own.
- With the attachment on the front, iris against the angle (honestly, I do not understand this term), there is a possibility that eye pressure will be very low if the HD silicon is evacuated, which causes the eye 'kences' or eye volume to be reduced due to the production of eye tissue that does not exist so as not to form an eyeball anymore.
Advanced Examination
Finally, the Rova doctor suggested that we consult the section:
Glaucoma clinics to ascertain whether there is a disruption or risk of eye pressure drop when HD silicone is evacuated.
Infectious
and immunological clinics to ascertain whether turbidity in the cornea
has to do with the presence of silicon HD or indeed the presence of
decreased corneal function. Usually, in the presence of silicon, the
cornea will be damaged because the blood vessel supply is disrupted. If
the turbidity of the cornea is connected with the declining function of
the cornea, then the silicon will not have an effect, so it
is given freedom whether the HD silicon will be retained or evacuated.
The silicone HD itself is still in good condition and not broken, so all that is done
is to avoid complications from installing silicone HD. The function of
the eyes itself cannot be predicted, whether it can improve or not.
Repeatedly, Zauji conveyed all we could do was just make an effort.
Finally, the Rova doctor suggested returning for an optical coherence tomography (OCT) and electroretinography (ERG) examination. OCT
is a medical diagnostic imaging technique that utilizes photonics and optical fibers to obtain images and characterization of
the tissues of both eyes. ERCG, or electroretinography, is an eye examination that can measure the
electrical response of light-sensitive eye cells.
Generally,
ERG examinations must wait in the queue because the long examination
takes a long time, especially for children who need an anesthetic because,
during the examination, ERG is not allowed to move.
Thank
God this time I got new knowledge. Doctors also do not give drugs,
including timolol, because the pressure of the eyeball is normal at the
value of 11 (normal numbers are 10–24 for patients who experience retinal
ablation surgery with silicon installation).
BPJS Clinic
We also went back to the BPJS clinic
in the next two days. As instructed by Rova's doctor in the retinal
poly of the BPJS clinic, we conveyed his notes to conduct OCT, ERG,
consultation in poly glaucoma and poly infection, and immunological poly.
The OCT examination is done first. There isn’t much queuing, so the waiting
time isn’t too long. We got the OCT shortly after the inspection was
completed. Unexpectedly, the ERG examination was carried out that day
also without a queue for weeks. I even took the time to chat with his
technician while waiting for the inspection to finish. The results of the ERG were given not so long ago.
By
noon, we slid into the glaucoma. A long queue requires high patience.
Alhamdulillah, the glaucoma doctor stated there was no indication of a
decrease in eye pressure or hypotony (aka an eye kinesis when silicon
HD was removed), so the decision to evacuate silicon or not returned
in the retinal poly.
Next
we queue in the polyinfection and immunology to consult about the
cornea. Similar to poly glaucoma, doctors in this section also stated
that the cornea is not affected by the presence of silicon HD, so the decision to evacuate silicon or not returned to the retina.
The
afternoon arrived. Thank God we can finish everything in one day. We
returned to the retinal poly after ashar with a beam of light from the
infection, and immunology was scattered somewhere so that it didn’t go
back into the retina. After a long wait, we confirmed back to the
infection and immunology, and finally the Zauji file was received in the
retina.
Ahead
of the magrib, the doctor in the retinal poly completed the Zauji
medical record that we would actually consult back to the Rova doctor at
the pavilion clinic. Thank goodness for the cool thing. This experience of retinal ablation surgery somehow glued us both to always be grateful for every state.
at the pavilion clinic certainly opens new insights on how to respond
to the experience of retinal ablation surgery that we have taken so far.
Post a Comment
Post a Comment