Had a very similar experience.

October, 2006 at Marine Corps Marathon, noticed a visual field defect in my right eye. Retinal detachment. Had the same treatment you've described: cryotherapy plus bubble, week of positioning to keep bubble in correct spot. All vision returned. Returned to swim/bike/run 3-4 weeks later.

In June 2007 the problem returned. Found during a routine follow-up appointment. This time I had surgery--vitrectomy and scleral buckle. Operation went well.

No further problems. Vision is good. No recurrence. And no impact on swim/bike/run.

It's certainly a scary event. It's easy to take vision for granted. I tell folks to err on the side of caution.

Larry

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Larry Creswell
http://www.athletesheart.org, @athletesheart

Thanks for the reply. Hoping to avoid your second experience. Would be really depressing to miss the IM but compared to losing vision, not so much.

I had surgery last March 11 for detached retina. Noticed the visual hole during a track workout - but had eye doc appt scheduled already - you know its bad when they say "sending you to specialist" and they schedule the surgery the next day. I was at higher risk for retinal detachment b/c of prior eye surgery (cateracts). I dont remember exactly what happened durng sx - had cryo and laser done to ensure the tear was reparied and there was no more damage. Then the air bubble to keep the eyeball inflated. They drain all the fluid out to do the surgery. Was stuck on the couch for a week - no reading noe computer - nothing. That was the worst part.

I went into the surgery after drilling the doc about return to training and racing. The first Xterra of the season was 30 days after my surgery and I still wanted to race. Iwas going to do exactly what he said - my vision is more important then any race. One week of zip - on the couch. Then one week of nothing over 100 heart rate. I was walking and on the spin bike because I could not drive yet. Two weeks after sx I was cleared to drive and get HR up to 120 on the spin bike. Still no running or swimming. I was walking easy and doing very mild workoits at CTS. I had to have someone get my bike out of my car - couldn't lift more then 10 lbs. I had my 30 day follow up the day before I left for the Xterra in Vegas and was prepared to not go if that was the verdict. But I was cleared to race - with the instructions to "not get kicked in the head and to only go about 80%"
And I behaved - with a very careful swim and mountain bike. I have more details on my blog - just look at march 2011.
The short version of that is I would take your time getting back - if something doesn't feel right stop, keep your heart rate down and focusing getting healthy. Then, when you are cleared to start training again ease back into like from any other injury. Usually, behaving the first time prevents a second time - or further surgery. But you should be fine for all your races next year if things heal well. I raced the whole Xterra curcit last year - pluses mountain biking and such. And while it wasn't my greatest season - I was still back out there working hard - and its paid off this year.
Good luck - and rest your eye! No slowtwitch every hour. Watch Tv listen to books and music but rest that eye.

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Vale!
Tracy T
http://www.thelencoaching.com
Some light reading::: http://www.tracythelen.blogspot.com

I had cryo over 20 years ago. It was so long ago I don't even remember which eye it was or how long they told me to take it easy. Since then I have done dozens of 100-mile runs, Ironmans, adventure races and even an Eco-Challenge. I think the biggest thing to worry about is taking a kick to your face in a mass swim start. Happened to me a few months ago and here comes the big new floater and flashing lights for a day. So far everything is okay, knock on wood.

Four years ago, I was stopped at the side of a highway on my bike when I was hit by a car doing 50 mph. Yes, I should not be here at all. Worst part of the impact was severe detached retina. I needed 2 surgeries, the first did not take, the second time was very invasive, cryo, laser welding, gas bubble, scleral buckle and weeks looking at the floor. I had done 3 IM before the accident and now 3 more since. I lost a complete season of training and racing, I was hit in April, returned to training in October, I think the second eye surgery was in July. My vision never returned to normal, it's mostly distortion issues and just poor vision out of one eye. Worst part is trying to determine how deep the potholes are that I am about to ride over as depth perception also suffered.

I was concerned about returning to my active lifestyle, after a few visits to my surgeon I asked him what his advice to me was. He said just don't get hit by a car and you will be fine.

It sounds crazy but boxers who get this injury always return to the ring. Good luck!

Very much appreciate yours and Tracy's and every one else's reply. Its good to hear that people dont feel limited in subsequent years. I can live with a long recovery if it means I can eventually run and bike as much (and as hard) as I want. No danger on the swimming end. I never push the envelope there. And I dont do any contact sports.
?!!!
One thing: If you really had those symptoms after that kick to the head every single account I have read in my brief scare says you should go to the eye doctor right now to verify you have not had another detachment. Those are the symptoms anyway. And apparently you can go on for a very long time (like over a year) with a detachment feeling fine before it goes really bad.

It might be that I am just overly scared now and just "got religion" so to speak. But those are definitely the symptoms. They are exactly the symptoms. And I have stumbled across too many accounts of someone who ignored them only to need the more drastic surgery later. Hell the guy who admitted me to the hospital told me about a 21 year old kid who ignored those symptoms and went blind in the eye..

Maybe I need to stop googling "detached retina"...

Joe. Thanks for posting. Best wishes on your recovery to 100% good vision.

Dev

The flashing lights and new floaters are something to keep an eye on - it's called posterior vitreal detachment and can be a pre-cursure to a retinal tear. Basically, the fluid sac (retina) is pulling away from the back of the eye and can tear. I actually had that happen prior to my retinal detachement - about 5 weeks before, was at work, had just finished with a really difficult patient and all of a sudden had the floater and a fireworks show in my eye. I did call the eye doc right away and got the semi-emergency opening. My doc told me what was going on and the hazards from the PVD. I took it seriously enough that I got names and numbers of eye docs and surgeons in Tucson before we headed down to 24 hrs OP. So to be safe, if I ever had any of those symptoms again, I would definitely be calling my eye doc. I will admit to still being a little skittish during swims - but haven't done many huge mass starts to worry about. And I have crashed, done some major soil sampling and such while mountain biking without issues.


Yes - stop googling retinal detachment!

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Vale!
Tracy T
http://www.thelencoaching.com
Some light reading::: http://www.tracythelen.blogspot.com

I tore my retina more than 20 years ago in middle school. I don't remember much about it other than hating the constant follow-up appointments and getting my eye dilated all the time. Now it doesn't bother me at all. Probably good to have had it happen so young so that my body could repair it so well. In truth the only thing I can say that I notice from the whole thing is that I now have a weird story about a pole-vaulting accident that I can tell from time to time.

Unfortunately, I can't offer any experience or expertise, but certainly want to send my well wishes to one of the good guys on ST.

I am a retinal specialist who also does ironman, mountain biking, trail running, etc... My info here is not directed at you but is simply an example of what I tell my own patients.

When it comes to retina detachments, I usually allow most of my patients to get back to ALL their normal activities once the bubble in the eye is gone. If a patient's retina is to come back off, after a great surgical repair, then it is not really within your control. Typical reason for a redetachment is the development of PVR (proliferative vitreoretinopathy). PVR is scar tissue and you have no control over its development regardless if you are running or in a coma somewhere. It is the biggest pain in the ass to any retinal surgeon (and patient, of course). Your doc knows your eye best, and has examined/operated on you, so make sure you take their advice over all others.

As someone else mentioned, it is always good to avoid any direct impact to the eye (regardless of a history of surgery or not). You will need continued follow up as I have had patients come back three years later with new detachments. Many people think of the body as "hey, I have a broken bone. The doc will put it back together and I will walk again". The eye is not exactly like that. We can put the retina back and make it a surgical success but there is not always visual success. The retina is like "brain" tissue so it may not always heal back to complete vision recovery even with great surgery. Also, because of the changes in vision, you certainly have to be extra careful when running or riding. Not because it will re-detach your retina but because of limited depth perception and limitation with seeing surroundings (ie, cars, other cyclists, etc....).

Thank you so much for the reply. I have no problem doing whatever I am told if I will eventually be able to resume a normal training schedule at some point down the line. I dont do any contact sports. Just running, swimming, and cycling. And in my tri swims, I always stay clear of the pack anyway.


As it turned out, though my original procedure (cryo + bubble) to repair the original tear did "succeed", there were additional tears that necessitated full blown surgery. I had a vitrectomy plus laser plus a bit more cryo. I am now about to start my 3rd consecutive week at home lying down, staring at the floor to keep the bubble in the proper position.

On the two follow-ups I have had so far, my Doctor has said all looks very good. But obviously I wont really know much until the bubble is gone.

In your experience, once the bubble is gone, is that the vision the person is going to have indefinitely or is there an additional period during which it sill might improve?

I was lucky - when that damned bubble went away (and you just had the same surgery I had to start with) - the vision in my eye was back to normal for me. The area where the tear was healed up and I did not have any holes in my vision - which is one possibility. I have noticed a little more issues with depth perception at times, especially when night riding and that eye does seem to get more "tired" then my other eye. I am also willing to bet I'm a little younger though :)


I also found it more annoying when the bubble was half gone - as it was like looking through a goggle half filled with water. Head ache inducing! Heal well, rest your eyes frequently and do what you need to heal. At least it's the "off" season when you have to take some down time and rest :)

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Vale!
Tracy T
http://www.thelencoaching.com
Some light reading::: http://www.tracythelen.blogspot.com

I have seen people continue to improve even a year out from surgery so don't despair. It is certainly aggravating, especially for an active person like yourself.

Is there any evidence to suggest a link between strenuous exercise and Retinal Detachment or Posterior Vitreous Detachment?

I'm a -3.75 and due to my line of work (pilot), I'd like to minimise any risk to my vision.

No, there is NO conclusive evidence. Most RDs related to sports are from direct injuries to the eye.

Your biggest risk factor is being myopic (near sighted). A -3.75 is not too bad (not considered pathologic myopia) but you would be wise to make sure you have a yearly eye exam and it is by a doc who knows how to evaluate your peripheral retina (looking for "weak areas" and/or retinal breaks).

Along the same lines...is there any evidence that endurance sports make CSR any worse? I have been recently diagnosed (last October) but was just told to quit caffeine. I have a follow up next month with the MD retina specialist. Just looking for a little heads up.

I am really surprised CSR has not been diagnosed in more triathletes. CSR is considered an idiopathic (no known cause) disease but is commonly seen in Type A personalities, people on steroids (ie, chemo pts as part of their treatment regimen), and, less commonly, pregnant women. I have never read anything saying endurance sports will contribute, or exacerbate, the disease. Mainly, I tell pts to reduce stress in their lives (yeah, like that is easy), cut back on caffeine and/or cigarettes, and stop use of steroids (if any and not part of needed treatment).

Bad thing about CSR is that it tends to recur in a lot of pts. Sometimes you will notice it and other times you will not.

Dont rush back, its your sight. MY GF is dealing witht the same thing after having something fall on her eye when she opened a cupboard.

Deriously, rest, make damn sure its healed up before going ut and crushing something that is ONLE cool here on ST.

FWIW- here is another "first person experience". I've got an eye that is extremely nearsighted- 20/400--. It has been that way since birth and early attempts to correct it were unsuccessful. I use the eye mainly for peripheral vision, but the limited vision is still important.

I've been made aware of the s&s of retina tears/detachments. I also knew from eye exams that I had two thin areas in my retina due to the extreme nearsightedness of the eye, and that due to this I was at an increased risk for a retinal tear/detachment. On a run in Jan '12 I noticed "floaters" and the next day had cryo and laser to repair a tear in one of the thin areas of the retina. At no time did I have any loss of vision. I had regular followups w my retina specialist to monitor the repair and after the visit in mid Nov '12 he released me to followup w my regular eye doctor or him (my choice) on a yearly basis. Total downtime was about 3 weeks until back to full activity.

Jan 9, '13 I notice a "shade" in part of the vision of the eye- ie a loss of vision in part of my visual field. The repaired tear from a year earlier had retorn and the retina detached. Jan 15 was scleral buckle, laser and air bubble surgery. I noticed a significant vision improvement, but still had some cloudiness at the extreme peripheral vision due to fluid behind the retina. At that time MD told me we could stay status quo, or have an additional surgery which would get vision back to the way it was before the surgery. Jan 29 I had a second surgery- vitrectomy and air bubble. Within 3 days I noticed that my vision was essentially back to where it was before the detachment on Jan 7. Two week followup was positive, and I was released to start light running. Two days later I noticed a dark screen in another area of vision. The repair held, but I had detached the other thin area of the retina. My third surgery for 2013 was Feb 19 laser to repair the second detachment and the injection of silicone oil. The oil will stay in, essentially splinting the retina from the inside for 3-4 months, and then I will need a surgery to remove the oil.

Right now my eye is a little sensitive to the light- specifically sunlight and fluorescent lights, and it is still a little irritated from a stitch that is slowly dissolving. I am cleared for running, road biking, but no mtb for a while. Some key points that I've learned-

--have confidence in your surgeon. I think mine is phenomenal. He spent a lot of time w me at each injury visit, and explained the positives/negatives of each surgery. For example w the silicon oil I have a much higher chance of developing a cataract, but also a much lower chance of tearing one of the repairs. It also helped that he is a cyclist, and he understood how important activity is to my lifestyle.

--take the info/recs from the lay person (me included) fwiw- anecdotes- everyone is different and every eye is different. In my case I already had limited sight in the eye, but I have learned that I want to keep as much of it as possible- I really noticed the loss when I had the detachments. All the below "--" are my anecdotes

--it seems return to activity is much faster after the silicon oil bubble compared to the air bubble. For example the day after surgery I was on the floor of the exam room showing the MD some back rehab exercises. When I saw the MD a week after surgery he told me that if I wanted to catch a flight to California and do a 30 mile bike ride there then he wouldn't have a problem with me doing that

--12 days post the vitrectomy and silicon oil I have minimal discomfort, I notice the vision is a little cloudier from the silicon oil, and if I really look peripherally I can see the meniscus of the oil

--12 days post surgery 3 I notice my eye does not constrict as well as the uninjured eye- a common side effect of my surgeries. Right now it is a little bothersome, but if it never gets any better it is a minor cross to bear given the fact that I could have no vision

--worst part of the whole process- the time spent on one side until the air bubbles dissipated

--pain post surgery was relatively minor- have taken about 6 Tylenol total

--the whole process has been uncomfortable and a little scarey at times....BUT compared to terminal cancer, loss of a limb and even if I did (do in the future) lose all the sight in the eye it could be a lot worse

--3-4 months from now I will need an additional surgery. At that time or at some time in the future I may have to also have cataract surgery

--there is a chance I could re-detach the retina at some point; right now the thin areas have been repaired, and if I get another tear/detachment then I will go back to the same MD

--I now can justify my collection of sunglasses, prescription glasses- to protect my eyes

--have confidence in your surgeon- he (or she) is the best source of info, and the good ones will take the time to answer your questions/address your concerns- mine easily spent 25-40 min w me at each office visit, and usually 10-15 min w me pre-op and/or post-op

Very much appreciate your sharing your experience. So I guess I should share an update.

Right now I am approximately 14 weeks post-the-first-procedure (cryo + bubble) and 13 weeks post surgery (vitrectomy + laser + cryo + bubble). Approximately 10 weeks after my surgery, my bubble was gone and my surgeon told me I could basically do whatever I wanted athletically. He said that it looks good and it's healed and that no more waiting was going to help. If there are further detachments, there's little I can do to prevent them. So I've basically been training for 3 weeks.

The eye itself is OK. It used to be 20/20 (sometimes 20/15) before surgery. That's corrected vision, mind you. Without glasses/contacts, I was blind as a bat before too. But now, the best that they can correct it to is 20/50. This impacts my job quite a bit as I work at a computer all day long. I can read the screen just fine with my left eye but only just barely with my right.

The worst part is that surgery has started the development of a cataract in the eye. I will need cataract surgery in a year or so. No getting around it. Oh well.

The second worst part is that the affected eye remains dilated all the time. It cannot constrict in bright light. The eye doctor has told me that it is reacting to the light and it could improve up to a year down the line but I just have to take it as it comes. So I make sure to wear sunglasses out, even when it's not too bright.

I believe I was very lucky. In particular, I am lucky to live in Boston and be right down the road from the Mass Eye and Ear Infirmary when this all happened. I literally walked out of my eye doctors office, traveled just a few blocks and was in one of the best eye treatment facilities in the entire world. Even if I had somehow gotten the worst guy in there, he probably would have been better than the best guy in most other places. And I believe I got someone very good.

So Ironman Austria is still on for me. The eye surgeon gave me his blessing.

1. What is CSR an acronym for? I'm not following that, even from reading previous posts
2. You were told to quit caffeine? Did they give you a reason why?

Sorry. Should've put a slight hijack warning. It's "central serous retinapothy"
And it's different than a detached retina. I should've pm'd the good eye doc.
CSR is made worse by stress, caffeine, nicotine and stuff like that.

I'm praying mine doesn't eventually progress to detached. Glad yours turned out as well as it did.

Thanks Eye3MD. Your advice is much appreciated. I have an annual eye exam but I don't always have my eyes dilated. Would you recommend this every year?

I've had floaters for years and the occasional flashing lights when looking at the sky but no loss of vision.

What is the likelihood of a retinal detachment occuring with my eyes at -3.75?