Surgery for Detached Retina Restores Vision for Tennessee Man

Last fall, Don Johnson, of Roan Mountain, TN, began seeing an “unbelievable number” of floaters in his right eye. “It started with dots, and then progressed to what looked exactly like a jellyfish right in my field of vision,” said Johnson.

Johnson contacted the Duke Eye Center, where he sees ophthalmologist Melissa B. Daluvoy, MD, for his yearly exams. He was told that if he saw “a curtain over [his] field of view,” or experienced flashes of light, he should go straight to an emergency room.

One morning at the end of October, “I opened my eyes and it was like lightning, and the lower half of my vision in my right eye was gone,” said Johnson. He went straight to his local emergency room, where he was diagnosed with a vitreous hemorrhage.

“They set up an appointment for me to see a local specialist, but I chose to go to Duke,” said Johnson. “My family has a long history with Duke. When we lived in the Florida Keys, we would drive 17 hours to be seen there. Duke is by far the best medical facility in the southeast United States, so that’s where we chose to go.”

Johnson got an appointment at the Duke Eye Center for the next day. There, it was discovered that his vitreous hemorrhage diagnosis was incorrect. Instead, Dr. Daluvoy diagnosed him with a detached retina, and Johnson was scheduled for surgery the following day with Duke retinal surgeon Yannek I. Leiderman, MD. 

“If the eye is a camera, the retina is the film,” explained Dr. Leiderman. “The eye is filled with a clear substance called vitreous gel. The gel changes with age in ways that can lead to holes in the retina. Liquid inside the eye can seep through holes and pool underneath the retina, which starts to come off almost like a piece of wallpaper peeling off the wall.”

Vitrectomy surgery starts with several “incredibly tiny” incisions in the eye. Dr. Leiderman then used a special instrument to remove gel from inside Johnson’s eye, and carefully reattached the retina. Next, he used a laser to seal up the tear. Finally, Dr. Leiderman filled Johnson’s eye with an air-gas mixture, like a bubble, to help the retina heal in place.

Upon Johnson’s release that day, “Dr. Leiderman told me what I needed to do and what I needed to be cautious of,” said Johnson. “And he also told me why. I appreciated that.” Johnson found Dr. Leiderman easy to work with, too. “His intelligence and focus are unbelievable, but he's such a friendly guy,” Johnson said. “He does not miss a beat. Not only do I respect him professionally, but personally, he's been great to deal with.”

Dr. Leiderman said that patients tend to find the bubble the most uncomfortable part about recovery. “When the eye is filled with something other than the liquid it's used to, it distorts things a lot, and vision is quite poor until the body reabsorbs the air-gas bubble,” he said.

It took six weeks for Johnson’s body to reabsorb the air-gas bubble. For the first seven to ten days, he had to be facedown for 45 minutes every waking hour. Johnson rented a sitting massage chair designed specifically to facilitate the head-down posture. “It has a mirror that you can watch TV in,” said Johnson. “If it hadn’t been for that, I don’t think I’d have survived.”

Johnson’s vision started to clear in a few days. Then a couple weeks later, it really “came back to life,” he said, adding that it’s now close to how it was before the detachment. He plans to follow up with Dr. Daluvoy to see if she can fine-tune it even more.

While the Duke Eye Center is known for taking on complex, difficult cases, Dr. Leiderman explained that there’s a benefit to coming to Duke for more standard procedures, too. “We are able to offer great care for common retinal procedures because of the expertise of our surgeons and our team-oriented approach to care. At the Duke Eye Center our outcomes are excellent because the whole team is outstanding.”