How long will my eye look droopy or swollen after detached retina surgery?

My surgery was two months ago, and while the redness is getting better, my eyelid still looks weird. It is swollen, heavy, droopy, lazy, call it what you will but it looks smaller than the other one because of this and it really bothers me. I am wondering if the surgery did muscle damage to my eyelid or something. I am lucky I still have an eye after the injury I had, but does anyone know if the eye will always look ';weird'; or will I ever look normal again? And if it will look normal, how long will that take? My doctor says don't worry, and I see him in a month, but I wish someone who has had this experience would tell me how their eye looks several months later. Thanks!How long will my eye look droopy or swollen after detached retina surgery?
Retina surgery is fairly traumatic. If you had trauma, then all the rules sort of go out the window. Trauma in it's stretching, tearing, pulling, response to blood in tissues, healing,...all of it is a tough road.





As I don't know what type of trauma you had, we can go over what the retina surgery itself does.





Assuming no damage to the eye itself, just a simple retinal detachment.





First, the conjunctiva is opened at the junction of the sclera (white part) and the cornea, the clear part. Some people use relaxing incisions so no tearing is done.





Then a pair of curved, blunt end scissors are placed in each quadrant...the superotemporal quadrant, superonasal quadrant, and the two lower ones and spread to gain access to the scleral surface posteriorly. Then the muscles, the four primary ones are each isolated with a muscle hook and then a large suture is placed around them. These are bridle sutures and are used to rotate the eye in different directions and stabilize it while placing sutures or placing a buckle or doing a drain to get the fluid from under the retina out.





Then the surgeon will look at the retina and mark on the outside of the eye where the little tears on the inside or other pathology are located. Once these areas are identified and marked, either sutures are placed behind them or a buckle is placed around the eye. The buckle, when tied into place creates a bulge on the inside of the eye which supports the tear or tears, and also shortens the circumference which lessens traction.





So around the eye we go. Mattress sutures are placed across the width of the buckle or band, and once the eye is soft enough, via drain or internal drain, the buckle sutures are tied into place. The surgeon then looks again to see if there's any tear missed, or that the cryo or freezing which is done around the tears to cause adhesions which seal the tear, are all well placed. If the retina is fairly flat over the buckle, and the tears are High, that part is done.





The areas are irrigated with antibiotic solution, sharp edges are trimmed, sutures adjusted, and the bridle sutures are removed. The conjunctiva is closed all the way around. Some people then put injections or antibiotics or steroids or both and after some ointment is placed, the eye is patched.





If there was a lot of blood in the eye itself, the middle chamber, the vitreous cavity will hold most of it. There may also be a foreign body..piece of wood, nail, metal, glass, plant seed or fiber....etc. which is removed at this time. A vitrectomy may be done to remove the blood and give visualization of the retinal status. Some don't do a buckle if there's a simple superior tear. After the vitreous is removed, air or gas is placed in the eye which holds the retina onto the wall. It also seals the tears. It can be used as an adjunct to a buckle, or by itself to hold the tear closed while laser or cryo irritation scars the retina to the outer wall tissues. Gas is used so that it won't absorb as quickly as air does. In severe cases, silicone oil is used so it'll stick around...forever. It can be removed later once the eye is stable.





The lid speculum that holds the lids open frequently damages the levator muscle. This muscle pulls the upper eyelid up. If it's tendon gets stretched, the lid will be a bit lower, slightly ptotic. In most people it takes about 6 months for the lid to retract back into place. In others there's been an injury and it may have to be surgically repaired.





These eyes look beat up for a few months. By 3 months or so, most look fairly normal. But a lot of people always find that this eye is always a bit more swollen, or slightly red or discolored, and the lid may not retract to it's normal position. The eye itself, if repaired, will adjust to the surgery and trauma. If all the tissues are ok, the eye will see well. In trauma, lots of time the lens is removed so the vitreous surgery or retinal surgery can be performed. Later or during the latter part of this repair, many will place a lens into the eye. And it might see well.





Have seen patients with nail gun injuries end up with a really funny looking iris, with an extra hole up somewhere which can't be repaired all that well, but see 20/20. Sharp injuries seem 'better' than blunt injury.





For instance a BB penetration to the eye almost always means a lost eye. It's not the BB, it's the contusion, the blunt trauma that distorts the tissues so much they don't recover. The eye usually ends of with a retinal detachment and may go into phthisis which is where it shrinks prune-like. If it's painful, it'll be removed, or eviscerated and a marble like implant placed. Then a prosthesis which is a ceramic eye which looks like the other eye, is placed. If done 'right' without complications, it'll move just like the other eye. But as it doesn't see, it won't maintain directional stability and will sort of look funny depending on the gaze direction at any one time.





For you, give this some more time. Most people can't tell which eye had the problem a year or so later. You are only a month out...that's pretty early.How long will my eye look droopy or swollen after detached retina surgery?
Wow... great answer from Paul B!