By Staff Writer Claudia
On Friday, October 2, I began noticing changes in my right eye’s vision. What started as unsettling visual symptoms eventually became something much more frightening: by Friday, October 16, roughly three-quarters of that eye’s field of vision was completely opaque. I could no longer treat this as a strange visual disturbance that might simply clear up. I needed help, and what followed was a day of urgent medical care, extraordinary kindness, and navigation through an impressive amount of Costa Rican traffic.
Living in Costa Rica, we have spent plenty of time figuring out the practical details of everyday life. An emergency involving my eyesight was a very different kind of test. Would I find the right specialist? How quickly could I get treatment? Within hours, those questions were being answered by people who understood that my vision could not wait.
A doctor who did not make me wait
I had an afternoon appointment with my ophthalmologist, Dr. Chun Cheng Lin Yang, at his office at Hospital CIMA in Escazú. But we arrived early, at about 9:15 that morning. As soon as he spotted me in the waiting room, he took me in rather than having me wait until my scheduled appointment. He examined my eye, confirmed a retinal detachment, and did not charge me for this second visit.
He then called a retinal specialist he knew, Dr. Carlos Cabezas Charpentier, and arranged a 1:30 appointment that same day. There was no leaving me with a phone number and the responsibility of figuring out the next step alone. He made the connection himself. In a moment when I was frightened about losing my sight, that personal handoff meant a great deal.
CIMA is a private hospital in San Rafael de Escazú, with specialist medical offices and round-the-clock emergency services. My visit was to the ophthalmologist’s office there; my surgery would take place at a different hospital. Dr. Lin Yang’s training includes ophthalmology in Guatemala and subspecialty training in oculoplastic, lacrimal, and orbital surgery at the Center for Facial Appearances in Salt Lake City, Utah. His response that morning gave me something credentials alone cannot: the feeling that someone recognized the urgency and was looking out for me. [1, 2]
A family logistics operation
Getting to the retinal specialist meant crossing town to Alajuela through more than an hour of traffic. Dr. Cabezas Charpentier examined me and scheduled surgery for six that evening. He recommended that we stay at a nearby hotel because I would need a follow-up examination the next morning. We booked a room at the Hilton Garden Inn at City Mall in Alajuela, and suddenly an ordinary Friday had become an overnight family operation.
My husband dropped me at the hotel to rest, and headed back to pick up our son from the Real World School in San Mateo. He also had to pack bags and return to Alajuela. It was Friday and payday, which added another layer of congestion to an already complicated route. While the doctors organized the medical side, my husband handled the considerable task of getting our family where we needed to be.
Dr. Cabezas Charpentier specializes in the retina, vitreous, and macula, as well as cataract surgery. His clinic’s biography describes medical training in Costa Rica, specialty training at Hospital Dr. Elías Santana in the Dominican Republic, and an observational retina fellowship at the University of Denver in Colorado in 1999. That international background was reassuring, but what mattered most to me that afternoon was that he had made room to operate that very evening. I was not being asked to wait days while my vision remained at risk. [3]
Another drive, then a warm welcome
The operation itself would take place at Hospital UNIBE in Tibás, another journey of about 90 minutes through traffic from Alajuela. UNIBE is a private hospital that opened in 2004 and provides surgery, inpatient care, medical imaging, laboratory services, and emergency care. The hospital operates around the clock, and reports having three operating rooms. Before that day, I had little reason to know much about it. By that evening, it would become a very important place in my life. [4]
When I arrived, the staff was waiting for me. I filled out basic forms, a much smaller amount of paperwork than I have come to expect from medical care in the United States. I had already called my health insurer and explained what was happening. Their instruction was to do what I needed to save my vision and submit the documentation for reimbursement afterward.
The attending nurse took excellent care of me. She brought my surgical garments and began a series of eye drops that, rather miraculously, seemed to sting less with each application as the preparations and numbing progressed. The surgeon came to speak with me, shook my hand, and explained what to expect, including three tiny incisions in my eye. My procedure was a vitrectomy with a gas bubble, and the repair included both laser treatment and cryotherapy, or freezing. His manner was calm and direct, which helped me feel calmer too.
The anesthesiologist asked about my height, weight, and medical history, with a little conversion needed from pounds and inches into the metric system. An intravenous line went into my wrist, followed by more eye drops. Then they took me by wheelchair into the operating room. To my working eyesl, it looked exactly like the modern operating room I would expect to see in a well-equipped hospital in the United States or Europe.
The rosary and the operating room
Everyone was kind and professional, but I still had one very understandable concern: someone was about to operate on my eye. They explained that I would be relaxed and comfortable, rather than necessarily unconscious throughout the procedure. Naturally, I asked to be completely knocked out. As it turned out, the doctor’s reassurance was well founded: I felt no pain.
I began praying the rosary, repeating the decades like a repetitive meditation as a way to settle myself. In all honesty, I probably managed only a few minutes before my awareness became hazy. I could hear the doctor and a nurse talking, but I could not make out their words. Then, seemingly almost immediately, someone told me it was over and helped me sit up to return to the wheelchair.
Afterward, I was given warm apple tea through a straw. By then, keeping my face pointed downward was part of the postoperative instructions because the surgeon had placed a gas bubble inside my eye. Even that small kindness, a warm drink offered carefully while I adjusted to what I needed to do, stayed with me. About half an hour later, I was on my way back to the hotel.
Why the gas bubble matters
The gas bubble acts as a temporary internal support, helping hold the retina in place while the treated area heals. Because gas rises, the position of the head determines which part of the retina the bubble supports. That is why my surgeon initially wanted me looking downward: the positioning was part of the treatment, not simply a suggestion for comfort. The exact position and how long it is needed depend on the repair, so those instructions must come from the treating surgeon. [5, 6]
The bubble also explains why recovery affects travel. As altitude increases and surrounding air pressure falls, gas inside the eye can expand and dangerously raise eye pressure. That makes airplane flights and some mountain journeys a concern while gas remains in the eye. My doctor told me to expect at least four weeks without flying, but the deciding factor is complete absorption of the bubble and his clearance, rather than reaching a date on the calendar. [6, 7]
By about 8:30 that evening, the traffic had finally eased. After a day of appointments, uncertainty, and long drives, we had a smooth trip back to the hotel. I had begun the morning with most of the vision in my right eye obscured. By bedtime, I had been assessed by two doctors and undergone surgery.
Recovery, cost, and perspective
The next morning’s follow-up went well, and the surgeon was pleased with the early result. That did not mean I could suddenly see clearly again. My eye needs time to heal, and the gas bubble will gradually be absorbed over the coming weeks. But while I am still on the mend, I can now see light and movement through an area that was previously opaque darkness. It is early, and I do not yet know what my final vision will be, but that change gives me hope. I left with drops to address inflammation, control eye pressure, and prevent infection, along with another follow-up scheduled for the following week.
I paid for the surgery by credit card the next morning: ₡3,988,000, which appeared on my credit card as an actual charge of US$8,776. That covered the surgeon, anesthesia, hospital fees, follow-up visits, and medications. Transportation and the hotel were additional expenses. It is a substantial amount of money, and reimbursement is a separate process that I still need to complete. I was fortunate to be able to pay upfront and concentrate on getting treatment. Before surgery, I had been given an estimate of about $17,000 for a similar procedure in the United States. Against that estimate, my bill here was roughly half as much, although actual U.S. prices vary with the procedure, hospital, insurance, and services included.
I cannot say how this would have unfolded in Costa Rica’s public hospital system because that was not the route I used. Nor can one experience stand in for everyone’s experience of private care. What I can describe is the urgency, coordination, and compassion I received from these doctors and hospital staff. At each step, someone understood what needed to happen and helped move me toward it.
My recovery is still underway, and I do not yet know how much vision I will ultimately regain. But I am deeply grateful that, on a frightening day, I felt taken seriously and cared for. The doctor who brought me straight out of the waiting room, the specialist who scheduled surgery that evening, the nurse with the warm apple tea, and my husband navigating the roads all became part of that experience. Those are the details I will remember alongside the surgery itself.
One lesson is worth sharing clearly: lightening bolt-like flashes, a sudden increase in floaters, or a shadow or curtain across vision need urgent medical evaluation. A posterior vitreous detachment is when the gel inside the eye separates from the retina, and is different from a retinal tear or retinal detachment, although it can sometimes lead to those complications. An earlier examination does not make a later change in vision safe to ignore. If a dark area or missing vision develops, seek urgent eye care rather than waiting for a routine appointment. [5, 8]
Sources
1. Hospital CIMA, Dr. Chun Cheng Lin Yang: https://directorio.hospitalcima.com/es/doctor/chun-cheng-lin-yang
2. Hospital CIMA, hospital and contact information: https://hospitalcima.com/ and https://hospitalcima.com/contactenos/centro-de-contacto/
3. Clínica Oftalmológica Charpentier, surgeon biography: https://charpentiercr.com/retinologo-dr-carlos-charpentier/
4. Hospital UNIBE, hospital history and services: https://hospitalunibecr.com/sobre-hospital-unibe/ and https://hospitalunibecr.com/contacto/
5. American Society of Retina Specialists, Retinal Detachment: https://www.asrs.org/patients/retinal-diseases/6/retinal-detachment
6. Cambridge University Hospitals, Surgical repair of retinal detachment: https://www.cuh.nhs.uk/patient-information/surgical-repair-of-retinal-detachment/
7. “Altitude and gas expansion in repaired rhegmatogenous retinal detachment,” Eye: https://pmc.ncbi.nlm.nih.gov/articles/PMC10697935/
8. American Society of Retina Specialists, Retinal Tears: https://www.asrs.org/patients/retinal-diseases/26/retinal-tears