Through a Glass Darkly

Some may have noticed, that it has been a week now since I have posted anything to the blog or much anywhere else for that matter. There is a reason for that. I have been under a complete black out. Not a news black out mind you, or even out of contact or out of reach of the neasrest wifi connection. All those have remained intact and my laptop is working fine. My black out has been due to one of my senses being a bit lacking of late. One of my most important senses I might add. I simply haven't been able to see for the past week.

They say that you don't truly miss something until you no longer have use of it. They say that many things in life we simply take for granted. Nothing could be more true when it comes to our ability to see. I have never had what were called hawk eyes. I have always worn glasses and for the most part, they have served me well. I could do just about anything that a normally sighted person could do and aside from the occasional having to take them off to clean them or the having to worry about scratching them or miss placing them, the world of glasses has been a quite tolerable existence in my experience. At least until about eighteen months ago.

That was when I went in for one of my annual eye exams. While there I received all the customary exams and testing, glaucoma, corneal exam, visual acuity etc. and in the end, the optometrist asked, almost as in passing, "has anyone ever told you that you have cataracts?" I responded well no, but added that I was reasonably sure that he was about to.

He assured me that the beginnings of cataracts  were present, but that they were not presenting a problem at that time, but he added that over time they would become a problem and require surgical intervention. We then discussed all the latest and most modern techniques for cataract removal and lens replacement and I left the office with my new prescription for my glasses and felt confident that this was something at the least several years in my future. Nothing to concern myself with at that moment that was for sure. I was only fifty seven at the time and this was something for the seventies crowd at the least. Hell! I couldn't even qualify for a senior's discount yet!

The irony of our conversation that day was the enlightenment that there are different kinds of cataracts. I never knew that before that day. Mine it turned out were caused by sun damage, which was interesting to say the least, as I had spent the majority of my career working night shifts and I have never been one to be a sun worshiper. I am truly one of the original pale faces who's forefathers showed up at Plymouth Rock asking the Indians 'where's the sun screen and the beach umbrellas?'

So here I am, suddenly beset with an ailment of the eyes that literally you expect to be something for the geriatric crowd. So, I spent the last eighteen months muddling through my options, but knowing all the while that my eyesight was literally diminishing before my eyes.  So after some serious soul searching and contemplation, I decided to go and see one of the preeminent local specialist in interocular  lens replacements and Lasik surgery.

I reasoned that if I was going to have to have this done, then I wanted the best, I was going to have the 'full Monty.' No reason to half step, might as well go full tilt and get the full treatment and be done with it. So I made my appointment and when I went in for my appointment, we discussed the cataract lens replacement surgery and a follow up with Lasik corrective lens surgery for my astigmatism. I was told that in the end, I would see 20/20 and wouldn't even have to wear reading glasses.

The doctor and his LASER EYE institute are nationally famous and preeminent in the southeast and he has many accolades and many testimonials from a wide variety of celebrities and athletes. All attesting to his skill as a Lasik Surgeon and how wonderful their eyesight was improved by his skilled approach with lasers and interocular lens replacements.  Of course, even with insurance, this procedure is rather expensive.

I opted for the top of the line interocular lens replacements. The lens that would not only restore my distance vision, but would also eliminate the need for reading glasses. What the hell! If I am paying this kind of money and I am having to have surgery on my eyes?" I am going to get it all done top flight.  The ophthalmologist surgeon and his in practice optometrist each assured me that I was an excellent candidate for the lens replacements and the Lasik and that I would be finished and fit as a fiddle in less than six weeks. So we scheduled the first lens replacement for the 14th of June. In my right eye.

I was told to expect a very short procedure, under 15 minutes beginning to end, but first I would have to have "flaps cut" for both eyes, for the later to be done Lasik surgery. Something about the pressure applied to the eyes while cutting preoperative flaps and the fact that they can't do that for several months if they don't do it before the cataract lens replacement surgeries.

So here I go. I arrive the morning of my procedure and I am taken to the 'recliner room,' where I am given more eye drops than can be counted. All deadening drops and dilating agents and afterward I am escorted into the LASER ROOM!

"EYE PROTECTIONS MUST BE WORN AT ALL TIMES!"

Everyone present had on those Woody Allen type white cotton paper suits, reminiscent of his movie 'Everything you always wanted to know about sex, but were afraid to ask.' I felt like I was going to be dressed like a tampon and loaded into the great sperm delivery gizmo like in the movie. But I digress.

Soon, they helped me up and onto a sterile looking white table and positioned me between two very large medical devices on pivots with swing arms and oculars and huge LASER IN OPERATION! WARNING signs. I presumed these to be the LASERS that would be cutting the flaps in my corneas and I felt like I was was either between the "R2D2" twins? Or I had been paced between the two destroyer robots from the movie Robo Cop.

After laying there for a rather uncomfortable and freezing several minutes, the doctor arrived and began commanding the robotic LASERS into position. My head was placed and locked into some medieval  apparatus and the doctor's last words were, 'hold still, this will just take a minute.'

At that point, he dropped some medical device directly onto my eyeball and suctioned it down. At which point, I went completely blind in that eye. This lasted for approximately a minute, then the suction device was released and the procedure was duplicated in the other eye. There is no way to compare the sensation, other than to say, it's like having a vacuum cleaner hose attached to the end of your eyeball.

Once both eyes had their 'flaps' cut (for later on down the road LASIK surgery) I was returned to the 'recliner room' where I was give Valium and more eye drops and a blood pressure cuff and allowed to watch TV. The only problem was, there was only one channel on the screen and that was the real time closed circuit video feed  of cataract surgeries in progress on those ahead of me. So, having sat there for the next two hours watching one cataract removal and lens replacement after another in high definition on a 42 inch screen? I felt like I was not only familiar with the procedure, but that I could probably also assist should the need arise.

My appointment was for 8:45 that morning and after the LASER eye flap cutting experience and the watching a half dozen of more interocular lens replacements, I felt that since I was the last one in the recliner room, then certainly I was the next one up. I had to be in the on deck circle! Right?

Wrong. The nurse came out and told me that there was one more patient in front of me, but she assured me that just as soon as his procedure was finished, I was next. So here I go again. I kick back once again in the recliner to watch yet another cataract replacement procedure live on closed circuit television. Yippy.

I have to admit, once you have seen one of these procedures done (several times) they tend to lose their appeal to your interest. So I am not really watching this last one all that closely. Just mentally watching the clock and wanting to get in there and get this over with. But after about fifteen minutes, I knew something wasn't right. The surgeon was still in the patient's eye and now he had needles and forceps! Holy bat crap Batman! That doesn't look like fun at all! A lot more involved and bloody. And it looks a lot worse than anything I had seen to this point.  Now I am captivated....

This operation goes on for an hour and needless to say, the screen now has my undivided attention. Finally, after an hour, the surgeon finishes and swabs out the eye and the screen goes blank again and then the  nurse reappears in the recliner room. She asks how I am doing, which was not the right question or approach for me at this point. I have been waiting over three hours for my appointment at this point and I can barely see due to drops and dilation. My eyes are sore from this suction cup flap cutting thing and I have just spent an hour watching some poor bastard get his eyes sewn up like someone darning socks. On top of all that, the fifteen milligrams of Valium that she had given me (three hours ago) to calm my nerves has completely worn off somewhere between "Days of Our Lives In Lens Replacements" and the "Let's Darn You Eyeballs!" episode on the big screen,  I am quite antsy (and quite mad) to say the least. Which I voiced to the nurse when she reappeared.

Of course the nurse apologized and assured me that the other procedure had simply gone far longer than anticipated due to complications, but she assured me that I was next. Just as soon as the surgeon had the opportunity to go and have his lunch. Excuse me? I have been waiting almost four hours now? And the guy is going to take a lunch break? Needless to say. I was way passed pissed off at that point, about six exits back as a matter of fact.

So roughly another hour passes and I finally get 'my turn' about two that afternoon and my procedure when it finally took place, took about twelve minutes start to finish. A drape was placed over my face except for the targeted eye and a glop of cold KY jelly substance (Lidocaine) in the right eye and here we go. The incision is made along the edge of the cornea and the instruments inserted and your lens is broken up with ultra sound and aspirated out. A little window dressing after that to supposedly polish the inside of the cornea, then the new lens is inserted through a small straw like instrument and positioned. A dab here and there of some liquid, a dab here and there of some medication and the next thing you know? They are sitting you up and you are finished.

The surgeon is finished with you at that point. The nurses take over and lead you out to recovery, The affected eye is very blurry, Mine had a large orange spot in front, they said from being under the bright light for so long. They said that it would dissipate in a few minutes and it did. The nurse gives you your meds and an instruction sheet to take home and follow. Take a pain pill when you get home and get some sleep. Then, here is a sleeping pill for later tonight. Come back and see us in the morning.

So off I go, sporting my new geriatric Darth Vader Ray Bans. To the parking lot where my driver awaited me and home we went. At home after the nap, I awoke to the terrifying reality that my vision in my right eye was highly diminished. In interior low light conditions, shapes and colors were about it. In direct sunlight with the Darth Vader glasses, I could make out faces and navigate.

I was told that after the surgery "your vision will be a little "fuzzy" for a couple of days. This wasn't a little fuzzy. Fuzzy to me means blurry and a little means a small quantity. Neither of those terms were applicable. My vision wasn't a little blurry or a little fuzzy. I couldn't see spit out of that eye, other than in bright sunlight and with dark sunglasses on
.  So at the next day's appointment I asked the surgeon specifically about this result, along with why my right eye looked like I had been punched in the eye. (It was blood red). He said the injury was from the flap cutting, but noting to worry about as it would clear up in a week or so. Having noted the night before in the mirror and again that morning, that my pupil in that eye was constricted down to a pin point. (Probably the reason that I couldn't see squat except in bright light. Just a guess.) I wanted to know how long this effect was going to last

The surgeon assured me that this was all to be expected and that it was all normal. Telling that my vision would clear up in 48 hours. Inquiring minds want to know, so I wanted to know. I asked the surgeon, 48 hours from yesterday? Or 48 hours from today?

At that point he just stopped, looked at his assistant and said, "oh....he's one of those."  Let's just say that at that point? my emotions peaked and I lost it. I said Doc! I'd kinda like to know what I am to expect, seeing as to this point, what has occurred is not what I was told to expect and I am having a lot of trouble seeing in this eye. The surgeon gave me one of those supposedly reassuring smiles and told me to check back in a week as he was leaving the room to see another patient. The assistant led me back to the front and arranged my next appointment for the following week.

The following day there was no change in my eye or my visual acuity. Nor was there any change on the third day (72 hours after surgery). So I called and made arrangements to have another ophthalmologist surgeon  examine me that day. He performed an extensive examination taking over an hour. Afterward, he told me that everything looked good and the healing was going nicely, but he agreed that I should have been told what to expect and given a more realistic time frame of healing. He also told me that the pupil had shut down because the other surgeon had paced a medication in the eye to specifically do that, And that sometimes that medication took up to a week to wear off. (couple of days?).

So, at my next appointment with my surgeon, I let him know a few things about how I felt about the entire ordeal and that I had sought out a second opinion. He naturally apologized for any inconvenience and misunderstanding and he assured me that the medication injected was necessary, to help keep the interocular lens centered in the eye until it was properly seated.

So, we went ahead and made plans to do the left eye roughly two weeks later. Last Thursday the 7th of July, I went in to have the second eye done. Thinking that I knew what I was in store for this time and what to expect. The surgeon assured me that he would use a different medication this time and that the pupil reaction time would not be as lengthy.

So last Thursday around 11 AM, I went under the knife once again. all seemed to be progressing with the surgery as the last time for a while. Then my internal body clock began to tell me that this was taking longer. Seeing as I was awake, I asked the surgeon Doc? Is there a problem? To which he answered that this lens was a little more difficult to get out and was taking more time. So more minutes passed. I had no way of knowing the time, but my body told me that we had to be at least thirty minutes into this by now. and that is about the time it began to hurt.

With my first lens replacement, there had been absolutely no pain. Just the visual sensation of shadows as the instruments were passed back and forth across the cornea. But now, there was a definite pain. I said Doc? What the hell is going on? That hurts. He told me that "this one had become more difficult and that the 'capsule had fractured,' therefore, he was having to suture in the lens in order to hold it centered.

So here I lay, head taped down all senses of sight taped over and deprived, getting claustrophobic by the minute as he is suturing my eye, I finally had to move the blankets off as I was getting hot and worried by the minute. Finally after an hour he was finished. and just like last time, he was gone. I was left with the nurses to lead me out to recovery for my next set of instructions.

This time I was told that being under the light for so long? Had completely 'bleached out my retina.' That 'my body had gone into defense mode and shut down the retina to protect it,' and therefore, it would be several hours before my retina would recover. I was sent home once again with my Darth Vader Ray Bans and told to take a nap.  Have you ever tried taking a nap? When you are suddenly and completely blind in one eye?  Didn't work for me either.

I paced the floor until late evening and. finally recovered enough light in the retina to barely be able to see shapes and a few differentiations of browned out colors. I finally took my sleeping pill about 11 and fell asleep in my recliner. And at 6:15, my internal body clock said 'that's enough, wake up. So I open my eyes and I am still basically blind. I can still see only the most minimal shapes and browned out colors. In a bright room, I can navigate by feel, but that is about the extent of it.

So I get ready for my follow up appointment to see the surgeon. Once I arrive, he comes in and has a look and tells me that I have a lot of swelling, but that will go down in a couple of days. That is what is screwing up my vision according to him, but that will go away. 'Everything looks good; keep taking my drops and he will see me again on Monday.'

I am thinking, this is great! I can't see shit and this guy is telling me that all is well and everything will improve and he will see me on Monday. So now I have at least all weekend of this to look forward to.  so what else can I do? I go home and I am miserable.

I can't watch TV, I can't read, I can't look at my computer. In essence, I can't do anything aside from sit in a chair and think about how screwed up my eye is. Then Saturday night the eye starts hurting. Not badly, but noticeably. I check my check sheet over with my now good eye and read that if I suddenly develop a 'deep boring pain, or I suddenly see large specks or other troubling things like bright flashes of light or a curtain creeping across my vision, then to call immediately.

Well, I have a pain, but nothing terrible (yet) and I do have this large speck that keeps floating in and out of my line of sight in that eye. but other than that, the main problem is that everything in the eye looks like I am looking through a shower curtain. I can't see or make or much of anything other than shapes. I am livid. I am scared, I am terrified, but what can I do?

So, I go to sleep about midnight and at 3 AM I am wide awake. The eye is hurting again (I had been taking Ibuprofen most of the day Saturday) only now, I can tell that what little visual acuity that I did have on Saturday is now gone. So in other words, the eye is hurting and the sight is getting worse (if that is possible).

So I walk the floor until 8 AM and finally get my wife up and then call the emergency number for the eye clinic. The female optometrist finally returns my call and tells me that it will be 2 PM before she can meet me at the office. So that meant another five hours of waiting to be seen, but once again, what options did I have at that point. I have to have the eye looked at and I was at their mercy. Either that or an emergency room and that would have easily taken at least that long or longer.

So we load up and make the hour long drive up to the office and the optometrist takes me back to one of the rooms where she checks the eye pressure. I had already told her that the eye was red and hurting. So she gives me some deadening drops and proceeds to check the pressure in my eye.

Once she did, she said that my pressure was pretty high, so she gave me some drops that she said would reduce the pressure and also two pills to take that should also help to reduce the pressure. After waiting ten minutes, she checked the pressure again and noted no changes in the pressure, so she gave me more eye drops and waited another ten minutes and again there was still no change.

She explained that she had a call and text into the surgeon, but at this point, that he had not responded. Finally, about ten minutes later he called. The optometrist had already told me that I might have to come in the following day to have the surgeon 'burp' the cornea to relieve the pressure. The surgeon finally arrived and consulted with the optometrist as to what she had administered and the results concerning the pressure.

The surgeon then took his own pressure reading and noted that nothing had changed. Prior to his arrival the optometrist had told me that normal pressure was 18-22 but that my pressure was 39. There was the problem.

So the surgeon gave me some deadening drops and then took a pair of round tweezers and rolled the fluid in the cornea over to the incision and literally drained off the excess fluid. Immediately I felt a release of fluid and a rather large tear run down my cheek, but more importantly, I could see out of my left eye.

The surgeon gave me some additional pressure reducing drops and told me to go home and come see him the following day. All I knew at that point, was that I could see in the eye again. Which after four days? Was quite a feeling of relief.

So I went back on Monday and was reexamined. I noted when I woke up that the vision had diminished again, but seemed to clear up after I was up for a while and after my drops. I went in and was reexamined and assured that all was going well and that everything would be fine. So, I went home and finished out my day. The surgeon had prescribed me some sleeping pills on Sunday, as sleeping had been something that had eluded me for almost a week.

So I went to bed Monday night I went to sleep in my recliner again and when I awoke yesterday morning? Back to square one. Couldn't see shit out of the eye once again. just shapes and colors. Everything is fuzzy once again and even after the drops, it took most of the afternoon to be able to clear up enough to drive.

So you guess it. Back on the phone to the eye institute and demanding an appointment to see the doctor again. Finally got in to see him about 1 PM yesterday. Only now? I have a large floater that has appeared in the eye. Looks like a large piece of belly lint and has a large triangular piece of gelatinous 'something' attached to it that looks amber.

I had told the surgeon the day that he was doing the lens replacement, that he had missed a piece of the lens, which he assured me the had not. I told him about the floater Sunday too, which he claimed he could not see.

Yesterday, the two optometrist dilated the eye and did a close and comprehensive look around and guess what? They saw it. Ultimately the surgeon has his look around and saw it too. Now he says 'That will absorb' and not give you any problems. But it is still dropping down into my field of vision and bugging the hell out of me. Which leads to the next question, 'what makes this one so special? Other floaters I have had most of my life haven't 'absorbed' or gone away. So why should this one.

As it stand presently, it is Tuesday the 13th of July 2011. It has been one week since my second interocular lens replacement. I woke up at 6:30 this morning and I still can't see out of my left eye. I have taken all my drops and I am about to take them again but seeing out of the eye just isn't happening. Yesterday, the surgeon told me that would gradually get better as the swelling in the cornea goes down. My question is this, what happened to the swelling in the cornea on Sunday when he drained the fluid and I could see clearly immediately?

And what about the Lasik to correct the astigmatism and give me 20/20 after all this? The surgeon says we need to wait about a month for that now.  Really?

This has not been a good experience. I go back to see him again tomorrow. Right now, it is 1:30 in the afternoon and I still can't see worth spit in my left eye. To even write this? I have had to boost fonts up to 24 and use my good eye. Yippy......