Eye News #3 – I’m Free!

I went to the retinal surgeon today, and he liked the looks of my eye.  He took me off of the pressure-control drugs that were giving me bronchitis (because my pressure was down from 40 or 27 to a superb “10”).   I can breathe again!  Also, he cut the combination steroid / anti-biotic drops from 4x to 3x per day, so he’s obviously taking moves to wean me off of those.

As for my vision, the gas bubble is still there, but is very small – it now takes up only (the bottom) 10% of my visual field in my bad eye.   The retina seems nice and flat — for example, I have no trouble at all reading the tiny print of (say) the Wall Street Journal   I can do this either with my glasses off or with them on, although it’s much easier with them off.   In fact, my main complaint now is that my prescription for my bad eye (the one recently operated on) does not seem to match my eye very well any more, although it’s still early days to be shopping for new glasses.

Other than that, I notice more glare in the bad eye (mostly due to the gas bubble), and more cloudiness (probably mostly due to some tiny debris still floating in the bad eye).  But these are minor complaints, and should both resolve themselves over time.

The surgeon praised my constancy in keeping my head down over the last two weeks (“I can tell by how clear your lens is that you were very careful about this.”)

But, the big take-home news is:

I can go back to work tomorrow,
I can drive a car,
I can read a book or a CRT screen,
I can put my head in any position I feel like putting it,
and…
I can sleep in a bed like a natural man (albeit with my Alien-like Sleep Apnea machine).

This last is The Big One. After two weeks of sleep deprivation, sleeping sitting up in a chair in the living room, to be finally be back with my beloved sleeping machine.  Ah, bliss.

Eye News #2 – One Week After Surgery

My right eye still has a big gas bubble in it, which plays hell with focus. I was thinking at first that this was tears (as in ‘crying’, not the other word which means ‘rips’) in front of the eye, but now I’m pretty sure that it’s the gas bubble. I can tell you, though, that I have exactly four fingers and a thumb on each hand, and that they can wiggle, which is much more than I could have told you on, say, Thursday.

The Big Deal will be:

(1) Did I have much retinal death from the detachment, or nerve death (glaucoma) from the increased post-operative pressure? The answer in both cases is “Probably not.”  The detachment was small and for a short duration, and the increased post-operative pressure was only 40 at its worst, and fell rapidly with medication and as the swelling in the eye abated.

(2) Is my retina now tacked down nice and flat, so that I have a good flat projection screen? Here, I just have no idea what the answer is — we’ll just have to wait for the gas bubble to go away so that I can focus and try to read.  When the surgeon looked at the retina (sneaking looks with lenses and mirrors or something to avoid the gas bubble) it looked good to him.

The eyedrops that were prescribed to lower post-operative inter-ocular pressure are giving me bronchitis, which I despise. Great gluey coughs, and when you finish one your feel like you have to start another right away. The manufacturers actually killed some asthmatics with their eyedrops, according to their product literature (although applied topically, the medicine disperses systemically). Also, the darn eyedrops slow production of new vitreous humour, meaning that they slow the elimination of the gas bubble.

In the meantime, I’m keeping my head down for the next 9 days to avoid cataracts, and as I may have already mentioned, you can’t keep your head downcast, and walk with your feet shuffling along, for very long, without it affecting your soul.  People ask me how I will spend my time, sitting in my chair with my head down, and I reply, in my best Jose Jimenez voice, “Well, I plan to cry a lot.”

Eye News #1

On Saturday afternoon, July 8, I started to see thousands of dots and big ropey floaters in my “good” right eye (as opposed to my “blind” left eye that had had a retinal detachment 25 years before), but then it was better on Saturday night.  The dots came back Sunday morning while I was riding my bike with my good friend John Blackburn and his sister-in-law. I joked that perhaps I was going blind, and that later on they’d be able to say that “We were there to see it — how we laughed!”

I had already decided to go see an Opthamologist on Monday, but then at about 6:00pm Sunday, I started getting a lot of the big floaters and my vision in my right eye deteriorated catastrophically to a cloudy mess (and by the way, if you want fast service at the Emergency Room, “Sudden Catastrophic Loss of Vision In One Eye” is a real door-opener; “Right this way, sir.”  They didn’t even finish taking all my paperwork before sending me back. Initial reports from the ER Doc were not good: “I can’t see anything — it’s all orange in there.” He paged a retinal surgeon, who confirmed (as expected) that my right eye was bleeding internally (hence all the floaters and dots, and eventually total cloudiness).

The retinal surgeon couldn’t see well enough into the eye to tell for sure what had happened, but he thought it was a bleed without a detachment, and he told me to come to his office the next morning for an ultrasound and possibly he would freeze part of the eye to stop the bleeding  He said that the eye is actually pretty good at clearing small amounts of blood from the vitreous humour, and that I should regain all or most of my vision in that eye.

The next morning (Monday) I went into his office, and he did the promised ultrasound, and showed me pictures of the retina, which was plenty detached.  He said that he’d have to operate that night (!!), and that they would stick instruments (straws) into my eye and remove the bloody vitreous gel.  This would be replaced with saline solution and a sulpherous pressurized gas to force the retina back down against the eye wall, where they could use cryo (super-cold) probes to kill parts of it, which would create more scar tissue and tack it down.

I arrived at the hospital Monday at 4:30pm, and they were completely surprised to see me then — the doctor had intended for me to go over to the hospital immediately, but the directions that he had given me said to go there at 4:30pm, so now they were just racing, racing, taking blood, doing EKG’s, completing the pre-operative physical, and by the time the anesthesiologist was ready to knock me out, they still didn’t have the blood work back.  So, the surgeon and the anesthesiologist looked at each other, and said, “He’s 44! He’s healthy!”   I offered that I had ridden 100 miles on a bike in a single day twice that year, and the anesthesiologist said, “Ok, you’re healthy in my book, and don’t let anybody tell you any different! Let’s go!”

They took me into the operating room, and we’re just chatting, and then I guess they put me to sleep for about 5 minutes while they paralyzed my right eye and inserted the straws and other microsurgery instruments into my eye.  Then they allowed me to wake up for the rest of the surgery, but I didn’t realize that I had ever been asleep or that anything had happened, so I started to chat and they said, “No, no, no, not now, we have things in your eye now.”  So I stayed quiet underneath my blanket.   My whole body and face were covered except for the eye that they were working on, so it was a bit cadaverous for me under the blankets. So it was simultaneously scary and boring for about two hours.

Plus, they were having trouble, which I could listen to because I was perfectly lucid.   The retinal detachment was small, but there was also a huge retinal tear — about a 1/4 of my retina was flapping around.

When they were done operating, they asked me if I would like to spend the night at the hospital, rather than going home immediately as per the original plan, because the operation had taken much longer than expected and I was likely to be in pain (and in the hospital, they can give you delicious Demerol shots).  I said sure, and was really glad I had.

Tuesday morning I checked out of the hospital and went to the retinal surgeon’s office for a follow-up.  He looked in and said that it looked good so far.

So now I have to keep my head down for at least the next several days, and possibly as much as the next week, while we wait for the gas bubble to dissipate, and for my eye to manufacture new clear vitreous humour gel to replace it.  This is because if the gas has too much contact with the lens, it will cause a cataract (which might happen anyway).  My inter-ocular pressure is high (which is good for the retinal detachment), but it’s too high (which is bad for glaucoma) so I have to take medicine for now to lower the pressure.

My current status is that I have totally unfocused and dark vision in my right eye.   I’m typing this using my left eye, the eye that for 25 years I’ve called “my blind eye”, but which I’m now going to call my “excellent eye”.

Thanks to everybody for the cards and flowers — it makes a huge, huge difference, when you’re in pain, to know that people are thinking of you.

More news as it happens.