Eye News #5 – Weeks 6 & 7 – Revenge of the Retina!!

You know, I’d stop writing these things if they would just settle down to end with, “…and the boy and his retina lived happily ever after,”  but it’s just been slightly more ‘interesting’ than that.

I guess the main thing that I want to say about Week 6 is that I got to go back to work again.  And also, I’d like to tell you about a visit that I made to Dr. Tran’s office that week (my retinal surgeon — he’s got an actual name):   My vision was coming back again, and I was generally feeling quite chipper, and so, as I was following his assistant Linda down the corridor to the examination room, there was a slight, but definite, spring to my step.   Mentally, I was whistling a cheerful tune.

Linda turned around to look at me as we walking.  She shuddered slightly, and said, “Oooooh…don’t bounce!!”

After that, it was easy to shuffle along again.

Which brings us to this week.   On Tuesday, Dr. Tran looked inside my eye and said, “Well, my friend, you have got another retinal detachment.”   He turned away to write a few things on my chart, and I joked, “You’re thinking: I’m gonna remodel my kitchen on this guy!” 

The gold standard of treatment, as mentioned before, is the mysterious ‘scleral buckle,’ which permanently changes the shape of the eye so that it is not as prone to ripping itself apart any more.  And, as Dr. Tran had said before surgery #2, “You really need one.” During surgery #2, he had only been able to use cryo and the gas bubble to tack down the immediate failure, without being able to make strategic corrections.

Dr. Tran’s theory was that the swelling that prevented him from accessing the eye the last time could be avoided this time by (a) having me take some steroids leading up to the operation, and (b) giving me a general anesthetic instead of injecting the tissues around the eye with a lot of local blocks.

He would be repairing the specific detachment with cryo and laser, and then he would heroically try to put a band around that eye.  One nice thing about the Modern Era is that a scleral buckle no longer involves retracting the eye from the socket (ew, gross!), the way that it did 25 years ago when I had a buckle put on my left (excellent) eye. Instead, they snake the band around between the eyeball and the muscles. Less violent in general, much faster recovery, and less chance of damage to the optic nerve.

He operated on Wednesday, and the surgery was a complete success.

Dr. Tran also made the comment that they couldn’t have fixed my Giant Retinal Tear if it had happened 25 years ago — they didn’t have the necessary gas bubble technology then. I remembered that they told me 25 years ago that they had only learned how to fix my left (excellent) eye’s problem 15 years before that, and I feel very lucky indeed — both eyes missed being irreparably blind by mere decades.

I’ve now got a big gas bubble in my evil eye, just like after surgery #1, and yes, I’m sentenced to the chair, looking down for the next several weeks.  But hopefully this will be it (or at least, if I could get another 20-30 years respite, that would be extremely nice).

Eye News #4 – Weeks 4 & 5 – The Retina Strikes Back!

When we last left our hero, he was back at work, and was whistling a happy tune (if a little unsteadily, because of the painkillers).

After three weeks the gas bubble in my eye disappeared, and I was (briefly) in heaven.  By this time, I could read quite fine print — some just-slightly-older colleagues were saying, “Hey, even *I* can’t read that!” 

There was a brief scare the third weekend after surgery, where my eye started to hurt like anything and I had to go into the emergency room again.   (Which, by the way, was the wrong thing to do, as I found out later.  I *did* need emergency help, but I should have just called my retinal surgeon, even on a weekend, and he would have had me meet him at his office — they’ve got better equipment and training there, of course).  My epithelial layer (which is the onion-skin thick topmost layer of the cornea) had sloughed off, probably due to an infection.   I was given a different, additional antibiotic, and it seemed to get under control, although my vision was set back about a week, because of the damage to the cornea.

Still, at about the beginning of week four, I stopped needing the painkillers, and was extremely happy to have my mind back 24×7.

Which brings us to the next weekend, four weeks after surgery.   I had gone out and bought new glasses, and was really quite pleased.   I was back to almost 20/20 vision, being able to read about half of the letters in the 20/20 line, and all of them on the line above it.

There is an old saying that I like: “Those whom the gods would smash down, they first raise up.”

I had noticed a wavering shadow in my vision, and because I was completely gun-shy now, I called my retinal surgeon, even though it was Sunday.  I was a little embarrassed, because this would be three weekends out of five that I was seeking emergency eye help, but better safe than sorry, and what it really looked like to me was another detached retina.  He listened with interest to my description, and said that he thought that it was probably just from all of the freezing that he’d had to do — “You’ll have a shadow there.  Still, come into my office tomorrow morning; I’m glad you called.”

It turned out that the next morning he had to treat a bad emergency, but he was able to see me that afternoon.

“Ah, you’ve got another retinal detachment.  I want to operate on you again as soon as possible today.  Wait here please while we try to line up an operating room.   Hopefully we’ll be able to get started in about two hours.”

Ok, now a warning to anyone who had been reading this up to this point.  The next part will make you say, “Ewww, gross!”

What he wanted to do was to put a scleral buckle on my eye, which was the same thing that had been done to my other (Excellent) eye 25 years ago.  At that time, the procedure involved them popping your eye out of its socket, tying a band (a sponge) around it like a belt, and then putting the whole mess back in your eye socket.  The operation was only 15 years old when I got it, and apparently techniques have changed somewhat, but that’s a fairly close description.  Apparently, my eyes need a nice permanent belt to keep them from wanting to rip themselves to tiny bits.

He had wanted to do this in the operation of a month ago, but couldn’t because of the Giant Retinal Tear.  Now that the tear was tacked down and in place, he wanted to put in the buckle, “because you really need it.”

I ended up at the same hospital as before, and even though the medical center is only two blocks big, with a single street down the middle, I still got lost on the way to the hospital (I’m a famously bad navigator).  There were lots of other adventures: I ended up getting shuffled around between rooms, was forced to listen to the Jerry Springer show due to roommate channel preemption, and they lost my underwear while moving my clothes between rooms.  (The aide in the retinal surgeon’s office, having asked “How was your stay in the hospital?”  was somewhat flustered to hear this.  “You mean you’re not wearing any underwear right this minute?”   “Oh no, I never said that.   As far as you know, I have on a spare pair that I have always kept in my car, just for any emergency that might arise.”)

As for the actual surgery, this was somewhat unsuccessful.   He was unable to retract my eye, either because it is still too swollen from the last surgery, or possibly because there are some adhesions from when they performed cryo on that eye 25 years ago.  He even made an cut in the side of the skin next to the eye, trying to make more room to get the eye out, and couldn’t. The only positive thing that he ended up doing, as I understand it, was to inject some gas into the eye to raise the pressure, to hopefully force the retina back down to where it belongs.  

My status now, a week after my second surgery on this eye, is that I have no idea what my vision is like in my eye, because there’s a medium-sized gas bubble in there again.  Also, it still hurts a lot (way too much to try walking around looking at things), and I’m popping painkillers with enthusiasm again.  When the retinal surgeon looked at the retina on Thursday, he said that it was either back in place or mostly back in place, but he couldn’t really get a very good look, even after giving me numbing eye drops.   He also gave me some eye drops to keep my eye always-dilated for the next (get ready) two weeks!  I’m walking around, inside the dark house, with my eye bandaged, with my blind-guy sunglasses on, and still cringing, vampire-like, at the light.

His final advice to me, as I left Thursday, was, “Don’t look down.”   Faithful readers will remember that the first operation’s aftermath featured near-total down-looking.   Not with this one, except at night, because he’s trying to get the swelling under control.  (My eye is comically swollen — if it continues much longer, people will be calling me “Mad-Eye”).