Eye News #11 – Nothing to See Here

I got around to going to my retinal specialist again yesterday (oog, it’d been 2.5 years since the last time), and everything was pretty stable: the interocular pressure was 17-left, 24-right, just about exactly where it had been the last time, and my vision was still fine, although my left eye (the one that exploded in 1976) has a tiny, cute little cataract, which has gotten vaguely worse over the eight or so years that we’ve been tracking it, to the point where my best vision is in my evil, Y2K-explody eye — though I’m still totally legal to drive, on the strength of the left (worst) eye alone.

My retinal specialist said that things were so stable that I could cut back to seeing him annually, which would still be about 2.5x more often than I’ve been going.

Oh yeah, and the staff at his office made a huge fuss about how much weight I’d lost, more than 65 pounds since when they knew me well:

“You look…fantastic!”

Eye News #10 – You May Feel a Slight Pressure

I went to the retinal specialist today, after far too long an absence. It turns out that I hadn’t gone since October 2003, and really, I should go every 4-6 months. I scored 20/20 on my Evil Eye (the Y2K eye), and only scored 20/40 on my Excellent Eye (formerly known as the Blind Eye). But Yee Ha, 20/40 is all you need to drive, and even then only in one eye, if you have a doctor’s note, so I’m more than good to go: clear the road!

The doctor looked into my Evil Eye, reviewed the many operations from Y2K, and said, “I can’t believe that you’re getting 20/20 out of that eye!’ I really have been getting the sense lately that I’m just cheating eye death at this point, and that some day, long, long before I want it to happen, I’m going to lose a globe (functionally, at least; cosmetically, I’ll still be golden, and a hell of an attractive fellow).

The assistant hadn’t been able to measure the inter-ocular pressure (a measure of risk of glaucoma) because the doctor had been using the equipment on another patient, so after the doctor looked at my eyes, the assistant came back in and took some pressure readings, and they weren’t great: 26 and 30. 20 is considered exactly borderline: below is good; above is bad.

The doctor came back in, re-measured, and got 18 (ok) and 24 (bad!), and he also said that the retina in the Evil Eye looked a bit thickened, a bad sign, so he ordered photographs of the eye, along with an angiogram: they injected strong yellow dye into my blood (apparently I can expect to pee fluorescent yellow for several days) and snapped many bright, painful photos.

Painful! It’s interesting: my Excellent Eye has always been (well, since its repair from detachment in 1976, anyway) remarkably light-sensitive, while the Evil Y2K Eye is just the reverse: the photographer was shining strong lights into my eye, and muttering, “Damn, that’s dark.” Then he would bump up the light, and try again, but my eye would just close down on him — I don’t think that I was properly dilated, or it may have been the nick in my iris from Operation #1 causes the iris to stay a bit more closed than normal; I’ve always felt that the light in that eye was just a little dark — and perhaps that’s why I see better than expected out of that eye, since a smaller f-Stop has an inherently better focus.

While the doctor and photographer were looking at my eyes on the computer screen, the doctor remarked, “He gets 20/20 out of that eye. [Can you imagine?]”

The photographer looked at the picture and said, “Whoa. [No way!]”

The doctor said that the optic nerve in the Evil Eye doesn’t show any sign of glaucoma damage, and the blood vessels looked fine in the angiogram, so he’s just going to have me come back in 6 weeks to re-test the pressure. I suppose that if it’s bad a second time, that he’ll put me on glaucoma medication, or consider surgery, oog.

Nothing for now, though.

Eye News #9 – Nothing But A Burning Light

You may recall that I had had pretty darn good vision after my recent cataract surgery, and I was (exceedingly) happy. But my vision gradually degraded, as 50% of all cataract surgeries do, due to a clouding of the membrane that separates the lens from the back of the eye. It was a gradual, but in the end, quite noticeable decline in acuity.

Well, I just got back from a quick outpatient procedure to correct this, and it couldn’t have been more trouble-free.

To destroy the errant membrane, they shine multiple laser picobursts into your eye (about 20 to 30 of them), each one of which causes a pressure wave that punches a hole through the membrane.

Actually, a great metaphor that the surgeon used is that you should imagine a tightly-stretched film of Saran Wrap. If you take a pin and pop a hole in the film, you’ll get far more destruction than just a little hole, because the film is stretched so tightly.

So, I sat down, and he aimed his laser this way and that, popping the film with his laser bursts, until the membrane was essentially destroyed. It was slightly startling, because I could FEEL the shock wave in the eye (like throwing a stone into a calm pond). It took about three to five minutes – I didn’t have to change out of my street clothes, even.

Many have asked, “Don’t you need all of your various body parts? Wasn’t that part there for some reason?” Well, it does more or less hold your lens in place, but the artificial lens that they put in during the cataract operation is sufficiently anchored down after 6 to 8 weeks that they can proceed with the destruction of the membrane.

And the results? Amazing. Using my evil eye, I after the operation, I could read the little badges on the cars with the brand name spelled out (“Mercury”) from a distance of several car lengths.

And, for actual before-and-after comparison, I had put a large book (The Way To Cook, Julia Child, hardcover) against the piano and had seen how many paces away from the book I had to be before I couldn’t read its title any more. All tests were made with the evil eye open, and the excellent eye shut. Before the operation, WITH my glasses, I could just read the book title from about 8 feet away. After the operation, WITHOUT my glasses, I could read the book from 10 feet away, and WITH my glasses, I could still read it from 23 feet away. I might have been able to do a little better, but I ran out of living room. So, almost a three-fold improvement in acuity, like going from 20/90 to 20/30. Naturally, I’m thrilled. (Even as I’m writing this just now, I can’t help being tickled at how sharp everything looks).

I’m pretty confident now that even should my excellent eye suddenly have some horrible mishap, I would still easily qualify to drive with just my evil eye, especially if they would consent to clearing the freeways every morning and evening for my convenience. And it’s clearly good enough for me to be able to depend on it for reading and working, even should the other one fail.

The evil eye still has the dread macular pucker (the scar tissue on the retina, which makes things a bit wavy), and I’m still taking eye drops every day to prevent the retina from swelling, and my eye still LOOKS a little evil, but from the inside looking out, I’m deeply satisfied. The retinal surgeon has no intention of operating on the macular pucker any time soon, so hopefully you won’t hear from me about my dopey eye for a long, long time.

-Tom

Eye News #8 – The Gas Menace, Episode II

First, the good news:

I saw my retinal surgeon, and he didn’t say,
    “Tom, you need to have one more operation on your eye.”

Isn’t that splendid?  I think that’s splendid. 

Now, the bad news:
    He did say, “Tom, you need to have two more operations on your eye.”

Details:

The operations are not scheduled yet. He wants to wait until I’m fully recovered from the earlier operations (which I assume means gas entirely gone and not taking any medications). I’m down to putting in one kind of eye drops (Cosopt) once a day, and the gas looks like it will be gone in about two weeks. I don’t know yet how long he’ll want to wait after that before the cutting begins.

The first problem is that the cataract is getting worse now, and will just continue to get worse. The whole cataract thing is a fairly common result when they have to use the gas in the eye. In fact, it’s my understanding that 35% of operations that involve the dread gas end up with patients getting cataracts. My retinal surgeon doesn’t do cataract operations, but I’m sure that he can recommend someone.

The second problem is that I’m seeing a nonlinearity, a permanent waviness, in my vision (as opposed to a shimmering waviness). This is a macular pucker, a thin membrane of non-retinal cells that have found their way to the top of the retinal layer (probably as a result of the previous detachments and surgeries, although that is not the only situation that can give rise to a macular pucker). Anyway, this membrane is growing on my retina (as opposed to shrinking, or remaining the same size), which is bad, of course, and plus, it has an inherent tension and strength which causes it to pull the retina toward it, much as if you grabbed a portion of your shirt in your fingers and bunched it up. So, this membrane is incredibly thin, and what they will do is to wait for it to “mature”, and then they’ll go in there and peel off the errant membrane. Spalding Gray has done a fairly hilarious monologue on the subject of his macular pucker (see his video, “Gray’s Anatomy”), which was actually the source of that 35% statistic that I mentioned above. My retinal surgeon WILL do this procedure himself.

Dr. Tran, my retinal surgeon, told me: “You know, by an astonishing coincidence, I had a guy like you last summer, also a programmer, and who needed several surgeries to correct his retina, and developed a cataract and macular pucker, and I ended up getting him back to 20/20,” so don’t lose heart.

Eye News #7 – Checkup Results 4 Weeks After Surgery #3

I saw the doctor again today — he continued to say that my retina looks great and that my lens is continuing to improve.  My pressure has dropped to 12, so he reduced my Cosopt dose from twice to once per day.  This should speed up the production of fluid.

He told me to be sure to continue looking down, which puzzled me at first, because I felt like I had about 45% fluid in my eye, which was about where he told me not to worry about it after the first operation.   However, another puzzling thing has been the fact that my focus has remained at about 1/4″ from my eye (giving me an excellent view of the hairs on my nose, but nothing else).   He has maintained all this time that, well, my eye still has a lot of gas in it, and that after there is more fluid, I’ll see more normally, and I just felt as if, “No, I remember what it was like before at 45% fluid.”

So, on the way home from the doctor’s, I noticed, just at the very tippy top of my vision, the return of a normal (for me) focus distance in this eye — I can clearly focus on fingers held a half foot or so from my hand (without glasses).   So, I realized that I still have MUCH less fluid in my eye than I had thought — it’s more like 20% or so fluid at best (after four weeks!), and I’m only now starting to get some meaningful amount of retina that is illuminated by light that hasn’t had to pass through gas on its way to the retina.

Sooooo: the good news is quite good (retina looks great, lens continues to heal, normal vision finally starting to return as eye slowly fills with fluid, and the rate of fluid production should increase now with the drug reduction), and the bad news is just the same darn old thing (gotta keep my head down).

Eye News #6 – Weeks 8, 9, 10 – The Gas Menace

You probably haven’t heard about the critical nationwide rattlesnake anti-venom shortage (and just as well, you’re probably thinking). Well, it’s true – the only company that manufactures anti-venom in the U.S. shut down their factory in February for upgrading, and they don’t expect to be back on line for at least another month or so. There was a story about this on National Public Radio last month, with one poison control center saying that they would normally like to have 10,000 units on hand to meet demand for the rest of the season, but that they only had about 45 units. A single bite can take 125 units to treat, so that’s not much of a stockpile. The company that made the anti-venom wouldn’t say how many boxes they had left in their stockpile, but they were releasing them on an emergency need basis.

This used to be a worry in my life, because during the week of August 28, I was scheduled to be going on vacation with Sylvia, Sean, Sylvia’s mom, and Sylvia’s brother Bill’s family. We would be rustically ensconced amidst the big trees — giant sequoias, in fact. There would be happy hikes among the trails, perhaps featuring fatal snakebites – mmmmm.

But, alas, it was not to be. After my third eye operation, only the week before, I again had an eyeball that was filled with dangerous, lens-corroding gas. I wasn’t even supposed to go above 4,000 feet (pop!), and the pass leading into the campsite was at 10,000 feet (kapow!).

Still, no reason why Sylvia and Sean shouldn’t go — this vacation had been planned for months. So, they left me alone and lonely, forlornly sitting in my chair, looking down. (Everyone asked several times if I would be ok, and I assured them that I had an adequate support network).

This was a good excuse for me to try http://www.homegrocer.com , and to take advantage of their introductory offer: $20 off my first order and free delivery, too. (If you try them, be sure to mention me, Tom Chappell — I’ll get a $15 kickback for referring you). It was an unalloyed pleasure — the smiling, uniformed delivery man arrived in his attractive, peach-decorated van, brought the groceries up to the door, slipped on little plastic bootie covers, and carried them into the house. All of the items were first quality, even the meat and the produce.

I didn’t do very much cooking, though — it was mostly a life of looking down. My good friend John Blackburn took me for my one-week check-up, and the doctor said that the good news was that the retina had excellent luster, that the cornea was healing nicely, and that the band (a.k.a. the buckle) that he had added was well positioned and nicely indented. The bad news was that long acquaintance with the evil sulphurous gas was causing my lens to develop a bit of a cataract (“almost unavoidable, after that much gas exposure”). He did say that young people (“and I include you in that category”) quite often heal these kinds of cataracts, and in any event, he could deal with a cataract, if the darn retina would just stay in place. My mother, after all, has artificial lenses in both of her eyes, and drives all over the mountains daily.

I was still in an amazing amount of pain. I asked the doctor about this, and he laughed and said that I had been in much more pain after the second operation, but that people (mercifully) don’t remember pain very well. I took my Vicodin and waited for time to pass. Finally, about eight days after the surgery, I was able to take off my eyepatch without screaming, “The Sun! The Sun! Ahhhh, what a world, what a world….”

John and his wife Karen had me over for a delicious dinner, and a rousing game of Scrabble afterwards. I’d like to say again how much everyone has helped me over the past 10 weeks, particularly my wife Sylvia and my friends Larry & Sally, Ron & Georgia, and John & Karen. You really know that you have friends when they go out of their way to help like this.

At this point the vision in my evil eye was weirdly cloudy, and I was again reduced to being able to tell that people have fingers on their hands, but not how many. I was plagued by an extremely peculiar horizontal line across my vision that mysteriously came and went, and also, sometimes I thought that I could see (clearly!) evil debris and corruption on my lens. This mystery was solved a few days later, when I realized that between the effects of the buckle, the swelling, and having an eyeball full of gas instead of liquid, my natural focus distance was about 1/4 inch away from my eye — I was focusing in on my eyeglass lens (which was sometimes dirty), and on the topmost rim of the glasses, which I could see perfectly sharply. Nothing else was in focus, though.

Two weeks after my surgery, I again saw the doctor and he still liked the look of the retina. I hadn’t seen much evidence of very much fluid production yet, but he said that this was normal because of the kind of gas he put in my eye — the especially long-lasting kind! It turns out that keeping your head down, and having gas against the retina, is very important for giving the retina a chance to heal properly — it’s not just a good idea because of keeping the lens wet. The cataract didn’t look too bad. He said that I didn’t have to be paranoid about walking for exercise, and gave me permission to work, but said that I would have to remain paranoid about working, because of the temptation to not keep my head down — it’s very important to keep it down.

I ended up going into work for three days and helping my teammates prepare for going to France. I couldn’t take the plane over because of the gas in my eye (kaboom!). I ended up staying at home the next week, but was able to attend the last few hours of each day’s meeting in France over the telephone. And all this time I’ve been keeping my head down, using a special flat-panel display that I’ve purchased, and looking at printouts.

The pain has been all gone since early this week, and at this week’s check-up the doctor again praised me for having kept my head down, and said that the cataract in the lens had improved quite a bit. My eye is still probably 85% gas (he used the long-lasting gas!), but I was noticing today that if I was looking down, I could easily count the number of fingers on my fully-extended hand, and in general everything looks much less dark and cloudy.

I’m starting to become less apprehensive about the ultimate conclusion to this whole affair. I probably won’t send another bulletin out until the gas is completely gone and I’ve gotten a new eyeglass lens for my evil eye, which may be quite a while yet — possibly several months (although I’ll be able to hold my head up high long before then).

If you don’t hear from me, assume that everything’s going well, and I’ll certainly send a short update by Thanksgiving.

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”).

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.”