The appointment started with the typical questions from a tech about how my vision was doing, if I was experiencing any pain or discomfort, etc.  Then it was time to read the chart with my left eye.  The E was not a problem.  The next line, C and D, I could see, but if I didn’t remember it I might have said G instead of C.  The next line, which I now know is DHN, I couldn’t see.  With the pinholes, I was able to make out the H.

She moved on to my right eye.  Good news there, I can still tell if a light is off or on if it is a foot or less away from my eye…  Yippee.  She then put, or should I say shot, drops into both eyes.  God only knows how many, but it was sure more than one of each.  One is to numb the eye to get IOP (pressure) readings, while the other was to dilate my eye.  While she was doing this, she left the chart on, so I continued to try to read it.  She then used a hand-held device to get the IOP (Dr. Ayres calls this device a glorified random number generator.)  IOP was nine in the left and mid to upper 20s in the right.  The previous week at my glaucoma appointment, it was eight in the left and 13 in the right using the standard device (the one that you put your chin in, press your head against the bar, and look at the blue light.)

She waited a minute or two and then tried to get another number on the right eye.  Meanwhile, I’m still trying to read the 20/100 line on the chart.  She then said I was cheating by continuing to attempt to read the line.  Eliz didn’t like what she said and asked how I was cheating if I was just trying to read the chart.  While the lady answered Eliz, I had my hand in front of my eye, trying to simulate the pinholes while still trying to read the line.  Hey, if you don’t want me to keep trying, shut the effing thing off!  As we got up to move to the next exam room, I glanced behind the chair where the chart is bounced off of a mirror and saw that the line was DHN.  Now maybe that was cheating.  How would that help me though?  It’s not like I could get a drivers license for reading the 20/100 line.

In the next room, Dr. Garg came in and asked some questions and then had a look.  He then told me that the only thing left to try were injections in the eye.  Before we try that though, he wanted to get another OCT scan to make sure the risk/reward was worth the attempt (actually, attempts, as it would take several injections over the course of a few months for it to work.)

Tom gave me the OCT scan a few minutes later, then we headed to another exam room.  After a minute or two, Dr. Garg came in and had a look at the scan.  He said that it wouldn’t be worth trying the injections as there was only a 15% chance of them helping me see better.  At that point, I said, “Okay, so there isn’t really anything you can do for me?”  “That’s right,” he replied.  He told me I could come back in five months (why?,) or sooner if I was having any other problems.  He did tell me to make sure that I see him, Dr. Ayres, Dr. Pro, or Dr. Ruffini frequently to get IOP readings.  Seems like ‘roids that I take 2x per day in the left eye could cause the pressure to rise.  Maybe it’s time to see Dr. House, Dr. Riviera, or Oscar Goldman…

So while my vision is not cuckoo bananas (a technical term Dr. Garg used at my last appointment in June,) it’s not good either.  So what do I do now?  Some days, my vision is better than others.  Today, for example, it sucked big time (I suppose that is a technical term I picked up somewhere along the way.)  Maybe I’ll see a little better tomorrow.  I’m not holding my breathe (but would if it would help…)

It’s Not Cuckoo Bananas, But It’s Not Good Either is a post from: ICantCU.com | © 2009, iCantCU.com. All Rights Reserved.

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Post tags: appointment, C.  The, chart, Dr. Ayres, Dr. Garg, Dr. House, Dr. Pro, Dr. Riviera, Dr. Ruffini, eye, God, H. She, iop, line, Oscar Goldman, pinholes, random number generator, retina specialist, Tom, upper 20s

Central Vision Visual Fields Test at Wills Eye

One of the problem I’ve noticed is that I seem to have more blind spots, especially in my central vision.  When Eliz and I were working with Jane at softball, I noticed I had trouble following the ball when Eliz would flip the ball to me from three to five feet unless I looked to my right.  I’m not sure what the above test indicates, but since I don’t think I’ve ever had this particular visual fields test I don’t think there is anything to compare it to.

Visual Fields Test Machine in the Glaucoma Dept. at Wills Eye

After my appointment at Wills Eye, Eliz and I walked up Walnut Street and stopped into the Associated Services for the Blind and Visually Impaired.  I had contacted them just before we moved Salon Supplies + Interiors and ForYourSalon.com out of that disaster of a building (which has been condemned, by the way.)  Between the move and setup of the business and waiting to see how things went with the surgery, I didn’t follow up.  Looking back, that seems dumb.  As it stands now, I don’t think things will improve dramatically, if at all.  You may say I’m a pessimist, but I disagree.  I would call myself a realist.  Sure, I can hope and wish, but I’ve been doing that since I was a small child.  Maybe I learn something and gain some confidence.

Visual Fields Test is a post from: ICantCU.com | © 2009, iCantCU.com. All Rights Reserved.

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Post tags: appointment, caption, central vision, Dr. Ayres, Dr. Garg, Dr. Pro, eye, glaucoma specialist, Jane, retina specialist, test, Walnut Street, Wills, wills eye

We didn’t have to wait long in the waiting room.  I was very curious about reading the chart.  The E was not a problem.  I could see the SL on the next line, but it didn’t seem as sharp as my previous appointment about 10 days earlier.  I could not read the OPLB line.  That was a step backward.

When Dr. Ayres came in, I told him about what was going on.  He took a look and said everything seemed about the same as my previous appointment.  No signs of retina detachment, the new lens was still in place, and there was no signs of rejection on the previously transplanted endothelia.  My IOP was at seven, which was down from 10 at my previous appointment.  As he put it, the good news is that it is not a problem from the surgery, but that means I don’t really have any way of fixing the issue.  He prescribed a non-steroidal eye drop just in case there was a little swelling that he didn’t notice.  He said it was like Advil in drop form.

On Tuesday I have a scheduled appointment with Dr. Pro, who is my glaucoma doctor.  I want to have a Fields test, because one of the things I have noticed is more blind spots, especially in my central vision.  Hopefully, he’ll find something that can be corrected.

So, it seems I’ve missed my opportunity to go to the movies or a Phillies game.  It might also be time to learn how to do things without much sight.  I was waiting for the surgery before I tried anything new, but I think it is time.

Going the Wrong Way is a post from: ICantCU.com | © 2009, iCantCU.com. All Rights Reserved.

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Post tags: appointment, central vision, Dr. Ayres, Dr. Pro, eye, eye drop, Friday, phillies game, problem, retina detachment, vision, wills eye

Again, I was unable to read any of it until I flipped the pinhole cover down.  Like magic, the E appeared.  I then said I know the next line is S and L, but I can’t see it.  She told me I was wrong.  What!?!  It’s not S and L.  Now I had to know.  I moved the pinholes all around until it was as clear as it was going to be for me.  I guessed O for the second letter.  Try again.  D!, I said next.  That was it.  The first letter (don’t ask me why I don’t read them in order) looked like it could be an O, G, or C.  I guessed G in hopes of it being the GD line.  No such luck.  C was my next try and that was it.  Kelly mentioned that this chart is made up mostly of similar letters that repeat often, so my usual deduction that I’ve got a one in 26 chance which increases with every letter doesn’t work.  I’m actually going to have to read them.

Once I was finished with the eye chart, Kelly took us to another waiting room, where Eliz read me the story of the Penn State mascot in a recent addition to ESPN magazine.  Before we could finish, we were called to see the doctor.  Dr. Garg asked me about my issues and mentioned that he had spoken to Dr. Pro about me.  He explained that even though my right eye doesn’t do much he still wanted to check it out.  Since my cornea is really cloudy and I have a pretty mature cataract in it, they would use an ultrasound to have a look.  He also explained a test they’d run on my left eye, to check for changes in the macular pigmentation.  Dye is injected via an IV (that’s iv, not roman numeral for 4) and pictures are taken.  After he mentioned the dye, I remembered that I had this test before.  The images are wicked.  Unfortunately, I didn’t have a flash drive on me to get the images.

I went into another exam room to have the ultrasound and then back to the second waiting room to wait on the angiography.  After a 10 minute wait, Tom called me back to have the angiography.  He took a couple of images of my eye before putting the dye in.  The dye made me feel nauseous for about a minute.  Tom took more images and left to give someone an OCT scan (which took him all of five minutes — about 1000x faster than mine took on Monday.)  He then came back into the room I was in to get two more pictures.

I waited in the angiography room for a few minutes until they called me to see the doctor again.  He explained what he thought was going on.  He increased my use of one drop to three times per day and added another drop to try and get the swelling down in the retina and cornea.  He suggested that I wait on having the cataract removed until I see him again in six weeks.

After three hours, we were out of there.  We headed down City Ave to pick up Jane from school.  She called me just before the ultrasound and said she wasn’t feeling well, which I knew when she left for school.  I also knew we’d be right down the street from her and could pick her up after the appointment if she couldn’t last the day at school.

After I spent an hour, or so, at home (at which time I found out my mom had gone into the hospital — more on that below,) we headed over to Viva Salon in Springfield.  They’ve been having a problem with a hydraulic base that was still under warranty.  We swapped out the bad base for the good one that has been in our car since the move and headed to my next eye appointment.

I had scheduled this appointment with John Ruffini, another NPHS alum, to talk to him about the cataract surgery (and before I knew of any retina issues.)  He had a look at my still dilated left eye and we discussed my options and the problems that could arise from taking out the cataract.  He also thought it was best to see how the eye reacts to the increased drops and new drop.  I have put off scheduling the cataract surgery because of moving the business and the fact that it could undo the partial cornea transplant.  My left eye has endured seven operations over the years, with another one imminent.  I’m tired of going through these procedures and the recovery with mediocre success.  The risk/reward factor isn’t great, though I would do anything to preserve any sight I still have.

After leaving John Ruffini’s office, we made a delivery in Holmes and stopped by a salon in Milmont Park to look at a styling chair that needs replacing.  We returned home at about 4:00 pm and had an alarm company tech waiting to convert our system.  It took him about two hours (the whole story will have to wait for another time.)

We were finally able to head to Riddle to visit my mom.  She went to the hospital at around 8:00 am this morning because she was having shortness of breath and chest pains.  The doctor wanted to keep her overnight for observation.  She seems to be okay, though uncomfortable because of the shingles.  We are hoping to pick her up and take her home tomorrow.

A Long Day is a post from: ICantCU.com | © 2009, iCantCU.com. All Rights Reserved.

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Post tags: 1964, C.  I, cataract, chart, congenital glaucoma, cornea, Dr. Ayers, Dr. Garg, Dr. Pro, Dr. Ruffini, Eliz, espn magazine, eye, Holmes, Jane, John Ruffini, Kelly, L.  Now, Media, Milmont Park, nether providence, Penn State, penn state mascot, Providence, Queen, queen of babylon, retina, retina specialist, Riddle, room, Rose Garden, Springfield, Strath Haven, StrathHaven, swelling, Teavana, Tom, Viva Salon, Wallingford, wills eye

Dr. Pro recommended a couple of retina specialists at Wills Eye, who also have an office at the Pagoda Building in Bala Cynwyd.  It was too late in the day to get an appointment today, so I’ll call them tomorrow and set something up.  I’d like to get something quickly to stop further decrease in my vision.  I already have an appointment with my local ophthalmologist, John Ruffini, on Friday and will discuss the scan, my options, and the cataract (which was the original reason I made the appointment.)

Time to See a Retina Specialist is a post from: ICantCU.com | © 2009, iCantCU.com. All Rights Reserved.

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Post tags: appointment, bala cynwyd, call, cataract, congenital glaucoma, cornea, cornea transplant, Dr. Ayers, Dr. Pro, Dr. Ruffini, eye, iop, John Ruffini, late in the day, retina, ruffini, swelling, wills eye

My OCT scan from 11 Jan 2010.

Image of My OCT Scan is a post from: ICantCU.com | © 2009, iCantCU.com. All Rights Reserved.

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Post tags: bellies, butts, caption, cataract, cornea, Dr. Pro, glaucoma, image, mine, New York, OCT, pagoda building, retina, update, vitreous retina, wills eye

My good fortune was that the machine was brand spanking new and both Irene and Todd had not yet mastered it.  Irene couldn’t get a good set of images and kept asking me if I was diabetic, which I am not.  She then said that the cataract in that eye must be really dense, because they couldn’t get a clear image.  She then decided to dilate my eye.  (This test was only for the left eye.  The right is waiting for the Six Million Dollar Man eye and I haven’t spotted those at Radio Shack yet.)  Dr. Pro had asked that the eye be dilated, but Irene thought it wasn’t necessary at the beginning.  While my pupil was dilating, Irene stepped out of the room.  Todd, Eliz, and I talked about the machine.  I asked Todd a question and didn’t get a response.  Eliz then answered for him.  Seems he didn’t realize I couldn’t see him and he nodded yes to answer my question.  After about 10 minutes, Irene walked back in, but Todd wanted his turn on the machine, so Irene coached him.  He couldn’t get a good image either.  Irene’s turn again.

After about 10 to 15 minutes of trying, we were asked to go wait in another waiting area.  We only waited there a couple of minutes and then it was back into the hot seat for me (and I didn’t stumble in the room this time since my eye was dilated…)  Finally, Irene was able to get the correct images the doctor ordered.  I asked if I could have one put on my flash drive.  Irene said no, but said she’d print one out.  As she looked through all the images, she realized that they weren’t that good.  She asked if she could try again on getting a good image.  At this point, either Eliz or I mentioned the Endothelial transplant from December 2008.  She then said that might be why she couldn’t get a good image.  Whatever.  She got some images she was happy with and printed one out for me…  In black and white!  The doctor will have a look in a day or two.  I’ll call on Wednesday to see what the story is.

I’ve got a scanner issue that is stopping me from uploading the image.  Hopefully I’ll figure it out tomorrow and have the image up here then.  I know it doesn’t look like this image:

OCT demonstrating normal retinal architecture.

My OCT scan from 11 Jan 2010.

So now I have to wait to hear from the doctor.  My image is a bit more “hilly” than the image above.  I’m hopeful this is the reason for my latest issue.  I also hope this can be fixed.

OCT Retina Test is a post from: ICantCU.com | © 2009, iCantCU.com. All Rights Reserved.

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Post tags: adventure today, caption, cataract, cornea, Dr. Pro, Eliz, eye, glaucoma, good fortune, image, Irene, machine, OCT, retina, room, surveillance camera, thin red line, Todd, waiting area, wills eye

So the holidays are over.  We’re out of Folcroft and restocking the shelves in the new space and we’re starting to make local deliveries from the phone orders we’re taking.  Just when it looked like things were starting to settle down, a couple of new challenges have emerged.  My mother hasn’t been feeling well since her fall about three months ago.  Eliz has been taking her to various doctors over the past week, with another appointment on Monday.  One doctor thinks she may have shingles.  It has worn my dad down.  He feels helpless since he can no longer drive and his vision and memory are starting to slip.  We’ll know more on my mom on Monday.

The other challenge is me.  I’ve noticed that my vision has deteriorated over the last six months and has really started to nose dive in the past few weeks.  (I got a new HDTV for my birthday and hooked up the HDMI cable about four weeks ago and was wowed that I could notice a difference in the picture.  Watching the news tonight, I couldn’t make out many of the graphics that said where the story was taking place and the reporters/interviewee’s name.)

At Wills Eye today, my glaucoma doc, Dr. Pro, told me he didn’t think the issue was glaucoma related.  My cornea doc had previously told me that he didn’t think it was cornea related.  Dr. Pro mentioned today there were two other possibilities: the cataract or a retina problem.  He said while the cataract might be the cause of some of the issue, he said it wouldn’t lead to the significant vision loss I have sustained over the past weeks.  I couldn’t read the big E on the chart with or without the pin holes.  The E is the 20/400 at the very beginning of the eye chart.  I was able to count fingers at about three feet.  This, of course, was in my left eye, the “good” one.  As usual, I could tell when a light was off or on using my right eye, so there’s no excuse if I leave a light on in a room…

This development is troubling to me, though not unexpected.  My whole life I knew the chances were good that one day the lights would fade.  Maybe this can be reversed.  I’ll know more on Monday after I have an OCT (The technique of optical coherence tomography (OCT) produces high resolution, high speed, non-invasive, cross-sectional images of body tissue. from the University of Miami) test.  Hopefully, I’ll have some images to post and some good news to deliver.  Funny how last April and May I was trying to find a way to be able to have a catch with Jane to now just trying not to walk into things or find items on my own.

As usual, there is never a dull moment with me, especially when I do walk into something.  I end up cursing like a drunken sailor with turrets even when I don’t hurt myself.  The frustration gets hold of me for a minute or two.  Sometimes it does actually hurt…

New Challenges is a post from: ICantCU.com | © 2009, iCantCU.com. All Rights Reserved.

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Post tags: 16th birthday, birthday, dad, Dr. Pro, Eliz, eye, Folcroft, glaucoma, hdmi cable, HDTV, holiday, holiday season, Jake, Jane, joyous season, rear ends, season, University of Miami, wills eye

After about 10 minutes, we were called back.  Christy asked about any problems, pains, etc.  She wrote down everything I said.  Then it was time for the eye chart.  Big E, that’s all I saw and even that wasn’t clear.  I could barely see that there were characters on the next line.  20/400, just like at the glaucoma study and Dr. Ruffini’s office.  Christy then flipped the pin holes down.  I saw the next line (CD, 20/200) and a letter from the next line!  The C& D (from the 20/200 line) showed up just like those ballplayers at Ray’s cornfield did for Mark.  For fun, she shined a light at my right eye.  I saw the light…  Hold the applause, please.  Dr. Pro wasn’t quite ready to see me yet, so back out into the waiting area.  We’re back to reading recipes like it’s 1999.  Sad thing is, I would have been able to read those recipes back then…

After five minutes or so, we went into another examination room.  First in was Dr. Katz, who, I believe, is doing a Fellowship at Wills.  He was very friendly and joked with Eliz and I.  He checked the IOP in both eyes (18 in the right and six in the left.)  He also looked around both eyes and mentioned that he saw the “button” in my left eye (the new part of the cornea that was transplanted last December.)  Dr. Pro came had a look and asked Dr. Katz for a quick evaluation while he (Dr. Pro) continued to checkout my eyes.

Dr. Katz stated that he got an 18 for my right eye, but didn’t know how accurate that was.  Dr. Pro said that it is hard to get a good (accurate) reading from that eye because of all the problems with it.  The cornea is thick with some scarring and there is a cataract that is pretty mature in there as well.  He then tried using a different device to get the IOP in the right eye.  From what I saw of it, it looked like one of those digital cooking thermometers.  Since the numbing drops were beginning to wear off, it didn’t feel too good being jabbed into my eye.  Dr. Pro said that the numbers were all over the place and that some of the readings were around 30.  (Perhaps my eye was simply picking the Powerball or MegaMillion numbers for the next drawing.  If Dr. Pro isn’t there for my next appointment in January, I’ll know…)

Dr. Pro then talked about the fold in the left cornea.  He told me to call and give Dr. Ayers (the cornea doc) a heads up.  He also told me to take the Pred Forte drops four times per day until I see Dr. Ayers at the end of this month.  He told me he didn’t know the cause for the fold and if it could be repaired without surgery.  Dr. Ayers would be able to tell me more.  Dr. Pro then began discussing my right eye.  He said it might be time for a trab.  I asked him why.  He thought the pressure was kind of high and I did have some vision in that eye and we should try and save it.  I mentioned that I had been told in the past by Dr. Wilson and Dr. Starer (R.I.P.) that any glaucoma surgery should be accompanied by cataract removal and a new (okay, actually it’s used, but new to me…) cornea.  I was a bit surprised by the suggestion of the trab recommendation.  My eye has very little pain usually (though, at that moment I could still feel where the meat thermometer was jabbed into it.)  Saying that I have some vision in that eye is like saying the homeless guy sleeping on the street with 18 cents in his pocket has money.  Is it true yes.  Is the sight meaningful?  No.  I then mentioned to Dr. Pro that I would be game for any type of experimental surgery on that eye.  After some additional discussion, Dr. Pro told me he just wanted me to know my options.

As we were waiting to checkout at the front desk, Eliz mentioned that my attitude had changed when he talked about surgery on my right eye.  I asked her if it was bad and she said that I was not disrespectful, but she could tell I wasn’t happy.  I wasn’t happy at all.  I still didn’t know what the problem was with my left eye and didn’t really care about how we can make my right eye minutely better.  I was extremely disappointed and frustrated.  When I got home that night, I began searching for answers on the fold.  I posted some questions in one of the yahoo groups I belong to, hoping for an answer.  As of this writing, I’ve got nothing yet.  I’ll keep you posted…  The best thing to come from the appointment, besides the recipes, was the fact that I didn’t notice any kids waiting to be seen.

Glaucoma Specialist is a post from: ICantCU.com | © 2009, iCantCU.com. All Rights Reserved.

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Post tags: appointment, c amp, Christy, cornea, Dr. Ayers, Dr. Katz, Dr. Pro, Dr. Ruffini, Dr. Starer, Dr. Wilson, Eliz, eye, eye chart, family gatherings, glaucoma, glaucoma specialist, I.  He, magazine, Mark, pin holes, R.I.P, Ray

I had also hoped to stop by ASB (Associated Services for the Blind and Visually Impaired – asb.org) tomorrow, as they are just across Walnut Street from Wills Eye.  I didn’t hear back from them, so I don’t know if we stop in.  I don’t get a chance to get out of the store too often, so we’ve got to make the most of it.  Jane and Margaret are covering for Eliz and I tomorrow, by the way.  I will post tomorrow or over the weekend on how he appointment goes.

Wills Eye Tomorrow is a post from: ICantCU.com | © 2009, iCantCU.com. All Rights Reserved.

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Post tags: appointment, asb.org, Associated Services for the Blind and Visually Impaired, black eye, clouding, cornea, cornea specialist, December, Dr. Ayers, Dr. Pro, Dr. Ruffini, Eliz, endothelia, eye, glaucoma specialist, Jane, Margaret, ruffini, specialist, tomorrow, Walnut Street, wills eye