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

I was not looking forward to another surgery on my left eye until things started going downhill in July.  The problem was, none of the doctors knew what was causing the problem.  The cataract didn’t seem much worse than a few months earlier, if at all.  After going from one specialist to another, it was determined it wasn’t a glaucoma issue or a retina issue.  Lets just hope it is the cataract that is the issue.

I’m having the cataract removed on 15 April (so I guess I’ll send our taxes in early…)  There is also a possibility that I’ll have another DSEK (endothelial transplant.)  The donor endothelia will be in the OR, just in case.  Evidently, removing the cataract risks damaging my now 70 year old endothelia (along with the other common risks associated with this in most people and specific risks for unique individuals, such as myself, with other eye issues.)

I am disappointed that I have to wait that long for the surgery.  I joked with Dr. Ayres that I was ready to have it yanked on Wednesday.  I’m sure I have been less than pleasant to be around at home.  Tonight, I was home alone while Eliz, the kids, and a few of Jane’s friends went to see Alice in Wonderland — I miss going to the movies.  My frustration level is high and it takes me so long to do many basic things.  I am so ready to get the cataract out, it is hard not to get excited.  I’m trying to temper the excitement, since it only leads to disappointment after the surgery (at least after the last three.)

Surgery No. 14 is Set is a post from: ICantCU.com | © 2009, iCantCU.com. All Rights Reserved.

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Post tags: Alice, alice in wonderland, cataract, cornea transplant, Dr. Ayres, Dr. Garg, Dr. Ruffini, DSEK, eye, frustration level, issue, Jane, retina, retina specialist, surgery

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

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

The nurse/assistant then put numbing drops in my eyes and took my pressure.  I’m not a fan of them taking my pressure, because they do not take their time getting a reading and are obviously not as skilled as the doctor in reading the results.  She got between 10 and 12 on my right eye (not that that eye matters.  Hell, I’d sell it to the highest bidder if I could – and no, PayPal would NOT be accepted for payment.)  She got eight in my left eye.  That eye hasn’t, pardon the pun, seen eight in quite awhile (since 5 Dec 2008, the day after my endothelial transplant, when my IOP was in the mid-teens due to something being blocked from the surgery.)  It has fluctuated between five and seven at most visits over the last six and a half years since my last trab (glaucoma surgery) in Feb 2003.  She then dilated my eyes.

Dr. Ruffini entered about 10 minutes later, and not a moment too soon, since Eliz and I had finished all the word scrambles from the paper.  I told him of my lousier than normal sight and the double vision I’ve been experiencing.  He had a look with a light that was 3457329845 times brighter than the sun.  He said he could see all the way back to the nerve in my left eye; my cornea was very clear; the cataract had grown slightly, but it wasn’t something that needed to be dealt with near-term.  He also mentioned a slight fold at the center of the endothelia.  He wasn’t sure what might have caused this, since it wasn’t there the last time.  I asked if the low IOP (hypotony) could have caused this and thought that might be it.  Wow, after 44 years of going to ophthalmologists, I actually contributed to the discussion!  He advised me to discuss the wrinkle with both the glaucoma specialist and cornea special at my upcoming appointments with them in October.

I was disappointed  when we left the appointment.  These things are going on in my eye, I still can’t see as well as I did back in March 2008 (before the problems with my cornea started,) and yet there is no solution.  Nothing.  I don’t know why I have such a hard time believing that.  I also don’t know why I’m having such a tough time dealing with it.  I’ve known since I was a little kid that this was my predicament.  Knowing doesn’t make it easier.  As my sight gets worse, I’ve gotten more miserable and I’m too young to be a grumpy old man.

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

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Post tags: appointment, clear as day, dilated, Dr. Ruffini, endothelia, eye, eyes, glaucoma, glaucoma surgery, hypotony, L.  Then, line, low IOP, mid teens, miserable, nurse assistant, pinholes, pressure, right eye, time, word scrambles, yesterday