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It has been a busy week, so I haven’t had a chance, until now, to post an update on last Fridays appointment with Dr. Garg, the retina specialist.  Unlike two weeks ago when I went to the glaucoma doc, this appointment was lacking most of the nonsense.  By the end of the appointment, I wasn’t any closer to an answer than I was since late April.

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…)

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As you’ve read here over the past seven weeks, I’ve been pretty frustrated and miserable.  On the way to my my cornea specialist, Eliz and I were talking about what I was planning on discussing with Dr. Ayres.  I was going to tell him how tired I was running back and forth to all these eye specialists who couldn’t really figure out why my vision had deteriorated to 20/200 (close to my pre-surgery acuity) after I was able to read most of the 20/100 line a week after the surgery.  I was also going to ask Dr. Ayres to ease off some of the drops.  I was up to about 8 to 10 per day, and after some, my vision was blurry for varying lengths of time, reducing my vision further.

So we’re driving down Lancaster Ave. after dropping Jane at softball camp at Villanova and we turn on Preston and Steve on WMMR (Eliz is a huge fan.)  They were talking about some guy who was trying to get into the Guinness Book of Records by singing the lowest note ever.  The discussion somehow turned to the Oak Ridge Boys and their hit Elvira (warning, don’t click the link, you won’t be able to get the song out of your head…)  They were talking about how deep one of the members of the band could sing, were making fun of the song and then mentioning that one of the members was from Collingswood, NJ (it is in southern New Jersey.)  I was laughing so hard I was crying.  Tears were streaming down my face for over five minutes.  When they finally stopped, we were just passing St. Joe’s on City Ave.  I grabbed a tissue and wiped my eyes and began to look around.  Things looked clearer to me.  We stopped at a red light and I looked at the trees and buildings and told Eliz that things looked better than before the tears flowed.

We were only a minute or two away (his office is on Presidential Blvd. in the Pagoda Building, just off City Ave.)  We sat in the car for a minute or two since we were early.  I looked at the building and the trees and things still looked better.  Once we walked in, things were still tough to see inside.  We took the elevator to his office and signed in.  Eliz grabbed a magazine and started looking through it.  I glanced at the front cover, but couldn’t make out the title, so I thought my vision was returning to its current normal.  After a few minutes, I was called back to Pod 3 (which I suggested on multiple occasions to rename EyePod 3.)  Tia was the name of the tech and she questioned me about what meds I’ve been taking and how my vision was doing.  Then she turned on the eye chart.  E looked clearer.  So did SL.  I was then able to make out the L first, then the P in the OPLB line.  (As I’ve mentioned before, I know all the lines down to DAO6, the 20/60 line, so I’m never 100% sure I’m actually seeing them.)  There is no alternative 20/100 line other then the OPLB line, like there are for the 20/80 line and better, so I was given credit for seeing the P and the L.  With the pinholes, I tried both the CAV8 (20/80) line and its numerical alternative without being able to read anything.

Dr. Ayres came in a few minutes later and I told him about what happened on the way into the appointment.  He then took a look and had me blink twice.  He noticed that my eye was losing the tear film in about five seconds (he didn’t use a stopwatch, instead opting for the technical Philadelphia, as in one Philadelphia, two Philadelphia, etc.  We always used Mississippi when we played football as kids.  You could blitz on five Mississippi…)  He then explained to Eliz and I that 10 seconds is the norm for the tear film to last after blinking.  I’m not surprised that my eyes aren’t normal.  Never have been, never will be.  He also mentioned that once the eye begins to dry, the visual acuity begins to fall.  He gave me more drops, over the counter lubricating drops for during the day, and a prescription for a drop to use at bedtime.  It is an antibiotic that evidently is somewhat thick.  It is used for infections in the eye, but I was instructed to close my eye and massage it onto the edge of my upper and lower lids.  I’ll let you know how that goes in a few days since I haven’t used it yet.  Dr. Ayres also took me off one of the steroid drops (two less drops per day) and Muro 128 (four times per day.)

Can it be that at least part of my current eye issues were discovered because of Preston and Steve?  Yup!  So, thank you Preston and Steve (and Kathy, Casey, Nick, Marisa, the Oak Ridge Boys, and that guy trying to sing the lowest note!)  Now I just have to hope that the new drop works.  Wish me luck (again…)

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I’ve been waiting for this appointment with my cornea specialist for weeks.  I have been having problems with my left eye since the middle of summer and both my local ophthalmologist and my glaucoma specialist noticed “folds” in my cornea.  Both thought that was the reason for my visual acuity dropping from 20/200 to 20/400 in my “good” eye.  My right eye has bothered me for the last day or two, so I wanted to have Dr. Ayers take a look there too.

I get called back and the “nurse” (she is more than a helper, but I doubt she is a nurse — please correct me if I’m wrong) puts up the eye chart.  I see the big E (20/400,) but not the SL (20/200.)  She drops the pinhole thingy over my eye and after some searching for the perfect pinhole, I see the SL line.  The OPLB line looks like some black blobs and I can’t make any of the letters out.  The “nurse” says, “Oh, that’s not so bad.  It’s only one line less.”  Really?  So if you are driving down the street, you don’t think seeing a sign with letters about 12 inches tall would be much easier to see than the sign with letters about six inches tall?  I’ve wasted a ton of money on signage then if it’s not that different.

After waiting an unusually long time to see Dr. Ayers (a total of about an hour fifteen minutes,) he finally came into the room.  We exchanged pleasantries and then discussed my eyes.  I told him about my left eye and not seeing as good as I had been and I am now having greater difficulty reading on the computer.  As I put my head into the applanation tonometer (the machine with the blue light on it,) I mention that my right eye is bothering me.  He took a look at the right eye and mentioned things like corneal edema, bullae, and some other things to the “nurse” who was writing everything in my chart.  I kind of knew that I had some bullae (small, fluid-filled blisters ,) because I’ve had sinusitis and been on antibiotics for the past two weeks.  (This is the third time I’ve had sinusitis in the last four months, could it be the mold at the store?)  The problem with the bullae now though is that when they pop, the pain isn’t going away and any kind of light brings additional pain.  I thought I might have an infection in the eye.  Doc said no and to use this stuff called Muro 128, which is basically a kicked up saline solution.  It also comes in a gel that I usually use.  I suppose I could also go to the kitchen and throw some salt in my eye…

As he checked out my left eye, he noticed the “folds” straight away.  He then said the “folds” are Haab Striae and I’ve had them for a long time.  He then (tried to) show me the sketches he’s done of my eye at every visit.  He realized I couldn’t see it and told me each one has them (the striae) there.  He said my eye looks good.  My IOP was eight in the left, 16 in the right.  Wow, so everything is good!  I am so relieved.  But wait, I can’t see as well.  There’s got to be something going on.  I do have a cataract in there, but the doc says he doesn’t think it is time to remove it.  Besides, by taking that out, it may wreck the endothelia that was transplanted in December.  Dr. Ayers says, “But we could just do another one.”  He said I might be able to 20/70 or 20/80!  Of course he said I’d get to 20/100 by doing the endothelial transplant.  I guess I’ve got to wait more than 42 weeks after the surgery to get there.  He doesn’t think the cataract is the problem though.  Dr. Ayers then adds, “Whatever it is, it’s not an easy fix.”  House!  HOUSE!  Where the hell is that guy…  Oh, he’s not real?  I thought that show was one of those reality shows.

Speaking to my dad about the appointment last night, he said, “What are they gonna tell you?  They can’t fix it, it is the way it is.”  I should have listened to him.  I’d have saved a few hours and the copay.  Not too bad for a guy that only spent two weeks in high school.

I’d like to thank Ken for transporting me to my appointment.  Since Ginny and Scott aren’t with us at the store, we don’t have coverage for Eliz and I both to leave store.  Between the mold, the economy, and my vision, it might be time to get into something else.

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