Everything Looks Fine…

Posted by: david  :  Category: eye check, recovery

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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Latest Eye Appointment

Posted by: david  :  Category: eye check

I went to see Dr. Ruffini yesterday for a checkup.  He is my local ophthalmologist that I see a few times per year or when there is a problem.  I’ve been having difficulty over the last few months with my vision, so I was happy to go to the appointment.  I was interested in seeing what my vision was, after only seeing 20/400 at the glaucoma study (20/200 with the pinholes.)  Sure enough, it was the same yesterday.  The difference between yesterday’s test and the glaucoma study’s test is that I knew the chart yesterday and could recite down to the 20/60 line with my eyes closed.  I could see the big E, but it wasn’t clear as day.  The next line (20/200) is SL.  I couldn’t see it at all.  I asked the nurse for a minute to continue looking at it, hoping it would come in.  It never did, so I asked for the pinhole thingy.  It was like night and day.  As soon as she flipped the pinholes down, I saw the S and L.  Then I got ambitious and tried to read the OPLB line.  I always look for the L in this line since it has straight lines in it.  No luck.  I could barely see any black where the letters were.

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.

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Almost Eight Months

Posted by: david  :  Category: recovery

It’s nearly eight months since my surgery (next Saturday, 4 July is eight months.)  I had an appointment today with Dr. Ayers.  We were taken back to the examination room, which was called Pod 3.  We joked with the tech, a seemed to be twenty something white guy, about the name of the standard eight by ten room used in countless ophthalmology offices everywhere.  The tech said the number designated the disease, while Pod made it sound high-tech.  Pod 3, therefore, was for cornea issues.

The tech asked how my eyes were feeling and if I’ve had any problems lately (good and not really unless you count the elbow Eliz landed on my left eye last night.)  He then asked if I was seeing any better and I responded by reciting the eye chart down to the 20/60 line.  Since he hadn’t turned on the machine yet, he knew my memory was still good.  I was a little worried when he turned the machine on.  I saw the E, but not clearly.  I also had trouble seeing the S in the SL (20/200) line.  If I didn’t know it was an S, I don’t think I would have been able to guess what it was (though there are only 26 letters in the alphabet and usually no duplicates on a line, so I knew it wasn’t an L.  I could also eliminate other letters that are not rounded, like A, K, X, H, E, F, I, M, N, T, V, W, Y, and Z.  Now I’ve got a one in 10 chance.  Is that seeing or guessing?  I told the tech my concerns.  He handed me the eye cover with all the pinholes and told me to try that.  Within 10 seconds I could see the S.  When I was rattling off all the lines before he turned the machine on, he said there were alternative lines on the machine, made up by numbers.  I asked him to go to those so that I could see if I actually could see anything there.  He put the largest line up, which was the 20/100 line.  Without the pinholes, I saw five black blobs.  With the pinholes I was able to spot the 7 all the way on the right.  I was pretty excited.

Dr. Ayers came in shortly after.  He had a look and told me things looked pretty good.  The only concern is that my IOP was six.  It has been fluctuating between six and eight for a few years, but has been at six for quite some time.  I asked if I could go swimming and was told I could.  I also asked if I could wear goggles.  Dr. Ayers advised me not to wear the goggles that the swimmers in the Olympics wear, but to use those that are larger.  Fortunately, I already own a pair of AquaSphere goggles, so I’m good to go.    Dr. Ayers told me to cut back on the Predforte to only Mondays, Wednesdays, and Fridays as he didn’t see any signs of rejection going on.  I’d like to be off the ‘roids at my next visit in October.  The cataract is still not ready to come out.  The amount of vision I’d pick up by having it removed isn’t worth the boatload of risk (it could wreck December’s surgery, as well as destablilize the eye as far as the glaucoma is concerned.)   That finished up my appointment and we were good to go.

So, the bottom line is that I was pleased with what Dr. Ayers told me.  I can do whatever I could do before the surgery (swim, lift heavy things – though, the heavier I get, the less I seem to be able to lift, etc.)  Still waiting on something/someone to fix my badly damaged optic nerve…

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