Tuesday 22 July 2008

my light shines on....

Yesterday I went back into hospital first thing to have a phakic intraocular lens (IOL) implanted into my right eye. The implant into my left eye had now been in place for almost exactly a week, and would now apparently have settled down enough for the second procedure to take place. Well, that's as may be, but as I sat and fretted on Sunday evening in front of the TV, opening and shutting each eye in turn and trying to assess the quality of the vision, it seemed to me that my left eye still had some way to go, and I was a little nervous about risking the overall quality of my vision by having the other eye done too. The eye was no longer really bloodshot, and I would say that the overall quality of vision was pretty good, but it still seemed to be a fraction blurred to me. I hoped that this was because of the sutures pulling on my cornea inducing a (temporary) astigmatism, but was anxious that if the other eye was done too soon, then my overall vision would be poor for however long it took my eyes to settle. On the other hand though, neither was I terribly keen to have the surgery postponed as I'd already got the time off and didn't really want to have to wait and reschedule. Plus I was just plain nervous about the procedure. I was looking forward to dumping my contact lenses for good (my glasses got dumped last week as I couldn't wear them with one corrected eye), but for all that the procedure is reversible, this felt like the point of no return as I was going to have to function with two eyes that would need time to heal.

My right eye is somewhat worse than my left eye. One of the reasons for the left eye to be done first was that the implant I required was simpler and could be inserted rolled up through a small incision in my cornea. I have a large astigmatism in my right eye, and in order to properly correct this, the implanted lens was going to have to be rigid and the alignment of the lens in my eye was going to be much more important. As a result, the lens could not be rolled up and the incision needed to place it underneath my cornea was going to need to be bigger. It's a more tricky procedure, apparently, and where local anesthetic was okay last week, this time the professor was keen that I should be put under general as it was more fiddly, would take longer and he didn't want me wriggling around on the operating table. Fine by me, and I took extra care not to have any breakfast on Monday morning.

Just the same as last week, I had my blood pressure and other vital signs checked in my room before being wheeled down to the operating theatre (I had a heart-rate of 46 bpm... not bad before eye surgery, eh?). After that though, things were quite different: I was given oxygen through a mask, I was dosed with first some local anesthetic and then a huge needle was inserted into a vein on the top of my right hand and then the general itself was injected. Weirdly, I could feel the anesthetic as it went into my body, as it was really cold and I could feel it travelling up my arm....but then my head began to swim (the anesthetist told me to imagine it was like my first gin and tonic of the day). Then I was gone. About two hours later, I woke up and the deed was done. I had a big patch over my right eye, and was wheeled back up to my room to wait for my checkup with the consultant that evening.

Last week, I killed the seven or so hours before the follow up by watching the cricket and reading magazines and things. This time around, although the cricket was on the telly again, the anesthetic seemed to knock my body for six, and all I could do was lie on the bed sleeping fitfully and generally feeling groggy. It was a bit weird last week when the local meant I was fully awake when the first eye was done, but at least I was up and running pretty quickly afterwards. The general anesthetic seemed to poison my system for ages afterwards, and I'm not sure that, if given the choice, I wouldn't have preferred local again. Well, maybe not. Anyway, I was still feeling pretty off when I went down to see the professor at about six that evening, some nine hours after the general had been applied. The procedure had gone fine and the professor seemed content with the way that the lens had been attached to my iris and with the immediate quality of vision. He patched the right eye back up and turned his attention to the left. I told him how I was still finding things a bit blurry, and although he didn't really give away much in terms of whether I should expect this to improve or if this was likely to be as good as it gets, he did get me to read out some letters off the chart and told me that the quality of vision in that eye was already good enough to meet the legal minimum for driving. That's good, I suppose, but it did make me feel rather nervous about other people on the roads if that's as good as they need to see. He also did a quick 'pinhole occlusion' test, where he covered my left eye with a patch with a number of small holes punched into it. Immediately, my vision cleared and I was able to read the letters all the way down to the last line. Apparently this shows my best corrected vision potential..... that's not to say that I won't need further correction on the eye, but it does indicate that whatever issue I have with my vision can at least be corrected to a far greater extent than it could before the operation. This is good. Ideally I won't need glasses or contact lenses at all, but if I do, at least my vision should be better than it's ever been before. C. also told me that the professor gave her a thumbs up sign when I wasn't looking, so I'm hopeful that everything is going to be okay. It won't be the end of the world if I need to wear specs or something for close reading, driving or watching the telly. A touch disappointing perhaps, but the vision I already have from both eyes is already more than good enough to do most things, which is all I ever really wanted or needed.

I uncovered my right eye this morning, and although it's pretty bloodshot from the surgery, the vision is pretty good and fingers crossed will only improve over the next few weeks. For now, I just apply the drops (a steroid to reduce inflammation and to help get rid of the blood and an antibiotic to help stave off infection) four times a day, cover my right eye up with an attractive plastic shield to protect it when I sleep for another few days, and then I'll go back for another checkup next Monday to see how it's all coming along. The stitches won't come out for another three months, and it's possible that I won't know how well my eyes have healed and how good my vision is going to be until then.

Still, I'm pottering about at the moment without any difficulty with anything much except small-ish writing when viewed from a distance (the kind that I would probably have been able to read ok with my glasses on, and now have to squint at a bit).

I'm cautiously optimistic, if a bit fretful... but it's early days yet.

What a palaver, eh?


  1. It sounds like a good success. I'll keep you in my thoughts for a perfect 20/20!

  2. The very idea of chucking the glasses and lenses away is quite exciting. I hope you're feeling a bit better today and that things continue to improve.

    A couple of years back I had my prescription substantially increased, which was making me feel a bit off, like I was slightly drunk most of the time. Eventually, after much faffing, it was reduced to a mid-point, and the optician told me that even at the original prescription, I was beyond the legal driving limit. (That's possibly not the right way to put it, but you get my drift.) With that prescription, I was unable to read subtitles on the TV, and would feel a bit lost if I was meeting someone in a busy pub. It really freaked me out to think there were people with worse vision than that on the roads!

  3. Katie - before I delete your comment as advertising spam - do me the favour of at least actually reading the post before you leave your garbage all over the comments. I didn't actually have cataract surgery and I think that's fairly clear from what I've written here and elsewhere. I'd thank you to at least make a bit of an effort. Do you really think that people reading this are going to click your link?