OK, it's been another long while, and a lot has happened. I left off in September, with mediocre vision due to residual astigmatism. On December 6th, I had PRK on my dominant right eye to take care of that astigmatism. PRK does essentially the same thing as LASIK, which is reshape the cornea, but with a different way of getting those pesky epithelial cells (the cells on the cornea surface) out of the way. LASIK creates a flap with a blade (microkeratome) or a laser. In PRK, the epithelial layer is removed with a chemical. Because this layer is entirely removed, and not just flipped out of the way, PRK requires a much longer healing time. The cells regrow and cover the hole in about three days, but the final integrity of the layer is not completely healed for about six months, causing a very gradual improvement in vision quality. During this time, there is also a tendency for vision to fluctuate temporarily, for a few hours at a time.
So for the first three days after the surgery, I had a bandage (clear) contact lens in my eye to cover the epithelial hole. This stage can be quite painful. Fortunately for me, it was not painful at all, though the Percocet they gave me could have helped with that. I used it for the first day, and was even able to watch a football game that night, albeit while wearing sunglasses. At this point my vision was very clear because there was no epithelial layer present. The main discomfort during those three days was due to general inflammation and the presence of the bandage contact lens. However, I had an anti-inflammatory drop that really helped. By Monday, the fourth day post-op, I returned to the surgeon's office to have the lens removed. As the epithelial layer sealed over, I lost some clarity of vision, and was seeing at about 20/50 out of my right eye. But everything was healthy, and I was told to continue with a steroid drop until told otherwise.
My vision steadily improved over the next few weeks as the epithelial layer continued to heal. I believe that I got to 20/20 after about two months (I forget the date at this point). I am now at six months past the PRK surgery, and things have settled pretty well. I occasionally had blurry moments, but they steadily decreased. At four months after the PRK surgery, my doctor declared the process complete and I was finally able to stop the steroid drops, which we had tapered down over time.
Now comes the ultimate question: am I happy? In general, yes, I am. I still have significant halo issues, but now that it's summer it's light out later so it's not as much of a problem. I've been to mutliple baseball games, and I am not seeing any worse than I did in the past. I think what I'm worried about now is fluctuation of my vision over time. I can't just change contact lens prescriptions any more if my eyes change. But regardless, it won't change enough that I will have to wear glasses to do all the outdoor stuff that eyewear would inhibit (beaches, water sports, etc, not that I do much of those anyway). I do feel that my vision has been a litle worse over the last few days, which worries me a bit. But then I second-guess myself and think everything's the same. I guess I just need to stop worrying about it and see how things go. If anything changes, I'll be back and update the blog.
Thanks for reading, and I hope my experience has been slightly helpful to one or two of you considering Visian!
Tuesday, May 20, 2008
Wednesday, September 5, 2007
Current Status
Hello All,
I apologize that it has been a while since I have posted. My schedule is cray, and I've been on a couple of vacations. The vacations have given me a good idea of exactly how well I see in most situations.
First, the good news. It is incredible to be able to go to the beach and wear sunglasses AND be able to go in the water. I was always afraid of losing my contacts, so I always wore my glasses to the beach. To be able to go in the water and see was phenomenal. These lenses really have changed my world, though not always as perfectly as I had hoped.
The bad news, though, is that nothing has really changed since my last post, which was right after the surgery. I still have significant night halos, and I no longer expect them to go away. I can control them to an extent with a drop called Alphagan P, which I take in the evening. It helps, but is not perfect and is not terribly consistent. Some night I see no halos, other nights they are minimized only slightly.
I am still wearing the light glasses a good portion of the time. I don't NEED them to drive, but they help a lot. I need them to play golf, attend a baseball game, or do anything that requires detail vision. I can read without them, but not as comfortably, and they help to watch TV as well.
My biggest issue, though, is that in order to correct this, my doctor said I'd have to have PRK. If you're not familiar, PRK is the older and more time-tested treatment. However, it is much more painful than LASIK, and takes a lot longer for the vision to stabilize. One internet account I read stated that the pain was excruciating for two days, and that the vision didn't get perfect for six months. I am really not happy about this. I have heard that some people have had LASIK after Visian surgery, so I need to look into that some more.
So that's the latest update. There are pieces to this that are great, but I am still frustrated and feel a bit misled. I'll have another appointment next month where we discuss the touch-up surgery more, so I will be sure to post again after that.
I apologize that it has been a while since I have posted. My schedule is cray, and I've been on a couple of vacations. The vacations have given me a good idea of exactly how well I see in most situations.
First, the good news. It is incredible to be able to go to the beach and wear sunglasses AND be able to go in the water. I was always afraid of losing my contacts, so I always wore my glasses to the beach. To be able to go in the water and see was phenomenal. These lenses really have changed my world, though not always as perfectly as I had hoped.
The bad news, though, is that nothing has really changed since my last post, which was right after the surgery. I still have significant night halos, and I no longer expect them to go away. I can control them to an extent with a drop called Alphagan P, which I take in the evening. It helps, but is not perfect and is not terribly consistent. Some night I see no halos, other nights they are minimized only slightly.
I am still wearing the light glasses a good portion of the time. I don't NEED them to drive, but they help a lot. I need them to play golf, attend a baseball game, or do anything that requires detail vision. I can read without them, but not as comfortably, and they help to watch TV as well.
My biggest issue, though, is that in order to correct this, my doctor said I'd have to have PRK. If you're not familiar, PRK is the older and more time-tested treatment. However, it is much more painful than LASIK, and takes a lot longer for the vision to stabilize. One internet account I read stated that the pain was excruciating for two days, and that the vision didn't get perfect for six months. I am really not happy about this. I have heard that some people have had LASIK after Visian surgery, so I need to look into that some more.
So that's the latest update. There are pieces to this that are great, but I am still frustrated and feel a bit misled. I'll have another appointment next month where we discuss the touch-up surgery more, so I will be sure to post again after that.
Sunday, April 29, 2007
Update
OK, it's been a month since I last posted, and I'm 2.5 weeks post-op on my right eye. Sorry not to have written sooner. I've had the flu, moved into a bigger house, and am now working shifts. So it's been a bit crazy.
Anyway, the right eye surgery went fine. Same deal as the left. However, pretty much immediately, it was obvious that the vision wasn't as good. If you remember, my right eye is my dominant eye and sees much better than my left. Well, I was only getting somewhere between 20/30 and 20/40 a week after the surgery. Not bad, but not what I was expecting. So at the one week exam, I asked for a glasses prescription. Apparently, what's going on is that my astigmatism is limiting my ability to see clearly. Essentially, the corrective power of the Visian lens is right, but it did nothing to fix my astigmatism. The Visian lens is approved for up to 2.5 cylinders (I think that's how it's measured) of astigmatism. I have 1.0 cylinder in my right eye, so I didn't think it was an issue. Apprently it is.
So now I am wearing a light pair of glasses for my astigmatism. It's annoying, but mostly that I'm a little confused as to how I have arrived here. It was suggested to me that this wouldn't be a problem. Well, it is. We should be able to correct it with Lasik sometime in the next few months, but I would really have preferred not to do another surgery.
Secondly, I am having substantial problems with night halos. Driving at night is an adventure, to say the least. I see a light halo around all lights, but at the edge of the halo is a bright circle that causes the problems. I understand that this could lessen over time, and that there are drops that can help lessen these effects. I'm hoping that this resolves itself, or at least calms down a bit.
So I am not as happy as I had hoped to be. I'm feeling a bit misled, and I'm surprised by the halos because by all accounts that is not one of the normal side effects of this surgery. I have heard of some who have some halo problems, but not to this extent. We'll see how things develop over the next few weeks. I have my one month post op in two weeks, and hopefully my sight will have stabilized and my course of action will be "clearer" then. Pun intended.
Anyway, the right eye surgery went fine. Same deal as the left. However, pretty much immediately, it was obvious that the vision wasn't as good. If you remember, my right eye is my dominant eye and sees much better than my left. Well, I was only getting somewhere between 20/30 and 20/40 a week after the surgery. Not bad, but not what I was expecting. So at the one week exam, I asked for a glasses prescription. Apparently, what's going on is that my astigmatism is limiting my ability to see clearly. Essentially, the corrective power of the Visian lens is right, but it did nothing to fix my astigmatism. The Visian lens is approved for up to 2.5 cylinders (I think that's how it's measured) of astigmatism. I have 1.0 cylinder in my right eye, so I didn't think it was an issue. Apprently it is.
So now I am wearing a light pair of glasses for my astigmatism. It's annoying, but mostly that I'm a little confused as to how I have arrived here. It was suggested to me that this wouldn't be a problem. Well, it is. We should be able to correct it with Lasik sometime in the next few months, but I would really have preferred not to do another surgery.
Secondly, I am having substantial problems with night halos. Driving at night is an adventure, to say the least. I see a light halo around all lights, but at the edge of the halo is a bright circle that causes the problems. I understand that this could lessen over time, and that there are drops that can help lessen these effects. I'm hoping that this resolves itself, or at least calms down a bit.
So I am not as happy as I had hoped to be. I'm feeling a bit misled, and I'm surprised by the halos because by all accounts that is not one of the normal side effects of this surgery. I have heard of some who have some halo problems, but not to this extent. We'll see how things develop over the next few weeks. I have my one month post op in two weeks, and hopefully my sight will have stabilized and my course of action will be "clearer" then. Pun intended.
Sunday, March 25, 2007
Left Eye Post-op
So how's it been since? Well, lots of good things, and one thing I'm concerned about. But first, to continue the narrative a bit.
By the time I got home, the local anesthesia had completely worn off. It didn't hurt at all (though they had given me some Tylenol after the procedure), but it felt like there was something in my eye. Since my wife had described "grittiness" after her Lasik surgery, I was sure this was just a result of the incision. No problem. I had been instructed to take a nap, so I did. For the first two weeks, however, I'm supposed to wear a clear plastic shield over my eye, so I don't rub it while asleep. Surprisingly, it's not hard to sleep with, though I can't comfortably sleep on my left side.
So I took a nap, and woke up around 3 pm to the incessant ringing of my cell phone. Our real estate agent needed something from us. So I looked in the mirror, and my eye was a little red and my eyelid was swollen, but nothing crazy. For the rest of the day I could feel something in my eye every time I blinked, but it wasn't awful. I also have a regimen of two different drops- one is an antibiotic that I use for about five days, and one is a steroid to control inflammation. Both I use four times a day. The steroid I have to use for a month, though, and both drops drip down through my tearducts into my throat. They don't taste very good, and quite sadly make it very unpleasant to drink coke, which is my only caffeine line. But maybe that'll break me of the habit.
Also, my surgeon called me in the evening, which was nice. He said that the "foreign body sensation" is common and should dissipate. By the next day, it was much better, and by Friday it was gone. My vision is as good as it was with my contact lens, which is great.
Now, the aforementioned concern. It is now the fifth day, and in low light I see a "ghost" around certain light objects. For example, when my blinds are closed, they let some light through, but I see a haze to the right of the window opening. I also see a halo around pinpoint lights, including headlights, streetlights, and my clock. I am not sure if this is related to the trauma to my eye from the surgery, or is something going on with the lens. I really hope that it's the former and will fade over time. It is quite distracting, and since I work in a low-light environment, it's a bit annoying. Looking at a computer is ok for some reason, though when I look at someone else's computer from a distance I see the "ghost." Objectively today everything looks the same, but maybe I'm getting used to it, because it seems to bother me less. My main concern is what happens with my "good" eye- will it also do this, and if it does will the combined ghosting and haloing be worse? That would be a problem.
I'm seeing the doctor again on Tuesday for a follow-up, and will ask these questions then. I also have my second surgery scheduled for April 11th. When I originally scheduled they said to plan for two weeks between surgeries, though it could be one, or it could be three or more. So I scheduled for the 21st, expecting to have the second surgery two weeks later on the 4th (he only operates on Wednesday, doing Lasik the rest of the week). Unfortunately, they didn't tell me that the surgeon would be on vacation then. On the day after the surgery, at my follow-up exam, he said he could do it this coming Wednesday, after only one week, but I am closing on my house that day and moving that weekend. So no go. Oh well. But I have my right contact lens, so as long as I put it in first thing in the morning and don't take it out until bedtime, it's no problem.
So overall, I'm happy, though with some reservations. Hopefully the issues will clear up and all will be good. So far the hassle of dealing with eyes is still there, but it's no worse than dealing with my contacts. And in month or so, I'll have new eyes, and hopefully my small reservations will be resolved.
By the time I got home, the local anesthesia had completely worn off. It didn't hurt at all (though they had given me some Tylenol after the procedure), but it felt like there was something in my eye. Since my wife had described "grittiness" after her Lasik surgery, I was sure this was just a result of the incision. No problem. I had been instructed to take a nap, so I did. For the first two weeks, however, I'm supposed to wear a clear plastic shield over my eye, so I don't rub it while asleep. Surprisingly, it's not hard to sleep with, though I can't comfortably sleep on my left side.
So I took a nap, and woke up around 3 pm to the incessant ringing of my cell phone. Our real estate agent needed something from us. So I looked in the mirror, and my eye was a little red and my eyelid was swollen, but nothing crazy. For the rest of the day I could feel something in my eye every time I blinked, but it wasn't awful. I also have a regimen of two different drops- one is an antibiotic that I use for about five days, and one is a steroid to control inflammation. Both I use four times a day. The steroid I have to use for a month, though, and both drops drip down through my tearducts into my throat. They don't taste very good, and quite sadly make it very unpleasant to drink coke, which is my only caffeine line. But maybe that'll break me of the habit.
Also, my surgeon called me in the evening, which was nice. He said that the "foreign body sensation" is common and should dissipate. By the next day, it was much better, and by Friday it was gone. My vision is as good as it was with my contact lens, which is great.
Now, the aforementioned concern. It is now the fifth day, and in low light I see a "ghost" around certain light objects. For example, when my blinds are closed, they let some light through, but I see a haze to the right of the window opening. I also see a halo around pinpoint lights, including headlights, streetlights, and my clock. I am not sure if this is related to the trauma to my eye from the surgery, or is something going on with the lens. I really hope that it's the former and will fade over time. It is quite distracting, and since I work in a low-light environment, it's a bit annoying. Looking at a computer is ok for some reason, though when I look at someone else's computer from a distance I see the "ghost." Objectively today everything looks the same, but maybe I'm getting used to it, because it seems to bother me less. My main concern is what happens with my "good" eye- will it also do this, and if it does will the combined ghosting and haloing be worse? That would be a problem.
I'm seeing the doctor again on Tuesday for a follow-up, and will ask these questions then. I also have my second surgery scheduled for April 11th. When I originally scheduled they said to plan for two weeks between surgeries, though it could be one, or it could be three or more. So I scheduled for the 21st, expecting to have the second surgery two weeks later on the 4th (he only operates on Wednesday, doing Lasik the rest of the week). Unfortunately, they didn't tell me that the surgeon would be on vacation then. On the day after the surgery, at my follow-up exam, he said he could do it this coming Wednesday, after only one week, but I am closing on my house that day and moving that weekend. So no go. Oh well. But I have my right contact lens, so as long as I put it in first thing in the morning and don't take it out until bedtime, it's no problem.
So overall, I'm happy, though with some reservations. Hopefully the issues will clear up and all will be good. So far the hassle of dealing with eyes is still there, but it's no worse than dealing with my contacts. And in month or so, I'll have new eyes, and hopefully my small reservations will be resolved.
The Surgery- Left Eye
OK, here comes the fun part. The surgery. Let me preface it by reiterating a key piece of information. A complicating factor to all of this is that I have Amblyopia. This is also called "lazy eye," despite the fact that people use "lazy eye" to describe any of several other conditions. What it means is that, as a child, I had a muscular imbalance that led my right eye to dominate, where my left eye basically started to deteriorate. If left untreated, I would probably be blind in my left eye. To treat this, you wear a patch over your "good" eye, to make the "bad" eye work (though "bad" and "good" are all relative when your prescription is as bad as mine is). I would wear the patch in the evening for a few hours, watching TV from about two feet away, and holding a book up to my nose. It was fun. But basically, your eyes stop developing by about six years old, so once that age passed, it was set and I didn't have to wear the patch any more.
Anyway, to this day my left eye only corrects to about 20/40. It's hard to describe, but the world looks clear, though there is no power behind it. I can see the edge of a sign clearly, but I can't read the words. It's weird. Anyway, my surgeon mentioned that they don't typically do surgery on people with this condition, because if by some chance your "good" eye becomes damaged, you're pretty much screwed. However, my surgeon seemed to believe that my amblyopia is slight, so away we go.
The reason I mention this is because the surgeon decided to operate on my left eye first. This way, if I have an adverse reaction to the whole thing, it's on my "bad" eye anyway. So though the procedure is done, it's hard to know how things will really end up until my "good" eye is done in a few weeks. But this is all preliminary. Let's get to the good stuff.
I arrived at the surgical center about an hour before the scheduled surgery. The waiting room was filled with senior citizens ready for cataract surgery. I felt very out of place, and I'm sure my wife did too. This unsettled feeling was complicated by the fact that the man sitting next to me sounded exactly like Boomhauer from "King of the Hill" and acted like he'd never been in a doctor's office before. Anyway.
In preparation for the surgery, I had to put a drop in my eye every half hour to dilate my pupil. I'm sure I looked quite odd. After a few minutes they called me in and had me wash my face, and then laid me down on a stretcher and put a nice warm blanket over me. Very cozy. A nurse then put an incredible series of drops in my eye, and started an IV in my hand. Apparently the next person they were supposed to operate on was having an issue, so I heard "well, Matt's dilated so let's get him in." They then put some numbing gel in my eye, and started rolling me, presumably to the operating room.
My surgeon suddenly showed up and wanted to see my eye, and then the anesthesiologist poked his head into my field of view (of course, I was staring at the ceiling) and started talking to me and asking me about my job. I hope the sedative isn't also a truth serum, because I don't know exactly what I said to him. I do remember saying "did you put the stuff in, because the lights are moving." He said yes. Good. I'm not going crazy.
Then came the surgery, and at this point it got kind of fuzzy. I remember some pressure in my eye, and I think I remember some very small pinpricks of pain. But that could be the drugs talking. I do remember the doctor telling me to keep my right eye open- I guess when it closed it was making the left eye squint. It seemed very fast- I think ten minutes tops. I think when it was done they let me fall asleep, because the next thing I remembered was sitting up in the stretcher in another room with the nurse putting in some drops and writing some stuff down. My surgeon came in and told me everything went great, and to ask who was with me. I think I said "my wife, in the green jacket." Fortunately, he brought her in, because the nurse went through a litany of instructions, not all of which I'm sure I understood.
Five or ten minutes later, I got up and we left. No big deal at all. I was a bit shaky, but put my coat on and got to the car with little difficulty. We decided to go get lunch nearby, and then we had to go to the surgeon's office a couple of miles away to get my pressure checked, to make sure it wasn't spiking. At lunch I called my parents, who seemed very surprised that I was even coherent, and that everything had gone so quickly.
So how was I seeing? Pretty well, considering that my eye was still completely dilated. On the way home, I could tell that the correction was right, even though there was a haze around everything from the dilation. Getting the right prescription had been my biggest worry.
So all in all, everything seemed fine. In a separate post (this one is too long already) I'll tell you about how things felt that day and the next, what I have to do treatment wise, and some of the aftereffects. But I'm sure you're tired of reading this now...
Anyway, to this day my left eye only corrects to about 20/40. It's hard to describe, but the world looks clear, though there is no power behind it. I can see the edge of a sign clearly, but I can't read the words. It's weird. Anyway, my surgeon mentioned that they don't typically do surgery on people with this condition, because if by some chance your "good" eye becomes damaged, you're pretty much screwed. However, my surgeon seemed to believe that my amblyopia is slight, so away we go.
The reason I mention this is because the surgeon decided to operate on my left eye first. This way, if I have an adverse reaction to the whole thing, it's on my "bad" eye anyway. So though the procedure is done, it's hard to know how things will really end up until my "good" eye is done in a few weeks. But this is all preliminary. Let's get to the good stuff.
I arrived at the surgical center about an hour before the scheduled surgery. The waiting room was filled with senior citizens ready for cataract surgery. I felt very out of place, and I'm sure my wife did too. This unsettled feeling was complicated by the fact that the man sitting next to me sounded exactly like Boomhauer from "King of the Hill" and acted like he'd never been in a doctor's office before. Anyway.
In preparation for the surgery, I had to put a drop in my eye every half hour to dilate my pupil. I'm sure I looked quite odd. After a few minutes they called me in and had me wash my face, and then laid me down on a stretcher and put a nice warm blanket over me. Very cozy. A nurse then put an incredible series of drops in my eye, and started an IV in my hand. Apparently the next person they were supposed to operate on was having an issue, so I heard "well, Matt's dilated so let's get him in." They then put some numbing gel in my eye, and started rolling me, presumably to the operating room.
My surgeon suddenly showed up and wanted to see my eye, and then the anesthesiologist poked his head into my field of view (of course, I was staring at the ceiling) and started talking to me and asking me about my job. I hope the sedative isn't also a truth serum, because I don't know exactly what I said to him. I do remember saying "did you put the stuff in, because the lights are moving." He said yes. Good. I'm not going crazy.
Then came the surgery, and at this point it got kind of fuzzy. I remember some pressure in my eye, and I think I remember some very small pinpricks of pain. But that could be the drugs talking. I do remember the doctor telling me to keep my right eye open- I guess when it closed it was making the left eye squint. It seemed very fast- I think ten minutes tops. I think when it was done they let me fall asleep, because the next thing I remembered was sitting up in the stretcher in another room with the nurse putting in some drops and writing some stuff down. My surgeon came in and told me everything went great, and to ask who was with me. I think I said "my wife, in the green jacket." Fortunately, he brought her in, because the nurse went through a litany of instructions, not all of which I'm sure I understood.
Five or ten minutes later, I got up and we left. No big deal at all. I was a bit shaky, but put my coat on and got to the car with little difficulty. We decided to go get lunch nearby, and then we had to go to the surgeon's office a couple of miles away to get my pressure checked, to make sure it wasn't spiking. At lunch I called my parents, who seemed very surprised that I was even coherent, and that everything had gone so quickly.
So how was I seeing? Pretty well, considering that my eye was still completely dilated. On the way home, I could tell that the correction was right, even though there was a haze around everything from the dilation. Getting the right prescription had been my biggest worry.
So all in all, everything seemed fine. In a separate post (this one is too long already) I'll tell you about how things felt that day and the next, what I have to do treatment wise, and some of the aftereffects. But I'm sure you're tired of reading this now...
Thursday, March 22, 2007
The Pre-operative Procedures
The next step was a more comprehensive exam to fully measure my prescription and do a few more tests. One involved counting the cells in my cornea, to determine if they were healthy. No problem there. I had my eyes "refracted" which seems to be the technical term for measuring your prescription, which I'm sure everyone reading this blog has done many times. Then I had another "refraction," this time with my eyes dilated. Hey, they can do anything they want if it helps them to get my prescription right. I always feel that I'm being inconsistent when I answer whichever lens is better, and I'm never confident that my prescription will be right. If anything, this has been my biggest worry with this procedure. Not getting the right prescription in contact lenses is one thing- you just order another trial pair and move on. When inserting a lens into your eye, you want it to be right. Granted, Dr. Bob said that if he didn't get it quite right, he'd do a Lasik touch-up for only the cost of the materials needed, but who wants that?
Anyway, after testing my eyes in myriad ways, I was done. Off to the surgical coordinator for scheduling. This turned out to be a bit complicated, based on the doctor's schedule and mine, as I am moving in about a week. She said that usually the doctor waits two weeks between the two eyes, but that it could be one week or even three. If I was confident that it would be one week, I would have scheduled for the 14th of March, because then it could have been all done before the week of my move. But instead, I scheduled for the 21st (he only operates on Wednesdays, as most of his practice is Lasik), thinking that the 4th or the 11th would work.
Next step, the iridotomy. I scheduled this for Friday the 16th, before the surgery which would be the following Wednesday. If you recall from the earlier post, the doctor had said that this is the more uncomfortable procedure, and the surgical coordinator had mentioned that people sometimes get bad headaches. So I was nervous. I didn't sleep well the two nights before it was done, mainly because of it (though I was also stressed out from moving issues and a complete moron who was pestering me at work).
Let me explain the purpose of this procedure. Basically, the iridotomy (also called the YAG-laser iridotomy, though my doctor called it an LPI, which I think stood for Laser Peripheral Iridotomy) is needed to compensate for the one significant complication that arises from the Visian surgery. Apparently, the lens covers the pupil to such an extent that optical fluid cannot move back and forth through the different chambers of the eye, sometimes leading to a spike in pressure in the eye (essentially, glaucoma). The iridotomy basically creates one or two small holes in the iris that allow fluid to move back and forth, keeping the pressure low.
As I've mentioned, Dr. Bob and the surgical coordinator both mentioned that some people find this uncomfortable. So I had visions of lasers burning through my eye and intense pain. I wish I had found other information on this before, because in the end it wasn't bad at all. The intense pain some people feel is caused by the eye drops that constrict your pupil. The doctor mentioned that I would get a headache, but I had some Advil so I popped three ahead of time. I also don't get many headaches, so I imagine those who do are more susceptible to getting one at this point. Fortunately, the Advil worked like a charm. I did get a slight headache, and the room got very dark (making your pupils small will do that), but it really wasn't a problem.
The iridotomy itself wasn't too bad, either. Dr. Bob used a lens against my eye to hold it open, and I imagine to help aim the laser at the proper point. He then used a foot pedal to shoot the laser. I'd guess it took six to eight shots to create each hole. I think he only did one in each eye, but I was so focused on holding still that I didn't count. Each shot felt like a little pop inside the eye, but was only painful for a split-second after each shot. I was very pleased when it ended, considering how nervous I had been. I stayed around for about 45 minutes to make sure my eye pressure hadn't spiked (are we sensing a theme here?), but then was free to go.
Only one problem, though. I couldn't see. The drops had constricted my pupils so much that I couldn't see a whole lot better with my glasses than without, and trust me, I don't see well. The doctor and technicians seemed surprised when I said I couldn't drive, so that was a bit interesting. So I had my wife come pick me up, which was a pleasant experience seeing as how the torrential rain that had consumed the day had turned into sleet. We managed to get my car to my aunt and uncle's house a few blocks away (that was a scary trip, but I knew exactly where I was going), and then we headed home. I first put the drops in around 2 pm, and though my pupils were constricted for about two days, I was able to see reasonably well again by about 7 pm.
So nothing left but the surgery. First eye was to be the following Wednesday, which was yesterday. More on that to come...
Anyway, after testing my eyes in myriad ways, I was done. Off to the surgical coordinator for scheduling. This turned out to be a bit complicated, based on the doctor's schedule and mine, as I am moving in about a week. She said that usually the doctor waits two weeks between the two eyes, but that it could be one week or even three. If I was confident that it would be one week, I would have scheduled for the 14th of March, because then it could have been all done before the week of my move. But instead, I scheduled for the 21st (he only operates on Wednesdays, as most of his practice is Lasik), thinking that the 4th or the 11th would work.
Next step, the iridotomy. I scheduled this for Friday the 16th, before the surgery which would be the following Wednesday. If you recall from the earlier post, the doctor had said that this is the more uncomfortable procedure, and the surgical coordinator had mentioned that people sometimes get bad headaches. So I was nervous. I didn't sleep well the two nights before it was done, mainly because of it (though I was also stressed out from moving issues and a complete moron who was pestering me at work).
Let me explain the purpose of this procedure. Basically, the iridotomy (also called the YAG-laser iridotomy, though my doctor called it an LPI, which I think stood for Laser Peripheral Iridotomy) is needed to compensate for the one significant complication that arises from the Visian surgery. Apparently, the lens covers the pupil to such an extent that optical fluid cannot move back and forth through the different chambers of the eye, sometimes leading to a spike in pressure in the eye (essentially, glaucoma). The iridotomy basically creates one or two small holes in the iris that allow fluid to move back and forth, keeping the pressure low.
As I've mentioned, Dr. Bob and the surgical coordinator both mentioned that some people find this uncomfortable. So I had visions of lasers burning through my eye and intense pain. I wish I had found other information on this before, because in the end it wasn't bad at all. The intense pain some people feel is caused by the eye drops that constrict your pupil. The doctor mentioned that I would get a headache, but I had some Advil so I popped three ahead of time. I also don't get many headaches, so I imagine those who do are more susceptible to getting one at this point. Fortunately, the Advil worked like a charm. I did get a slight headache, and the room got very dark (making your pupils small will do that), but it really wasn't a problem.
The iridotomy itself wasn't too bad, either. Dr. Bob used a lens against my eye to hold it open, and I imagine to help aim the laser at the proper point. He then used a foot pedal to shoot the laser. I'd guess it took six to eight shots to create each hole. I think he only did one in each eye, but I was so focused on holding still that I didn't count. Each shot felt like a little pop inside the eye, but was only painful for a split-second after each shot. I was very pleased when it ended, considering how nervous I had been. I stayed around for about 45 minutes to make sure my eye pressure hadn't spiked (are we sensing a theme here?), but then was free to go.
Only one problem, though. I couldn't see. The drops had constricted my pupils so much that I couldn't see a whole lot better with my glasses than without, and trust me, I don't see well. The doctor and technicians seemed surprised when I said I couldn't drive, so that was a bit interesting. So I had my wife come pick me up, which was a pleasant experience seeing as how the torrential rain that had consumed the day had turned into sleet. We managed to get my car to my aunt and uncle's house a few blocks away (that was a scary trip, but I knew exactly where I was going), and then we headed home. I first put the drops in around 2 pm, and though my pupils were constricted for about two days, I was able to see reasonably well again by about 7 pm.
So nothing left but the surgery. First eye was to be the following Wednesday, which was yesterday. More on that to come...
The Initial Consultation
OK, now that I have a few minutes, here's another piece of the puzzle.
As I mentioned on one of the earlier posts, I've had a few eye problems in my life. And ever since Lasik became popular, I've been tempted to look into the possibility for myself. I don't really know much about the origins of Lasik, but I do know that it was developed, or at least refined, in the country of Colombia. Since I used to work an issue that sent me to Bogota on occasion, I decided to be evaluated while I was there. This was in 2002, and I went to a doctor my coworker recommended, since she had the procedure performed there the year before. To sum up, he said that I could do Lasik but that he could only "guarantee" about a 90% correction, meaning I would still need contacts or glasses. Obviously, not good enough, and I was nervous about the idea anyway. So no deal.
However, last spring my fiancee (now my wife) decided to have Lasik, and went to LasikPlus in Alexandria, VA. She chose LasikPlus because her insurance offered a discount there. I think she ended up paying about $1700 an eye, including lifetime touchups. She was thrilled with the outcome, and routinely comments on her "bionic" vision. She read something on a car's bumper sticker this morning that I couldn't even identify as letters. It just looked like a white blurry line. So she has been suggesting to me that I should get Lasik. So the next time I went to my optometrist, I asked him about it.
He said that it was possible that I could be a candidate. He recommeded two surgeons in the DC area, the guy who did Tiger Woods, and another doctor who I have occasionally heard on the radio. Let's call him "Dr. Bob." My optometrist said that both of these guys would give me a good evaluation, and could offer me alternatives (if need be) that the "Lasik Factories" would not. The difference between them, apparently, is the use of the microkeratome by the Tiger Woods guy, or the use of the Intralase Laser by Dr. Bob. Apparently, most of the errors with Lasik (though there are extremely few) seem to come from a malfunction of the microkeratome (a small blade that creates the Lasik flap). Since I wanted to reduce all possibility of error, I made an appointment with Dr. Bob.
On the day of the consultation, I had several tests done, few of which I can accurately remember. One involved measuring the topography of my eye, one measured the thickness of my corneas, and a few others involved various blinking lights. The very nice technician then had me watch a video on Lasik, and went to talk to Dr. Bob. After a few minutes, I was called back to see the Doctor himself. When the nice technician stayed in the room, and Dr. Bob mentioned that she was staying to learn about the procedure he was recommending, I knew that something was amiss...
Dr. Bob did not think that the tests showed me to be a good candidate for Lasik. He said that the amount of cornea that would need to be burned would take me close to the minimum recommended amount, and that touchups would be very tricky. He did mention that I could go to one of the aforementioned factories and they might accept me, even within the ethical boundaries, but that he wouldn't recommend it if I were his relative. Instead he recommended the Visian procedure. At this point, I could go into detail about what he said, but most of it is covered by the links under "Other Visian Resources" on this page. So if you're not familiar with the procedure, go ahead and browse to those sites. He did say the procedure is more expensive, but he took pains to state that he doesn't make any more profit from this than he does from Lasik. He mentioned that the surgery is very easy, but made a point to caution me that one of the pre-operative procedures, the iridotomy, is uncomfortable and bothers some people. More about this in a later post, as this particular point is what prompted me to start this blog. Finally, I asked him how many he'd done, since the procedure was only approved by the FDA about 18 months ago. He said he'd done about 50 procedures. But apparently nobody in the DC area has done more, and it's very similar to cataract surgery, of which he had done many. In fact, upon further investigation, he had done the cataract surgery of my beloved pediatric opthalmologist, who did my strabismus surgery when I was six. Not only that, but he took time to see my mom, who was undergoing neurological tests for headaches. He identified her problem as a vision issue, which her own opthalmologist had missed. So the fact that Dr. O trusted Dr. Bob meant a lot to me.
I left the office with a DVD (the office's only copy, so I had to return it) showing the procedure in more detail. It even had a video of the surgery on it, which the technician made me promise not to watch. I was a little shell-shocked, because I thought that I had learned as much as I could about Lasik, and was expecting a simple yes or no answer. I tried to research the procedure as much as I could, but unfortunately found very little (ok, zero) patient-based information. I couldn't find any first-hand accounts of the procedure, how happy people were, etc. All I found were the ridiculous videotaped stories posted on the STAAR website. If that's not propaganda, I don't know what is. But after thinking about it for quite some time, talking to friends and family, and particularly my wife, I started to think more positively about the procedure. In the end, what I couldn't get over was what is so promising about Lasik- the thought of being able to see without contacts. I wouldn't have to close my eyes when white-water rafting, fearing that my lenses would come out. I could actually wear sunglasses on the beach, and be able to see while swimming. And maybe, just maybe, I could see the baseball a little bit better at the ballpark. This was all an unreachable dream. But maybe not any more.
As I mentioned on one of the earlier posts, I've had a few eye problems in my life. And ever since Lasik became popular, I've been tempted to look into the possibility for myself. I don't really know much about the origins of Lasik, but I do know that it was developed, or at least refined, in the country of Colombia. Since I used to work an issue that sent me to Bogota on occasion, I decided to be evaluated while I was there. This was in 2002, and I went to a doctor my coworker recommended, since she had the procedure performed there the year before. To sum up, he said that I could do Lasik but that he could only "guarantee" about a 90% correction, meaning I would still need contacts or glasses. Obviously, not good enough, and I was nervous about the idea anyway. So no deal.
However, last spring my fiancee (now my wife) decided to have Lasik, and went to LasikPlus in Alexandria, VA. She chose LasikPlus because her insurance offered a discount there. I think she ended up paying about $1700 an eye, including lifetime touchups. She was thrilled with the outcome, and routinely comments on her "bionic" vision. She read something on a car's bumper sticker this morning that I couldn't even identify as letters. It just looked like a white blurry line. So she has been suggesting to me that I should get Lasik. So the next time I went to my optometrist, I asked him about it.
He said that it was possible that I could be a candidate. He recommeded two surgeons in the DC area, the guy who did Tiger Woods, and another doctor who I have occasionally heard on the radio. Let's call him "Dr. Bob." My optometrist said that both of these guys would give me a good evaluation, and could offer me alternatives (if need be) that the "Lasik Factories" would not. The difference between them, apparently, is the use of the microkeratome by the Tiger Woods guy, or the use of the Intralase Laser by Dr. Bob. Apparently, most of the errors with Lasik (though there are extremely few) seem to come from a malfunction of the microkeratome (a small blade that creates the Lasik flap). Since I wanted to reduce all possibility of error, I made an appointment with Dr. Bob.
On the day of the consultation, I had several tests done, few of which I can accurately remember. One involved measuring the topography of my eye, one measured the thickness of my corneas, and a few others involved various blinking lights. The very nice technician then had me watch a video on Lasik, and went to talk to Dr. Bob. After a few minutes, I was called back to see the Doctor himself. When the nice technician stayed in the room, and Dr. Bob mentioned that she was staying to learn about the procedure he was recommending, I knew that something was amiss...
Dr. Bob did not think that the tests showed me to be a good candidate for Lasik. He said that the amount of cornea that would need to be burned would take me close to the minimum recommended amount, and that touchups would be very tricky. He did mention that I could go to one of the aforementioned factories and they might accept me, even within the ethical boundaries, but that he wouldn't recommend it if I were his relative. Instead he recommended the Visian procedure. At this point, I could go into detail about what he said, but most of it is covered by the links under "Other Visian Resources" on this page. So if you're not familiar with the procedure, go ahead and browse to those sites. He did say the procedure is more expensive, but he took pains to state that he doesn't make any more profit from this than he does from Lasik. He mentioned that the surgery is very easy, but made a point to caution me that one of the pre-operative procedures, the iridotomy, is uncomfortable and bothers some people. More about this in a later post, as this particular point is what prompted me to start this blog. Finally, I asked him how many he'd done, since the procedure was only approved by the FDA about 18 months ago. He said he'd done about 50 procedures. But apparently nobody in the DC area has done more, and it's very similar to cataract surgery, of which he had done many. In fact, upon further investigation, he had done the cataract surgery of my beloved pediatric opthalmologist, who did my strabismus surgery when I was six. Not only that, but he took time to see my mom, who was undergoing neurological tests for headaches. He identified her problem as a vision issue, which her own opthalmologist had missed. So the fact that Dr. O trusted Dr. Bob meant a lot to me.
I left the office with a DVD (the office's only copy, so I had to return it) showing the procedure in more detail. It even had a video of the surgery on it, which the technician made me promise not to watch. I was a little shell-shocked, because I thought that I had learned as much as I could about Lasik, and was expecting a simple yes or no answer. I tried to research the procedure as much as I could, but unfortunately found very little (ok, zero) patient-based information. I couldn't find any first-hand accounts of the procedure, how happy people were, etc. All I found were the ridiculous videotaped stories posted on the STAAR website. If that's not propaganda, I don't know what is. But after thinking about it for quite some time, talking to friends and family, and particularly my wife, I started to think more positively about the procedure. In the end, what I couldn't get over was what is so promising about Lasik- the thought of being able to see without contacts. I wouldn't have to close my eyes when white-water rafting, fearing that my lenses would come out. I could actually wear sunglasses on the beach, and be able to see while swimming. And maybe, just maybe, I could see the baseball a little bit better at the ballpark. This was all an unreachable dream. But maybe not any more.
Quick Update
I'm sorry I haven't written for a few days, and the longer I wait the further behind I get. In a nutshell, I had my first eye done yesterday, and it went great. I'm seeing just as well as I did before, though the eye is still a bit dilated and there is a very small amount of swelling. So all in all, a success. I've got a lot of stuff to do for my move today, but hopefully I'll have some time to add another post about my initial consultation and why the doctor recommended Visian...
Saturday, March 17, 2007
My Vision Background
OK, so in order to provide some context to this discussion, a little background on me is probably helpful.
I am a 29-year-old male, living in the Greater Washington DC Area. I have been wearing glasses since I was two, and have a wide array of vision problems. First, I am heavily nearsighted- in the -9.00 range. I also have a slight astigmatism for which I have been wearing soft toric contact lenses for about 10 years, and gas permeable contact lenses for seven years before that. I also have amblyopia (aka "lazy eye"). This means that one of my eyes is not as strong as the other, in fact correcting only to about 20/50. Finally, I was born with strabismus, where the muscles in my eyes were imbalanced, making me look all cockeyed. I had surgery to correct the strabismus when I was six.
Now, you might wonder, how do I even function? Well, none of this is very major, other than the nearsightedness. The amblyopia is mildly annoying, but for the most part my good eye (my right one) does the heavy lifting while the left eye provides peripheral vision and depth perception. I can see pretty well out of it on its own, but not in the detail required to read anything at any distance.
I had been wondering if Lasik was an option for me for many years, and at the prodding of my wife (who had Lasik last year and now comments on her "bionic" vision), I asked my optometrist about it. He said that I might be a candidate, but that due to the myriad eye issues that I have, should see one of the top surgeons for an evaluation. He explicitly directed me away from the "Lasik Factories" that promise deep discounts on Lasik. He assured me that one of two doctors in the area, one of whom operated on Tiger Woods, would provide an excellent evaluation and would give me all of the available surgical options.
I think this is all the background necessary for the moment. I've posted two of these this morning, tried to have the site added to Google (not sure if I was successful), and should probably get to the business of the day. We still haven't packed anything, and there's lots of college basketball to watch. Hopefully tomorrow I will get to the next installment in this series, though I know nobody's actually reading this yet, so I'm not feeling the pressure, yet...
I am a 29-year-old male, living in the Greater Washington DC Area. I have been wearing glasses since I was two, and have a wide array of vision problems. First, I am heavily nearsighted- in the -9.00 range. I also have a slight astigmatism for which I have been wearing soft toric contact lenses for about 10 years, and gas permeable contact lenses for seven years before that. I also have amblyopia (aka "lazy eye"). This means that one of my eyes is not as strong as the other, in fact correcting only to about 20/50. Finally, I was born with strabismus, where the muscles in my eyes were imbalanced, making me look all cockeyed. I had surgery to correct the strabismus when I was six.
Now, you might wonder, how do I even function? Well, none of this is very major, other than the nearsightedness. The amblyopia is mildly annoying, but for the most part my good eye (my right one) does the heavy lifting while the left eye provides peripheral vision and depth perception. I can see pretty well out of it on its own, but not in the detail required to read anything at any distance.
I had been wondering if Lasik was an option for me for many years, and at the prodding of my wife (who had Lasik last year and now comments on her "bionic" vision), I asked my optometrist about it. He said that I might be a candidate, but that due to the myriad eye issues that I have, should see one of the top surgeons for an evaluation. He explicitly directed me away from the "Lasik Factories" that promise deep discounts on Lasik. He assured me that one of two doctors in the area, one of whom operated on Tiger Woods, would provide an excellent evaluation and would give me all of the available surgical options.
I think this is all the background necessary for the moment. I've posted two of these this morning, tried to have the site added to Google (not sure if I was successful), and should probably get to the business of the day. We still haven't packed anything, and there's lots of college basketball to watch. Hopefully tomorrow I will get to the next installment in this series, though I know nobody's actually reading this yet, so I'm not feeling the pressure, yet...
Why am I here?
Hello there,
I am about to undergo vision correction surgery using the Visian Implantable Collamer Lens (ICL). I have had a number of questions about this procedure, very few of which did I find answers to on the web. No matter how many questions I asked while at the doctor's office, upon further reflection I always had more. So I am here to provide an explanation of my experience from beginning to end, in hopes of answering the questions of those considering the Visian ICL.
Right now, it is Saturday morning, March 17th. I am scheduled to undergo the surgery on my left eye, the first to be treated, this coming Wednesday. It will probably take me some time to catch up to the speed of events, but I want to be as detailed as possible from the initial consultation to the end of treatment. So bear with me while I catch. If you have questions about a part of the procedure that I haven't described, please feel free to post a comment and I will try to answer your question. As another FYI, I am moving in two weeks. So I'm a bit busy...
I hope I can help at least a few people make a good decision about this procedure. So far, I'm excited about the prospect of being able to see without contacts or glasses, though I'm a bit nervous about the procedure. But I'm pretty sure that's normal :)
I am about to undergo vision correction surgery using the Visian Implantable Collamer Lens (ICL). I have had a number of questions about this procedure, very few of which did I find answers to on the web. No matter how many questions I asked while at the doctor's office, upon further reflection I always had more. So I am here to provide an explanation of my experience from beginning to end, in hopes of answering the questions of those considering the Visian ICL.
Right now, it is Saturday morning, March 17th. I am scheduled to undergo the surgery on my left eye, the first to be treated, this coming Wednesday. It will probably take me some time to catch up to the speed of events, but I want to be as detailed as possible from the initial consultation to the end of treatment. So bear with me while I catch. If you have questions about a part of the procedure that I haven't described, please feel free to post a comment and I will try to answer your question. As another FYI, I am moving in two weeks. So I'm a bit busy...
I hope I can help at least a few people make a good decision about this procedure. So far, I'm excited about the prospect of being able to see without contacts or glasses, though I'm a bit nervous about the procedure. But I'm pretty sure that's normal :)
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