Archives for October 2009

Everything Looks Fine…

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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Glaucoma Specialist

I had my glaucoma appointment at Wills on Friday.  As Eliz and I waited, we looked through some magazines.  I’m not sure what they were, but they had recipes and ideas to make family gatherings enjoyable while preparing meals.  As good as the Wills Glaucoma Department is in treating their patients, they are lacking in the magazine subscription department.  Two of the mags Eliz read to me were not new.  One was from 2002, while the other was a decade old.  Yup, pre new millennium!  I mention this, because this was best time of my appointment.

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.

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Wills Eye Tomorrow

Okay, I’m going to try to keep this short…  I’m scheduled to see my glaucoma specialist tomorrow.  His name, fittingly, is Dr. Pro, and he is…  It was at an appointment with him late in September of last year that he noticed the clouding of my left eye and recommended me see a cornea specialist, which I did within a month.  That led to the December surgery.  I guess I’m hoping for lightning to strike twice.  As I’ve mentioned in previous entries, my vision has been giving me additional trouble over the past few months.  Dr. Ruffini noticed a slight fold in the cornea that was not there the last time I saw him.  Is that the problem, or is it something else?  I am hopeful that Dr. Pro will spot something, and if he does, I hope it can be corrected.  If not, my last bit of hope will come at the end of this month when I see Dr. Ayers, the cornea specialist that put in the 69 year old endothelia and gave me a black eye in the process (don’t worry, I forgave him for the shiner…)

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.

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