It’s Not Cuckoo Bananas, But It’s Not Good Either

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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Visual Fields Test

My appointment with my glaucoma specialist went well, except for the fact that I was back to the 20/200 line and even that wasn’t as crisp as a my second PostOp appointment on 27 April (I also believe it was slightly worse than my unscheduled appointment with Dr. Ayres this past Friday.)  I’m glad everything looks great, but that isn’t helping me see better.  As per Dr. Pro’s (and Dr. Ayres’) recommendation, I’ve scheduled an appointment with Dr. Garg, the retina specialist I saw earlier this year.  I have a feeling I know how that appointment will go too.  Everything will look fine, but my vision will still suck.  Call me Nostradamus.  I’ll let you know how things go on 18 or 19 May.

Central Vision Visual Fields Test at Wills Eye

Central Vision Visual Fields Test at Wills Eye

One of the problem I’ve noticed is that I seem to have more blind spots, especially in my central vision.  When Eliz and I were working with Jane at softball, I noticed I had trouble following the ball when Eliz would flip the ball to me from three to five feet unless I looked to my right.  I’m not sure what the above test indicates, but since I don’t think I’ve ever had this particular visual fields test I don’t think there is anything to compare it to.

Visual Fields Test Machine in the Glaucoma Dept. at Wills Eye

Visual Fields Test Machine in the Glaucoma Dept. at Wills Eye

After my appointment at Wills Eye, Eliz and I walked up Walnut Street and stopped into the Associated Services for the Blind and Visually Impaired.  I had contacted them just before we moved Salon Supplies + Interiors and ForYourSalon.com out of that disaster of a building (which has been condemned, by the way.)  Between the move and setup of the business and waiting to see how things went with the surgery, I didn’t follow up.  Looking back, that seems dumb.  As it stands now, I don’t think things will improve dramatically, if at all.  You may say I’m a pessimist, but I disagree.  I would call myself a realist.  Sure, I can hope and wish, but I’ve been doing that since I was a small child.  Maybe I learn something and gain some confidence.

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Going the Wrong Way

Since Wednesday or Thursday, I’ve noticed that my vision didn’t seem to be as good as it was earlier in the week.  By Friday, after talking with Eliz, we decided it was probably a good idea to try and visit Dr. Ayres, the surgeon that removed the cataract (and performed the endothelial transplant in Dec. ’08.)  Fortunately, they were able to squeeze me into their busy schedule at Wills Eye at noon on Friday.

We didn’t have to wait long in the waiting room.  I was very curious about reading the chart.  The E was not a problem.  I could see the SL on the next line, but it didn’t seem as sharp as my previous appointment about 10 days earlier.  I could not read the OPLB line.  That was a step backward.

When Dr. Ayres came in, I told him about what was going on.  He took a look and said everything seemed about the same as my previous appointment.  No signs of retina detachment, the new lens was still in place, and there was no signs of rejection on the previously transplanted endothelia.  My IOP was at seven, which was down from 10 at my previous appointment.  As he put it, the good news is that it is not a problem from the surgery, but that means I don’t really have any way of fixing the issue.  He prescribed a non-steroidal eye drop just in case there was a little swelling that he didn’t notice.  He said it was like Advil in drop form.

On Tuesday I have a scheduled appointment with Dr. Pro, who is my glaucoma doctor.  I want to have a Fields test, because one of the things I have noticed is more blind spots, especially in my central vision.  Hopefully, he’ll find something that can be corrected.

So, it seems I’ve missed my opportunity to go to the movies or a Phillies game.  It might also be time to learn how to do things without much sight.  I was waiting for the surgery before I tried anything new, but I think it is time.

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