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.


Risk vs. Reward

As many of my friends and family know, I love sports.  My favorites are baseball, hockey, football, and the real football (you know, the one where a player kicks the ball a majority of the time — some call it soccer.)  Throughout my life, I have played organized baseball (Little League,) street hockey (intermural in high school and middle school,) and basketball (intermural in middle school.)  I’ve also played pick up games of the above sports, along with football, soccer, and tennis.  I have played these sports despite having limited vision.  I really enjoyed playing these sports.

I was told by my parents (okay, more my mom than my dad) to be very careful while playing.  My mom always brought up the subject to my eye doctor (who happened to be a family friend and more importantly a Flyers fan.)  By the time I was in fifth grade, I was told not to play football (which was usually Kill the Guy with the Ball) anymore unless it was touch.  When I began having additional trouble in seventh grade (more on that in a minute,) one of the specialists I saw at Children’s Hospital made this statement in a letter to my local ophth: “Unfortuneately, David seems to be athletic…”  It went on to say that I should stop playing most of the other sports I loved playing.

One Sunday while I was in seventh grade, I went across the street to play basketball with my friends Billy, Joe, and Kurt.  I was the smallest of the four, because I was the youngest.  The others were two grades ahead of me.  I didn’t mind playing rough, I actually enjoyed it.  At some point, an elbow may have been thrown.  There may have been a hard foul (it was 32 years ago, who remembers the trigger.)  Whatever happened, Kurt and I came to blows.  I was holding my own until Kurt landed one in my left eye (that’s the good – only – eye.)  I turtled quickly.  Joe and Billy pulled Kurt off of me.  Our afternoon of basketball was over.  Later that evening, when my eye wouldn’t stop hurting, we called our family friend.  He told us to come over and he’d take a look.  My dad ran me over to his apartment.  He took one look at my eye and said let head over to the office.  So, dressed in his PJs, Dr. Starer drove with us over to his office.  He noticed nothing damaged from the punch and said the pain was probably not in my eye but around it.  He then checked my IOP.  It was higher than normal (he always liked to see my IOP between 8-12.)  Thus began three years of instability in my left eye which ended on 20 May 1980 with my first trabeculectomy (it was my 11th eye surgery overall.)  I like to believe that without playing hoops that day and getting into that fight, it might have taken months to notice the increased IOP.

As my vision has worsened over the years, I play less and less sports.  I miss it.  The other night my daughter wanted to practice pitching.  She is trying to get the mechanics of windmill pitching so that she can pitch for her team at FCS.  I can’t see well enough to catch her, but I want to play…  I noticed that she is sometimes scared of hitting the batter.  I thought I could be the batter and try to distract her while she pitched.  Over time, my theory is, she would block out the batter and just throw to the catcher’s glove.  My wife was nervous.  My daughter was nervous, but she liked having me out there.  Since I wasn’t going to swing, I decided I’d square around to bunt.  I wasn’t sutle either.  I’d jump from my batting stance as I’d get ready to bunt, usually while she was in mid-windup.  I’d offer at pitches I thought were good, but I never laid down a fair bunt.  I did make contact with five or six pitches however.  Did I almost get hit?  Three or four times.  Two pitches came close to my head, but missed.  Did I have a helmet on?  Nope.  Was the reward worth the risk?  You bet!