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.


Almost Eight Months

It’s nearly eight months since my surgery (next Saturday, 4 July is eight months.)  I had an appointment today with Dr. Ayers.  We were taken back to the examination room, which was called Pod 3.  We joked with the tech, a seemed to be twenty something white guy, about the name of the standard eight by ten room used in countless ophthalmology offices everywhere.  The tech said the number designated the disease, while Pod made it sound high-tech.  Pod 3, therefore, was for cornea issues.

The tech asked how my eyes were feeling and if I’ve had any problems lately (good and not really unless you count the elbow Eliz landed on my left eye last night.)  He then asked if I was seeing any better and I responded by reciting the eye chart down to the 20/60 line.  Since he hadn’t turned on the machine yet, he knew my memory was still good.  I was a little worried when he turned the machine on.  I saw the E, but not clearly.  I also had trouble seeing the S in the SL (20/200) line.  If I didn’t know it was an S, I don’t think I would have been able to guess what it was (though there are only 26 letters in the alphabet and usually no duplicates on a line, so I knew it wasn’t an L.  I could also eliminate other letters that are not rounded, like A, K, X, H, E, F, I, M, N, T, V, W, Y, and Z.  Now I’ve got a one in 10 chance.  Is that seeing or guessing?  I told the tech my concerns.  He handed me the eye cover with all the pinholes and told me to try that.  Within 10 seconds I could see the S.  When I was rattling off all the lines before he turned the machine on, he said there were alternative lines on the machine, made up by numbers.  I asked him to go to those so that I could see if I actually could see anything there.  He put the largest line up, which was the 20/100 line.  Without the pinholes, I saw five black blobs.  With the pinholes I was able to spot the 7 all the way on the right.  I was pretty excited.

Dr. Ayers came in shortly after.  He had a look and told me things looked pretty good.  The only concern is that my IOP was six.  It has been fluctuating between six and eight for a few years, but has been at six for quite some time.  I asked if I could go swimming and was told I could.  I also asked if I could wear goggles.  Dr. Ayers advised me not to wear the goggles that the swimmers in the Olympics wear, but to use those that are larger.  Fortunately, I already own a pair of AquaSphere goggles, so I’m good to go.    Dr. Ayers told me to cut back on the Predforte to only Mondays, Wednesdays, and Fridays as he didn’t see any signs of rejection going on.  I’d like to be off the ‘roids at my next visit in October.  The cataract is still not ready to come out.  The amount of vision I’d pick up by having it removed isn’t worth the boatload of risk (it could wreck December’s surgery, as well as destablilize the eye as far as the glaucoma is concerned.)   That finished up my appointment and we were good to go.

So, the bottom line is that I was pleased with what Dr. Ayers told me.  I can do whatever I could do before the surgery (swim, lift heavy things – though, the heavier I get, the less I seem to be able to lift, etc.)  Still waiting on something/someone to fix my badly damaged optic nerve…