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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Latest Eye Appointment

I went to see Dr. Ruffini yesterday for a checkup.  He is my local ophthalmologist that I see a few times per year or when there is a problem.  I’ve been having difficulty over the last few months with my vision, so I was happy to go to the appointment.  I was interested in seeing what my vision was, after only seeing 20/400 at the glaucoma study (20/200 with the pinholes.)  Sure enough, it was the same yesterday.  The difference between yesterday’s test and the glaucoma study’s test is that I knew the chart yesterday and could recite down to the 20/60 line with my eyes closed.  I could see the big E, but it wasn’t clear as day.  The next line (20/200) is SL.  I couldn’t see it at all.  I asked the nurse for a minute to continue looking at it, hoping it would come in.  It never did, so I asked for the pinhole thingy.  It was like night and day.  As soon as she flipped the pinholes down, I saw the S and L.  Then I got ambitious and tried to read the OPLB line.  I always look for the L in this line since it has straight lines in it.  No luck.  I could barely see any black where the letters were.

The nurse/assistant then put numbing drops in my eyes and took my pressure.  I’m not a fan of them taking my pressure, because they do not take their time getting a reading and are obviously not as skilled as the doctor in reading the results.  She got between 10 and 12 on my right eye (not that that eye matters.  Hell, I’d sell it to the highest bidder if I could – and no, PayPal would NOT be accepted for payment.)  She got eight in my left eye.  That eye hasn’t, pardon the pun, seen eight in quite awhile (since 5 Dec 2008, the day after my endothelial transplant, when my IOP was in the mid-teens due to something being blocked from the surgery.)  It has fluctuated between five and seven at most visits over the last six and a half years since my last trab (glaucoma surgery) in Feb 2003.  She then dilated my eyes.

Dr. Ruffini entered about 10 minutes later, and not a moment too soon, since Eliz and I had finished all the word scrambles from the paper.  I told him of my lousier than normal sight and the double vision I’ve been experiencing.  He had a look with a light that was 3457329845 times brighter than the sun.  He said he could see all the way back to the nerve in my left eye; my cornea was very clear; the cataract had grown slightly, but it wasn’t something that needed to be dealt with near-term.  He also mentioned a slight fold at the center of the endothelia.  He wasn’t sure what might have caused this, since it wasn’t there the last time.  I asked if the low IOP (hypotony) could have caused this and thought that might be it.  Wow, after 44 years of going to ophthalmologists, I actually contributed to the discussion!  He advised me to discuss the wrinkle with both the glaucoma specialist and cornea special at my upcoming appointments with them in October.

I was disappointed  when we left the appointment.  These things are going on in my eye, I still can’t see as well as I did back in March 2008 (before the problems with my cornea started,) and yet there is no solution.  Nothing.  I don’t know why I have such a hard time believing that.  I also don’t know why I’m having such a tough time dealing with it.  I’ve known since I was a little kid that this was my predicament.  Knowing doesn’t make it easier.  As my sight gets worse, I’ve gotten more miserable and I’m too young to be a grumpy old man.

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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…

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