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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A Long Day

It has been a long day.  It started off with a trip to the retina specialist at 8:30 am.  We were a few minutes late, so only had to wait about 10 minutes in the waiting room.  Eliz had a cup of tea from the Senseo (or similar) machine, while I brought my own (my favorite Teavana mix: Queen of Babylon and Rose Garden Rooibos.)  I was called back into the first exam room, where I would (try to) read the eye chart and go over my eye issues.  Kelly asked about any of my eye problems and then noticed we were from Media.  She said she grew up in Wallingford.  When Eliz told her we did as well, she mentioned that she graduated from Strath Haven in 2002.  I told her I graduated from Nether Providence and Eliz from Strath Haven and Kelly asked if I went to school with her mother since I was born in 1954.  I laughed and asked if I looked 55…  I guess if there’s going to be a mistake, that one isn’t bad at all.  She corrected my birth year to 1964 and we moved on to the eye chart.

Again, I was unable to read any of it until I flipped the pinhole cover down.  Like magic, the E appeared.  I then said I know the next line is S and L, but I can’t see it.  She told me I was wrong.  What!?!  It’s not S and L.  Now I had to know.  I moved the pinholes all around until it was as clear as it was going to be for me.  I guessed O for the second letter.  Try again.  D!, I said next.  That was it.  The first letter (don’t ask me why I don’t read them in order) looked like it could be an O, G, or C.  I guessed G in hopes of it being the GD line.  No such luck.  C was my next try and that was it.  Kelly mentioned that this chart is made up mostly of similar letters that repeat often, so my usual deduction that I’ve got a one in 26 chance which increases with every letter doesn’t work.  I’m actually going to have to read them.

Once I was finished with the eye chart, Kelly took us to another waiting room, where Eliz read me the story of the Penn State mascot in a recent addition to ESPN magazine.  Before we could finish, we were called to see the doctor.  Dr. Garg asked me about my issues and mentioned that he had spoken to Dr. Pro about me.  He explained that even though my right eye doesn’t do much he still wanted to check it out.  Since my cornea is really cloudy and I have a pretty mature cataract in it, they would use an ultrasound to have a look.  He also explained a test they’d run on my left eye, to check for changes in the macular pigmentation.  Dye is injected via an IV (that’s iv, not roman numeral for 4) and pictures are taken.  After he mentioned the dye, I remembered that I had this test before.  The images are wicked.  Unfortunately, I didn’t have a flash drive on me to get the images.

I went into another exam room to have the ultrasound and then back to the second waiting room to wait on the angiography.  After a 10 minute wait, Tom called me back to have the angiography.  He took a couple of images of my eye before putting the dye in.  The dye made me feel nauseous for about a minute.  Tom took more images and left to give someone an OCT scan (which took him all of five minutes — about 1000x faster than mine took on Monday.)  He then came back into the room I was in to get two more pictures.

I waited in the angiography room for a few minutes until they called me to see the doctor again.  He explained what he thought was going on.  He increased my use of one drop to three times per day and added another drop to try and get the swelling down in the retina and cornea.  He suggested that I wait on having the cataract removed until I see him again in six weeks.

After three hours, we were out of there.  We headed down City Ave to pick up Jane from school.  She called me just before the ultrasound and said she wasn’t feeling well, which I knew when she left for school.  I also knew we’d be right down the street from her and could pick her up after the appointment if she couldn’t last the day at school.

After I spent an hour, or so, at home (at which time I found out my mom had gone into the hospital — more on that below,) we headed over to Viva Salon in Springfield.  They’ve been having a problem with a hydraulic base that was still under warranty.  We swapped out the bad base for the good one that has been in our car since the move and headed to my next eye appointment.

I had scheduled this appointment with John Ruffini, another NPHS alum, to talk to him about the cataract surgery (and before I knew of any retina issues.)  He had a look at my still dilated left eye and we discussed my options and the problems that could arise from taking out the cataract.  He also thought it was best to see how the eye reacts to the increased drops and new drop.  I have put off scheduling the cataract surgery because of moving the business and the fact that it could undo the partial cornea transplant.  My left eye has endured seven operations over the years, with another one imminent.  I’m tired of going through these procedures and the recovery with mediocre success.  The risk/reward factor isn’t great, though I would do anything to preserve any sight I still have.

After leaving John Ruffini’s office, we made a delivery in Holmes and stopped by a salon in Milmont Park to look at a styling chair that needs replacing.  We returned home at about 4:00 pm and had an alarm company tech waiting to convert our system.  It took him about two hours (the whole story will have to wait for another time.)

We were finally able to head to Riddle to visit my mom.  She went to the hospital at around 8:00 am this morning because she was having shortness of breath and chest pains.  The doctor wanted to keep her overnight for observation.  She seems to be okay, though uncomfortable because of the shingles.  We are hoping to pick her up and take her home tomorrow.

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