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Tommy's World

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My Story:   May, 2002

          I guess I am in the middle of a life of eye problems. I am a white, male, 59 years old, born and raised in the country on a farm  and later worked at a steel mill around gas and electric arc furnaces for about 20 years. After that I worked 14 years at an auto production plant with most of that time spent around spot welding robots that threw lots of hot sparks as well as electric arc wire welder robots. My eyes through the years have been abused, it is plain to see. I was an electrical maintenance employee (electrician) during these years.  
      I was born with perfect vision for the most part, with at least 20/20 vision in both eyes and the left one was 20/15 and the right one was close behind. I enjoyed life for 40 years with no problems with my eyes. At 40, I started to see the aging process effect the control of my eyes to zoom in and out on things that I looked at. Time changed things to the point that I was wearing glasses all the time by late 40's.
       Because of my life style, I planned to retire early since most of the people I worked with at the steel plant were dying by the age of 65 or earlier. By age 55, I retired. I was having vision problems at the time but didn't realize that it wasn't just a prescription problem. Within 12 months later I had to have cataract surgery on my right eye .     I didn't know anything about this sort of thing but was told that it was a "Piece of Cake" these days and there was little to worry about. That was the first mistake. The surgeon was about to retire and should have before nearly destroying my right eye. 
       At this time, a stitchless incision was the standard - he made the incision to large, he tore the sac behind the lens, he put the wrong lens in and he left stitches ends so long they irritated me for a month before he agreed to remove them.  I was awake during the surgery.  They put an extreme amount of pressure on the eye before the surgery which was very uncomfortable.  During the surgery alarms rang in my head as I heard the doctor say...... "Oh Oh".... and again when the nurse asked which lens he wanted to put back in me.  His response being,......."Ah, Oh, just give me one like we put in the woman before him".    I came back in to his office the next day and was so sick to my stomach that I almost vomited in his office. They immediately gave me a medication to reduce the pressure in my eye - it was 20+ at the time. They took the bandages off my eye and all I could see was a single light in all the darkness - it was the sun shining through a window - it was a bright sunny day that day. Everything else was black or a deep dark blue.  I went home and daily looked across the street at the same time each day to see if there was any improvement. Very slowly over the coming 2 or 3 months I regained some vision in the right eye and came out with 20/50 vision in it.    The doctor's response to my questioning my vision was, "Well, guess you might be a little nearsighted".  Yep, that was no lie anyway.   During this time, the left eye started to deteriorate and during the following 12 to18 months, I was at a point of about 20/50 to 20/60 vision in my left eye also. 
      A surgeon said that he could correct the damage done to the right eye with laser surgery. I was hesitant to have anyone touch me after my first experience, but the alternative was total blindness. I went ahead and had the laser surgery done on the right eye and true to his words, he gave me 20/20 vision in it again. This surgery was done with Valium and I took a small dose, not quite enough though.  When he started, they put a cup over the eyeball to hold it steady and at a set distance from the laser.  At first it felt like they were trying to suck my eye ball out of the socket, but I held steady for the 10-20 minutes and he shaved and reshaped the cornea.  I left with a plastic shield over my eye for that night and could see good the next morning and very good at the end of a week.  The only problem is that the first doctor abused the eye so much that he created a floater and some other floating material in the right eye that sometimes it is still clouded up, but it is usable overall at least now - just not extremely dependable.   The surgery was done while I was awake under mild sedation to keep my eye from moving.  It took about 20 minutes to do the work.  The doctor shaves and reshapes the cornea to a different shape to match the shape of the eye and the lens prescription in the eye.  If he does a really good job of it, the cornea is perfectly round and leaves no astigmatism .  I was left with a slight amount but very little.  Final objective of all this is to come up with a mix of the three to be 20/20 or what ever the person wishes to have. Some wish to have a little near sightedness to be able to read without glasses.  I preferred to have all distance vision and use glasses if/when needed.  Thank you Dr. Eudaly and Dr. Doane.
      After that, I went ahead and let another doctor do the cataract surgery on the left eye. This doctor knew what he was doing and did a fine job and he encountered the same problems as the first doctor did - notably, the lens was dried to a crystal form and stuck to the sac behind it. This doctor put tht new lens in and examined it while in place and said,  "Nurse there is something wrong with that lens, get me another one".  He folded and removed the old one and then folded and inserted the new one.  He looked at it then and remarked,  "There that looks better, I see what was wrong now, the old lens was torn".  Thank you Dr. Carl Stout for  a job well done.  He had to scrape the sac that is between the lens and the vitreous gel because the old lens was dried and stuck to it which when the old lens/cataract was removed it left debris stuck to the sac.   This is how the first doctor tore the sac on the right eye,  remember the "Oh, Oh".  The next day the bandages were removed and I had 20/15 vision again like I did when I was 16 and no side problems. I thought my problems were over... Not so, a membrane grew across the right eye lens shortly later and had to be cut.  A year later, a membrane grew across the left eye lens also and had to be cut.   These Yag laser surgeries were quick and basically painless.  They shot short bursts of laser beams at the membrane and cut it.  The membrane is like a rubber band,  once it is cut it draws back out of the visual area to cause no more problems.  There was a short instance of a burning sensation each time.  No  bandages were needed, only eye drops were prescribed for a few days afterward.   This is 5 times they have cut on my eyes by now. After the membrane was removed from the left eye though, the vision didn't clear back up and something else was wrong. I had lost that perfect vision that I had gained back only about a year earlier. 
      I was sent to a retinal specialist. The "first" one spoke of "macular degeneration" and leaking of blood behind the retina. At the next visit, he retracted the statement and told me about a membrane across the retina. At this point I'm not sure just what he said because it sounded so contradictory and had me very mixed up as to whether he knew what he was doing or not. I went to the "second" retina specialist. He told me that there was a membrane across the retina and it was wrinkled and was not supposed to be there. I have 20/50 vision in that eye now and can not distinguish a straight line, no edges of anything have any distinct line.  Letters are strangely blurry. "Strangely" is used since the likeness I can  compare with is like holding the eye chart up over a hot asphalt highway  with the heat radiating up and making the letters wiggle and distorted when  looked at, or similar,  would be to look at the chart though an aquarium full of moving water. (See Grid & Eye Chart) This doctor is the son of the doctor

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This is what the grid looked like shortly before surgery.
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This is what the eye chart looked like as it began to distort out of focus.

that did the fine work on the cataract on my left eye earlier. He told me that the operation was an outpatient surgery and although it has its risks, it was a very minor one that takes about 30 minutes usually (actually it took over an hour), (my cataract surgery took about 10 - 15 minutes and I was awake and watched the surgeon do the work, even without the lens, although he was upside down and very blurry then). He says that most don't have the surgery done this early and wait until there is less vision in the eye before they do it. He says that waiting won't make a difference in the quality of regained vision usually. I doubt that the insurance will help on the payment at this stage either - they seem to be a stickler about points or levels needed to be attained before they will pay for the surgery. At the present rate, I should be at 20/100 level before the end of the year, it is the latter part of May in 2002 now. It seems to have only started about 4 or 5 months ago and is growing very fast, as did my cataracts. My big concern after reading all the testimonials is that if they DO the work and DO GET GOOD RESULTS, what happens then, do I get to have the experience of it growing back again and go through all this again and again and again???
      The next chapter of my life of trying to hold onto my vision I am sure will be told in the coming 6 months to a year. My confidence while driving right now is dwindling greatly - the right eye isn't dependable for continued vision and seems to tire easily plus it seems that I feel better with the left eye patched while driving because it interferes with the image that the right eye gives to me, but then when the right eye blurs out of control, I have no eyes to see with. It leaves me in a serious situation when it comes to driving .
     This is written for those that might be interested in how vision problems effected me and how it seemed to progress through the years or for insight as to what they might experience as "seen through my eyes". Vision was the least of the things that I had considered a concern with aging and retirement.  Hobbies and daily activites leave much to be desired when you realize that much of it beginning to be done by feel rather than site. I enjoy art and photography and the computer also, as well as target shooting with air rifles - without site, these loose much of the enjoyment.

 

Epiretinal Membrane Surgery 

Day 1 Wednesday July 22, 2002 ---- 7:45AM: : They admit me and put many drops in the left eye then put an IV port in the back of my hand. They give me the anesthesia so they could give the shots in my eye. I feel nothing. They take me in the operating room and I became fully awake. They put a cover over my entire body leaving only my left eye exposed. They have me tilt my head back some which requires a support under my arthritic neck. I have to lie dead still for at least an hour. I feel nothing of their work but my body was fully wake. I lay there & listen to them joke & talk about what is going on in my eye. The membrane is thin and makes it difficult to remove because it wants to tear into shreds as it is removed. I could have waited longer but it would have made the retina more wrinkled, so am not sorry I went ahead and did it now. They poke three holes in my eye. One is to pull the vitreous gel out, one is to pump the saline solution in and one is to put instruments through to do the work. They bandage me up, give me a surgery pack, tape, drops, pills, glasses etc. They give me pills, oxycodene for pain and also some pills for nausea. My eye now has no vitreous gel in it and is filled with saline solution. The nurse informs me that Iím not allowed to sleep on my left side and limited on my back. She reads off the rules to me about bending over and lifting weight. I am allowed to take my normal walks around town of an evening.

I sleep some the rest of the day but very little. The deadening stays until about 5 or 6 PM. Then all Hell brakes loose. THOSE STITCHES!!!!!!! Any eye movement at all would light a fire in my eyelid and eye. I made it through the night until the 2:45 PM appointment. I start taking the oxycodene like candy. It seemed to help a little although not enough to let me sleep.

Day 2 Thursday:  Didnít sleep last night at all. Sit in a recliner all night dozing as long as I could but no sound sleep at all. I keep the appointment today. They take the bandages off. I see light. I can make out a crude image of the Doctor standing in front of me. With work I can make out the large letter E on the chart, but that is stretching all reasoning. Additional damages........... the cornea was damaged during the surgery. They tell me that this is not uncommon and will heal if cared for correctly. All this time with the bandages on my eye is supposed to be to help heal the damaged cornea. I hope it does. I had no astigmatism at all in that eye and would like to have that again, especially if I regain most of my vision back out of that eye. They rewrap the eye and send me home for the next 4 days to come back Monday July 29 at 9:40 am. This is in hopes that wrapping the eye will allow the cornea to heal back like it should be. Each day the bandages have to be removed and 1 drop out of each of the containers has to be put in my eye, except for one which is only put in twice a day. This is a challenge. The stitches are a constant irritation and sometimes near unbearable. Any movement of my eye sets me on fire.

Day 3 Friday: Didnít sleep again last night. Sat in the recliner and dosed again all night. The burning was unbearable when I would dose off. My eyes would start the rapid eye movement and that would be the end of any sleep. Using the other eye for vision is near impossible. Using it to see with causes me to constantly move it to focus on things I am looking for which in turn also moves the left eye too. This causes me to sit most of the time with both eyes closed to avoid the burning pain from the left eye. I finally came up with a temporary solution. I cut a small piece of card stock in a shape to cover the right eye, then put a paper punch hole in it located where my eyes usually are focused when at rest and the left eye doesnít hurt. By taping this over my right eye, it causes me to not be looking around with my eyes but causes me to turn my head instead to see what I am looking for. This doesnít give me much satisfaction in doing much other than I can walk through the house without stumbling over things and can sit and eat and have an idea of what I am eating. Over all it works though and is a temporary solution to the problem and I can sit and watch TV to kill some time. I stepped outside in bright light and the right eye had no problem over all but the closed, bandaged eye was unbelievable. I felt I had been blinded. Even with the eye closed and bandaged, the light was so bright that it was comparable to looking at the sun itself it seemed.

Day 4 Saturday: Made it though the night this time in my bed. Slept fairly well. The eye is still tender and burns as well as the stitches causing irritation. I woke up twice, a somewhat normal occurrence. This morning the eye feels raw. My sinuses are clogged up and think that might have something to do with it though. The eye feels dry. I have peeked out at the world while doing the drops scene and everything is blurry and there are no straight lines on anything yet. He told me that the retina was wrinkled from the pull of the membrane across it, but thought it would eventually straighten out in time. Each drop is supposed to be put in my eye and then wait with my eye closed for five minutes before the next drop is administered. I have found that washing my eye lid and surrounding area with a saline soaked solution is very soothing and makes my eye feel much better for a few minutes. I almost look forward to the "eye wash" period anymore. The stitches are still a constant irritation but not as bad as they were. I think Iím just learning to tolerate them is all. They are supposed to dissolve on their own. This day is almost over. The first part seemed rather docile for the most part. The last part was spent at my in laws. I have removed the makeshift "Blinder Patch" I had put over the right eye by now. We were outside and we were looking around all over the place. Consequently, my eyes were moving from side to side a lot. It wasnít long but I started feeling tender spots in my left eye again like there was something in it. It felt dry and was burning. It was time for the eye drops and we checked it and it was very moist as usual. I used saline solution and washed the outer part and left the bandage off for about an hour. This felt good for a change, although I couldnít see out of it. I put the bandage back on and quit my looking around all over and things calmed down again.

Day 5 Sunday:  Tried to do the drops myself. Removed the bandage and the eye was crusted shut. Used saline solution to wash the eye. Felt good. Put eye drops in my eye. Bandaging is another thing though. The bandage has a pad in the middle that is pressed against the eyelid and is supposed to help hold the eyelid shut when the other eye comes open. This is a very sensitive operation, both from the point of tenderness and the right amount of pressure at the right point to hold the eyelid closed. Noontime, got the bandage off, washed the eye and then tried to wash all the adhesive off my skin that is building up on me from the tape. Try as hard as I may each time, it is gooey and doesnít want to come loose. Anyway got the drops in and am looking around with the eye to see if there is anything that makes me feel good about all this pain and inconvenience. So far all I can see is light and gross overall images if they are close. The TV, about 10 feet away, has images on it but all I see is a change of color to indicate that there is anything happening on the screen. The straight lines I lost with the membrane are still lost at present and are even worse than before as far as I can tell at this time. The eye still looks like a raw slab of meat. It is all red and nasty looking. I donít remember ever seeing my eyes looking this bad. At present all the work done so far has not produced anything to indicate any improvement to me, maybe even some losses.

Day 6 Monday: Got up ready to keep my Doctorís appointment.  I slept pretty well last night. I have not adjusted to single vision yet and make lots of mistakes in distance judgment. I took the bandage off my eye and took a shower and tried to clean the adhesive off my face from the tape. I put in the drops at that point. While I wait for Jo, I look around and little is distinguishable at all with out the bandage. She puts a new one on for me to wear to go to the Doctorís office. They ask questions and answer mine. The retina is wrinkled and will take time to smooth out....... how long isnít known. The doctor says he would expect it to happen fairly quickly though. I asked what fairly quickly was in his dictionary and he said in the next 2 to 4 months. He checks my vision again and the letter E seems to be easier to distinguish at this point but nothing else seems to have changed. He sends me home without the bandage and tells me to come back Aug. 15th. He is satisfied with the healing of the cornea. I spent the rest of the day with out the bandage and am very unstable with both eyes working. The left eye is sending all kinds of false information to mix with the right eyeís information. It is much easier to walk or do most anything with a patch over the left eye right now. The redness seems to be diminishing some. I seem to be seeing pinkish areas instead of all bright red areas. As the day went by, I seemed to adjust to the left eyeís lack of focus and stability seems to be a little better. The sun is bright in the left eye. I found that one of the drops is a dilation drop to keep the eye dilated. They said this was to reduce the work that the left eye would be doing for awhile. It does promote me to protect that eye more when I am in bright lights or outside. The chart on the wall where I could see the top letters before the surgery is no more than a white spot with some dark smears on it now.

Day 7 Tuesday: It has been a week at the end of this day since the surgery.  The eye seems to be turning a bright pink in general instead of the bright red now. There are tinder spots in my eye yet and have to put additional liquid tear drops in my eye between the normal drop sessions because my eye seems to become dry and irritable during the mid session times. I use Genteal drops that seem to give longer lasting comfort from the dryness. I sat in front of the TV today and was strangely surprised. All of a sudden it seemed that I was able to crudely read the large letters on the TV. Yes the largest ones are becoming easier to distinguish as letters. I looked across the road like I did after my first eye surgery to see if I could see the neighbors shed out back and the windows and doors in it. Yes, I could make out what appeared to be a building and there were dark spots visible where the windows should be. No straight lines are noticeable yet and nothing has a distinctive edge yet. This will be a welcome change if/when it happens. As for the eye chart I used before the surgery, I still canít see the largest letters and the sheet is very distorted.

First Week Synopsis: Surgery was a bit uncomfortable for personal reasons, Cornea damage seems to be on good repair, Stitch irritation disappeared and dryness has taken its place, need eye drop moisturizer regularly, Vision isnít as good as before surgery but seems to be improving at a faster rate each day, Eye seems to be changing back slowly toward a white color. Lines are still distorted with no distinct edge. Still am not driving or lifting anything. Get scolded by my wife constantly about what I try or want to do, maybe it is because she loves me and wants good things to happen.

Day 8 Wednesday: The start of the second week. This morning I change my drops program. I was putting in drops from Ocuflox and Pred Forte four times a day. And Atrophine Sulfate twice a day. Today, I change to three times a day on the Pred Forte and continue on with twice a day with the Atrophine Sulfate and discontinue the Ocuflox. Things seem less distinguishable. Things seem more hazy and less distinctive for clarity. Hopefully as the day goes on, it will clear up. Balance and coordination that followed the removal of the patch a couple days ago seem to have disappeared for the most part although I am now getting back close to what I had for vision before the surgery. Later in the morning, I look at my eye chart again and find that I can almost distinguish the largest letters now.

Day15 Wednesday: The Start of the third week: Have discontinued the Atrophine Sulfate and dropped to twice daily with the Pred Forte on Wednesday the 15th day. The eye has been continously dilated up to now. It has been 24 hours since the last time I put the Atrophine in my eye yet it is still dilated for some reason. The dilation seems to add to the visual problems. Light spatters and makes things hazy when I am out in the sun light and the eye is extremely sensitive to the extra light allowed to come in from the dialation. At night time though it seems the things are darker when looking through that eye also, it seems that there is less light allowed in at night even with the dilation. Things donít seem to make any sense in that respect. Objects are still distorted, I really donít seem to see a difference in the distortion although I can make out the largest letters on the the eye chart now. They arenít clear but are distinguishable with a little effort, just he same. Even the next line down has some letters that are distinguishable now. The distortion is causing almost all the visual problems now it seems. If there was no distortion, I think that I would likely be able to see pretty well for the most part. As the dilation reduces, the distortion may lessen its effects. The distortion seems to primarily be in the area just below and to the left of the center viewing area, although a square area is entirely distorted in shape. A year ago I could read the fine print at the bottom that held the printerís name on the chart, approximately 20/15 vision. Now the level is about 20/50 or in that neighborhood. The eye is white for the most part. Two of the incisions are barely visable but the third is very visable and didnít heal as smoothly but doesnít seem to be causing a problem.

Day 22 Wednesday: The start of the Fourth Week:  On the 17th day the pupil is still dilated. Evening time............ noticed that I can now read the third line down on the eye chart...... no lines are clear though . Everything is still very distorted. All the letters I am able to read are very fuzzy.. The lines are distorted and seem to try to run together on right end.........or............ run apart on the left end........ depends on a personís prospective. On the 22nd, I have another eye appointment. Havenít been using the Atrophine for a week now and the eye is still dilated but in the past day the pupil seems to be finally reducing in size at last but is still very large. Vision seems to be increasing steadily but the distortion seems to stay there as well as the fuzziness of all things. Visual checks indicate 20/30 vision now but that is stretching the imagination some. Vision seems to increase, as the dilation seems to decrease. Pressure check shows 12 which is good. A correction check shows that glasses can increase the visual ability but donít do anything about the distortion. Asked Dr about pain in my eye lately. In the past few days I have had a pain show up steadily in my left eye. At first it seemed like a dull throb for just a second and then it was gone. Now it has progressed to more of a real pain that seems to stay longer and makes my head ache too. It almost seems to make me sick at times. It does seem to happen more often now to and most the time it seems to happen when I am looking around. I received no real answers. The eye chart on my wall is readable through the 3rd line and some of the 4th line is readable too now. The building across the road now has a shape and distinct windows in it even if they are distorted and fuzzy. I can even read the computer screen in 10-pt type with some effort and time. I only put one drop of Pred Forte in my eye once a day for the coming week and that will be the end of the drops so far as plans are now. They say that I can see well enough to pass my driversí test at this point........That is scary to think that there are others on the road right now with no more vision than I have right now. I drove to the Drís office today and scared my wife (and me too) when I mistook a Tractor Truck coming down the road for a family car.

The Start of the Fifth Week--- One month has been completed Day 29     It has been a month since the surgery. The pupil has now reduced in size to normal in comparison to the other eye. While it was bad enough to start with, especially the unknown, it has turned out good, very good. Every day seems to show improvement. I'm sure that this will slow down soon, I hope not until I recover all my eye sight, but I have progressed far enough now that I can function with that eye pretty well. That is more than I had really expected after they took the bandages off my eye the first time. Today, the lines are still distorted but the lines are slowly gaining definition as to edges and shapes are coming in with more detail each day. I look at the chart on the wall and can read part of the fifth line now. I look across the road about a block away at my neighbors building and not only can I now distinguish the building and the windows in it but can also distinguish individual boards on the side. While I am pleased, I have known perfect vision not that long ago and want more back to the point of that 20/15 I had only a year ago. But the vision is good enough that I will not be unhappy even if it doesn't get any better. I don't think I would be human if I didn't wish for just a little bit more than I have though. I have had so much more than some people in my life, I can hardly imagine what they have had to live with as far as eye sight.

Day 36 Wednesday: Start of the 6th Week    I can read the entire fifth line now on the eye chart, not quite as well as with the right eye yet but can read it just the same. I would probably be deemed to have 20/20 vision back in that eye again at the doctorís office now. The chart image is still distorted but doesnít seem quite as distorted as it was in the beginning. There are light fuzzy spots scattered on the chart that donít have crystal clarity. This is probably damaged individual cells in the retina causing this. As I work in my woodworking shop, straight lines are bent and distorted yet and I have to close my left eye periodically to let my right eye take control of what I see. Balance and depth perception have increased to the point that I notice no real problem anymore. At this point the two eyes work together. I only have to be careful that the image I perceive is the one from the right eye and not the left. Sometimes the left eye image seems to take control and what I see is misleading with the distortion. At this point glasses would likely give me fine tuned acute vision in both eyes except for the distortion. In the past 4 Ĺ years, I have had several new prescriptions for my glasses and have not received more than about 30 days of use out of any of them because of changes in my eyes. I look forward to getting glasses at last and being able to use them regularly to see with acute visibility for a change and getting away from the astigmatism residual left in my eyes. From here on there would be little to document other than possible back falls. From now on the increase of vision will be slow if ever coming.

Epilog:  September 1, 2002    My left eye has progressed beyond expectation at this point.  It still has some distortion in it but not to the point of causing a lot of problems.  The acuity has increased to a point that I can see BETTER with the left eye again than with the right eye.  While I can not read the printer's name at the bottom of the eye chart again .... yet, .... I can freely read the entire chart top to bottom.  I am PLEASED!  The Doctor did good, real good!  Thank you Dr. Tim Stout for a job well done.

To you that read this, I hope you found some understanding and value for your time spent reading it.  When I went into each of these surgeries, it was a new thing that I had no knowledge of and heard many different discriptions of it.  If you have any questions that I might be able to help you with, I would be pleased to offer anything from my experience.  Please address them to   Tom Raymond .  Click on my name to send an email if you wish. Please visit Mr. Milos Kalab's site for more information.