Me Versus Eye Surgery

Photo credit: “3 Meko my friends eye” by andypuma2010

---

---

Hello my friends! Long time no see! (Ha ha, pun intended.)

As anyone who read my last post knows, I’ve been having an “interesting” last four weeks, due to emergency eye surgery. I’m still not back to 100% yet, but my recovery is progressing well enough that I can post a little more about the details. This turned out to be a longer post than I expected, so I’m putting all the gruesome details of the eye surgery here, and plan to write another post about the wonderful people and devices that helped me to cope with this emergency. So if you’re grossed out by medical stuff, feel free to skip through this one…

The story begins in mid-February, when I went to San Diego for the biannual Southern California Writers Conference from Feb 14-16. I had a wonderful time, as I always do, going to interesting talks and workshops, meeting other writers, and spending time with friends I’ve met at prior conferences. On Sunday I started to have some odd visual flashes and a big black floater, which disappeared before I got too worried about it. But the symptoms weren’t the same as when I’d had a retinal detachment before, so I felt fairly safe.

Having said that, let me back up and start the story much earlier. About eight years ago, I had a retinal detachment in my right eye. I went to the hospital and ended up with a couple rounds of laser surgery. This seemed to work for a couple days, until the retinal detachment suddenly worsened. I rushed back to the emergency room and had emergency surgery: a vitrectomy, where they remove the vitreous fluid from inside the eye, use laser surgery to essentially solder the retina back into place against the back of the eye, and then insert a gas bubble into the eye. Luckily, you’re unconscious for this procedure! Unluckily, eventually they wake you up, and you have to spend a week or two laying face down practically 24/7, so that the floating gas bubble gently presses against the healing retina to keep it into place. Unfortunately, even though we did everything as quickly as we could, it wasn’t quick enough: the nerves under the detached retina had already atrophied and died, and I permanently lost vision in much of my right eye. Worse, the blind spot covers the central portion of that eye, so although I am glad to have at least some peripheral vision in that eye, I am basically blind in it: no reading, and no 3D images for me.

As you might imagine, this makes any health problem in my remaining good eye that much more terrifying. So on that Monday morning in mid-February, when I noticed the bubbling effect that I’d had with the last retinal detachment, I called a friend for a ride to the emergency room right away. Unfortunately, the ER was the only option, since all the regular eye clinics were closed for the Presidents Day holiday. (Pro tip: try not to have your medical emergency during a federal holiday; it’s extremely poor planning.)

Sure enough, I was experiencing a retinal detachment. They couldn’t do laser because there was too much fluid, so they used cryotherapy instead – a technique that freezes the retina in place. They also did a partial vitrectomy and inserted a gas bubble into my eye, like last time. This time I was conscious for the whole procedure. There were needles involved. It took approximately forever. I won’t explain further how horrible this was, except to say: I do not recommend being conscious for this procedure. There might have been whimpering involved.

The next morning (Tuesday) it seemed to me that the curtain-like “bubbling” obscuring my vision had grown rather than shrunk, but at my follow-up visit, the doctor assured me that all was well. By that afternoon, it had gotten even worse, and I noticed a new area of bubbling, so I had a friend drive me back to the eye clinic to request an impromptu examination. The doctor was at the hospital by now, and assured me by phone that I was fine. I assured him that I was not. We went to the hospital, insisted that he examine me, and lo and behold: I was not fine. There was a new retinal tear, just as I’d said. To his credit, he was apologetic and said that he was very glad that I’d come in. They did additional cryotherapy on the new tear, and told me to stay face down, and to come see the top retinal specialist the next afternoon.

That night, it got worse. I woke up in the middle of the night and realized that the bubbling blind spot was about to cross over the center line of my vision. I knew I’d have to go in for intensive surgery (under anesthesia) so I ate a health bar as my “last meal” at 1:00 am, set my alarm, and somehow went back to sleep. The next morning I fasted, and called a friend to be rushed to the hospital at 7:00 am. I asked to see the top retinal specialist (the same doctor I’ve been seeing for years) and told the reception nurses that I needed to have a complete vitrectomy ASAP. They hemmed and hawed about whether it was authorized and I said I didn’t care, get me my doctor.

My doctor squeezed me in right away and when she saw the test results and examined my eye, she was very concerned. We had what would have been a hilarious conversation had I not been terrified of losing my sight, in which she kept trying to convince me not to panic but that my tear was worse (yes, I know, let’s fix that right away), that I should have a complete vitrectomy (yes, I agree, let’s do that) and that we shouldn’t wait until tomorrow (yes, I agree, let’s do that right now!). She also explained that the surgery would be more involved than the last time. They would put a “band” (a scleral buckle) around the back of my eye, which reduces the tension on the retina, and instead of a gas bubble they would use an oil bubble. The oil bubble is larger, and easier to see through (sort of) but has to stay in for 6-12 weeks and then be surgically removed, whereas the gas bubble is gradualy reabsorbed into the eye over a short time period.

I am so glad to have such good health insurance and to go to such a wonderful hospital. They were able to move around the surgery schedule and got me into surgery within a couple short hours. I was out of surgery and home by lunch time.

I was also miserable from the effects of the surgery, still confined to staying face down 24/7 (which is incredibly uncomfortable after a surprisingly short period), and fairly sure that I’d lost most of my sight.

They took the patch off at my follow-up the next day, barely more than 24 hours later. But those felt like the longest 24 hours of my life.  It was hard not to think about all the things I’d never be able to do again if I lost my central vision. It struck me how much my life revolves around being able to see, between my career work, my writing, my love of art and cooking… Certainly blind people have a much wider range of accommodations these days than ever in history, and live full and meaningful lives. But the life I had been living would profoundly change, and much would be lost. I tried to be brave, but boy, it was a lot harder than being brave about cancer or any of my other surgeries.

You might  imagine the cavernous depth of my relief when they took the patch off, and the large swath of blackness blocking three-quarters of my visual field was not, in fact, a permanent blind spot. The surgery had been successful!  Well, so far, at least: the retina had been reattached over most of the visual field (other than a small blind spot in the lower edge). Now all I had to do was be patient, and follow directions, and hope to high heavens that the lasered-down retina stayed in place.

I’m really bummed  that I didn’t take any photos of my eye in the first few days after that third surgery because wow, it looked like something out of an especially gory horror movie. The first few days were the worst, recovering from the surgery itself. The face-down positioning lasted eleven days but it felt like eleven weeks: I would not wish that level of dizziness, discomfort, sleeplessness, and excruciating neck and shoulder pain  on anyone. The worst part was all the weird flashing and popping and lights inside my eye, which would have been an interesting firework show had they not been so terrifying. Every new flash filled me with horrible fear  that it was a sign that the retina had detached again — that I needed to rush to the ER once more — and I had to wait for a few seconds to be sure. It’s been four weeks so far, and that hasn’t happened, for which I am hugely relieved. Every day with no recurrence is a good sign, but I won’t really be out of the woods until the first year after the surgery.

The quality of my vision fluctuated for weeks. While I could technically see out through the oil bubble, the focus shifted in an out, from very fuzzy to almost clear. For a moment I’d be able to read, but the next moment it would be a blur. The scleral buckle makes the eye more near-sighted while the oil bubble acts as a mushy magnifying glass. Sometimes my old glasses were better than nothing; sometimes they were worse, vastly over-correctly my temporarily less-nearsighted eye.

At the three-week mark, the eye itself looked about 95% healed, although it still ached like the dickens from the inside, especially after I tried to read or focus for more than a few minutes at a time. But the vision was stabilizing, and I was able to see well enough to do most things again around my apartment. I went to the optometrist for a new prescription and to order temporary glasses to last until they take the oil bubble out, at which point I’ll need yet another new prescription and new glasses. Now we’re at the four-week mark and I’m still waiting for those new glasses. My vision hasn’t really improved much in the past week – still both blurry and oily and phasing in and out, and it strains my eye to read on the computer, even at SUPER magnification. I’m hoping the new glasses will improve the situation.

Having had a wide range of surgeries from various health problems, I joke that this is the worst part of he recovery period. The first part of recovery, you’re in so much pain and everything is so impossible, that just getting by from breakfast to bedtime feels like a huge accomplishment. Now I’m in the “annoying” phase, where my level of things that bother me has reduced back down to almost everyday levels, and I can afford to be supremely annoyed by the little things, like the nagging itching and tugging in my eye, and the fact that when I overdo it with reading (me? overdo it?!) it still aches like the worst migraine.

Also annoying:  the fact that I still can’t take care of everything by myself and have to depend on the kindness of my friends. Lucky for me, I have amazing friends, and they not only bring me stuff and take me to my appointments, but have helped fix up my technology so that it’s helping me too. But that’s another post…

Finally, here’s my Public Service Announcement: if you ever have any weird symptoms in your eye, go to an ophthalmologist – or the Emergency Room — immediately. Don’t wait to get an appointment for the next week or even the next day. Go NOW. If it does turn out to be a retinal detachment, you could very easily become blind by tomorrow if you don’t get it treated. I hope you will never have reason to follow this advice, but I hope even more so that if it comes up, you do.

Take care of yourselves, my friends.

---

---