Wednesday, 10 March 2010

More Follow-up Visits

February 9, 2010

Went for a post-op follow-up to the O.D., Dr. M. Seemed like a waste of time to me. She says 20/80 is my uncorrected distance vision. I knew the figures at the ophthalmologist's office had to be wrong. Dr. Labor's office is simply trying to be more generous. I'm allowed to strain and blink a lot in order to read a line.

February 10, 2010

Went for follow-up (1 mo. post-surgery) to Dr. L's office.

Jodie is the name of the tech who does the visual acuity tests. I told her I was not there to schedule my 2nd eye for surgery. She asked what, then, I was wanting to see the doctor about. I feel there is a distinct lack of communication. I was specifically told to come back in two weeks, so that is exactly what I did.

OK, so then Dr. L. comes in to look at my eye and again said that the astigmatism is likely the cause of the problem. I asked him if he did the LRI incisions in the O.R. and he confirmed that, yes, he did two of them. He said it is "not too uncommon" for my eye to be at this stage. He indicated that many times, there is quite a dramatic change at the 3-month mark after surgery. So, that means there might be a real change around mid-April. If not, and eliminating the presence of any confounding variables (like the macular pucker), he could do a further procedure with the laser, to try and correct the astigmatism. I didn't ask him outright, but I'm sure he means a LASIK procedure -- that is elective of course, and I can't see myself shelling out a few thousand more (which I don't really have) for a procedure that I will pay out-of-pocket for, when I've already sunk $3300 for one Crystalens for one eye (and one more to come). So there we have it.

I did tell Dr. L. that I wasn't quite ready for the right eye cataract surgery, because I wanted to make sure that everything was OK with the left eye first, and that I was going see Dr. R, on Feb. 19. Dr. L. seemed fine with that.

My article about epiretinal membrane surgery and vitrectomy is at:

Vitrectomy: What to Expect With Macular Pucker Surgery

My article about the vitrectomy and face-down positioning is at:

Hints for Enduring Face-Down Positioning After a Vitrectomy

Practicing Accommodation with the IOL

Jan. 27, 2010

Started reading a large-print book -- Guilty As Sin by Tami Hoag, set in 16 point type. Doing this for 15 minutes, then switching to my NIV Bible for 15 minutes. I believe the Bible has 14 point type but I'm not sure. I can read it Ok but it is a struggle. I wish I could have found a better large print book at the library. This one by Hoag goes back to 1996. Her earlier experience as a romance novelist shows, and not in a good way. I've got to find one of her newer efforts.

OK, I'm writing tonight with my new Levenger fountain pen. I think it is OK for a $60 pen, although I do agree with one reviewer that it would have been a lot nicer if they could have made it with an extra fine point nib. It certainly writes smoothly but I really feel this fine point is too broad.

Friday, Jan. 29, 2010

Did some reading this morning - both from my Tami Hoag book and from my NIV Bible. I believe that my Bible probably has 14 point type -- at least I tried to measure it and that's what it looks like.

I think that my left eye can see print at reading distance, if not small print. It may be improved. Suzanne called me this morning. She had worried yesterday because she was having some visual disturbances not seen before with her migraine headaches. Fortunately, she was able to see a retinal specialist in town and there is no worry of a retinal detachment. Praise God!

Tuesday Feb. 2, 2010

Continuing to practice reading. I traded in the Tami Hoag book that was so boring and picked up Kill the Messenger in large print. It's definitely an improvement over that other book.

I'm not sure that my vision at near distance is any better. At choir rehearsal on Sunday, I lasted the entire time with no reading glasses and it was OK. The notes are a lot easier to see than the words.

My article (2nd one) about the Crystalens is at:
Is the Crystalens the Right IOL for You?

Friday, 5 March 2010

Two-week Follow Up with Doctor

Tomorrow is my 2 week check-up with Dr. L.

On the forums today, I saw a posting from a 44-yr.-old man who had a cataract extracted from one eye a few months ago. He was having trouble with "waxy vision" in his eye, especially at night. He might have to be YAG'ed. He then did a follow-up posting a bit later, and said that, once the Crystalens had been implanted about 3 months, he saw a big improvement w/his problem while taking no action. He did not recommend doing two Crystalens implants two weeks apart. He says the Crystalens is a lense that requires much patience. Meaning, that it takes quite a while for it to heal and settle in. So maybe I shouldn't feel so bad that I can't get both eyes done, two weeks apart. This is pretty much the feeling I got from Dr. R., who said I should wait and see how I do.

Tuesday, January 26, 2010

Went for a 2-week follow-up visit with Dr. L. I spent some time with the tech, measuring distance vision and then I had to read from a card. According to them, my distance vision is 20/50 in the left eye. I really feel that reading is being overly generous. Because I struggled to read the top line, but maybe the top line was not the same line I read last time.

Ok, so Dr. L examines my eye and declares, "You're about where I expected you to be at this time." And "Your main issue is astigmatism, and that's what I was trying to correct in the operating room." I don't think it really registered with me, but later on I figured that Dr. L meant that he had done the limbal relaxing incisions (LRI) during surgery. These are meant to help the cornea flatten out and might correct the astigmatism to a degree. He says that everyone is an individual in their response and that patience is required. Sometimes the desired outcome may be longer coming. At any rate, I do have a Crystalens, so he told me he wanted me to practice reading as much as possible. Start with large print for a few minutes and then go down to a bit smaller print. I haven't had accommodation in a long time and therefore my ciliary muscles need a work-out. I will see my optometrist on Feb. 9, Dr. L on Feb. 10, and Dr. R. on Feb. 19

More Follow-up

Saturday January 16, 2010

It's all so subjective, but it almost seems like I'm seeing a slight improvement in vision out of my left eye. Not so sure though.

My left pupil is almost back to normal size now -- it's only slightly larger than my right pupil. Because of this, I'm not getting very much of the glare and halos now. I was able to drive home tonight from the grocery store. This means I will be able to go to BSF next Monday morning.

The way I'm checking my vision is I'm looking at the clock on my kitchen wall. I'm covering the left eye and then the right eye. There is a Nature post-it on my frig, which is probably 24 point type (red) and sitting at my kitchen table, I can make it out pretty well with my right eye and (almost) with my left one.

January 21, 2010

I further investigated macular pucker on the Internet. I found an Amsler grid on a web site, downloaded the grid, and did the test.

I had never done this before the cataract surgery, but I did it today.

With my right eye covered and staring at the dot in the center of the grid, my left eye sees a slight distortion on the lower left quadrant of the grid. This definitely could be the epiretinal membrane causing this, or it is some macular edema from the cataract surgery. It is very interesting for sure. I decide to write a hub called, "Save Your Vision With the Amsler Grid."

January 23, 2010 Saturday

Still pretty subjective but there may be a slight improvement in my distance vision in my left eye. I'm still looking at the wall clock and my refrigerator.

Three days ago, at the airport, I could look up at the FIDS monitor and read it fine without glasses. But it was unreadable using my left eye.

Well, I hope there is an improvement, but I'm prepared for anything. One thing is sure -- I'm really tired of using those eye drops 4 times per day.

Thursday, 4 March 2010

The Second Morning After Surgery

Wednesday, January 13, 2010

Slept well last night. Went this morning to get my hair cut and out of my eyes. It's hard when your hair is in the way and you have to tape the shield on your eye each night.

Subjective feelings this morning -- it feels like someone has given me a new eyeglasses prescription. Walking definitely feels unsteady, and it doesn't help that I've had my light-headedness for 20 years. Something must be different. So I am careful where I go and I am trying not to do anything quickly.

The sunrise colors were very pretty this morning. The dawn rocked! Pre-sunrise the light showed a different quality!

There are halos around strong light sources like the TV and lamps, but I assume it's because pupil is dilated and that it will get better.

Last night I looked into my left pupil (dilated) and I couldn't believe it -- I could see the Crystalens. How tiny the lens must be!

Thursday, January 14, 2010

My vision doesn't seem to be a bit better in the left eye. I've checked the halo effect again around lamps and my TV, and it almost looks like the amount of halo margins has decreased a bit -- I think.

Did some research on the Internet. Eyes do not heal at the same rate. It could take up to a week for vision to begin improving.

Friday, January 15, 2010

I put on a pair of blue jeans today and I'll never forget how vivid the blue denim appeared in the mirror.

My article about the Amsler grid is at

Save Your Vision With the Amsler Grid

The Follow-Up to Surgery

January 12, 2010

Follow-up appointment with Dr. L early in the morning. Joy takes me in the morning and Toni comes to get me after I am done.

Tech assistant at Dr. L's office removes eye patch and some of the gunk. She has me read eye chart and I don't think vision in that eye is very good. I turns out to be 20/70. Dr. L and his optometrist examine my eye, and placement of lens is good, but my cornea is swollen and there's some other edema in another spot. My left pupil will have to stay dilated for all the two weeks so that lens can settle in. This will mean lots of light coming in, and I have to wear sunglasses outside.

Dr. L says my uncorrected vision in the left eye should improve when the swelling abates and it can take several days for this to happen. Full healing take 2 weeks. OK, so I go home.

I think I can better evaluate my vision in familiar surroundings and it's true. When I get home to my kitchen there is a lot of light flooding in. When I cover the right eye, everything looks cleaner and brighter. When I cover the left eye and only look out of the right eye, the kitchen walls and colors definitely have a dingy, yellowish cast to them.

Cataract surgery is like washing the eye with Oxydol or Tide -- all my whites look brighter now! And pinks and blues definitely look better.

In fact, the light early in the morning does have a blue cast. It makes sense, if the world is being subdued by an amber cast, that it has been blocking the blue spectrum of light. How cool! Literally, how cool!

Right Before Cataract Surgery

Pre- Jan. 11, 2010

Started pre-operative eye drops -- Vigamox, Navanac and dilating drops.

Jan. 11, 2010

Joy takes me to the surgery appointment at the surgical hospital. We are to get there at 9:00 AM. I don't get called to start the pre-operative process until around 10:25 AM. Joy and I keep seeing cataract surgery patients coming wheeled out to go home, and all have patches on the right eye.

It turns out that Dr. L does all the right eyes first, then the left eyes. Only one other patient and I are having the left eye done today. I am the last person to have the surgery today! Dr. L does it this way to avoid confusion. Seems very intelligent.

I start by having lots of eye drops put in -- every five minutes -- then the nurse comes to look for a vein in my hand to put the IV. Then I also have some goop (Lydocaine) put all over my eye, to numb it.

They put me on a gurney and I have to wait in the hall -- seems like a long while. My watch reads 11:30 AM. I am wheeled into the O.R. around noon. Before I get in there, I can hear music coming from the O.R. Oh no! Some light rock F.M. station playing. I guess some surgeons like to have music playing. I'm reminded of the movie The Doctor and the kind of music the surgeon liked to have playing. This makes me laugh. It has been ages since I had surgery.

Well, they get me ready for surgery and I definitely know when the sedating fluid (Versed) is going in my arm -- I can feel it stinging. Apparently the position for this ophthalmic surgery is not supine or semi-supine. Nope! They put me with my head lower than my feet -- and I feel my neck kind of going off the pillow and my head kind of hanging -- on what, I don't know. I don't know how it's being supported at all. But then I don't know much of anything! I don't remember anything about the surgery except for Dr. L telling me to look at some pretty lights a couple of times. Later I learned that the patient needs to fixate on something to keep the eyes opened.

I wake up in the recovery room and it couldn't be much after 12:45 PM. This twilight sleep isn't bad! The nurse comes around to check on me and give me water. My blood pressure keeps getting checked.

Around 1 PM, the discharge nurse gets me ready to go home with a patch over my left eye. Joy goes home with me and stays around 2 hours till she's sure I will be OK.

That night, I go to bed around 9:30 PM and sleep most of the night. Since I must sleep with a patch over my eye for a week, Tessy and Meadow have to sleep in their crates -- too bad for them, but I don't want them pawing at my head, even by accident.

My article about Refractive Lens Exchange is at

Refractive Lens Exchange, A New Alternative to LASIK

Choosing the Lens, Measuring for Surgery

December 1, 2009

Saw Dr. L in his office again to discuss the type of lense. He had previously said that ordinarily, he would enthusiastically recommend the Crystalens, but with my macular pucker, he couldn't guarantee that I'd have the great accommodation and great vision if I got one. But eventually I did opt for a Crystalens-- an expensive alternative, but worth a gamble, I think. Dr. R, the retinal specialist, said I really only had two choices -- a Crystalens or a monofocal IOL -- because any other lens would hamper the peeling of the ERM if he had to do surgery. He said, "You tell Dr. L -- NO to defractive lenses.

If I get a Crystalens, and it doesn't work like advertised, what I'll have in effect is a very expensive monofocal lens in my eye.

December 7, 2009

Had pre-operative appointment with Dr. L's staff to take measurements for my lense, which must be ordered. It will take 30 days for it to arrive. There is plenty of time before the surgery.

My article about the cost of cataract surgery in my area is at:

Cataract Surgery Cost -- Dallas/Fort Worth

Trouble Begins

Sept. 2009

Went to the optometrist for the first time in 1.5 years. Had been noticing eyeglasses prescription seemed wrong. Instead of Dr. C. in Fort Worth, I saw Dr. M. in their Southlake office. Dr. M. advised cataract in left eye was larger -- referred me to Dr. Labor.

Early November 2009

Saw Dr. Labor -- he advised cataract surgery for left eye but also identified an epiretinal membrane there. He advised me to see his associate Dr. R. before having surgery.

Mid-November 2009

Saw Dr. R. in Fort Worth. He did OCT scan on my left eye- said there is "significant traction" on the retina and he is surprised that I don't already have distorted vision. Since we don't know how much the macular pucker is contributing to the poor vision, he wants me to have the cataract out, then come back to see him on Feb. 19. I scheduled the cataract surgery for Jan. 11, 2010.

My article about the choices for premium IOL is at
Crystalens Cost With Cataract Surgery