Friday, June 18, 2010

Day 22

I just came back from my third checkup today and things are apparently progressing very well.

For a short recap of relevant events, about a week ago I started experiencing the "ghosting" effect that everyone at the eye clinic warned me about. For me it was more like double vision; I would see some text (say, a sign) and right above that text would be a pretty clear, relatively solid copy of that text. Both eyes experienced this, but it was more severe for the left eye than the right eye. I asked the technician who was helping me why it happened and he explained that some slight astigmatism can occur while healing progresses.


Other than that, I've had relatively little pain as healing has occurred. A few times, I've woken up with that terrible feeling like my epithelium had started healing to my eyelid and opening my eye felt, at first, like ripping skin and then like burning onions. But this was likely also because of dryness since I'm moving from using Flarex, an anti-inflammatory drop, four times a day to two times a day. Lessening the Flarex use is also apparently important because the drops tend to thin out the layers of re-growing epithelium, so Dr. Manche also told me that healing should progress much faster as I slow and eventually stop using these specific drops altogether.

At the moment, I'm seeing at around 20/30 in both eyes, though my left eye is still lagging behind my right in terms of healing. As Dr. Manche explained, there are five layers of epithelium that need to be healed and each takes around 6-8 days to do so, but since they grow towards the middle of the eye from the sides of the abrasion that is made during the procedure, when they meed in the middle there tends to be some wrinkling or buckling (the example he used is like the meeting of tectonic plates). I was told that these deformities will correct themselves once the epithelium layers are completely healed, so during those days I'll be able to see marked changes in the clarity of my vision from day to day.

Other than this, there doesn't seem to be any news to report! No dryness, except once or twice. No more pain. My vision is already good enough to drive and getting better day by day. Hopefully things continue to progress quickly and positively!

Tuesday, June 1, 2010

Day 6

Today, I had my bandage contacts removed! While there's no difference in my vision (everything is still blurry), Dr. Manche assured me that this week was going to be the worst as far as blurriness goes. I went to my last class of the quarter today despite not being able to see very much (you'd be surprised how nerve-wracking it is to navigate public transportation when everyone and everything is a blur) and had the interesting experience of an in-class debate where I couldn't discern the facial expressions of my professor or any of my class members. You would think that would make it easier for me to say what I think, but I'm realizing that I'm very dependent on other peoples' facial cues when I'm communicating with them. I've also had a few friends walking in on me trying to use the computer--face super close to the screen and text ballooned up to enormous sizes--and that's earned me a laugh or two. I've also had the absolute joy of explaining to one of my professors that I need her to print off a special copy of the final for me where everything is in 18 pt font so that I don't have to strain so much to get through it. But after that last exam on June 4th, I'm totally done! Working my ass off to finish my thesis before the procedure was definitely the way to go.

I'm still feeling every now and then like I have something stuck in my eye but otherwise the pain is gone. It might also be worth mentioning that while Dr. Manche told me that these contacts were meant especially to hold on tightly to your eye--thus, the "bandage" aspect--I didn't actually end up feeling a difference between these and the regular contacts I wore throughout middle school and sporadically from high school on, which is probably the same reason why I stopped wearing them in the first place. I'm not sure if a pain scale rating is relevant anymore though, and I wish we had some kind of established scale for blurriness that I could actually measure at home so I could track that as well, though even that might not be sufficient. Even as I'm blinking and typing this entry, one blink will show clear[er] text and the next blink, everything will be fuzzy again.

I just have to keep telling myself that it's the worst week! Everything after this will be easy!

Monday, May 31, 2010

Day Five

Unfortunately, the blurriness began today. It's irritating because while it's bad enough that, say, a computer screen is hard to see without putting my face very close to it, the prescription on my old glasses is too strong to clear anything up, so I just have to tolerate fuzzy vision for a while. The strangest part is that pre-PRK, my left eye was a good amount worse than my right eye. Right now, I'm definitely leaning on my left eye when I need to see things more clearly, which is something I've never done since I was--what, 8 years old? My optometrist told me that one eye got worse more rapidly than the other because I had a habit of leaning on my left hand while I read, putting my left eye that much closer to the book and compounding the damage done to my left eye because of close reading. Either way, guess that side is getting its chance to lead for the first time in my life!

All the markers of clarity that I used in my previous post (the TV at 8 feet, the door at 15 feet, etc.) are blurry like they were when I was myopic. Obviously, this is part of the healing process, but it reminds me of the reason why I wanted to get LASIK in the first place. I'm not the most patient person at the best of times and I love instant gratification, so it feels like a tease to be able to see so well for a few days (especially since was lucky enough to bypass the terrible pain that most PRK patients experience), and then be able to track it exactly as it leaves again. To be fair, though, I knew that this was coming and, honestly, it just helps to be able to whine about it a little.

I've been reading up on some medical studies about post-PRK epithelium healing (studies done on children, actually, which found that for the kids studied between the ages of 5 and 9, it took an average of 3.5 days for their epithelium to heal completely--damn age onset!) and it really seems like a good deal of lubrication plus resting the eyes (that is, not using the computer as much as I do despite the dryness and irritation it causes) really helped the patients' eyes to heal faster. So now, in addition to the regular anti-inflammatory and anti-bacterial drops I'm putting in every 6 hours, I'm going to try to use the lubricating drops regularly in between as well. I have another appointment tomorrow--lets see how it goes!

Today, on a pain scale, was only a 3 out of 10 at most (when I woke up from a nap and my left eye was so dry it wouldn't open).

Sunday, May 30, 2010

Day Four

So while today, I would say, is the same amount of discomfort as yesterday, my sensitivity to light is pretty substantial. The brightness on my computer screen is turned very low and even that sort of strains my eyes. I felt like a rock star wearing a friend's borrowed sunglasses indoors (because I've obviously never had a reason to buy sunglasses in the last couple years--I could never pull off the glasses over glasses look) but opening the fridge was like looking into a small supernova.

Unfortunately, the pressure of a sleeping mask on my face is also pretty unpleasant, so I've closed all my blinds, turned off all my lights, and I'm planning on spending most of the day with my head under my covers, sleeping again.

There's also a marked difference in vision with my left eye now, which has gone blurry. Luckily, I haven't noticed any haziness or glare otherwise.

My attempt to hang out with friends had to happen in the darkest part of the apartment, and I felt a bit like a shady drug deal was going down. We decided to watch a movie--Ip Man 2--and while I can happily report that I could read the subtitles more often than not, I did spend most of it looking away from the screen at the darkness beside the TV. Suffice to say I have no idea what this movie was about.

Maybe as a result of pushing my light-sensitive eyes to do much more than they wanted to, at night I had a bit of a headache and that onion-burning feeling in my eyes again. I popped a Vicodin and went to sleep (on my own--sleep debt is its own Valium) and when I woke up a couple hours later everything felt normal again. I broke into my audiobooks at this point, which have been sitting on my ipod for years as I've really had no use for them, and an hour and a half later, I have to say they aren't so bad at all.

Overall, today was a 4 out of 10 on the pain scale, dropping to maybe 2 out of 10 when I was just relaxing in the dark not doing anything (i.e. bored) and rising to a 4 out of 10 when I was trying to entertain people who'd come over.

Saturday, May 29, 2010

Day Three

I woke up today because of the "pain" in my eyes, although it wasn't excruciating as I thought it would be. Instead, the sensation is persistently annoying and absolutely comparable to the feeling you get when cutting onions, except that blinking doesn't make it go away. I took a Vicodin and it seemed to make even the sensation go away enough that I'm on a computer typing this entry up right now.

Although I prepared for severe light sensitivity by putting up temporary curtains, the light of my slightly dimmed computer screen or the not-dimmed television screen doesn't irritate my eyes. At first, when I woke up because of the onion-eyes feeling, the bright sun bursting through the windows was terrible, but that could also be just because I woke up and then stared directly outside. Mild artificial light in the room felt fine as well, and so, just to test, I opened one of my blinds to let natural light in and only after about half an hour to an hour later did the light begin irritating my eyes enough that I needed to close them.

Hopefully, as this is supposed to be the worst day by other accounts, this is as bad as it gets because, really, it's not bad at all. By about 10pm I've slept most of the day (Vicodin plus a student's regular amount of sleep debt around thesis time made this easy). Dr. Manche did warn me that the blurriness I'm experiencing is going to increase in the next few days and if this is the extent of the pain, I know what it is that I'll be more irritated by (blurriness after a few days of good vision? Gah!).

Overall, today felt like a 5 out of 10 max on a ten point pain scale, and only at the points where I had that persistent onion fumes feeling.

Day One

(This is the day of the procedure.)

Afterwards, I immediately felt like I was seeing better (and still do). While there are some spots that were blurry and a bit of haze, everything was much clearer than it had been for a long time. I could see the things on my desk from my bed (about 8 feet away); I could see the clear outline of the door to my room (about 15 feet away). Standing in the aisle of Walgreens, I could read the labels of all the medicine on the shelves.

I did start feeling discomfort though, but definitely not "pain", the day of the procedure. My eyes felt dry and grainy, like there was something stuck in them--but I'm not sure this is any worse than how it was when I was wearing contacts as a sleep-deprived student though (although I guess I still am a sleep deprived student wearing [bandage] contacts). I'd say on a pain scale, I was a 3 out of 10. My eyes were irritated and the right one kept wanting to close but, again it's more discomfort than pain.

I was very anxious to bear with the painful part that, according to accounts by the doctor and people who have gotten PRK before, would be coming in the next two days.

The Procedure

On May 27, 2010, I went into the clinic to have the actual PRK procedure done.

Payment was taken care of at the front desk and I didn't have to wait more than a minute before a medical resident (I'm assuming that's who they were) came to get me prepared. I was take to a regular exam room where I was given the consent form that I'd already read over at home. I skimmed it again to make sure it was the same document and signed it. Then, we went over all the different drops that I would be needing post-procedure, what they did and how I should apply them, and I was given a bag of them to take with me. I was asked if I wanted a Valium to calm me beforehand and I yes so they opened a pill packet onto my hand and got me a cup of water. I have to say that I didn't really notice the effects of the Valium at all though. Even after the procedure, I couldn't tell that there were any
lingering sedative affects.

Let me note here that while I, having worn contacts, wasn't normally queasy at all with things being around or in my eye, the amount of involvement around the PRK procedure was on completely different scale (that is, surgery does not equal daily contact use or, I don't know, removing lashes form your eye, etc.) so I was glad to have something to calm me down at least psychosomatically.

Anyway, the technician asked if I had any further concerns and I mentioned that since I'd only been getting one or two hours of sleep a night for at least two nights before, that my eyes were already very dry and that it was very important to me that Dr. Manche was very liberal with the re-wetting drops. I'd watched Youtube videos of LASIK and PRK procedures prior to this (not recommended for the faint of heart, but it gave me a great sense of how long the actual procedure would take--not very long at all). This very popular video in particular (a recorded LASIK procedure with the patient commenting via video comments on their experience as it was happening) made me concerned because they do mention that their eyes were getting extremely dry between re-wettings and that at one point the doctor took so long that the dryness was "unbearable": http://www.youtube.com/watch?v=O4kDC4sZ5Jg The technician assured me that Dr. Manche would definitely make sure that wasn't a problem.

Then, I was taken into the room where the laser was, put into a terrible shower cap with gauze squares tucked underneath on the sides of my face in order to keep my hair out of the way and, as I would later learn, to soak up the torrents of drops that Dr. Manche would put into my eyes. They positioned me on a chair. My one gripe was that it seemed the chair wasn't made for someone as small as me (I'm 5'2"), but that's how most things are in my life. So I had to scoot myself up higher on the chair in order to look into the laser machine.

Dr. Manche came and helped me position myself so that I could stare into the red light that the laser would be using to track my eye (it's a red dot with a ring of light around it). He then began taping my eye lashes out of the way and applied anesthetic drops to my eyes. At this point everyone in the room was making casual conversation to keep me at ease and this continued through the maybe 10 minutes it took to do everything. Part of me realized that it was to keep me calm or distract me, but another part of me wished that he was giving me technical explanations of what he was doing as he did it. As I was laying down, I asked that they think of
a time when they were on a flight where the pilot landed the plane so skillfully, so beautifully that they didn't even feel the landing and everyone broke into applause--and told them that I expected the same (including the applause) at the end of this procedure because it was going to go so smoothly. They laughed and put in the instrument that would keep my eye open the whole time. I have to say that this thing made me pretty nervous because it reminded me of the torture scenes in A Clockwork Orange, but I actually only felt the tiniest pressure once they were in. My eye kept trying to blink and, I think because Dr. Manche was re-wetting my eyes so often as the muscles in my eye were trying to blink, it just felt like I was actually blinking so it wasn't uncomfortable at all.

Now, the actual procedure began
and it all happened very quickly. Overall, I have to say it was very disconcerting to be able to see all these things happen to my eye, and to feel a bit of pressure and (thankfully) no pain. Like I mentioned before, I'm not easily grossed out but the experience of this made me a little queasy to think about. I don't know the names of the instruments, so my descriptions will be pretty plain, but there was some kind of cylinder that was used maybe to mark where the epithelium was going to be removed. Then, Dr. Manche warned me as some kind of spinning, whirring flat, disc-like thing removed the epithelium from my eye. This was nerve-wracking because you can hear it do its work, but your eye sort of blacks out as it's happening. There was some fiddling around with sponges and scraper-like things probably to remove the leftover pieces epithelium. Then the laser treatment started. I was told to look at the red light and to move as little as possible. I could hear the zapping sound and actually smell something burning. I don't know if that was the smell of disappearing eye tissue since the laser is a cold one, or the smell of the laser itself. It was nice to know how the laser worked beforehand so that even though I tried to stay as still as possible, I know that involuntarily moving my eye wasn't going to destroy my eyesight forever.

When the laser finished, Dr. Manche doused my eye with some kind of liquid and BAM! the world (or rather, the laser instrument and the red light) looked instantly clear! Dr. Manche removed the thing holding my eye open and then started removing the tape. He explained that the tape is made so that it doesn't take any lashes with it when it's ripped off (thank god). He put something over that eye, taped it shut, shifted me over, and repeated the entire process for the other eye. I do have to say that I could feel more pressure with the left eye than the right eye, which made me really nervous that the anesthetic drops hadn't kicked in completely (especially when the spinning sandblaster-like thing removed the epithelium), but as the procedure kept going things started feeling the same again. Everything actually happened so quickly that, I told him later, I didn't even realize when he put the bandage contacts in. When everything was done, I could look around and instantly tell that the world was much clearer than I'd seen it for a while without the use of glasses or contacts.

I walked out to the waiting room on my own where a friend was waiting to drive me back. I
was definitely feeling a little loopy from the Valium (which had finally kicked in during the procedure) and my newfound vision and I couldn't stop staring at everything outside the window was we drove back.