Anne and I went to lunch at 11am just like every other day. My co-worker Richard met us at Soup-r-Salad. By chance we met Anne's boss Ron, and her co-worker Bob and all sat around and talked. My anticipation had been growing for a few days. I dreamed about the surgery and what it might be like during and after. I couldn't imagine having clear vision without my glasses or contacts. Wouldn't it be great to have clear vision without the discomfort of the contacts, or the need for the glasses hanging on the front of my face? Wow. Of course, if it doesn't work, I'll be out $2000 and still have to wear the glasses. Or worse, it might be uncorrectable. Oh boy...
Anne drove me home about noon and I carefully washed my face with Betadine. My pre-operative instructions said I should wash my face with Phisoderm. Somehow I read that and my mind translated it into Betadine. I can remember when I was little and my mom, a nurse at Ireland Army hospital at Fort Knox, would bring home bottles of Phisohex. Yucky smelling stuff, it was a disinfectant skin cleaner. My instructions were to wash my face the night before with this stuff paying special attention to my upper and lower eyelids. Then again this morning. I did that, but since my appointment was at 12:30pm, I also came home after lunch and carefully washed them again. I had read online that the key to a good surgery was a sterile, debris-free environment when the flap across the top of my eye is cut.
After that Anne drove me over to the American Laser Vision office. It's near our house, about 5 minutes away. The pre-operatvie instructions recommended that someone come with me and stay the whole time to help out with the post-operative procedures. Since my eyes would need to stay shut for 2 hours after the procedure, someone would have to be there to listen, take the packet of material, including eye drops, a pair of goggles, a hip-pack (?), and lead me out to the car, drive me home, and put me to bed. Anne brought along some of her work to keep her busy. The instructions said that the surgery would take 15 minutes, but plan to be at the office for 1.5 hours.
We arrived and I signed in.
We sat for a few minutes then an office assistant called my name and I came up. First thing up was paying my $ 1998. That's about $1000 per eye. I had checked the week before at work to see if Raytheon's health plan covered this. I discovered that they didn't exactly cover it, but had negotiated a "special rate" with some of the Opthalmologists in the area. It was $ 1800 per eye. I'm sure that was a fine price 2 years ago, but now the going rate is $ 795 per eye without astimatism and $ 995 with astimatism. So our health plan covered nothing. I probably could have said "I'm from Raytheon!" and they'd have said "Ok, that'll be the special rate of $ 1800 per eye! Thanks for telling us!". hmmm...
He gave me a cute shower cap thingy and a mask and had me put it on. Then he verified my name, birthdate, age, and some the numbers and information on my chart. Then he had me fill out a name tag with my name and birth date and stick it upside down on the left side of my shirt. This was presumeably so the doctor could read it as I'm laying there under the VISX laser machine.
He then passed me off to another assistant who led me back to the back of the office where the laser machine was. There was one other person sitting there, a man in his 50s along with his wife. He was also wearing the shower cap and had his head on a pillow and his eyes closed. He looked very relaxed. The assistant took me into another room and gave me a Valium. She whispered quietly "Dr. Selkin gives his patients Valium, but Dr. Frazee doesn't. I brought you here so the others couldn't see, or they'd want one too." Ok, fine. I'd rather have the Valium than not if it would keep me calm during the procedure and help me sleep afterward (it did).
The assistant sat me down and put two different sets of eye drops in my eyes with the insstructions to keep my eye closed until I was called. She suggested I try to relax and not talk much to keep me relaxed. Ok, I can do this. The Valium helped I think. After about 10 minutes I heard someone come and get the man beside me. They led him back to the laser room and shut the door. In about 10 minutes he came out and he was very excited. I carefully listened to his instructions. Keep his eyes closed for 2 hours, then start using the two medicinal eye-drops in the proper order, then wait 30 minutes and use the saline eye-drops as necessary to keep his eyes lubricated and comfortable. Ok, I could do that too. His wife was bubbly saying how he was a "good patient." I guessed that meant that he kept the screaming to a minimum, and only punched the doctor once or maybe twice. That would be a goal for me, I wanted to be a good patient too.
After a while they called my name and Anne and I headed to the back room. There were about 5 people already in there. Anne headed to the back to a chair setup for visitors. She was able to watch the whole procedure on a big monitor. Dr. Selkin introduced himself and verified my name and my age, then my birthdate. Then he asked me my birthdate again. Wonder what the fascination with birthdate and age was all about? He pointed out that I would still need reading glasses due to prespyopia (sp?). I quietly told him I didnt' need them yet. He quietly told me I would soon. grrr... The machine is large. At one end is a chair reclined all the way back, with arms. It is on a revolving post that allowed me to lie down then rotate into position undet the laser arm mounted such that it was directly over my eyes when in position. There were two people standing around the machine operating knobs and buttons, watching dials as electricity ran up the electrodes like small lightning bolts making a sizzling sound as they popped out the top and dissipated. Steam shot out of protruberences at certain points. I think one of the assistants had a hump on his right shoulder. (I may have imagined this last point).
Dr. Selkin sat me in the chair and rotated me into position. He put a piece of tape over my left eye to keep it closed, then put some anathestic drops in my right eye. Almost immediately he put a special clamp-like thing around my eyelids to hold them open, then put a suction device on my eye to hold it in position. From there things got a little wierd. Looking up I saw a small green light surrounded by a fuzzly red corona. He put some more drops in my eye then brought some kind of device with a ring on it toward my eye. He poked around the edges of my eye with some tool telling me to hold my eye wide open, then I felt a small tug. Things went dark at that point. Then I saw a fuzzy red light with slowly evolving geometric shapes. It would get smaller, then enlarge. While this was going on I smelled burning flesh. There was no sensation except for a little pressure. No pain at all. Dr. Selkin kept saying "Is the suction on?" "Yes, doctor." "It's not doing anything at all!" This spooked me. I thought he might mean that the suction that was holding my eye steady wasn't working right. So I carefully concentrated to keep my eye rock steady. Turned out that was not what he meant at all. He was talking about the suction device that cleared the smoke and burning smell from the operating area. I did not feel relaxed and had to make special effort to calm down and release the tension in my shoulders, back, legs, and arms. I was very tense. The smell didn't help. This went on for maybe 30 seconds, and it was done! Dr. Selkin put some more drops in and I felt him pressing around on my eye, then more drops, then he told me to close my eyes. The procedure was done. He took the tape off my left eye and moved it to my right eye and did the exact same thing on my left eye. The left eye seemed to take less time than my right.
When the left eye was done he rotated my away from the laser and asked my to sit up. He pointed at the clock and asked what it said. I could clearly see it, 1:17pm. He told me to close my eyes and one of his assistants led me and Anne back out to the waiting area. He sat me down and explained the post-operative instructions just like the guy who preceeded me. Anne went and brought the car around and they both led me to the car and Anne drove us home. I was pretty relaxed by that time due to the Valium. I jumped into bed with my goggles on. Anne set the alarm for 3:30pm and I conked out.
At 3:30pm the alarm went off and I opened my eyes and jumped out of bed. My vision is certainly much clearer that it ever was without corrective lenses! I could easily read things. But seeing is like looking through a fog. I can't see clear at a distance yet. The Doctor said that this would clear up in 24 hours. There is an irritation when I blink, much like when I got my first pair of gas perm contact lenses, but not as severe. My left eye feels more irritation than my right. I immediately put in my prescription eye-drops and wandered around the house to test out my new eyes.
I'm sitting here now in front of the terminal screen writing this, not 3 hours after the surgery. Even from the time I started this log till now my vision has gotten clearer. I'm wearing some clear wrap-around sunglasses that I used to protect my eyes during bike rides when the weather was rainy and overcast. These are easier to wear than the goggles and serve the same purpose.
I woke up this morning with both eyes much clearer than yesterday. I still have a little haziness, but it is not bad. My left eye is very clear close up but somewhat blurry at a distance. My right eye is exactly the opposite. I was easily able to drive, so I drove over for my 8am follow-up post-operative appointment. I have 20/20 in my right eye and 20/30 in the left. The doctor carefully examined my eyes and said the flap was so perfectly placed that he could hardly see the lines. I can easily see the smallest font on my terminal screen, I can drive just fine, and the irritation I felt yesterday is completely gone in my right eye and almost completely gone in my left eye. I have continued to use the medicated drops the doctor prescribed, but I haven't used or needed the Bion Tears. I don't seem to have any problems with dry eyes.
At 8am this morning I went in for my next follow-up visit. I've been using the two eye-drops, Ciloxin and Econopred, every 4 hours all week. This stuff really sucks. The Ciloxin causes a very bad, bitter taste in my mouth about 5 minutes after dripping it into my eyes. The Econopred leaves my eyes cloudy for a while after putting it in. So I'm real happy that I don't have to do that anymore.
My eyesight is:
The haziness is slowly clearing. It is still very apparent at night, I have to drive a bit more cautiously. This is supposed to clear in a "few months." I have absolutely no problem driving during the day.
The comfort is spectacular. No pain, no irritation, no dry-eye, nothing. And now I can stop wearing my protective goggles at night.
I have recently noticed another effect. When I'm working in from my computer or reading for long periods of time and then look up at a distance, my eyes take a _lot_ longer to focus on the distant object. Like, maybe 10-20 seconds before it comes into clear focus. Once I've focused out there I can focus in close easier. After that first attempt, I have no problems until I focus in close again for a long period. But that first attempt to focus at a distance is difficult. I told the doctor this and he said this is normal for Presbyopia. But it is much more noticeable now than before the surgery. I think the surgery has affected my eyes ability to change focus quickly, or encouraged the development of Presbyopia (?)
Finally, as I was sitting in the queue waiting to talk to the doctor I started talking to the fellow beside me. He also was at his 1 week followup visit. Turned out his eyes were almost identical to mine in terms of required correction. He said that his eyes had been corrected just like mine, right eye for distance, left eye for close-in. We both wondered if the doctor had done this on purpose and not told us or gave us the option? hmmm...
I've decided that I need to stop "picking" on my eyes. I never had good eyesight in my right eye with my glasses, and I never closed my left eye and tried to mentally "force" the right eye to be clear. But this is exactly what I'm doing with my new left eye. I remember when I got my gas perm contacts. They were very uncomfortable for weeks, and my vision wasn't great either for a long while, until I got adjusted. What I need to do now is just ignore it, use both my eyes, and let my brain adjust. Then I'll take stock again at my 1-month followup appointment, on March 2.
And, yes, I'd do it again.
My Texas Driver's License renewel came up for March 3 this year, my birthday. I drove over to the DMV office in the afternoon today to renew and try to get the corrective lens restriction removed. I chose to go in the afternoon because the vision is much clearer in the afternoon and evening than in the morning. I have no idea why this is the case, but it has been true for the last few days, maybe a week.
I waited in (a _very_ long) line until my number came up and walked around to position 6. The very bored woman took my paperwork and gave me the vision test. It was a machine I put my head up against and looked through a scope. There were 18 numbers and letters arranged in a single list from left to right. She asked me to read all the numbers/letters from left to right. I could tell that the leftmost 6 had my right eye blocked, the center 6 used both eyes, and the rightmost 6 had my left eye blocked. I could easily read all of them! Woo Hoo! She completed the paperwork, gave me my temporary, took my picture, and sent me away.
I'll get my new Texas Driver's License, with the corrective lens restriction removed, through the mail in a couple of weeks.
This morning, I met with Dr. Chen, another optometrist in Dr. Selkin's office. He measured my eyes and my eyesight was:
Question: When can I get a corrective lens for my left eye?
Answer: Right away, and he wrote me a prescription for my left eye. My right eye doesn't really need one. However, he said I should not get any contact lenses until my eyes have stabilized, and that has not happened yet. He said the glasses would correct my vision now, but my eyesight would still vary and change over the next month or so before finally stabilizing. I should expect this. Fine.
Question: I'm thinking of getting an enhancement on my left
eye. When can that be done?
Answer: After it stabilizes and stays that way a while. It is different for each patient, but maybe at 3 months, maybe at 6 months.
Question: I've heard about "Adaptive Optics", also called
"Wavefront Analysis Technology". When will that be available?
Answer: He didn't know what I was talking about!(?) He said it would at least be a year out. But I don't believe him.
Question: How Long (typically) does it take before the haloes
around lights at night go away?
Answer: It's different for different people. It should slowly reduce in time, and for some people it never completely goes away.
Question: How long before I can open my eyes underwater?
Answer: Anytime now. However, if the chlorine bothers them I must not rub them! That's the big deal at this time.
Question: What about eye exercises?
Answer: These help the muscles, not the cornea healing. He didn't think it would help the healing process any.
I left the office and headed to work. Once there I called my regular optometrist office, Dr. Kurtin, to discuss my new prescription for glasses. The receptionist said to come on over. I wouldn't need to talk to Dr. Kurtin at all. I drove over and went immediately to the back. They were not busy. The woman in the back took my old glasses and the prescription and wrote out the order. I asked her if she had a -0.75 corrective lens in her stash that I could try. She thought she did and went back and got it. It was a large disk, about 3 inches in diameter, with the -0.75 spherical correction visible in the curved surface. She said to hold it up to my left eye, tight in close to my nose, with the convex surface out. It cleared up my vision perfectly!
This was one of the things I was very worried about. Perhaps the surgery had messed up my eye such that it couldn't be corrected with a lens. This was not the case. Whew, massive relief.
So I asked her if she had a -.25 lens back there. She said that was a very slight correction and she might not have it. But after rummaging around she found one. I held the -.75 up to my left eye, and the -.25 up to my right, and everything was in perfect focus, and I tried reading in close and could do that too. This is very good news! Also, the correction was spherical and didn't have any correction for astigmatism. Perhaps my astigmatism has really been corrected! I guess time will tell on that too. She pointed out that the Dr. had not written me a prescription for the right eye at -.25. Fine, I can see just fine through my right eye without correction. So my new glasses will have a clear lens for the right eye, and the -.75 correction for the left.
I picked up my new glasses on Monday. They were everything I expected. I could see clearly from both eyes. This is great.
I've been wearing my glasses for the full month. I've had no problems at all with my eyesight. I usually put saline drops in before going to bed just to increase the comfort a little at night. I don't seem to need them during the day. My eyesight seems to be fluctuating slightly from day to day. Not much, but enough to notice. My left eye has degraded slightly from .75 to 1.00. My right eye has degraded slightly from 0.25 to 0.50. The doctor thinks it also has a slight amount of astigmatism returning. I've noticed that the halos around the lights at night has been slowly reducing. Turns out part of the halo was just my need for a slight correction that the glasses provided.
I asked Dr. Chen to give me a new prescription for both eyes. I told him I won't be coming back for another follow-up visit for 6 months or so, until after the biking season is over, maybe in early October. Hopefully by then my eyes will be completely stable and I can have an enhancement done.
I took the prescription to LensMasters this time. My company, Raytheon, has a deal with them to reduce the costs a little. I had my .75 correction increased to 1.00 in my left eye, and the clear glass replaced with a .25 (with some slight astimatism correction) lens. I kept the old lenses. They were ready in 45 minutes. My left eye was once again perfect. My right eye didn't seem much better. hmmm... They had given me my old lenses, so I took the .75 lens that used to be my left eye correction and held it up to my right eye. Perfect! What does this mean? When I got home I took a good look at my glasses. I discovered that the lenses are symetrical. This means that I can take the old .75 lens and put it in for my right eye replacing the new .25 lens with the astimatism correction. This worked great. I can now see very, very clearly with both eyes. better than I used to be able to see with my gas perm contacts, and much better than I could see with my old glasses (from before the Lasik surgery).
I drove over to Wal-Mart later in the day and went hunting for clip-on sunglasses. I found some that were just right, clipping over my glasses at the edges with little hooks. They are light weight, block UVA/UVB, are polarizing, and should be just fine for biking. And how can I beat $ 7.95 for sunglasses?
I've been negligent writing on this log, and with Christmas coming up, I figured I should update it! My eyes have been stable for months. I wear glasses all the time now. With my glasses, my left eye is a little fuzzy in the mornings, then both are very clear and sharp during the day, then a little fuzzy in my right eye after dark. It's not enough to affect my driving, but it is noticable. It's much better than it was with my contacts, just due to the comfort. My glasses are also fairly scratched up. I probably should get that fixed. Ok, it's on my list. I visited Dr. Selkin's office in September and again saw Dr. Chen. My prescription was the same. I talked with him about getting an "enhancement" to correct my vision the rest of the way and he suggested I wait. Fine by me. The longer I wait, the better the technology gets.
Besides, I have discovered that I am getting presbyopia! That is, my right eye needs reading classes. Actually, since my eyes are a slight bit near-sighted all I have to do is take off my glasses and I can read fine. I'm starting to feel a little of it in my left eye too, but not as strongly as in my right eye.
I think I'll wait until the full two year period during which I can get an enhancement free-of-charge. That should allow the presbyopia to settle, and the Lasik technology to get better.
This is my one year followup with Dr. Selkin. My eyes have changed slightly again, a little worse on both sides, the astimatism in the left eye has changed. I am still considering an enhancement, but not until my eyes have completely settled down. Dr. Chen has recommeded a follow-up visit in 2 weeks to see where I stand. He wrote me another prescription for eyeglasses. I filled the prescription. With glasses my eyesight is very good, quite crisp, and completely acceptable.
Another follow-up. My eyesight has stayed the same. I did not see Dr. Chen this time. It was a another optometrist. Fine. She suggested I have an enhancement on just my left eye, the dominant eye. After a lot of thought I decided not to do this. I'm going to wait until my eyes have completely settled down and my prespyopia has kicked in. Maybe in two years. In the meantime, I wonder how soft contact lens would do?
I made an appointment with Dr. Kurtin, my old optometrist to see about getting fitted for soft contacts. He did some tests and said:
Since last entry, I've tried these Hydro-Extreme contacts that I described last entry. These are 57% water and good for people with dry-eye. Turns out (Dr. Kurtin believes) most people that have had lasik surgery have dry eye. I don't think I have this, but maybe I do and don't know it. Also since they are so thin and flexible they can conform more easily to my irregular eye shape. Anyway, these contacts really sucked. First, they didn't correct my vision very well. I'd blink and see clearly, then I'd blink and see fuzzy, back and forth, one eye then the other, with mostly fuzzy vision. Also, and perhaps worst of all, I tore them up at an alarming rate! They were supposed to be wearable for a month then throw them away and get another pair out (he sold me a years supply. hmmm...). The first pair lasted 1 week. The second pair lasted about 2 weeks. I think the problem is that I took them out and put them in a lot. And I guess I wasn't very gentle with them. They would tend to fold up. So I'd unfold them and drop them into the solution. That folding and unfolding caused creases which eventually tore them.
When I returned to Dr. Kurtin's office I asked his assistant about this durability problem. Brandi said that this is the most common complaint about these contacts. When I talked with Dr. Kurtin he suggested I try a different brand, "Frequency 55", similar but maybe a little more durable. Also these are aspheric and may fit better than the previous brand. Ok fine. I gave him back the old ones (for a refund to be applied to the new ones) and currently have a trial pair of the new ones. These are a little better, but not much. My right eye is almost perfect with these new aspheric contacts. But my left eye, my dominant, is never clear and sharp.
So I wear them to aerobics and take them out all the rest of the time. They are certainly comfortable and acceptable for aerobics classes, but not for biking or for work, or anything else really.
I have another appointment on May 6 to see how they are working. In the meantime, I'm mostly in my glasses and only using the contacts for aerobics classes.
My eyesight is now completely stable all the time, from morning till night, and I don't see halos around lights anymore. I feel completely comfortable with my eyes as they are now. I wear glasses most of the time except when I go to aerobics classes when I wear my soft contacts. My contacts are now quite good, but I had to make a change.
Dr. Chen's Dr. Kurtin's Eyeglass Contact Prescription Prescription Left: -1.25 -1.25 Right: -0.50 Astig 0.50 x 036 -1.00 ( difference of 0.50 )Notice that my right eye, which is pretty crisp and clear, has a stronger contact prescription than my left. hmmm... It seemed to me that, since my left eye was fuzzy, it might need a slightly stronger prescription. I also found a reference on the internet that contacts prescriptions might need to be stronger than an equivalent glasses prescription. Ok, scientific investigation over, I found www.aclens.com and ordered myself a new box (6 lenses) with a correction of -1.75, exactly 0.50 more than Dr. Kurtin's prescription. This worked great! The new contact corrects the vision in my left eye pretty close to perfect. Also I discovered that aclens.com is _much_much_ cheaper than Dr. Kurtin. My prespyopia hasn't changed significantly since last time. My right eye is showing signs of it but my left eye is not. I am carefully exercising both eyes in an attempt to hold it off as long as possible. Of course, it's a lost cause. I _am_ going to get older and it does affect everybody in time. But still, I'll keep up the exercises and see how long it takes.