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A year in the life - Lograh

Thursday, 17.Feb.2011

9:37 - A year in the life

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Okay, so not quite a year. More like 10.5 months since last update.

At first, I thought that I should write about the whole lazor-eye thing right away since my memory can be rubbish and I didn’t want to loose the details. Then I thought perhaps I should at least wait till my eyes settled down. Then I just kinda slacked for a few months, as I am wont to do. Luckily, the details haven’t faded much from my mind – I doubt they ever will.

It was the most nerve-wracking experience I have ever had. I’ve always been somewhat “touchy” about my eyes. I contemplated getting contacts once but couldn’t even handle the idea of poking my eyeballs on a regular basis. It amazes me how casual some people can be about that. This is one of the reasons I went with PRK instead of LASIK. I wanted as little physical contact with my eyes as possible, and I was under the assumption that PRK was a sort of all-lazor affair.

I was horribly, terribly, wrong.

Sure, the part the doctors defined as the procedure proper was all-lazor, but the prep work was maddeningly not. After all the various tests they had me do where the computer built up totally cool maps of the structure and shape of the front of my eye (I should’ve asked to keep a copy) they gave me some drugs to help calm me and then we went into The Room.

It’s not a large room, smaller than my bedroom, actually. This can make for not much extra space when there are four people in there. It didn’t help that over half the room was taken up by The Lazor and its associated control equipment. Oddly enough, there was no machine that went ping. They had me lay down, and one of the kind assistants gave me a squeezy ball. This ball was genius, whoever first thought that patients for this need something to squeeze the ever-loving shit out of during the procedure is a god in the nursing field. I feel sorry for anyone that has to go through this without a squeezy ball. I still have that ball, and just seeing it makes me smile for the comfort it helped provide.

So yeah, I lay back and they prop my head up very carefully and begin the prep work. First step is to do a minor re-inactment of the ending to clockwork orange. Pulling my eyelids back WAY farther than I ever open them, and then using tape and some wires to hold them open. Thankfully they are flooding my eye with some sort of ice-cold numbing agent the whole time so I really don’t feel much. Part of me wonders if this is a good thing, since it gives the whole experience a weird sort of other-worldly tint. I’m perfectly awake, with my eye forced open (the other one covered shut) so I can’t help but watch as they are running various washes over my eye. Then the real “fun” part hits.

Have you ever seen those electric toothbrushes that spin? Not the ones that go back-n-forth, but the type that has a round head with bristles that just spins around really fast?

Yeah, on MY EYE!!!

I can’t blink. I can’t turn away (the friendly assistants are helping hold my head still). I’m forced to watch as the doctor holds the spinning brush of doom in his hands and carefully lowers it straight down on my eye. There is no pain, thankfully, but I can feel the high-frequency vibrations shake my entire eyeball in the socket as he slowly grinds away the outer layers of skin covering the front of my eye. He’s very calmly telling me the progress, and reminding me to do what I can to just look straight up. Meanwhile my eye is bouncing around from the spinning brush being moved to various angles clearing away the entire work surface.

No ball has ever been squeezed so hard.

Thankfully, that part doesn’t take very long, and he was quite willing to dump gallons of the numbing stuff all over my eye. When all that was over and he pulled the brush away I noticed the world had a very odd quality to it. Everything was slightly blurry, of course, due to the liquid that had been used to wash and prep my eye. But aside from that, everything seemed brighter. I remember noticing how, in the brief moment I had, all the colours seemed more vibrant and the lights were so bright all sudden-like. Amazing how much more light was getting in my eye now that a few layers of transparent skin had been viciously ground away. Anywho, they were done prepping that eye and so they swing over the arm containing the business end of the lazor machine. It comes into position and I see an orange light blinking in the center. Doctor says to just look straight at the light and I’ll hear a few clicking noises once they get going.

It is an interesting point of contrast how the whole team was so casual about the brush grinding away my eye’s skin, yet I think that was the most agitating experience in my life. Similarly, everyone on the operating team got noticably more concerned once the lazor machine got involved and they kept trying to reassure me while I’m laying there, staring up, hearing the clicking of the lazor firing and feeling tremendously disappointed there are no “pew pew” noises. I know, I know, the skin grows back and the lazor is what could have blinded me. Still, it was like the overall stress in the room remained constant and we just took turns with who was feeling it. I almost felt like I should have offered them the squeezy ball when it was their turn to freak out.

Someone needs to install a speaker on the lazor and have it make sound effects. “Pew pew” is preferred, of course, but even a simple “bzzzt” would be better than the short “click click” it made. And get something in that room that goes “ping”, while they’re at it. At least one of the assistants said “laser charging”. Not quite “I’ma chargin’ mah lazor” but I was willing to take what I could get.

Once that eye was done they placed a contact lens on it and covered it up and we moved on to the other side to do it ALL OVER AGAIN with the next eye. YAY! At least this time I had been through it once so I kinda knew what to expect. Doesn’t mean it was any less stressful, nor did it spare that poor ball.

They lead me back to a post-op room, give me all sorts of instructions I’m only vaguely aware of (thankfully they thought to have my ride in the room also so he can pay attention). It’s weird, I’m not overly drugged up during this but my awareness is now so entirely shot by the experience that I may as well be. I managed to pay enough attention to know what kind of drug schedule I’d be on (four kinds of eye drops, many times a day) and various notes (wear the silly goggles at night, the dark glasses any time I leave the house, don’t drive), and then we head out. They let me keep the ball, which was of course the largest concern on my mind at the moment.

The next week was rough. I had wisely thought ahead enough to take the entire time off from work. Doctor’s orders to not look at a computer screen for more than a few minutes at a time, though, so even though I had all day to do anything I wound up not doing a heck of a lot. Can’t play video games, browse the web, whatever, when you can’t look at a computer. Couldn’t focus enough to read any books. Basically I sat around the house and took my pain meds for the irritation. Oh yes, the irritation. That skin that was ground away? It was growing back. For comparison, have you ever fallen off a bike and had a nice red patch of skin scraped away by the road? That irritated itchy pain you get when it’s growing back? Yeah, just like that. Only, of course, ON MY EYES! And I’m under strict instructions not to rub my eyes for any reason. And you remember those contacts the doctor puts on my eyes after the lazor? They’re still in during the healing process. An entire week I got to sit around and not rub my eyes while the skin grew back under these contacts.

Drugs, lots of drugs.

I go in after a week, and they remove the contacts and proclaim that the skin is healing nicely and everything is going as expected. I began the long slow process of “stabilization”. I had read something about this when I was doing my research, but it wasn’t quite clear to me just how much your eyes will continue to change for months after the procedure. There is a large jump in your vision right away, but even at 4 months out there were still some minor changes going on. The doctors explained it to me as being more related to my brain having to re-learn how to use my eyes. The lenses were done immediately, and the skin healed up in roughly a week, but my brain was still interpreting the signals as though the eyes were still blurry. Also, it was controlling the muscles as though the lenses were still not focusing right. So while my eyes were supposedly “good” right from the start, my brain refused to believe them since it had been going so long with “bad” eyes.

Now, finally, my eyes seem to have stopped changing and I’m pretty sure that what I have now is what it’s going to be. There are quite a few things I wasn’t really prepared for. The most obvious difference stems from my ‘handedness’ in my vision. Most people have a dominant eye, and for the most part it’s not really something you need to think about. You look at something and you see it. In cases where both eyes can see the item, your brain will prefer the image from the dominant eye and just use the other eye as a sort of ‘supplemental’ data. Previously, my dominant eye (my right eye) was the better of the two, so it worked out well. I had a clear(ish) picture from my dominant eye, and the secondary data wasn’t so hot but was good enough for giving stereo vision. Now, however, my dominant eye is not as good as the secondary one. So I’m constantly getting *noticeably* better images from the secondary eye, but my brain wants to toss that info in favor of images that seem fuzzier. It just feels *WRONG* in a way that I’m incapable of describing. Almost like my right eye feels weak or somehow cloudy. Of course, all the vision tests say it’s fine. 20/20 in the right eye, but it’s that left eye that is causing trouble. 20/15 in the left eye is just slightly better enough that the right eye feels “off”, and there’s absolutely nothing that can be done about it.

Another difference that I was entirely unprepared for, but that seems reasonable, is I now have a noticeable depth of field in my vision. Photography folk know what I’m talking about, but for the rest of you here’s a summary: You know how in some pictures where there is a line of things going away from the camera (think shots of pool tables with balls scattered about) and one item is in focus but anything closer or farther away is blurred? That’s “depth of field” Well, technically, the distance between the closest and farthest things that are still in focus is the “depth” of the field, but whatever. Previously, since everything was blurry anyway I never really noticed if something close to me was any more or less blurry than the thing I was looking at. Now that my eyes can actually *focus* on an object, I’m stunned by how blurry everything else will get.

There’s also an ongoing issue where often focusing on an object will take a conscious act of will. I’m not sure exactly what is causing this, perhaps my brain is still not quite sure how to make the muscles work, or perhaps they are getting tired from being used in this new manner, but frequently I’ll notice that I’m looking at something but it’s totally not in focus. I just have to think to myself “focus on that”, and sometimes blinking helps, and suddenly it will snap to focus. Not the worst side-effect possible from the procedure, but a curiosity all the same.

All that said, having gone through it once would I do it again? Yup. As I age, my eyes will age just like everyone else’s. They’ve been re-set now to where they “should” be, but there’s nothing magical about the procedure. They will weaken and deform, just like anyone’s eyes, and in another 15 or 20 years from now they might again be approaching the point where lazors once again become a reasonable option. When that happens, I’ll evaluate the choice just as I had this time. If my priorities haven’t changed much then I’ll certainly sign up once again. It was nerve-wracking, and the recovery was painful, but already I can say that I think it was worth it.

Comments:

From:dotarvi
Date:23:13 17.Feb.2011 (UTC)
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Yikes. Just reading this made my eyes water. And now that I know about the scrubbing device I think I'll stick with glasses.

I, too, am very sensitive about my eyes. I can imagine scenarios where I would go through that, but they'd have to be pretty extreme.

I'm glad you found it worthwhile, though. Very glad. :)
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From:lograh
Date:0:31 18.Feb.2011 (UTC)
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Yeah, it's interesting they didn't mention the prep work scrubbing away the skin of your eyes in any of the online documentation I found. The doctor also didn't talk about it during any of the various screening visits I had in the weeks leading up to the procedure. Those bums waited till the day of, when I'm sitting there in the pre-op room, then they told me about the scrubbing away of my eye-skin.

I think they do that on purpose. Had I known I would have seriously re-considered the whole thing.

It's really not so bad, physically, given how numb your eye is while they do it. It's more of a psychological thing having to watch as someone scrubs your eye with a toothbrush. If you can keep your anxiety in check for just a few minutes (it doesn't take long) then you can make it through.

For me, it was a question of being able to drive ever again. My eyesight had slipped below the legal limit for driving without glasses, but I knew that the peculiarities of my eyesight meant that I would never get glasses that worked properly for me. Every pair of glasses messed with my distance vision enough that I felt it was dangerous for me to try driving much while wearing them. I'd use them in a pinch, but I tried to avoid it. Having a license that said "must wear glasses" would be almost an outright ban on my driving. No more being able to visit my dear friends out of state was a terrible thought. :)
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From:drkaos
Date:5:35 19.Feb.2011 (UTC)
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Okay, I almost had to stop in mid-read.

I've had eye surgery when I was about five. A neighbor kid thought I'd look better with a stick in my eye, so he pinned me and shoved one in. Trip to the ER, head clamp, eye wires, muscles in the eye immobilized with needles full of muscle relaxants, then lights out to dilate and pull the splinters from my eye. All I really remember is the restraints and the needles coming towards my eye, and the green light in the dark. But since then I've had BIG, big problems with anything coming near my eyes.


I had already decided laser surgery wasn't for me. You just told me how right I am.
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From:lograh
Date:15:45 21.Feb.2011 (UTC)
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(assuming this was meant for me.)

Woah, head clamp? Yeah, that's much more hard-core than what I had. I'm sorry to have brought back some of those memories. You definitely want to pass on the current versions of laser eye surgery.

What surprises me is this. The laser they use shapes the lens by burning away specific parts of it. Why can't they just use that same laser to burn away the skin covering the lens? Why need to use the spinning brush of doom in a human's hands at all? That way there'd be no physical object (yeah, yeah, light is particle/waves, photons are mass/energy, whatever) touching the eye. Seems like it would be considerably less traumatic to me. Perhaps there's an issue with the skin growing back after it has been burned away vs. being scrubbed away.
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From:lograh
Date:15:41 21.Feb.2011 (UTC)
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I'm just glad I didn't take the LASIK route. Where PRK grinds away the skin with a brush, LASIK uses a blade and cuts around the bottom to make a flap out of the skin! YIKES! I've done careful grinding with a tool and careful cutting with a blade, grinding is much easier and less likely to seriously screw up my eye. :)

I'm glad it's over and I can see better now also. :)
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