Thursday, December 8, 2016

Surgical Light Show

Yes, cataract surgery is finally in the past, and I'm recovering. Of course, you know me, and writing abut it is never going to be that simple.

First, the big lie. Both the doc's office, and the person from the Eye Institute who called the day before to remind me of the appointment ('cause I'd forget?) and to bring insurance and ID cards along with the extra $500 for using lasers, both of them assured me that I could do the procedure under a general anesthetic. I mentioned previously that I have/had a horror of having to watch surgery on my very own eye.

When I mention that during prep, they actually laughed at me for being so silly as to think I could get a general. I suggested they talk to whomever it is sending out the reminder calls to get their info straight. But I was there, the IV was hooked up, I really wanted to see again with that eye, so I figured it was too late to back out. But it was a passing thought.

I settled for reminding myself that the procedure was only supposed to last 15 minutes, and I've had worse times in the dentist chair. So really, how bad could it be?

I know, I know, never  ask that question unless you're ready for the answer. But it turns out that maybe the only good thing about a cataract as thick as mine was is what you couldn't see before, you also can't see during.

Except the light show.

They taped the good eye shut during the procedure. Thank goodness. They also had a shaped pillow to hold my head steady, and enough anesthetic that I couldn't move that eye around if I wanted to. In spite of that fact, they told me to stare at the bright central light. I could feel the eyelid spreaders, first pulling the top lid up then the bottom down, but there was surprisingly no pain.

It didn't work, of course, for me to stare at some alleged central bright light. The cataract made the whole field of vision uniformly bright giving me nowhere to look. Except... slightly up and left of center there was a light show going on, so I decided to concentrate on that. It was a fairly small circle, and nobody said they didn't like where the eye was pointing.

It's a bit hard to describe accurately, and not just because it came into sharp focus, got a bit blurry, then a lot, then returned to sharp. The colors when in focus were blue and white, blurring into the background brightnes when focus was lost. The background was a nice deep blue, just a touch more faded than indigo. Inside that were vibrating white shapes that could be described as gears, stars, or pointy amoebae. They didn't move relative to each other but they moved, giving me something to focus my attention on, to study other than the actual procedure. I was surprised retinal fatigue didn't seem to come into play. Shouldn't things get dark occasionally, colors reverse?

The light show didn't block my awareness of the procedure, of course. The Doc was telling his female assistant what was going on while she was commenting on things like how hard it was to tell how deep to cut with the laser with such a solid cataract. Occasionally she commented on his doing a good job - how reassuring -  and he pointed out how well the pieces of cataract got sucked out of the eye. Oh, there was another tiny one.

At that point I wondered if I should be seeing anything different, but no. Not till the big ring began appearing. My first impression was it was a rubber or a diaphragm, but wrinkled with darker lines radiating from the outer ring in towards the center like spokes in a bicycle wheel. Was my vision going to have lines in it like that? It went away for a little bit, then returned without the spokes but with bits like dust and microbes coating it. Were those just "floaters"? Did they forget to clean it properly? Couldn't they see it was dirty? Or maybe were those teeny bits of the cataract that hadn't been removed?

In no time after that surgery was finished. I couldn't see a thing but generalized light, a bit of a disappointment as I hoped for some kind of vision now. More eye drops, a pad over the surgical eye held by a stretchy band to avoid my tape allergy, the good eye's pad removed so I could see again for the shift off the gurney onto a chair to make sure I was good to go.

While the bandaging was happening, I peeked a bit but saw almost nothing. Not until the eye was closed. Then I saw general pink, with a horizontal deep red center figure 8 radiating spikes out all over, tiny needles on interconnected balls, the left one being smaller. I guess the tranquilizer they gave me before surgery was really working, because I wasn't freaking out that my vision might be like this.

Once the bandaging was complete, I found I couldn't keep the left eyelid completely closed, as a ring of white light around the bottom kept informing me. I finally decided to just keep both eyes closed unless absolutely necessary, like, say, walking to and from the car. It reminded me of back when I had Bells Palsy and couldn't close the eye properly. As it turned out, I couldn't do it now either. I was so numb, I found out later as feeling slowly returned, that the numbness included not just the eye, but the brow and forehead, one side of the nose, and the upper lip. Kinda like a trip to the dentist, just without the drill. And as each bit wore off, the area newly unnumbed hurt, whether it actually did or not.

They gave me water and crackers since it was late afternoon and I hadn't had food nor drink since before midnight. Of course they also shot me a pageful of instructions during this process. Some were the same as both the general handout pamphlet or the typed handout from the Doc, some different.

So... I guess take your pick. Which drops how often? One set of instructions had every four hours for 3 meds, one had two meds 4 x day but 1 only 2 x day, one added artificial tears every hour to avoid irritation. Then there was the pill for after supper (which schedule? mine where 4PM was breakfast? or theirs?) that kept me up all night peeing so there wasn't pressure buildup inside the eye.

The light show wasn't anywhere near over. While the light pressure bandage was on it, I had a center of bright dancing purple lights, shaped much like NASA's space pictures of noctilucent clouds,
 but not in blue. Simultaneously with them were flashing pinpoints of light in red and yellow, about 2 or 3 at any time. Both went away when I pulled the bandage slightly up off the eye for a couple seconds.

The eye patch  stayed on for 5 hours until it was time for the first drops. That was when I could actually see something real out of that eye for the first time in weeks or months. I forget now just how long it's been how bad, especially as it got worse a bit, then better, then worse. I found out that wasn't at all unusual for cataracts from the prep nurse while we had a bit of time.

Hey, nice that something about me resembles normal, eh?

For bed, after the last drops, I covered the eye with a rigid curved frame which I'll use at least a week for sleeping protection, held on by reusing that elastic strip and a safety pin.

So how was my first look at the world through the new lens? Blurry. Red. But visible again. Unless of course I looked at a light, like the dining room chandelier. Every light turned into a shimmering black blob for as long as I looked at it. I kept rechecking just to see if the effect was real. It was. I just had to hope it was simply another version of the light show artifact from having my eye messed with so drastically, and indeed, it hasn't reappeared, nor any of the other bits of the light shows, since morning. The blur is still there, but it's better. The whole eye is vampire red, and recolors my vision a bit, but that's all supposed to get better.

Steve drove me back to the surgeon's regular office this morning for my post-op check, and he - the surgeon -is happy. The eye chart already shows my vision restored to 20-50, and he expects it to become very close to 20-20. I'll still use trifocals because there's no near or middle distance correction, but that's my old normal.

I'll take it!

Oh, and there's a completely different schedule of which drops when, plus a new drop to replace the final of the 4 x a day ones before bed.  Damn good thing it's all printed out.

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