What I'm Looking Forward To

Just 6 days until my surgery! I'm so excited! I have a trip booked to Mexico next month and it dawned on me that it will be the first time I'll be traveling with absolutely no concern for my glasses/contacts. And here are some of the other random things I'm looking forward to:

1. Taking a nap: Just the sensation of letting my eyes close without having to worry about taking off my glasses or drying out my contacts.

2. Flying: Every trip has been fraught with the concern of how to maneuver my contacts or glasses.

3. Sunglasses: I stopped wearing contacts 3 weeks ago. Even though these glasses are transition, I miss my sunglasses!

4. Opening my eyes: I can't even imagine what it feels like to wake up first thing in the morning and see the clock.

5. Swimming: I have only been able to swim without glasses or contacts- smacking into the wall is only fun the first dozen times!

I had my LPI (Iridotomy) on Wednesday (2 days ago). I have been using my Prednisolone Acetate Opthalmic solution 4 times a day since then and I will continue using them until Tuesday....2 day break and then....ICL!  More random thoughts later.

ICL Surgery Prep: Laser Peripheral Iridotomies (LPI)

Let me start by saying pardon any typos or grammatical errors- I'm typing this mere hours after having the LPI procedure and let me tell you....that HURT. Today's tech was Brynn, and she sweetly warned me that the procedure could be "awkward"...that is probably the understatement of the century. But, let me start at the beginning.

Rocking my coke bottles in the waiting room

Today's appointment was my LPI- Laser Peripheral Iridotomies. I also had a chance to meet Dr. Lyon who is the surgeon who will be doing my ICL surgery. I was a bit apprehensive when I arrived- there is precious little online about the LPI procedure and all I knew for sure was that the doctor was going to put holes in my eyeballs. Yikes!

The appointment began in the exam room. Dr. Lyon came in and re-explained everything about the ICL procedure including a blow-by-blow of what next Thursday would look like. I cannot describe how much of a relief it is to have every single person in the practice narrate what to expect in exactly the same way- very reassuring! Dr. Lyon was open to questions and responded graciously even when I asked him how many ICL's he had done (over a hundred) and for how long (7 years). While that doesn't seem like a ton, it's important to remember that this is still a newer procedure and the cost is quite high- people aren't exactly rolling in off the street by the dozens to get this done. But, between the cataract surgeries and the Lasik procedures- clearly this is a doctor who knows eyes! One of the nurses put some constricting drops in my eyes and then they had me sit in the waiting room for a few moments to take effect. I took that opportunity to take some Ibuprofen- I was warned by the nurse at my last visit that the LPI would likely give me a headache. As the drops took effect, my nose started running and my pupils started to constrict:

Spooky!

I was called to the procedure room by the most delightful nurse (tech?) named Brynn. Let me just say that Brynn needs to be sought out by Visian ICL to do their promotional videos....this woman knows her stuff and made everything sound perfectly doable. Case in point....she cautioned me by telling me that things might be "awkward". Seriously. "You might pass out, but I'll definitely catch you!" She offered me some crackers and juice as I had missed lunch, and answered even more questions that I had. (another Q & A post to come shortly).

She applied some numbing drops in both eyes and then I got to belly up to this laser machine:

Dr. Lyon came in and sat facing me on the other side of this machine. A 'lens' was put into my eye and then the fun began. Looking straight ahead, Dr. Lyon fired the laser into my eye repeatedly until he was able to break through the cornea to create the hole to prevent pressure buildup. It did feel like a rubber band snapping my eyeball while a bright red light was being shone into it. The second hole in my first eye took a really long time to pierce through and it felt like he had to zap me a ton for it to happen. Through all of this Brynn was there, reminding me to breathe, ratcheting the laser strength up or down based on his request. Once the first eye was done, the doctor removed the lens and as I backed away from the machine to have my eye flushed, I suddenly realized that I was seeing only in black and white out of that eye. That was freaky! It only lasted a few minutes before I could see color again, but it was a very odd sensation.

After both eyes had been completed, my vision was atrocious. I wasn't sure how on earth I was going to drive myself home. There was goop that had been put into my eyes around the lens that was really messing with my ability to see. Luckily, Brynn was on hand to do another eye flush then applied my first dose of my steroid eyedrops that I will need to use 4 times a day until next Tuesday. A few more minutes later and I was able to do a very shaky drive home. Let me share something- if I could do today over, I would definitely take my co-worker up on her offer to drive me today. It was way too bright, the sunglasses they give you didn't sit properly over my glasses and I was just not as comfortable as I would have liked to be. Fortunately, I only live about 15 minutes away so the drive was not too bad.

I took a few more Ibuprofen when I got home and waited for my eyes to clear. Once the night time rolled around, I had a very unpleasant surprise...halos around lights! What? I haven't even had the ICL yet and I already have this??? I'm going to hold off from panicking and hope that this is to do with the stress my eyes went through today. I'll do another Q & A in a few day's time and then......BIG DAY!

ICL Surgery Q & A

Tomorrow I have my iridotomies, followed next Thursday by my ICL surgery. In the meantime, I thought I'd share the questions I asked my doctor (and his responses):

Q: Confirm which Dr. is doing the surgery?
A; Dr. Robert Lyons is a board certified ophthalmologist who has been performing cataract and laser refractive surgery for many years. He previously served as an ophthalmologist in the United States Air Force and is a veteran of Operation Iraqi Freedom. He has performed thousands of surgical procedures and has been a surgical mentor to many ophthalmology physicians-in-training. He has been trusted to perform laser vision corrective surgery on fighter pilots in the United States Air Force.

Q: How soon can I fly following surgery?
A: Give it about 2 weeks to be safe. 

Q: How soon can I engage in strenuous activities?
A: Give it about a week

Q: Will any of the prescribed eyedrops bleach my lashes? (I read that somewhere). 
A: No

Q: Will I experience 'halos' at night?
A: Based on the measurements we have seen, this should not occur in your case. 

Q: Can I drive that weekend? (I have tickets to see Hedwig and the Angry Inch!)
A: Yes. You should be able to drive the next day. The anesthesia wearing off, and not the vision, is the limiting factor. 

Q: Do you have a charity I can donate my old glasses to?
A: Yes. Bring them to your surgery and we will have the Lions Club collect them. 

Q: What if I sneeze during my ICL surgery?
A: As you will be under anesthesia, this is highly unlikely to happen. However, the doctors can read the body's preparation to sneeze and it gives them ample time to remove any objects from the eyes. 

Q: What if my vision is not great after the ICL surgery?
A: Unlikely, but we can make adjustments with Lasik (at no additional cost)

Q: What if something feels 'weird' after the surgery?
A: In the kit provided you have the cell phone number for Dr. Lyon and others. Call them right away. 

Q: What if it's too odd?
A: We'll go in and take them out!

I was pleased with how thorough they were answering all of my questions- he didn't shrug anything off as too silly. I'm getting more excited! 9 days to go now!

ICL Surgery Measurement Day

Today was the first step of my amazing journey! I spent about 2 hours putting my eyes through what felt like the Olympics of eye exams...I had a wonderful tech named Elaine who, once I explained that I planned to fully document the process, did a fantastic job of explaining each machine and allowing me time to take pictures. So, here we go!
I arrived and was called back quite promptly. I was taken to a room which had about 6 stations with eye equipment at each one. I'll do my best to recall each one:

This was the first station I started out. The one on the right measures anterior chamber depth, I think the one on the left measured for astigmatism among other things. Astigmatism higher than 1 is considered bad (and potentially would require additional laser after the ICL to completely correct vision). Mine was 0.27 and 0.33 so the doctor was quite happy with those numbers.  Both machines were connected to each other and the final picture that it put out in the end gave a rendering of my eyes:

Once I was done at this machine, I was taken to this one which measures prescription strength. Looking into the machine I could see what looked like a hot air balloon at the end of a street. Elaine made several clicks so that it went into, then out of, focus:

Next I was moved to a station to measure my peripheral vision. This was the only one where I was allowed to wear my glasses. I was given a buzzer and had to press it every time I noticed a 'wrinkle' appear. It was kind of tricky and I'm not sure if I passed or failed this one:

The last station I used in this room was this one:

The Optos took what felt like a Xerox of my eye once I leaned in. The image it took looked like this:

The doctor was able to tell that my eyes looked healthy and was particularly pleased to see the pinpoint in the center of each eye.

With that room finished, I was taken to the room that had the equipment specific to ICL surgery. All the tests I had done so far were also used for Lasik patients.
The next room had these 2 machines first which again involved sitting and leaning into them. I have completely forgotten what these were measuring, but I did get pictures!

The last machine in that room was to measure the corneal cells. Preferably, a denser amount of cells, close together is found. Here is the machine and the readout:

Once done in that room we went to the exam room. We did the usual machine (is it better like this, or like this?), then my eye pressure was checked using this machine:

Elaine dilated my pupils and after I sat for about 15 minutes she took me back to the first room for the hot air balloon test again.

So, after ALL these tests, I am still a candidate for ICL and when the doctor came in to talk to me he seemed very pleased with everything he saw. Exactly 2 weeks from today I should have, for the first time in my memory, absolutely perfect vision....I am beyond excited! Next week I have an appointment to have my iridotomies (tiny holes for drainage in my eyes). I'll be filling you in on that one next.

Background: My 30+ Year Journey with Glasses

Me at about 14

I remember vividly a time in Kindergarten when I just couldn't see the blackboard. I would be in the front row, squinting so hard and wondering why the teacher was writing in such tiny font. At some point I must have told my mother and, after an eye exam, I had my very first pair of (glass) glasses. The feeling I experienced when I put them on is one I will never forget. The way everything suddenly became crisp, clear and in vivid color...I couldn't believe I had been missing out! That euphoria lasted exactly 3 days until I did a high jump at recess and my glasses slid right off my face and shattered into a million pieces. This was the very first sign that my life with poor vision was not going to be easy. At all.

At a friend's birthday party...yep, that's me on the left.

Over the years we tried different things- I was an avid reader and my prescription was often so strong that I preferred to read without my glasses holding the book right up to my face. This spurred a fun game for my classmates who would walk by and slam the book into my face yelling "Slambook!". Ouch. My mother though bifocals (then, later, tri-focals) would help. This led to a weird tic of me constantly tilting my head to find which section of my glasses would help in each scenario. I had the 'librarian chain' to hold my glasses in place, the bi-focals, then, for something different, we started with all kinds of wacky colors because my mother thought it would add a little pizzazz to the situation. It did not.

My freshman year of college I spent Spring Break at a friend's home in the Bronx and that trip changed my life forever. She took me to an eye place in the nearby mall and I got my very first pair of contact lenses. I.was.amazed. Not only did I not have to wear glasses all the time, but I was surprised to find that beneath the coke bottles, I had a fairly decent looking face! I bought my first pair of sunglasses, went crazy with the makeup and proceeded to make up for lost time. It was amazing...for a while.

Dominican Republic, 2011

If you've ever worn contact lenses, you know that sticking your finger into your eyes every day is only charming for a while. The other issue that had reared its head was that my love of travel was in direct conflict with my need for contact lenses. Each time I would have to plan ahead for how I would do the trip- should I wear glasses during the flight? Where would I stow my glasses if I needed to sleep? What if they slid on the floor and I couldn't find them? What if it was sunny when we landed and I needed sunglasses? And with the FAA regulations on liquids it became even more complicated to just throw contacts in by handbag. I know these are that my mother lovingly refers to as 1st world, electricity-having, problems, but to me they put a real damper on a hobby that should have been nonstop fun.

In the past 2 years or so, I have had an increasing number of people that I personally know, undergo Lasik. I went back and forth with the idea and finally, this fall, went for a consultation. I knew that the window for any corrective action was closing and, to be honest, I have a crippling fear of impending blindness. I wanted to take the step that might help me avoid getting to that point. I have so many fears surrounding my terrible vision- I keep a spare set of glasses in my car because I am terrified of having a contact rip in my eye when I need to drive. I check the screws on my glasses daily because I worry that I will lose an arm. I have an old set of glasses I keep for relaxing my hair at home because the chemicals ruin the arms. I have a backup pair of glasses I keep in my drawer in the bottom left corner in case I need them to help me find my current glasses. I mean, it's a whole event.

My Lasik consultation was a colossal fail. The doctor told me that I was not a candidate due to blah, blah, blah and also blah. I was crushed. I had finally summoned all my courage to go for the consult and to be told that I was out was a huge blow. But from my dark sad hole, I became aware of him talking about 'another option'....I wiped my tears and listened to him tell me about the Visian Intraocular Lens Implant. This was a way to have my vision corrected (possibly to even higher than 20/20!) with implants that would go behind my corneas. I was...intrigued...Could this really work? I was excited until I saw the cost- all payable up front, not covered by insurance. Yeah, no way.

Winter 2015. My 'cute' frames

But, as Dean and I talked more and more about it, suddenly it didn't seem so impossible. We calculated how much I had been spending annually on eye care, glasses, contacts, solution and realized that this surgery would pay for itself in just a few years. The thought of opening my eyes in the morning and just...seeing....gosh, that still makes me weak in the knees just thinking about it. After a lot of discussion and research we decided it was worth pursuing. The facility I am going to has done tons of this procedure with amazing outcomes. The cost includes all pre and post-op care, as well as future Lasik if I need it to adjust my vision. (With your vision corrected to a reasonable strength, you can have Lasik if needed in the future for a slight tweak). My surgery is early February and I have a few pre-procedure visits I need to have before then. I plan to share every step of this journey in case it is something you are considering for yourself.