Update on the Eye Issue

This morning I was to have the YAG procedure performed on my right eye. It was an inconvenient date and time as our daughter was visiting us from Los Angeles for a long weekend, and I was looking forward to spending her last day here doing fun things. Thinking the right eye was going to be taken care of on September 12th, I was not anticipating this conflict. See my previous post for more on that.

When I got to the office today for my 10:00 appointment, I explained that my left eye just is not right. So again they sent me upstairs to have an eye exam done, fitting me in around patients who were already scheduled for such activities. Obviously I was screwing up the schedule of not only the surgi-center but the regular office as well. Dr. Pepose said this time there is not any filament or stray cells on my lens. Instead it is my astigmatism in the left eye that is causing the problems.

My vision with both eyes together is 20/20, and I have tried to explain that I am happy with the outcome in terms of what I can read. However, it is the quality of what my left eye sees that is the problem. Everything is slightly blurry. My frustration comes from the fact that I paid (a lot!) for the enhanced intraoccqular lenses to be implanted during the cataract surgery, and also for my astigmatism to be corrected in the left eye. The lenses and correction were not covered by my insurance, so that was all out of pocket. So to be told now that the astigmatism still exists came as a shock to me.

Apparently my astigmatism was corrected to a certain point, which is obvious as I was reading 20/50 with that eye before surgery and it is now 20/30. However it was still not as good as my right eye, which is why I am seeing the difference between the two eyes. My choices are 1) live with it, or 2) have an additional procedure know as Limbal Relaxing Incisions (LRI) done to further correct the astigmatism. The downside is that I may lose a little near vision, but what I do see will be clear. What a choice!

While I have tentatively scheduled the procedure just to secure a spot on the calendar, I'm not really sure what I'm going to do at this point. One decision became clear to me, however. I am definitely not going to have the YAG done on the right eye at this point. I'll be leaving well enough alone on that one for the time being.

More Eye Issues

eye ball

Yesterday I went back to the eye surgeon to have the same surgery performed on my right eye that had been done on the left last week - the YAG laser procedure. But that is not what ended up happening. After I got checked in and before the nurse put the dilation drops in my right eye, I mentioned that the left eye was still cloudy. In fact, I think my vision was worse in that eye than before I had the laser done. That proclamation resulted in her talking to Dr. Pepose once he came out of the surgical suite he had been in, and he decided he wanted me to have a thorough exam done on my eyes before proceeding.

The bottom line is that they determined I had a filament that was still covering my left eye, and he wanted to go ahead and take care of that first. So the YAG was repeated on the left eye, and the right eye was rescheduled for Monday.

I'm not convinced the left eye is totally cleared up yet. I'm going to see how things look in the morning, and may give the doctor's office a call. At this point I'm not even sure I want to have the right eye done, because I certainly don't want to have it turn out like the left eye.

All of this is pretty disappointing as my vision was better before I had the darn cataracts removed!

Eye Yi Yi

creepy eyes

This morning I had the YAG laser capsulotomy performed on my left eye to remove the cells that were forming on the back of the new lens that was inserted following my cataract surgery in June. Essentially it was as if I was looking through a window that had finger prints on it. That is not exactly the result I was hoping for after bucking up for the expensive replacement lenses. My surgeon noticed the problem when I was in for my one month follow up appointment. In fact he said the right lens had some cells on it as well, but that the left eye was more prominent and the cells should be removed.

My insurance company insisted that I wait 3 months post-surgery before they would approve the YAG procedure, which is why I didn't have it done before now. Fortunately for this I could drive myself to and from the appointment. I arrived at the surgical center about 8:50 for a 9:00 appointment. I signed the appropriate paperwork, and at 9:15 was taken in the back to have my eye dilated before returning to the waiting room. Shortly after 10:00 I was again taken back, this time for numbing drops, and then seated before Dr. Pepose in front of what looked like the normal machine they use to examine your eyes. He placed a clamp on my left eye to keep me from blinking, and as I kept my chin and forehead pressed against the machine, he zapped my eye with the laser. In less than five minutes it was all done.

The assistant rinsed my eye, and then placed Lotemax drops in my eye. Lotemax is an anti-inflamatory steroid drug, and one of the three drops I had to use in both eyes following cataract surgery. For this, I need to place one drop in the affected eye three times a day for a week.

I asked Dr. Pepose if I could go ahead and schedule the right eye since my deductible and maximum out of pocket expenses have been satisfied for the year, which for us ends on September 30th. He said absolutely, so I will get it done next week. I also told him about the fact that my left eye has a bit of discomfort still. I asked him if he ever wore the hard contact lenses. I got my first pair of those before my sophomore year in high school, and they were extremely painful to get used to. You had to build up a callus on the back of your eyelid, and that is sort of how this feels. He suggested I try taking fish oil pills twice a day, as that has proven to help some patients with dry eyes. Otherwise the option is for me to use prescription eye drops like Restasis. I'd like to avoid that if possible, so I'll give the fish oil a go and pray for the best. My left eye has seemed a little better the past few days, so perhaps I am turning the corner on that problem anyway. Of course, having the laser treatment done may change all that.

In all, I was at the office an hour and twenty minutes. They had warned me to be prepared to be there two hours, so getting out early was a bonus. Hopefully next Wednesday will go just as smooth.

Horsing Around in Shannon County

Wild horses of Shannon County

Last weekend we photographed the wild horses in Shannon County, Missouri. But I almost didn't get to go. Wednesday afternoon I was working away on the computer when it seemed that my left eye was not focusing correctly. When Jim and I went for a walk that night, I noticed that it had gotten worse, and I was seeing a blob out of the left eye. It was moving like a floater, but it was rather large and shaped like a vertically squished circle. But then I saw some white flashes like lightning on the left side of the eye, and that was very disconcerting.

The American Academy of Ophthalmology website lists these things as possible indicators of a torn or detached retina. It further warns that if prompt attention isn't paid to the eye, blindness can occur. Well, that certainly sounded scary. The next morning I called my ophthalmology practice and explained what was going on. They agreed I should have it looked at, and scheduled me with the retina specialist at 12:40. I skipped my morning pickleball just to be on the safe side. After thorough testing, the retina doctor said she could see what I was referring to, but my eye pressure was good and there were no signs of any tear or detachment. She explained it was just a big old floater, and that each eye will most likely have something like this. The average age is 67 when it occurs, but she added that nearsighted people get them earlier. In 85% of the cases they disappear on their own. If I am one of the unlucky 15%, I can decide if I want to live with it or have it removed by laser surgery. Unfortunately it cannot be removed when I have the cataract surgery done. So, bottom line was good news and a clearance to make the drive to Shannon County the next day.

For Christmas Jim had given me a gift certificate to attend a workshop about photographing the wild horses in Shannon County, Missouri that was offered through the Academy of Nature and Wildlife Arts. As background on the horses, it is believed that the herd formed after residents left their livestock behind during the great depression. Though there was an effort by federal officials to remove the horses in the 1990s, local protesters intervened and petitioned the National Park Service office in Shannon County. Legislation was passed to protect the animals, with the condition that the herd remain at 50 horses. When the number grows, the Missouri Wild Horse League rounds up some of the younger stallions, who are tamed and then adopted by local farmers. The herd roams free on land located in the Mark Twain National Forest.

Echo Bluff State Park

On the way to Eminence, where our base would be for the weekend, we stopped at Echo Bluff State Park. A project of SWT Design, I had heard about the park for years and had seen many pictures of it during and after construction. But I had not yet seen it in person. Missouri's newest state park opened in 2016, so everything is still pretty new and sparkly. It will take time for the added vegetation to mature, but in terms of camping or glamping, the park has something for everyone. Tent campers will find themselves on wooden platforms, the campers and RVs are on a nice concrete pad with good facilities nearby, the main lodge offers rooms and a restaurant, and cabins built for singles and large families are also offered. The lodge is located near the echoing river bluffs, from whence the park got its name. The park has been so popular that reservations need to be made a year in advance for weekends or any day during the summer. It has also become a wedding destination, which was not something that was anticipated. It is a wonderful park, and I appreciate how they kept several of the old structures from when the property was Camp Zoe.

Following lunch at the lodge, we got back on windy, hilly, narrow Highway 19 and made our way to Alley Spring. Located in the Ozark National Scenic Riverways, Missouri's 7th largest spring discharges 81 million gallons of water each day. The grain mill at the site was constructed in 1893, replacing an earlier mill that had been built in 1868. It was a wheel-less mill, operating instead on a turbine system. The mill closed in 1918. It has been preserved by the National Park Service, along with a one-room schoolhouse that is located nearby.

Alley Spring

By late afternoon we made our way into Eminence and checked into the Riverside Properties. Located on the Jack's Fork River, the choice of accommodations includes the motel or cabins. Some cabins are located along the river while others are across Highway 19 from the motel. We could have stayed anywhere around Eminence, but the workshop instructor had a room at Riverside and would be having meetings with the group there. We opted for one of the cabins along the river so we could have some cooking facilities and the ambience of the river out back. The cabins went under water when the river flooded last year, so they were touted to be recently renovated. The decision to stay in the cabins ended up to be a cause for concern that evening when turbulent weather rolled into the area.

Riverside cabins along the river

Stay tuned...

The Eyes Have It

My annual eye exam was in January, and I anticipated that the test would reveal what I already knew - my eyesight was worse than the previous year. Though I had passed the driver's license cursory eye exam in October, I know that I am slipping my reading glasses on more frequently. Still, I was unprepared for the ophthalmologist to suggest a prescription for glasses. Huh? I had LASIK done on both eyes in 2004 to eliminate the need for glasses or contacts. I was expecting the doctor to suggest a "tweak" of my previous surgery, not offer up glasses.

When I told him I would like to discuss an enhancement, he explained that he would need to do a more in-depth test for cataracts before we could consider that. If cataracts are present, then LASIK is not a choice. Instead, the option is cataract surgery. As my mom, dad and sister all had cataracts, I knew it was a matter of time before they showed up on my eyes. And sure enough, the additional test revealed the beginnings of cataracts. On the plus side, insurance covers basic cataract surgery, while LASIK is considered an elective procedure.

Before it could be determined if my cataracts were far enough along, additional tests needed to be run. I had a two hour appointment this morning, which entailed multiple tests on my eyes, a discussion with the doctor after he performed an eye exam, a followup test as the optic nerve in one eye was a little enlarged and they wanted to rule out any problems, and then a meeting with the scheduling department.

The bottom line is that I am approved by the insurance company to have surgery on both eyes, and the optic nerve issue is one they believe I was born with and nothing to worry about. The biggest consideration is what type of lens I want to have placed during surgery. Insurance will cover just the minimum lenses, which most likely means needing glasses the rest of my life. They also will not cover the correction for the astigmatism in my left eye, which seems stupid but there you have it.

The next step up in lenses would be similar to what I had done with the LASIK surgery. One eye was corrected for distance, and one for nearness. That has served me well for the past 14 years, with the exception of using reading glasses in low light and with small print. The doctor is concerned, however, because of the fact that I am a writer and a photographer, the lenses might cause problems for me in one area or the other. It is not an exact science, and while it worked well following my previous surgery, those were my own lenses he was working with and not man-made ones.

The final option is using extended depth of focus lenses. Relatively new on the market in the United States, the lens provides improved near and intermediate visual acuity while maintaining comparable distance visual acuity. Sort of like what our eyes were like when we were young, I suppose. As you might imagine, because they are state of the art they are very pricey.

If I was quite a bit younger, the pricier lenses would be a no-brainer. If I was quite a bit older, going the basic route would be a no-brainer. But here I am, stuck in the middle... When Jim gets home tonight we will discuss the pros and cons of the options, along with the associated costs. Although I met with scheduling today, I cannot set up the first eye surgery until a lens decision has been made. The second surgery will take place two weeks after the first, as they want one eye healed before they work on the second. Following surgery, there is no lifting or vigorous exercise for a week. Weeks without pickleball?

Eye, caramba!

Oh, Say Can You See...

Not too well, actually. I had my annual eye exam today, and was due for having the eyes dilated. I don't mind the process, but I sure hate driving afterward. If only I could guarantee a cloudy eye doctor day. The last time my eyes were dilated, it was bright and sunny out, and I admit that driving home was a challenge. Despite the reverse drops that had been put in my eyes, the light outdoors nearly blinded me. I can't believe they think it is okay for people to drive that way. This year I took my sister with me to the appointment. She was going to drive us in her car, but when we left my house, her car refused to start. So I drove our smaller car to the appointment, knowing it was more the size she would be comfortable driving. It was nice to have Kathy's company for the fifty minutes I had to wait before being taken to an exam room.

The exam went fine, and I was handed the What Not to Wear roll up sunglasses for the trip home. Placing them under my own sunglasses, I was a sight to behold on the way out. I should point out that I am not a very good passenger under normal conditions. I usually am the driver wherever I go as other people's driving (including my sister's) bugs me. Add into the equation that I felt like I was looking through Vaseline and my sister was driving our car, and I was a nervous wreck. I finally leaned back and closed my eyes for the duration of the trip. Even now, four hours after the dilation, my eyes still look like a cartoon characters. Thank goodness this only happens once a year.