The Joy of Contacts

[plthijinx]

i had 2 procedures done on my left eye. the first one was PRK circa spring of '97 and sonofabitch it hurt like hell. that reduced my vision from 20/400 to 20/200 in my left eye. after that i waited until the LASIK proceedure was perfected and had my vision corrected to roughly 20/30ish in both eyes, doing the proceedure only on one eye at a time for the "just in case" factor. i only wear glasses to drive and fly. i highly recommend the LASIK proceedure, it is really nice to wake up and be able to see not only the alarm clock but the TV as well. but i would recommend doing only one at a time. old school i guess. i know they've perfected the proceedure even more since but i'm always a little cautious about my eyes......

[wolf]

For me ... a little cautious is wearing contacts.

A lot cautious is not letting some guy who assembly lines patients approach my eyes with a laser.

nuh-uh.

nope.

no.

[kelliekd]

what frustrates me about contacts is that the doctor perscribes by the BRAND, not by what your vision calls for. I wanted to switch to overnight contacts, but would of had to make another appointment to do so. ARG!!!

[wolf]

There are differences in fit with the different brands, even with different types within the same brand.

Now that I have to wear torics I've missed out on a lot. No color contacts, no Wild Eyes, and worst of all, no overnights.

I had 30-day lenses. They were awesome.

well i have been wearing contacts since a long time now
and i really love them
no more teasing from friends and all
and also ther are very comfortable
i had certain problems in blinking in the beginning but now i am all right with them

[BigV]

Pray for me.

I am the designated driver and hand holder for SWMBO who will go under the laser in the morning. That's not strictly true--she's strong, I'm the one who'll need the sedative :shivers: Anyway, wish her and me the best, please. I'll report back tomorrow.

[seakdivers]

Ooooh definitely let us know how it goes!! I am still too scared to do it myself, so I need all the stories good or positive so I can make up my mind for sure.

Good luck - I hope it all goes perfectly!!

[Clodfobble]

Make sure all the lights are off when you get home. Keep the house as dark as possible for at least a couple of days.

[wolf]

Since you're paying for this, does that mean you get the pygmy goats?

[BigV]

Ok, short story: It works, totally worth it.

From the start, MrsV has endured contacts, and tolerated glasses, but wasn't happy with either one. Locally, King and Mockovak Lasik laser eye surgery clinic offered a "free" seminar. Turns out the seminar was indeed free and really just for information. But MrsV was a motivated qualified potential customer and the clinic's outreach earned her attention. She attended the seminar during my time in BSL.

When I got back, we talked about the different options, and the different costs. She scheduled an evaluation. This was no small deal, since it was about 20 miles from our house, and the evaluation included procedures (eye dialation) that would prohibit her from driving herself. It took about half a day including the exam and the paperwork giving her her treatement options and payment options. We brought the details home and talked it over.

She was *very* excited at the prospect of having her 20/200 vision permanently corrected to 20/15. Sounds like a miracle to me. I have good vision, so I don't experience the hassle of lenses and glasses in the same way, but I think I get it. The questions we had were: Do we want to do this? (yes) Do we want to go with lower cost less detailed laser or the more expensive finer grained laser? (more). Do we want to go with the basic, extended or lifetime "warranty" plan? (lifetime). How would we pay for it, free financing for 12-18 months, cash, credit card, savings, etc (still in flux).

So an appointment was scheduled for today (the appt was made one week ago). During the last week, we had to have a prescription filled for a optical antibiotic. We brought this little bottle to today's appointment. We arrived a couple of minutes late (traffic) but were promptly seen by a finance intake person, a peppy young woman who helped facilitate our payment and paperwork. We had to sign in a couple of places, for the money, the insurance waiver (not a medical procedure, but a "cosmetic" one), and label used as a name tag, to be applied above the left breast, upside down.

We had previously decided to go with the simple laser and the extended plan. The simple laser removed only a uniformly thin layer of tissue under the cornea. But any astigmatism, which is the result of an unevenly curved cornea, would remain, since the vision correction with the simple laser would leave these microscopic bumps and hollows intact. The eye would be able to focus better, refract the visual image more closely to the retina, but any abnormalities would remain. The other laser (the epi-lasik, I think) removes less tissue overall. It does this by mapping the topography of the cornea and the removing only tissue from the high spots and leaving the low spots untouched. It worked in a grid pattern of about 10-12x10-12 spots over the area of the iris. The spots overlapped slightly.

Back to the nice finance/intake lady. The prices were arranged McDonalds style, with the upgrades in laser ascending from left to right, and upgrades in length of service ascending from bottom to top, giving a grid of six choices. We had tenatively settled on the simpler laser and the middle service level, leaving one upgrade in each direction. We asked a couple of questions and decided on both upgrades. The original price was $1399/eye. The upgrade to the fancy laser was $1499/eye and the upgrade from the one year of free adjustments ($500/eye thereafter) to a lifetime of free adjustments was $1699/eye. We raised our limit by $300/eye, but I never felt pressured to do this. But then I might be induced to buy the all weather undercoating too, who knows. Our total was $3398.

The lady then brought out a little kit with the supplies for MrsV's eye care over the coming days and weeks. She has to take her antibiotic and another topical anesthetic 4x/day, five minutes apart. The artificial tears are minimum 1x/30 minutes today and every couple of hours thereafter. She also placed a nighttime tylenol on top to be taken as we left, as the numbing solution would only last about 30 minutes past the end of the procedure. There were nice looking high coverage dark sunglasses included, to be used liberally. Also included was a set of goggles, ski goggles style, but much lighter construction, and clear. These were to be used during sleep, no touchy! She even demonstrated, stewardess style, the method for putting them on, strap in back of head first, then carefully hold goggles out and bring down.

MrsV was instructed to rest her eyes, even sleep if possible for the next day. No computer, reading, television, sewing, driving, etc. No eye work. Questions? Ok. Moving on.

We were escorted to a small waiting room with three other patients and their drivers. She was given a surgery rooom style hair net and booties, and instructions not to do up her hair in any kind of ponytail, etc. The reason was to have a stable base on the back of her head, not some wobbly ponytail. She was offered juice, snacks, etc. Thanks. After we had waited about ten minutes, Dr. King walked in in his scrubs and introduced himself, asked how she was doing, and offered her a sedative. I don't remember the name. Little white pill under the tongue or with water. I thought it sounded like a good idea, but I decided to let her have it. The doctor left and said he'd return in a little while as the pill took effect. Ten minutes later, she was buzzing a little, whee! That passed soon and the nurse/assistant came in and escorted us next door to the surgical suite.

The suite was a large room, not brightly lit, like a slightly dim office. In the room was another woman sitting at a bench near a machine with a cushion long enough to lie on. I did not go in, it was not necessary to do so to watch since the entire wall was made of glass. Everything was visible. My attention was directed to a large television monitor, where I could see what the surgeon would see. Boy, would I see.

MrsV sat on the bench, then reclined and a cushion was placed under her knees. Her head was at the business end of the machine, of course, and the assistant began to prep her, while the nurse that escorted us from the waiting room began to work on the machine. MrsV was given a large stuffed dragon to hold on her tummy as a comfort and to keep her hands occupied. MrsV's eye makeup was taken off, not that she was wearing any, but her eyes and the surrounding area were thoroughly cleaned, and a clean white gauze pad was placed over her eyes. Then the surgeon walked in.

He sat at the third stool in the room, at her head, looking down at her upside down face, in postition to read her name tag applied earlier. Everyone except MrsV wore a surgical mask. She told me later that there was plenty of dialog in the room, but I heard none of it. The gauze was removed from her right eye first, and the assistant applied some clear tape to her eye, taping her eyelids w-i-d-e open. I think at this point, or before, the anesthetic was applied, because that tape looked damn uncomfortable. It started very low on the eyelid, where the eyeliner would be applied and gripped and opened and stuck down. Then a pair of metal retractors were inserted over the taped edges of the eyelids. She told me this was the most uncomfortable part of the procedure, especially the lower ones. I have to tell you, it looked painful. Her eye was as wide open as it could be without tearing something.

Starting with the eyelid tape, I watched the rest of the procedure on the monitor. After the retractors were put in :shivers: a small rectangular plate with a circular boss on it was mated to the retractors. The circular boss had a hole in it about the size of her iris. Think Borg. The next thing I saw was a machine with a flexible shaft and a complicated set of locking cams on the end placed over the protrusion on the plate. Then the device was locked in place, and slowly it arced back and forth once, then it was unlocked and taken away, and the frame removed from the retractors.

The next step was very smooth and quick, and I only understood for certain when I watched it repeated on the second eye: her cornea was lifted off her lens and flapped "upward". The machine I saw arc back and forth once was the thing that cut her cornea from her eye. The cut was not complete. Imagine standing looking at your eye. Look at your pupil. Imagine a clockface superimposed on it. The cut was in a plane parallel to the iris and extended from 12:30 aaalll the way around to 11:30, leaving a small, "1 hour" hinge at the top of the iris (cornea, actually, since the iris is behind the cornea). Back to the table. The cornea is "flapped" toward the doctor, revealing the lens of the eye. The outer surface of the cornea is super duper smooth like a shiny drop of water. The inner surface of the cornea exposed by the cut is more of a matte finish, but still kind of shiny from the wetness. At the beginning I could see the catchlight reflection on the outer surface of her cornea from a red (laser) and green (another laser) light, but now that catchlight was gone.

Things were moving quickly, and from the time the surgeon had sat down to this point was about two minutes. Now that the top of the cornea was out of the way and the middle was exposed, the laser ablation began. I could hear nothing but I imagined a popping sound corresponding to the flashes of blue-green light at a pace of about 4/second. These little flashes were small, like I said, about 1/10 to 1/12 the diameter of her iris. The pattern of flashes was not regular, but all over the grid, like a disco dance floor, or whack-a-mole. Pop pop pop pop pop for about 10-15 seconds, then a break for maybe several seconds then again. Pop pop pop pop pop pop. Again I couldn't hear anything, but it felt that way.

Cont'd--

[BigV]

The next thing I saw was some forceps gripping her cornea and "flopping" it back into place. The forceps disappeared and into view came a white foam wedge on a stick. Some wetting solution (probably saline) was applied to her eye and the surgeon used the little foam wedge to smooth out the cornea, so it sat neatly and symetrically in the area from which it was recently removed. When I asked the doctor about this part later, he mentioned he was making sure it fit into the "gutter". Imagine a dome, now slice off the top and set aside. On the round area on the top of the remaining base, remove some material, but not from the edge. When the top of the dome is replaced, it will want to settle into the very shallow "cup" made by the removal of the material. Settling the top of the cornea onto the base of the cornea and tucking in and smoothing any bumps or wrinkles or irregularities was a critical part of the process, since this is the very window through which the light must pass and bend on it's way to the retina. A hand made mistake here negates all the technical benefits of the procedure. This is one area where the human skill of the doctor's steady hand and good vision (he's a customer of his own service, going on five years) pays off.

Once he was satisfied with the result, a clear solution was poured into her eye and also a creamy white solution. Then a large light blue jelly-like thing was placed over the whole iris. I learned later this is a contact lens. It's purpose is like a bandage, to physically stabilize the wound. When we return tomorrow for the five minute followup, the doctor will remove it.

The next step was the removal of the retractors :aaahhh: and the removal of the clear surgical tape :relief:. The process was repeated with the other eye. The only difference was I could not see the flashes as well, and during the clean up there was a little blood. I later learned it was from a small cut on the eyelid from those damned retractors. The amount of blood was miniscule, not enough to form a whole drip. But when my wife's eye is filling a 24" television monitor, I did get a little Clockwork Orange vibe. She's really okay, though.

In ten minutes it was all over. She sat up, shook the doctors hand and walked out in to the "recovery room". We sat together and talked for about ten minutes. She said she could see better already. Her eyes looked really rough, like crying or tired or drunk or smoked out all together. But with all that hardware (and medicine) in there, there was good reason. She said it was a little foggy, but not unfocused. Success! The doctor came in after a few minutes, asked how she felt, do we have questions, etc. He asked her her to sit at a vision microscope an he checked his work. He pronounced her fit to leave, and we did.

We had lunch on the way home, and the Tylenol was making her sleepy, so we went home. I could tell the medicine in her eyes was beginning to wear off, she said they were stinging (NO rubbing!!). I helped tuck her in on the couch and helped her with her first round of eye drops, gave her the phone and the remote for the tv (to LISTEN ONLY to her soap opera) and went back to work. I did get a call an hour or so later, and we decided that another pain pill was a good idea. Rest is important, and pain inhibits rest.

We have a regimen of eye drops every hour it seems for the next thirty days, and the healing will continue for three months. She can expect gradual improvement during that time, over and above the dramatic improvement she's seen already. On the way home, while the drugs were still soothing her eyes, she said "I can't believe I'm not wearing glasses." Her vision, in the first minutes after surgery, was comparable to her corrected vision. I think a case for "miracle" could be made.

As things progress, I'll keep you updated if there's anything dramatic to report. But after today's success the only thing dramatic worth reporting would be negative. Possible, of course, but if everything goes as planned, the only thing to happen will be the donation of a couple of pairs of glasses to the local Goodwill.

[seakdivers]

Oh.

hmmm

[eyes winced in a sympathetic fashion]
no. still not decided yet.... let us know how she feels in a couple of days. [un-wince....kinda]

[BigV]

As promised, poor phone camera pictures.

Pic one -- The suite.

Pic two -- On the bench cuddling with dragon.

[BigV]

pic one -- retractors holding lids w-i-d-e open.


pic two -- cornea cutter baseplate in place.

[BigV]

pic one and two -- cutter in place and moving across