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February 25, 2006

On the Recovery Road - Day 15

Continuing my Laser Eye Surgery series. Today is exactly 15 days after my ASL/PRK surgery.

My eyes are slowly getting better. I have my own test, from the window where I work here, about 1 block away there's an Aristocrat sign on one of the building. Just after the surgery I couldn't even recognise it, but now I am starting to make up the letters and when my eyes are lubricated properly I can actually read it, struggling perhaps but I can. So that's a good progress.

On a short distance test, like my doctor said my right eyes will be spot on. If I cover my left eyes, my right eyes is working perfectly. Almost like what it was with glasses. On the left, still not so good. With the left only things I'm seeing a bit double, just like an astigmatism. I remember the opthamologist said that the doubling because the eyes are very dry not shaped properly. This is also what causing the starburst she said.

On my laptop, I've decreased my fonts setting from 120dpi back to 96dpi, but still at 1024x728 res. So it's still a way long way to be back at 1400x1050. But at least I can read comfortably (when my eyes are properly lubricated) at this size and I can finally see more than 6 lines of code on the screen again :)

So getting there, but not quite there yet, especially on the left eye.

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February 23, 2006

About overcorrection

I found a disturbing article about overcorrection here. Certainly an issue that I need to bring next week when I come back to see my doctor.

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February 22, 2006

One Week After

Well it has been over 1 week since I had my eyes lasered. I left my last post about the still grittiness of the left eyes on the Wednesday morning. This turned out to be a bigger problem that expected.

Last Wednesday I woke up with still some gerittiness on my left eyes, I called the centre straight away as requested. The receptionist of course couldn't answer and she said one of the opthamologist will have to call me back. I've waited for a while for their call back waiting to see if I have to go to work or go back to surgery. 8:15AM passed and that's the time limit I prepared to wait before I had to go to work. I had this feeling that they'll call me back in the middle of my way to work.

Sure enough, on the way to work I received the call back from them saying I have to come back NOW, they need to check my eyes straight away! That sucks, I was at the other side of the harbour already and now I had to go a big loop to go back north.

So I arrived at the surgery, this time the same opthamologist who saw me the day before took my case again. She took some measurement, didn't say much and decided to call the doctor straight away. The way they work in this surgery is that you won't see the (main) opthamologist straight away. First you see the assistant opthamologist and then they will escalate you to him (the main dude). For simplicity sake I'll call all the assistants the opthamologist and the main dude "the doctor" :)

Anyway this gotta be more serious, because the day before I didn't even get to see the doctor. He took some more measurement and didn't say much. He said I'm extremely dry (on the eyes). He changed a couple stuff. First he took me off Ciloxan, asked me to use Refresh Liquigel instead of Bion Tears. And just before going to bed instead of using Poly Visc I'm supposed to use a much stronger Chlorsig (a prescription only). So there you go you know my routine. That on top of the need to use to use Flucon four times a day. There you go, so that's my regime for the past week. All of them are in the convenient "blue bag" which now I have to carry everywhere. ChlorSig/Poly Visc is initially really hard to use. It's a gel, so you really have to open your bottom eye lid, squeeze enough gel and close your eyes. It's a bit hard to do it in the beginning, but I'm good at it now. Come to think of it, I've come a long way from keep missing those damn eyes when administering my own eye drops to a real pro heh :)

The dry eye thing is quite annoying, but not because it's irritating my eyes, but I can't see properly when my eyes are dry. It's strange but true. I never realised how important the tears are for your eyes. He gave me some drops and straight away I can see better. He asked me to come back to see him again in 1 week time (this Wed 22/02 to check on my eyes).

Fast forward 1 week ...

Today is exactly 1 week later, so what's happening? Well, my vision is still not 100% I mean not 20/20 yet. I know that 20/20 is a myth with refractive eye surgery but I can always hope :). My eyes are no longer light sensitive, I can drive without sunnies during the day but I still don't dare to drive at night. At night I'm seeing both the halos (it's OK) and starburst (bad!!). And I still can't work on my laptop with its original resolution. I have to put the resolution down and use large font size to be able to work comfortably. And, I found this really strange, I'm having problem focusing at near objects! This turned out to be perfectly normal, more about this later.

The halos are expected because of my pupil size. During the assessments, two centres that I went to both warned about the possibilities of the halos because of my pupil size. Whether this will go away, no one can give me a straight answer. Fair enough, but both centres are happy to operate me because all measurements are still under the accepted numbers. My optometrist friend who did his eyes said that he still see halos even after so many years, but it doesn't bother him at all. It should be OK they all said.

Well the halos turned out not too bad for me, it's nothing really, definitely not like Sandy Keller's halos so it doesn't bother me. But what really bad is the starbursting. In Sandy's simulation I'm slightly better than #6, but at a long distance cars really like #2. The problems with starburst is that I can't judge correctly both the size and speed of the incoming cars. This is damnably dangerous. It could be a 16-wheelers coming at me or a Daewoo Matiz, I wouldn't have a clue until it gets closer.

I discovered the starburst when I drove to Coles at night. I did OK because the road is empty, I know the route very well and it's less than 2Km away. But I won't be driving at night any further than my own suburb for a while.

So at 7:30AM this morning I was back at the surgery for my 1 week check-up. Again to see the main doctor, but first the opthamologist to see me first and take all the measurements. Right eyes are quite good, apart from the dryness, I'm seeing quite well on the chart. But the left one is still having problem. I'm seeing doubles and without the lubricant only up to the second line on the chart. That's bad.

Anyway I also complained about the near object thing and she did a quick focusing test. This is where you have to focus to a point, as she move the point toward your eye you have to say stop when it becomes double. Mine stop at about 30cm from the tip of my nose :) Wow! She said. Well try again, this time try to focus really hard. I did better the second time around, which much encouraging and after re-focusing several times, it stops about 2cm.

Then the explanation came, for short-sighted people, especially those who have been using their glasses for a long time, the muscles used to focus near objects become lazy. Because we never use them! It's too easy for us (short-sighted people) to focus at near objects, in fact we never have to do anything to see near objects. We're short-sighted ha! So don't worry she said, and she gave me some eye exercise that I have to do several times a day. The should be able to focus at an object at the tip of my nose without any strain on my muscle. That's the goal. At the moment I can, but I do really feel those muscle struggling.

So that's all done, I asked her what's my eyes measurement at the moment. She wouldn't say anything and let the doctor decide that :) She left me at that and said that the doctor will come and see me soon. Since this is very early in the morning, he came in really quick. After a quick chit-chat he said well my right eye is spot-on, perfect he said. Good! But .... not so on the left eye. There's a slight over correction. Damn .... I know that this is one of the risk, 1% he claimed at his centre but it really sucks to be that 1%. Part of the contract is that if there is under/over correction they will do another laser for free. Most centres will do it for free or for a very small fee ($100 for the other centre that I went to). However, he didn't say whether I'm going to need another laser eye surgery, or even if I can do another laser eye surgery. I remembered that he did say that he must get my right eye spot-on because my cornea was too flat to get another correction, but said nothing with the left-eye. So do I need another one? Well only time can tell for now.

What's causing the over correction? He doesn't really know, but thinks it is the slower than expected healing period of my left eyes. I asked him this time what's my eye measurement are? He said my right eye is seeing slightly better than 20/20, and it should be OK after a while. With the left, well there's a slight over correction but it's very small, almost negligible he said. We just have to wait and see for now.

He took a while thinking whether he was going to give me a stronger steroid drop than the Flucon, but finally he decided to upgrade me to Maxidex for now before seeing him again in a week time. In saying that he said he doesn't usually see patients this often :) Ha I have seen him 4 times in just over 1 week. 1) The surgery, 2) when the contact lens popped off, 3) when my left eyes are still having problem 4) today. And another for next week, must be a record for him. The only one day that I didn't see him was when they took my soft lens bandage off.

So there it is, I'm slightly disappointed with the over-correction on my left eyes and the fact that I'm still not 100% and not being able to drive safely at night. Although I do know that with this procedure a longer recovery time is required. I have high hope still, and I don't think I will start writing my story for Lasik Memorial just yet.

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February 21, 2006

Lasered!

A few months ago I made the decision to go under the blade, or actually the "laser". Yes, on Friday 10th Feb 2006 I had a refractive eye surgery to correct both my myopia and astigmatism. I have been thinking about it for a while, but for some reason dropped under my radar when I heard about all the possible complications (the site itself doesn't have much but at the bottoms there are good links to other better sites about refractive eyes support groups) from the surgery.

I was actually in the middle of writing one long post about why I'm doing it, but I'm no where near completing it. For some bizarre reasons I got emotionally affected just by writing why I want to get rid of my glasses.

So instead, I'm going to blog the experience itself. For various reasons I will not disclose the place where I did it. If you want to know, email me privately.

There are many types of refractive eye surgery types that you could do. The most common and preferred method these days is LASIK. I have a few friends who have done it and they all had good results. The best thing about LASIK is that most people will pretty much reach their best visual acuity within a few days or within the first week.

However, I didn't do LASIK. The reasons will be too long too explain and out of context of this post. The procedure that I did is ASL (Advanced Surface Laser) as my doctor called it, but really it's PRK. So it does take a while to recover, even up to three months to recover.

Anyway, to keep things going. I arrived at the surgery at about 9:45AM. They like to make people arrive at least 90 minutes before the scheduled surgery to do the forms, payment, consent forms etc etc. They didn't need to do anything at the day of the surgery because they already have all my data on the assessment day. This is where you had your 2-3 hours long assessment to determine if you are a candidate for a refractive eye surgery.

Both of my brothers were in tow as they will be my "carer" for the weekend. With PRK you will feel the pain for the next 48 hours at least, so they'd like to keep you in Valium and some extra strong pain killers to speed up your recovery. This is also the reason why you need a "carer" in the first few days after the surgery because there are drops that needs to be administered every few hours. You can't do that yourself while you're in Valium can you!

While I was doing the consent form and payment, they gave me a Xanax tablet relax me. I almost scoffed at them saying, "Nah don't worry about it I can take it no worries". But I thought for the better and decided just take the tablet. So they put me in the surgery gear, white coat, head cover etc and sent my brothers to get the prescription filled.

When they arrived I looked back at the "blue bag" (they put all the the prescription in a nice zippable blue bag) and a bit shocked. They gave a bunch of Valium, 20 Panadeine Forte, 2 Xanax and a bunch of other eye drops for maintenance. I thought bloody hell, I would probably just take a few of them and keep the rest for "emergencies". Certainly I wouldn't need 20 Panadeine Forte. Oh I couldn't be more wrong.

Both of my brothers went into a tutorial room with a bunch of other "carers" for instructions. We, the patients, had to wait outside. Seems like they don't like us to know what our "carer" were told ha :)

So time past, I almost fell asleep waiting for my turn (it's the Xanax) when they called me. Finally, I thought. They lead me to the surgery room and both my brothers were asked if they wanted to see the procedure? They can because in the surgery room there's a massive glass window for the audience. So off they went. On the surgery room they told me that there's a change of plan, they won't see me on Monday because of the size of the ablation, it will have to be Tuesday to give my eyes enough time to recover. Apparently the ablation surface for my eyes would be be bigger than most people. Normally they would do the operation on Friday and patients will need come back on Monday to for the post-op check up.

Up to this time I was still feeling upbeat and very exited about it. The good doctor smiled and asked me how I was doing. Fine I said. So I lied in the operating table and this is where reality started to descend on me. I was about to do it! Someone is going to laser my eye and reshape my cornea. I was starting to be really nervous. You know what, I was thinking of not taking the Xanax, but I now I wished I had taken 2!

I told them that, the doctor and his assistants, they just laugh and said relax, it won't take long. It was pretty quick, like they promised.

First they put something in my eye to keep my eye lid open during the surgery and patch the other eye. Then it began! I wanted to know what they were doing with my eyes, but I couldn't believe how nervous I was during the the operation that I could barely speak :)

I had to guess what happened next, but they put some drops first, which gotta be the local anaesthetic. Then some some actions that removed my ephitelium. So that's all done here come the laser. They actually said that. "Now we are going to laser your eye, it'll be 40 seconds". They put the laser over my eye. "Keep looking at the light and try not to move your eye!". Yeah, yeah they told me that their laser is one of the fastest in the world to track your eye movement but I still don't dare to challenge that statement. So with full and utter concentration that I didn't think I could muster again I looked straight at the blinking red dots in front of my eyes and tried hard to move. "Wait a second, there are 3 lights, which one do I look at?", I said at a lame attempt of making a joke. Surprisingly that made them laugh, them middle one they said :)

"We're starting now!", a voice in the background said. Nothing happened and I couldn't feel anything. "40 seconds!" ... "30 seconds!", the voice at the background kept me informed how much longer it will be. As the seconds tick, the light was becoming blurrier and I smelt something burning, I was about to ask why but I remembered that I should kept my head and eyes straight ahead, so I kept quiet and concentrate at the blinking light. "20 seconds!", "10 seconds!", "Done!" .... phew.

That was the longest 40 seconds in my life.

Then the shock came, as soon as the laser went they did a few things in the eye. "Alright we're going to poured cold water now.", that's actually more shocking than the laser! The water that they poured was freakishly cold and I almost jumped from the operating bed. Once that all done, the soft contact lens bandage was put in (this was to be taken out on Tuesday when I come back for post-op check up).

Now the left eye. Damn ... I almost forgotten about it. If you thought I wouldn't be as nervous by now since I had one done and know what's coming, you're totally wrong. I was still nervous as hell and now really wishing that I had taken 3 Xanax :)

What happened next is pretty much a carbon copy of what happened with my right eye. However, instead of 40 seconds it took 44 seconds for my left eye. I can only guess this was because of higher degree of correction that they had to do on my left eye.

The entire operation was very quick, less than 15 minutes all up. I was still in disbelieve when it was done. My doctor lead me out from the operating room, on the hall way he said, "So can you see that sign over there?".

And I could! I don't know how to describe my feeling at that time. Although still very blurry and with the soft contact lens protecting my eyes, my sight have already improved so much that I could now probably walk around without my glasses.

They led me into a darkened room and both of my brothers with instructions what we had to do in the next few days. That's all done, up the sun glasses that they told me to bring because I would be light sensitive after the operation, they just removed a chunk of my cornea, without the sunnies I wouldn't have been able to open my eyes. They gave me 3 Valium straight away after the operation (or was it before? I couldn't remember anymore) and that took the full effect on the way home. As soon as I got home the only thing that I could think of was going to bed. As I wobbled to my room and changed my clothes, my left soft lens bandaged fell off! Fark! As the instruction said, if the soft lens bandage fell off don't attempt to put it on yourself and go back to the centre immediately. Even call the doctor's mobile if it's Sunday.

So my brother quickly drove me back to the surgery. Obviously they didn't think it was that dangerous because I had to wait another 15 minutes before the doctor came and see me. He checked my eyes and put the soft lens back on. I asked does this happened often? No not really he said :) Some people's soft lens bandage fell off on Sunday he said, but not straight away after people got home. Well it's good to be unique they said.

So now back again to home, and by this time, those 3 Valium and a Xanax reaaaally was working. I wobbled back to my bed ... and slept for the next 3 days.

Funny that I couldn't remember much what happened in the next three days - Friday, Saturday and Sunday, even some of Monday. It went so quick because of all those Valium and Panadeine Forte. Initially I predicted I would only take like 4/6 Forte but tell you what, by the end of Monday I had finished all 20 tablets of Panadeine Forte.

Holly crap! I couldn't believe it myself. Like I said, I couldn't remembered much, but every time I woke up on those Friday/Sat/Sun my eyes were so gritty and irritating that the only thing that I could think of is take those Valium and the Panadeine Forte and go to sleep again. My brothers gave me the drops when I needed it. I think they have done some when I was asleep.

By Monday afternoon I was pretty much sober, my eyes weren't as gritty as the past few days and I was feeling OK. My vision was blurry as hell but I could watch TV and did other stuff. This was the same with 4 other people whom I know who have done it at the same place. They all said the weekend went so fast that they didn't realised it was over. That's why they said don't worry about the weekend, you won't notice it. And I didn't.

So Tuesday came and my brother drove me back to the surgery. This time the assistant came to see me. She took the soft lens bandage off and check my eyes. Everything was OK she said. But unfortunately the wound on the left eyes still hasn't healed fully but it should closed by the end of the day. She gave me instructions extra instructions how to for my left eye and sent me home. She said if it still feel gritty in the next day I should call in.

So that was pretty much it. Of course the next day came and my eyes were still gritty. But that's for another post :) This is already one hell long of a post which I should have done last week.

Update: Correcting the date, it's not 17th Feb it's 10th Feb.

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