Friday, 4 October 2013

son of stickler - follow-up appointments

I had my follow-up appointment on Friday 20 September, two weeks after the surgery, at 10.40. I was seen pretty quickly for the initial measurement and assessment, but then saw people come and go for the rest of the morning. The chap who saw me saw I was still there and went to see why. I'm not sure whether I was being saved up or had been overlooked, but someone had my file. I saw a doctor soon after that - I'm going to guess she was Spanish, though I didn't catch her name, though she was very communicative and helpful. She had a look, wanted to have a better look and get the senior doctor (it was Ms Obi's clinic, so may have been her) to have a look too, so put some drops in and asked me to wait to be seen again in about fifteen minutes; it was about 1.15, so I asked if I could go and eat something, which I did.

So, they said that the op had gone well, but that there were two things which concerned them. One was that the pressure in my eye was still too high, as it had been at the time of the operation. (In fact, the ?spanish doctor wondered to herself why I'd been given my follow-up appointment as part of their clinic, which I gathered was more of a glaucoma-related clinic, but I guess worked out it was because of this high pressure; glaucoma, it turns out, is caused by high pressure in the eye.) I was prescribed Azarga, two drops a day. I'd still be on the Maxitrol, the post-op eye drops, going down from four to two drops as scheduled the following day for another two weeks. Azarga is one of those drops with a big list of side effects and who shouldn't take it, and where they ask you if you have any problems with your heart (nothing beyond hypochondria, I thought), and where you have to press the corner of your eye for two minutes after putting it in so that it doesn't get into the rest of your body too much.

The other was that the lens was not sitting in the central position in my eye that it should be, but was slightly to the side. This was not because it had been put in wrongly, but because the sac in my eye in which the lens sits was off-centre. They didn't want to go back in (the sac is held in place by, I'm calling them threads, and I guess trying to adjust them would be major if in fact possible at all), but wanted to see me again, I presumed so they could see how I was coping with this off-centre lens; if I was coping fine, I guessed, that would be fine, and if not they would have a think.

They made me a pair of appointments for Tue 1 October at the same clinic, first for a thorough eye test with the optometrist before being seen by the doctor. (On paper I had 1.30pm appointment with Mr Lim the doctor and 3pm with the optometrist Ms Patel, but they told me to to turn up for the 3pm appointment, as the doctor couldn't see me usefully until I'd had the eye test.) I wasn't cleared for getting a new eye test with a view to getting new glasses.

I remembered on the way home that in the post-retina-op process there had been talk of something being off centre so that my vision wasn't hitting the best place on the back of my eye; I guessed this was the same thing and was sorry I hadn't remembered during the appointment. I wasn't sure whether it would have made any difference in any case - I don't think they thought the off-centredness was a result of the cataract op, and I'm not sure if it was a result of the retina op or if it was something I'd always had or had been developing because of the Stickler's. (I had remembered to mention the retina op and the Stickler's in this appointment.)

I wasn't worried about the high pressure or the off-centre lens, they being under care, but was disappointed about the 'not yet' on getting new glasses. I still had the micropore tape on the right lens.

On Tuesday 1st Oct - this Tuesday - I went in for my 3pm eye test first. The optometrist's name on my prescription was J Mehta, so I presume it was her (of course she told me when I went in, but I never remember). She gave me a full eye test on both eyes (whether or not it was relevant, I told her re the retina, the stickler's and the cataract). At the end she wrote me a new prescription, and said that, as long as the doctor said it was okay, I could get new glasses on the basis of that prescription, which took me by surprise. She went to talk to the doctor while I waited in the corridor, and in no time at all I was in to see the doctor.

I had still had the micropore tape on the right lens, and explained why when she asked, that it had been too disconcerting after the op when the glasses lens was too strong for my needs, which she was fine with. But she took the tape off to measure the strength of the glasses, and I found when I put them back on that they weren't as disconcerting as they had been. And as I sat in the corridor I was pretty sure that I could cope and get about now without putting the tape back on. I have; I guess my eye just needed that bit more time of recovery (and also, of course, there's the good old adaptable brain adjusting). The day after I was still covering the right eye up for reading and computer screen, but I don't need to do that now so much. The wateriness, grittiness and light sensitivity have all pretty much gone too.

The doctor - the ?spanish woman again, with as per last time a once-over from the senior doctor, Mr Lim in this case - tested the pressure again and was very happy with it. She said I should stop the Maxitrol on schedule and just carry on with the Argaxa, and that would be us; as we talked, however, she realised I hadn't been on the Argaxa before but only since the op (ie I guess that I wasn't a glaucoma patient); so she said I should stop the Argaxa when I stopped the Maxitrol (that is, yesterday as I write), and they made another appointment a month hence at which they would test my eye pressure again. If it was fine, then that was fine, it was obviously high related to the op, and was now back to normal; if it was high again, then it might be a permanent after-effect relating to silicone and I would need to go back onto the Argaxa (I guess forever).

As far as the off-centre lens went, she didn't mention that specifically at all. But she said that the eye test done today had shown that I could get a prescription that would take me back up to 6 (in both eyes, I presume) - I presume that means normal vision - and so it was apparent that their concern in the previous appointment was that they would not be able to do that. Again she said, apparently to confirm with me, that the target for the outcome had been such that I would still be short-sighted and need glasses; I said yes. The senior doctor had a quick look and was happy. I was sent off having been told that I could now get new glasses.

Yesterday morning I went into the Institute of Optometry and spent over an hour choosing frames and lenses. I came out £585 lighter, and should get my glasses in a fortnight. The lenses are expensive, only partly because I'm getting light-reaction built in, which will help since I am more light-sensitive in the right eye since the retina op. I looked at quite a lot of frames without regard to price, and came down to two which were both equally expensive; still, they're going to be on my face all the time, I will hopefully have them for a number of years, and it would potentially be a false economy to put very expensive lenses into cheap frames.

As for my eye, we'll see how it feels - how they both feel - when I have my new prescription glasses.

As far as the eye lens goes, Douglas said that a colleague of his has had both his done, and it is disconcerting because both his pupils now appear to sparkle. I haven't noticed such an effect. What I did notice immediately after unveiling the eye the day after the op was how different the colours were from each eye. Everyone says it's much brighter, which is true, but more than that, everything was whites and blues compared to browns and yellows; it was very striking when you alternated between eyes. I don't know if this is all to do with the lens or also to do with the fact that the right eye since the retina op has been full of aqueous rather than vitreous fluid. Either way, I anticipated that the brain would adjust to balance this out; the effect does certainly seem less marked now; I wonder how it will be with the new prescription. There will be more adjustments for the eyes and brain to make then anyway, of course, both for the correct prescription but also for the physical differences in the glasses lenses. The woman in the optician's was taking quite detailed adjustments and measurements, especially in relation to which point on each glasses lens I would most naturally be looking out of, given the position of my pupils, and she indicated that this in particular was quite different from the way my current glasses were configured and would take a bit of getting used to.

So, a couple of weeks till the new glasses, another couple more to the next appointment.