The story of my left eye – so far: Part II
[Part I, which dealt with my iridotomies about fifteen or so years ago, can be found here.]
When I left off my story in Part I, about fifteen or so years ago, I’d recently had two iridotomies. The one in the left eye was unusually large and let in extra light, although I got fairly used to it over time. But every now and then I’ve sometimes had eye technicians or eye doctors exclaim on seeing it, “Wow, that’s an incredibly large iridotomy!”
Then about seven years ago I was told I had the faint beginnings of cataracts in both eyes. It wasn’t a problem yet, except that when I looked at the moon at night the image was somewhat doubled. Same with glowing numbers in the dark, such as on my clock-radio. Nothing much to get excited or disturbed about, though.
Then a little later, one day when I’d been to the eye doctor for my annual checkup and come home, I looked in the mirror with my eyes dilated and saw an odd thing about the pupil in my left eye: about a quarter of the pupil’s circumference hadn’t dilated along with the rest. My left pupil looked like someone had taken a noticeable bite out of the circle.
How odd, I thought. That had never happened before. But the eye doctor, who must have seen it, hadn’t mentioned it to me as a cause for concern, so I pretty much forgot about it.
Then one day about four years ago I was in a store dressing room trying on some clothes and suddenly I saw something that looked like a lightning bolt in the outer periphery of my right eye. It kept happening, particularly when I turned my head to the right, and I quickly realized I might be having an eye emergency called a retinal detachment.
My regular eye doctor had retired two years earlier and I hadn’t been to an eye doctor for those two years, but I called the office and they set me up with someone else who had impeccable academic credentials. She saw me pronto, that day, and assured me that it wasn’t a retinal detachment I was experiencing but merely something called a posterior vitreous detachment, quite common in older people and usually innocuous except for an increase in floaters and those lightening flashes for a while.
While there I was asked to read the eye chart before my eyes were dilated. With my right eye I could see as well as ever, which was pretty darn well. But when I closed my right eye and looked with only my left eye, I discovered that I could barely read the top letter on the eye chart. Everything below that first line looked like Chinese characters, and very blurry ones at that.
I was so shocked that I almost fell over. My mouth went dry and my hands went cold. What on earth had happened to me? And I was almost as shocked and upset that I hadn’t even noticed it until that moment; apparently the vision in my right eye had grown almost totally dominant over the left. I managed to tell the eye doctor that in the last two years my left eye had apparently gone from almost 20/20 vision to being almost unable to read the eye chart, and I hadn’t even realized it. Why had that happened? How had that happened? When had that happened?
The doctor didn’t seem to know and what’s more she didn’t seem to care. I asked whether it could have been from my cataract, but she was adamant that my cataract wasn’t bad enough to account for it. Then I asked her another question: what about that area of my pupil that didn’t dilate along with the rest of the pupil? What was that all about? No one had ever explained it.
“Oh, you just have some scar tissue there,” she answered. This was profoundly disturbing to me as well. Scar tissue? How on earth did I get scar tissue? “You must have had some inflammation at some point in the past,” she answered. When I asked how I could have had inflammation serious enough to cause scar tissue and not even realize it, she shrugged again. Our session was over.
I made a mental note to find an eye doctor who was more interested in these things than she seemed to be. The posterior vitreous detachment in my right eye seemed to resolve uneventfully, though, and then about a year later I found myself in another eye doctor’s office for my checkup. This time I was told that the cataract in my left eye was indeed bad enough to have caused my precipitous vision loss. But about the scar tissue no one had a clue. Must have been some inflammation, but for no seeming reason and outside of my awareness, which made no sense to me. But no one seemed to think that the scar tissue represented any particular problem.
By this time I knew I had to have cataract surgery, probably in both eyes. The vision in my right eye had become worse by this time as well, although nowhere near as bad as in my left. I thought maybe I’d have the surgery in the spring, but then COVID hit and elective surgery was out of the question. Meanwhile, both eyes got worse and couldn’t be corrected much if at all with eyeglasses. I started having more trouble driving, reading street or traffic signs, finding things in the supermarket, and even some difficulty on the computer although my near vision continued to be rather good in my left eye, which was so much worse at distance vision than my right. The only plus – if you can call it that – was that the halos around street lights were very beautiful, like enormous crystalline snowflake patterns made of hundreds of tiny diamond shapes, with each of the tiny diamond shapes having borders in the form of tiny rainbows.
Because of COVID I waited until the summer of 2021 and then went to the best cataract surgeon in my local area. He did a workup and said that sure, he’d do my cataract surgery. But my case would be more difficult than the typical one because of the scar tissue.
No eye doctor had ever mentioned this as a potential problem before; they’d all acted as though the scar tissue was a small and unimportant feature of my left eye. But this doctor was saying that the adhesions I had that were stopping the pupil in my left eye from fully dilating – adhesions which are called posterior synechiae – meant that my lens in that eye was somewhat stuck to my iris. And it’s the lens the surgeon must remove when cataract surgery is performed.
I asked him whether this scar tissue was from my iridotomy (I had looked online and read that scar tissue was more common in people who had previously had iridotomies). He said no, certainly not.
“Your cataract removal will take a little longer than usual,” he told me. “And your recovery will take longer, too.” Again, I felt an increase in fear.
I asked him whether he had seen this sort of thing in patients before. “Oh, sure,” he said. I asked him how often. “One or two times a year,” he answered.
One or two a year didn’t sound like very often to me. This condition was obviously not very common, and at that moment I resolved to go to Mass Eye and Ear in Boston, one of the most famous and highly respected eye hospitals in the country, for a second opinion and surgery there.
Unfortunately – partly because of backup from all the postponed surgery because of COVID – I had to wait six months for that appointment, which was this past January. The appointment was with a doctor there who specialized in complex cataract surgery rather than run-of-the-mill situations. I had great confidence that he would tell me that he was experienced at this sort of thing and that despite the difficulties of my case he had full confidence that my surgery would be successful.
When the day of my appointment at Mass Eye and Ear came, my workup with technician after technician was long. But I felt that at last I’d come to the right place. Then in came the doctor – actually, two of them. They examined me briefly and then spent some time softly discussing my case right in front of me, although not yet addressing me. Something in their tones made me feel uneasy, although I couldn’t understand exactly what they were saying.
Then my doctor turned to me and said, “Your case is a very difficult one and your surgery will be very hard to do. There’s a very good chance it won’t succeed.”
This was not what I had expected to hear and certainly not what I wanted to hear. I felt suddenly sick to my stomach as well as shaky.
[To be continued in Part III…]
It certainly seems like a valid suspicion. I’d be worried that his insistence that it certainly wasn’t caused by the iridotomy may be just him protecting a fellow practitioner from liability or something. But then again, I’m fairly paranoid when it comes to my health.
Quite the harrowing story so far. And a good cliffhanger at the end there. I’m looking forward to reading the final part, which I assume and hope has a generally happy ending.
Scary business. My mom has had retinal surgery, and I’m very myopic, and I have only a glimmer of what is after you. You have my sympathy. Remember that the reason things which go bump in the night are scary is because we don’t know what they are. Dr. James Wilson, of House fame, had to give Dr. House $25 every time he told a patient they had cancer and the patient replied with a “Thank you”. Nobody appreciates getting cancer, but knowing one has cancer is tons better than knowing something is wrong and the doctors haven’t a clue. So, I would offer you one of my swear words, but I haven’t many, and “bother and drat” seem inadequate. I have too few swear words. But I do have prayers, and would offer you one of those.
The Prayer of St. Francis de Sales
Be at Peace
Do not look forward in fear to the changes of life;
rather look to them with full hope as they arise.
God, whose very own you are,
will deliver you from out of them.
He has kept you hitherto,
and He will lead you safely through all things;
and when you cannot stand it,
God will bury you in his arms.
Do not fear what may happen tomorrow;
the same everlasting Father who cares for you today
will take care of you then and everyday.
He will either shield you from suffering,
or will give you unfailing strength to bear it.
Be at peace,
and put aside all anxious thoughts and imagination.
St. Francis de Sales 1567-1622
Aaack! A succession of eye doctors who didn’t recognize your condition and didn’t take it very seriously is alarming. Fortunately, you kept looking for good advice.
My husband, a few years ago, discovered he had a very threatening tumor called a paraganglioma in his abdomen. We found a surgeon who arrogantly told us he was the only guy in the Southeast who could safely remove it. He can be as arrogant as he wants, because he did remove it and my husband is alive. This is no thanks to the doctor who suggested he “wait and watch.” If he’d done that, he’d be dead.
Nonapod:
That was my reaction to his complete denial, too.
My regular eye doctor had retired two years earlier and I hadn’t been to an eye doctor for those two years
None of my business of course, but I would think someone with your history should probably have an annual ophthalmology check-up.
Thanks for sharing your story. It reminded me that I should make an appointment soon too, not that I’ve ever had any issues other than those that go with normal aging. Also a lesson on the importance of finding the very best doctor you can for anything non-routine.
I’ll share one story related to my wife. We were on vacation in Nice, France, and she got those floaters and lightning bolts. Having had it before she knew she had to find a doctor ASAP. But on a summer weekend in France? She dug around on the internet and found a local retinal specialist and emailed him. Amazingly, he answered within a couple of hours, saying that he was away, but he’d already spoken to his resident who was waiting for her at a nearby hospital. She went and it was fine. A few days later that doctor whom she’d emailed, emailed her again to find out how she was. Amazing.
I had the posterior vitreous detachment happen to me in one eye in late March 2020. I didn’t know what it was and thought that there was some internal bleeding since I had that experience before from an eye impact injury. The quickest appointment was about 3 weeks away.
Then as covid ramped up I was concerned that the eye clinic would shut down completely. But they just masked up. The vision in that eye was moderately messed up but is considerably better now. The doc said I can look forward to it happening in my other eye, statistically speaking. Thanks doc.
Modern medicine generally invokes feelings of fear and loathing in me, but it beats leaches. Be cautious and consider ourselves lucky.
Jimmy,
A friend of mine was in France several years ago with his wife when she had a stroke. Boy, did he go on and on about how terrific and inexpensive they were. If only we were more like France. I’m not sure but I think there are transfer payments between the US and France in a case like that since she was on Medicare. He was unaware of that. She recovered from the stroke reasonably well.
When we traveled overseas on Medicare, we took out temporary insurance which covered emergency treatment and repatriation if necessary.
TommyJay, it was also inexpensive out-of-pocket (maybe $75), but I have no idea who pays what to whom, and I didn’t want to seem like your friend saying it’s so much better everywhere but here. I think we just lucked into a very special doctor, which can happen anywhere.
neo:
That Covid thing played hob with my eyes as well in 2021 and didn’t get sorted out for about 8 months; I blame Vlad! 🙂
No, actually Brandon and our King Jay are the vilians.
🙂
Neo, this whole thing sounds terrifying and so frustrating as well. I’m sorry about your lemon eye doctors — the ones who brushed you off and the one who wasn’t interested. I’m glad you found a good one in the end and look forward eagerly to part III, especially after that cliff-hanger ending.
All my life, I’ve had crummy, complicated vision with a number of different issues (farsightedness, amblyopia, astigmatism and more, plus I now have cataracts, plus like you, I have narrow angles and have had iridotomy procedures as well as an actual attack of acute angle glaucoma that fortunately did me no harm — see a comment I left in your part 1 of this story for more details, if you wish. Luckily, glasses work to correct most of it.) As a result, I’ve spent a lot of time with ophthalmologists and optometrists. I’ve been been under the impression that many of them seem exceptionally interested in and enthusiastic about eye problems and are eager to talk about them. This seems different from many other specialists, and I’ve wondered if there’s something about ophthalmology that attracts the kind of person who likes to talk about his or her work. But after reading your account, I’m changing my mind and realizing that I’ve probably just been lucky!
Wow . . . what a story [so far!]. Thanks for sharing.
Very best,
M J R
At least two maddening things about members of the medical profession are reflected in this post:
– Lack of intellectual curiosity about matters outside their knowledge base and experience. A patient faced with this attitude either assumes that the issue is as trivial as the doctor indicates (sometimes to the patient’s detriment, if the issue is in fact a significant one) or, acting on his/her own suspicions, has to do the research and get additional opinions.
– Bedside manner — the two doctors talking about Neo in front of her. They could have politely gone back to their office for a few minutes (“We need to review a couple of things but we’ll be right back”). And, they could have led up to their blunt announcement by explaining the physical and medical aspects of the situation and just phrased it a little better while still being honest.
Thank you for sharing this story, Neo. As you had a successful outcome here in California, I’m hoping you will share the name of the doctor when the time comes.
Sharon W:
I will.
I had a scary experience with my right eye about 20 years ago; I was working hard writing some entries for a medical encyclopedia when I noticed zigzag-shaped lightning flashes appear along the side of my right eye. There was no pain, but the visual disturbance was worrisome. I’m very nearsighted, and I knew that that’s a risk factor for retinal detachment (as is being middle-aged or older). I didn’t feel safe about driving, so a friend kindly took me to the ER of the local hospital.
Eventually I was sent to an ophthalmologist elsewhere in the hospital, who examined my eyes and then gave me a pencil and a piece of paper with a circle printed on it. He asked me to draw what I was seeing on the circle, which represented the visual field. I drew several lightning flashes along the right edge of the circle. He told me that what I had was not retinal detachment but a fairly uncommon problem called retinal migraine. I was confused by the term because I had no headache at any time during this episode. He said that the visual disturbance comes from the same type of spasm in a blood vessel that can cause migraine headaches, only with retinal migraine the affected blood vessel is in or behind the affected eye, and the patient may not experience a headache.
He then asked me whether I was under stress (boy howdy, I said), and he advised me to go home, take a nap, and then do whatever worked best for me to lower stress. He said that if I could bring down my stress level, the problem was not likely to return (he was right about that; it hasn’t come back in all the years since), but to call him right away if the retinal migraine recurred or any other visual issue appeared.
He could not have been kinder or more understanding. I’m sorry that Neo had such an unpleasant experience with the kind of Boston doctor we in CT refer to as Mass holes.
I do enjoy these medical stories. Few doctors are perfect in touch and attitude (who among us is?) but the narratives continue. There are also expectations of beautiful recoveries that may be unrealistic.
After all, we are all destined to die!
Youch! What a story. and a cliffhanger at that. I’m looking forward to good resolution (pun intended.)
Physician heal thyself.
Cicero:
You’re the real cheerer-upper! 🙂
Fortunately, though, for most people, cataract surgery is fairly straightforward and “beautiful recoveries” are not at all unrealistic. I think being a cataract surgeon is probably very satisfying, to be able to help so many people so greatly.
My guess – and you would know much more about this than I – being an oncologist has it’s great rewards but there’s also a lot more tragedy.
Correction: ITS great rewards. No apostrophe.
If only we were more like France.
OTOH, Princess Di died because the French tried treating in the ambulance for over an hour and didn’t get her to the ER stat like we do.
I had two small retinal tears in 2016. The first stapling treatment was 850 zaps with a laser while looking upward as far as I could and not moving, loads of fun. When it was over, vision was totally black in that eye, and I was almost too exhausted to panic. A minute later, the assisting technician comes back and tells me I may have blindness for a few minutes. She was right, but I would have liked a warning.
…when I noticed zigzag-shaped lightning flashes appear along the side of my right eye.
PA+Cat:
Interesting. I’ve had something like that once every 3-6 months for about twenty years. It fades after 30 minutes or thereabouts, so I don’t worry about it and never mentioned it to a doctor.
Though it does seem to occur somewhat more often with age. I don’t notice a stress component, though I’m kinda highly strung, so who knows.
My eye drama was a retinal tear about six months ago. I had one ten years ago, so I knew to get to a retina specialist quickly after I saw an increase in floaters and an arc of light on the periphery of my vision in dark rooms. The treatment was done in the office the same day, securing the retina to the back of the eye using cryotherapy (sort of spot welding around the tear so the retina will not detach). Scary but treatable; back to normal the next day. An acquaintance disregarded similar symptoms about a week before my episode and had a retinal detachment. It was treated successfully, but it was complicated, time consuming and with lingering side effects.
Now, the level of floaters is quite annoying and I may be a candidate for replacement of the vitreous fluid which creates anxiety to contemplate.
Amusingly, the doctor who treated me was dressed colorfully, wearing what looked like a loud golf or Easter outfit—mauve pants and a plaid sport coat. It reminded me that the doctor who treated me ten years prior was also dressed in a picturesque manner. His plaid was in a vest under a pumpkin-colored blazer. He looked like he was ready for a Gilbert and Sullivan Society performance.
What Kate said in her first paragraph at 2:48 PM.
And
YIKES!!
Neo (and others), you have probably already mentioned this to your doctor(s), but if not, be sure to mention that you are seeing double. It is something that can creep up on us and we don’t realize it is not right. I gather it is not all that uncommon a condition, but also not really common enough for the staff or doctors to ask about it unsolicited.
My double vision was easily corrected with an Rx that included specifying a “prism” value (3 in my case). This is not normally needed or specified for correcting the more run of the mill vision declines.
But they don’t always seem to know what causes double vision, possibly being a brain issue more than an eye issue in some cases. Sort of risky if you are driving, especially at night, and see two lanes of road and two identical cars ahead of you, to determine which lane to steer your car on. (Of course, closing one eye for a second helps, but still … )
R2L:
My seeing double was from cataracts rather than a lack of coordination between the 2 eyes. It’s easy to tell the difference. If it’s cataracts, you see double – or more- with each eye alone. Only way to correct it is surgery, not prisms. It only happened with me with print or things that glow.
20/15-20/20 vision my entire (then 67 yr) life. Then, from nowhere, sudden flashbulbs in right eye — retina both tearing and detaching. Eye doc makes my wife leave courtroom work to drive me downtown to famed, pioneer Wills Eye Hospital in Phila; any response less stat or comprehensive risked permanent blindness. Recovery unfun: they shoot a bubble of gas into your eye, so that visually you’re under very slowly receding water for days, during which you can’t lie on your back and, day and night, must keep your unobstructed face pointed down. Laissez les bons temps…
Ergo: any sudden flashes, shower of floaters or veil descending, get help — STAT.
I’m named after my ophthalmologist grandfather, b. 1881, d. 1947. Far less likely he could have saved his own grandson from blindness.
Gratitude — the parent of all virtues, right?
This is indeed scary.
Hope there’s a happy Hollywood ending….
Neo, I commend you for the persistence in pursuing more helpful, informative, and reassuring care for your condition. My wife always says when one interacts with the health care system “You have to be your own advocate!”. She is right about that.
And this: “The only plus – if you can call it that – was that the halos around street lights were very beautiful, like enormous crystalline snowflake patterns made of hundreds of tiny diamond shapes, with each of the tiny diamond shapes having borders in the form of tiny rainbows.” is a perfect example of making lemonade when life serves up lemons. Lemonade is delicious – sipping it makes life so much better than sucking lemons.
What Scott said about Neo’s lovely snowflake sentence. And as for Ralph L, Le Mot Juste, Matthew M and several others describing vision crises — yikes, yikes, and yikes indeed. Such terrifying stories that fill me with awe at what modern medicine can accomplish. How many of us would be blind right now if we’d lived decades or centuries ago?
On double vision: I had eye surgery at age 4 and since then have had amblyopia, meaning I can’t see with both eyes at once. This prevents me from having double vision in the traditional sense. But lately, when I’m tired, I sometimes have something like it in my “dominant” eye, caused by developing cataracts. As Neo said, it mainly occurs with things that glow, like text on a computer screen (though thank heavens, not on my Kindle!) I see a kind of dim ghost image a little way above the “true” image, so it looks, for instance, as if a road has two white lines along the verge, one of them floating in the air above the other. With print, I can “correct” it by relaxing my focus a little so that the text blurs just a tad. Somehow that merges the two images and makes the text more legible. And anti-glare coating on my glasses has worked miracles, especially with driving.
Cataract surgery is in my future, getting closer lately as I’m starting to think I’m having trouble distinguishing colors, especially those with yellow in them. (In retirement, I’m focusing on a long-neglected interest in making art, so this matters.) I’m reading all these reports of “beautiful recoveries,” as well as the scary surgery tales, with close attention.
What a cliffhanger.
Nonapod and Watt, I agree with you.
I had a vitreous detachment about 15 years ago with a similar experience. Didn’t complicate the cataract surgery on that side.
The comments about the French health care system, I studied this back in 2008. I spent a year at Dartmouth, after I retired, studying health policy. I wrote a series of blog posts about it beginning here.
My conclusion was that France was the reform model best suited for our country. This was, of course, before Obamacare which shifted us to corporate Medicine and was not an improvement.
This whole discussion is very interesting to me, but especially because this paragraph:
I have had the same issue with double vision. The description of occurring with glowing numbers is spot on; it also happens with neon lights and that sort of thing, but also with brightly painted horizontal lines. It only seems to happen in the evening, or (oddly) when I am on an airplane. What is odd is that the second image is a fainter image, slightly below the main image. And I have the effect even when one eye is closed.
Over the years, I have been through three eye doctors, and none has been able to give me an explanation. They look at me rather strangely when I tell them that it is vertical double vision, and not horizontal, as you would get if the two eyes were not cooperating. One suggested I should get my head examined. My current doctor just left the area, and I have to find a new one, so I am going to take a copy of your post when I see the new guy.
Our health issues as we age are big events in our lives. A blow-by-blow description of an ailment and the path followed to overcome it is the story of life. It grabs our attention.
Finding the best doctors can be a challenge and sometimes we have no choice. Fate can play a role. My emergency appendectomy was done by the ER Doctor on call that night. It turned out that he was the top surgeon on the hospital staff. Fortune smiled.
On the other hand, my wisdom tooth extraction was supposed to be done by the best oral surgeon at Oak Knoll Naval Hospital. But he was playing golf that day and I got a new oral surgeon just out of internship. My right lower jaw is still numb all these many years later. Fortune frowned. Be thankful we don’t have universal healthcare……yet.
Looking forward to part III.
Mr. BIll:
Do you have the beginnings of cataracts? That was one of my first symptoms, while my cataracts were still very minor.
For the past 12 years or so I’ve made sure to have an annual eye exam. I’ve always been blessed with good vision, except for presbyopia as I aged. Years ago my eye doctor started asking me if I was ready to take care of my cataracts, and I more or less said “what cataracts?”. But finally I was convinced, and could afford the adaptive replacement lenses that would change shape like a (young) normal lense. My advice: Don’t wait – I couldn’t believe how much lighter the world was. Also, get the adaptive lenses if you can at all handle it. The usual practice seems to be to put a near vision lens in one eye, and a far vision lens in the other, but as a pilot I decided to go with far vision in both eyes and use reading glasses when needful, which turned out to be not as often as I expected.
Mr. Bill, you’re describing precisely the same “vertical” double vision that I have when tired. I had an experience very similar to yours when I tried to tell my optometrist — a very skilled and intelligent guy who’s normally right on top of things — about it. He flatly refused to believe me! He said it must simply be blurred vision from eye strain. But my ophthalmologist recognized it as a symptom of my not-too-severe-yet cataracts.