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Medical Forum / General / Vision / January 2006NEW Case - Should I accept this vision
Or perhaps better, what's a plan of attack to correct it, or, perhaps, as myeyedoc says "Wait and see" Have written about pending cataract surgery in past months. It is done: Distance lens, both eyes - Alcon SN60WF - UV w/blue lite filter Left eye:12/05 22.5D Right eye: 12/12 23.5D Pressure soared in both eyes (40+) at 4 hour check but both subsequently reduced. I do have glaucoma in both eyes Am off all meds in left eye. Vision is great. Both eyes foggy for 1st 24 hours. Doc said due high pressure, and it cleared up as he said it would (though in both cases he actually massaged my eyeball to bring it down) Current meds right eye: Lotemax 3X daily, XiBrom 3X daily, Betamol 2X daily. First two reduce one drop/day/week, untill both sked to stop by 01/12. Betamol to reduce (probably revert to Xalatan) as readings permit. I am not concerned over pressure resolving. See Myeyedoc again 01/05 He is out of the area as I know him personally apart from practice. At the time of right eye IOL implant as agreed previously, and due a "natural" astigmatism, he performed an LRI (Limbal Relaxing Incision in right eye. Do not have pre-post CYL readings, if they are relevant Now---Vision is right eye is fuzzy, hampered by multiple images. If I look at a vertical object (e.g. flag pole) I see the object and about four ghosts. At night, when I look at a star, or a yard light across the lake, I see the smile from a smiley face, sometimes with purple ends. With both eyes (or left alone)(BE/LEA) I can read the crawl on a Fox news, channel, but with right eye only (REO) it is just a run together moving line, not even distinguisable as print. While I can read my black on white monitor screen with my +1.0 reading glasses (BE/LEA), If I go REO, it is just a fuzzy line of obvious print. Did notice that while looking at a visiting pelican with binoculars, that the vision was great, with either eye, and the ghost images virtually erased in the REO. Doc's idea is that it is going to go away. If it has changed, it is infinitesimal, perhaps at closer distances This is not a lets sue the doc evolution. This is a lets help Roy to ask the right questions, provide the correct information. so that together we can give Roy the best possible vision. Finally. I have worn glasses all my adult life. It does NOT bother me that I will have to continue to do so. May shift to progressives; have always had lined trifocals before. May try that Sola out to 8' progessive for computer work. Thoughts/ideas. please. Merry Christmas to all And to all: Have good sight Did > notice that while looking at a visiting pelican with binoculars, that > the vision was great, with either eye, and the ghost images virtually [quoted text clipped - 11 lines] > Merry Christmas to all > And to all: Have good sight Due to the bit with the binoculars,I think it's refractive, maybe the relaxing incisions didn't work out. Anyway, get a good refraction, and if you're used to trifocals, stay with them, or make sure they will redo the progressives no charge in a trifocal if you can't adapt, and give them no more than 2 weeks of full time wear for the adaptation. w.stacy, o.d. >Or perhaps better, what's a plan of attack to correct it, or, perhaps, >as myeyedoc says "Wait and see" [quoted text clipped - 40 lines] >have always had lined trifocals before. May try that Sola out to 8' >progessive for computer work. SO, I went to MYEYEDOC today for a visit 3+weeks since the surgery on the R-EYE. Surgery, which included IRL to reduce existing astigmatism induced a greater (WOW!!!)astigmatism than was there in the first place. At least on paper, and after the refraction this morning, it can mostly, but not entirely be corrected by prescription. However, I am getting the "free" Medicare glasses(lined trifocals)now so that I can see what I can see, and so when I see the opthamologist again in 3 months (he really wants to let it heal fully) we can discuss how to fix the problem with my knowing whether I can live with it as is. I guess lazer surgery is a possibility. Glasses should be here by the end of next week. In 3 weeks I will go in for a pressure check. At that time, or perhaps closer to the time I see the opthamologist again, I intend to to have another OD see what he can come up with. Any comments would be appreciated and anyone who can discusss the further surgical interventions. Roy Success percentages can only be developed when there are failures in any given procedure. >SO, I went to MYEYEDOC today for a visit 3+weeks since the surgery on >the R-EYE. Surgery, which included IRL to reduce existing astigmatism >induced a greater (WOW!!!)astigmatism than was there in the first >place. > Oops. Makes me wonder if he was 90 degrees off on his calcs. Were there no stitches? Maybe some other complication happened. Try to get those pre and post op SRxs. > I >guess lazer surgery is a possibility. > Maybe, but I don't think I'd do it, unless there are some irregularities that can be smoothed out via wavefront. w.stacy, o.d. >Oops. Makes me wonder if he was 90 degrees off on his calcs. Were >there no stitches? No >Maybe some other complication happened. Try to get >those pre and post op SRxs. I am reading this to mean that I should get a copy of my pre surgery and yesterday's vision prescriptions >> I >>guess lazer surgery is a possibility. >> >> >Maybe, but I don't think I'd do it, unless there are some irregularities >that can be smoothed out via wavefront. Haven't gotten to do much research on this yet, but I am seeing that lazer surgery is used to correct astigmatism. Not so??? >w.stacy, o.d. > I am reading this to mean that I should get a copy of my pre surgery > and yesterday's vision prescriptions Yes. I'll have a better handle on where you were and where you are now. > Haven't gotten to do much research on this yet, but I am seeing that > lazer surgery is used to correct astigmatism. > Not so??? Yes, but it's generally not as successful as simple myopic LASIK is. And LASIK itself carries some additional risks for you, so I'd be pretty careful here. At the very least you should wait at 6 months to see if the cornea is stable, but post those Rxs. w.stacy, o.d. >> I am reading this to mean that I should get a copy of my pre surgery >> and yesterday's vision prescriptions > >Yes. I'll have a better handle on where you were and where you are now. OD Before: 1-27-05 Sphere/Cyl/Axis +4.00/-1.25/090 OD After 1-05-06 +0.50/-3.00/100 OS Before: +3.75/-1.50/094 OS After: +0.50/-0.75/065 There were two Adds Before, both were +2.50 After, both are +2.25 As I said, I am getting my "Medicare glasses" straight line trifocals, with these prescriptions now (on order). Intend to see if I can live with what I can or can't see, as part of the decision process as to what I do, if anything, next - after a suitable waiting period. Also, intend, a bit closer to the 3 month look/see by the opthamologist, to trot my eyes.prescriptions into 1 or more ODs to see what they see. Thanks for your interest and assistance. BTW, here is part of an email I sent to my kids, and other concerned relatives this morning. It was about what I could see now: "So, what do I see now? I am currently sitting about 3'+ from my monitor, and can read it with my left eye, or both, but my right eye reveals only garbled, run-together black lines. A pair of $1.00 half-glasses from the Dollar Tree Store makes vision better. If I sit down to read, I can, with some squinting and arm adjusting, read a newspaper. A different pair of half-glasses with a different correction makes that better. and I can look over the top to watch TV. Went to Wedding Crashers (terrible movie - sexual comedy has to be properly done to be funny, and this wasn't) with Sue the other night and had no problem with no glasses. Drive with no problem, with no glasses. Can actually see better at night than I used to. On the other hand, with my right eye if I look at a thin vertical line (think flag pole) I see it and 3 ghost images. If I look at a star, I see the smile from a smiley face, and looking at a yard llght across the lake produces the same image. It is the aspect with the lights that is the biggest PITA > OD Before: 1-27-05 Sphere/Cyl/Axis > +4.00/-1.25/090 [quoted text clipped - 6 lines] > with what I can or can't see, as part of the decision process as to > what I do, if anything, next - after a suitable waiting period. Looks like he might have been 90 deg off (kind of like a clerical error), on locating the incisional meridian, but the result is probably livable, since you've pretty much resigned to wearing glasses full time anyway. Fortunately, you won't have much vertical prism problems so slab-off grinding won't be needed. I wouldn't consider addtitionl surgery of any kind for this assuming your glasses work out ok. w.stacy, o.d. On Fri, 06 Jan 2006 19:52:41 GMT, Roy Starrin <starrin@verizon.net> provided the following in the latest chapter in the continuing saga of his cataract surgery >OD Before: 1-27-05 Sphere/Cyl/Axis > +4.00/-1.25/090 [quoted text clipped - 11 lines] >with what I can or can't see, as part of the decision process as to >what I do, if anything, next - after a suitable waiting period. Got the glasses Friday. So, first blush w/o the suitable waiting period. Both eyes "see" beautifully when it comes to sharp, clear, etc. HOWEVER COMMA The vision bending is beyond belief. Recognizing that I have had the glasses for about 24 hours and I may need to adjust to them, some of the visual phenomenon I am experiencing are almost (but not quite) enough to cause nausea. When I read the newspaper, it is trapezoidal; the big edge to the left. All is sharp and clear, however. To a small degree my computer screen is the same. Not a big problem!!! If I sit down, or stand above the circular kitchen table and look down at it. it tilts severally to the left and down (toward an axis of about 30 degrees left) so much so that I expect stuff to roll off the table---but of course it doesn't. If I stand at the kitchen counter, looking down at it, it appears to shift similarly, or if I glance left out of the corners of my eyes as I sit here at my computer desk---in other words, flat surfaces are not seen that way. If I lift my vision from the counter and look out the window. All is well. I find that if I shift my head 30 degrees left, and my eyes back 30 degrees to the right, the problem improves considerably. I also find that this condition is improved if I close one eye. It goes away if I close the bad (right) eye, it is much better if I close the good one. The optometrist says he did in fact read the glasses and they do match the prescription. We are still looking at whether we will do more surgery at some point (3 months hence). I am interested in (closer to that date) having a couple of ODs do a refraction to see how close they all are. I am interested in getting a second opinion from an MD as to what my alternatives might be for surgery and perhaps some recommendations. So, gang, you can really help the process, if you can give me an opinion as to the current visual affects (cause and fix) as well as what specific refractive processes might be included to ensure I get the best possible refactions in the future. Recognizing that these glasses are about 3 weeks post surgery on the right eye, if there is not a major adaptive change between my brain and what I am seeing, I don't believe I could live with it, as is. If the consensus is I may have to, then I may become the modern day man in the Hathaway shirt. Thanks again for all your insights Roy > Both eyes "see" beautifully when it comes to sharp, clear, etc. > HOWEVER COMMA > The vision bending is beyond belief. The bending is probably due to the anisometropic cylinders (astigmatic correction). Might resolve with time. Try also tilting the frames a bit by lifting and lowering the temples above and below the tops of your ears. If changing this tilt helps at a particular angle, the frames can be adjusted to achieve this (pantoscopic tilt). I do think additional refractions might zero in on it, as well as consider undercorrecting slightly on the strong cyl. I'd really recommend against additional surgeries for what is essentially now a refractive error, but they are your eyes. w.stacy, o.d. |
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