January 2010


The second day after surgery has been a lot better than the first. Yesterday I tried to get by just wearing my glasses, but toward the end of the day I went back to wearing the metal shield. What a big difference! It blocked most of the light and made my eye a lot more comfortable.  I also started instilling my steroid drops (Prednisolone Acetate) first, since it tended to burn a little. When I instilled the Vigamox drops, they would take away some of the burning. I continued wearing the shield and my eye feels a lot better.

I still spent most of the day resting and relaxing my eye. I was also able to spend a little bit of time on the computer checking e-mail and writing this blog. I will be off work for two weeks, and seeing how I feel after using the computer in 30-minute intervals I know that I’ll need those full two weeks. I’m a web developer, so I need my eyes!

Things are feeling a lot better today, but I’m still waiting for the eyelid swelling to go down. Thanks to all of my friends and family who continue to call. I even got a fruit basket from work!

I had my post-operative appointment the morning after my surgery. When my bandage was removed, my eye was gooey from the ointment and tears. I could tell immediately that my vision had improved. While it was still very blurry, my vision wasn’t distorted as it had been… plus I was actually able to read two lines on the eye chart! I was also amazed that I could see a little bit of depth in objects. I was holding a tissue, and it didn’t look flat. Wow! The eye still felt good with very little pain. I was told to continue taking my eye drops six times a day, and I was given a third drug to take once a day to control my eye pressure. My eyelid was swollen and my eyes were very red, but they felt OK.

After the appointment, I went home. It was overcast at first, but when the sun came out I could tell that my eyes were very light-sensitive. Even with my eye closed the sun caused my eye to hurt. I went home and my eyes were very irritated. The swollen eye would press against my cornea every time I blinked, so I wasn’t feeling very good. I didn’t feel very good the rest of the day, so I spent most of the time sleeping or lying with my eyes closed. I noticed some cloudiness around my eye near the stitches, but the doctor said that this, allowing with the irritation and swelling, was normal.

According to the doctor the surgery was a success. I arrived at the hospital in time. It only took a few minutes for me to get checked in, and about 20 minutes later I was taken to the back. I changed out of my clothes was prepped in one of the examining rooms. I was asked a million questions about my medical history, any allergies and any current ailments. The staff started my connecting me to oxygen, a finger probe, and a blood pressure sleeve. The nurses also started a series of drops in my eyes. I also had to take a couple of pills, which I was told was to check for any allergies to sulfate. The doctor arrived and marked my surgical eye. The anesthesiologist arrive later, and did the same thing. I continued to receive a series of drops about every 10 minutes.

Things were moving along pretty quickly, and I was told that my surgery was being moved up about an hour; I was originally supposed to be the second patient. The anesthesiologist told me that I need to be given two shots behind my eye, but that I was be put asleep for that procedure. A few minutes later I was told that I was getting the anesthetic. I was looking up at the ceiling at the time, trying to feel when it would kick in. It seemed like a few minutes later when I noticed that I couldn’t see out of my left eye. At that point I was getting ready to be taken to the operating room. I didn’t feel a thing. Anesthesia is a trip!

I was taken to the O.R. where the doctor and his intern were present. I thought that my eye had been paralyzed, but it had just been covered. I guess when I was “under” they had propped open my eye and covered it up. I could see a little bit, but since the vision in my uncorrected eye is horrible and I had not active muscles to focus, there wasn’t much to be seen. My other eye was covered with a patch. I could still see light through the bandage or gauze, but nothing else. I could see the doctor poking and prodding at my eye, I received more drops.

A little bit later I could see the doctor place the trephine (a circular cutting device) over my eye. It just looked like I was looking through a small metal tube. He gave it a few twists, then I could see him pull out my old cornea. I saw the new cornea put in place. It seemed cloudier than my old cornea, so I couldn’t really see anything after that point. He started the stitching. After a few stitches were applied, I heard him mention that he was starting the running stitch; this is the one around the perimeter of the cornea. He was explaining to the intern what he was doing and what to look out for with regards to the tightness of the stitches. I also heard them talking about the football game. I’m just glad I didn’t hear him say “now you give it a try…”

The stitching took about 15 minutes, and after the doctor was finished he rinsed out my eye and bandaged it up. I remarked to him about the fact that there was no pain. I just hoped that would continue. I was taken back to an examining room, and my wife and mom stopped back to see me. I was still in no pain. Fantastic.

After about 30 minutes I was released from the hospital and went home. I was able to call and text some friends and family to let me know that the surgery was finished. I was still in very good spirits and experienced no pain, just a little discomfort. I felt something under the bottom of my eye, almost like I had an eyelash in my eye. Other than that, just numbness from the top of head around to my left cheek.

I was able to eat (finally), and my children, parents and in-laws stopped by to check on me. Right after they left I went to sleep… and slept for about 7 hours. I took some preemptive Tylenol before my nap. I only felt a tiny bit of discomfort while I was sleeping, but still no pain. I was expecting the anesthetic to wear off and experience sharp pain, but that hasn’t been the case. I still feel fine, thank God!

I was never able to fall back asleep, so I’ve been up all night watching one-eyed television and typing this blog post. My follow-up appointment is at 9:10 am. This is when I will get the eye shield removed and get the first glimpse from my new eye. I’m excited.

Today has been a great day so far.

Today is the big day. I slept well, surprisingly. The hardest part for me this morning is not being able to eat anything. I will be heading to the hospital around 11:30 and the the surgery is scheduled to begin around 1 pm. My wife and my mom are coming with me. I’m still not sure exactly what to expect when I arrive. Wish me luck.

Tomorrow I start taking the Vigamox drops. These are antibacterial drops, I assume to clear up any possible infections. Today the family and I attended the North American International Auto Show (Cobo Hall, Detroit, MI). I had a few interesting experiences related to my KC. Ford had a 3-D driving simulation. I wanted to give it a try, knowing that my left eye hadn’t been clear for about 10 years. Of course, I could not see in three dimensions, further confirmation that I need to undergo the surgery. I also had the usual stumbles over ramps and curbs, since I have no depth perception. Oh well. Only 5 days to go.

My story began when I was in elementary school. I was diagnosed as being nearsighted and started wearing glasses in the third or fourth grade. I tried soft contact lenses in high school and the first year or so of college. Those were fine for a while, but then started to become unbearable. I could wear them for a few hours, then it felt like someone dumped sand in my eyes. As time progressed, I noticed that my eyes were becoming more sensitive to light and wind, so I actually preferred glasses.

I never had a problem getting prescriptions for glasses until the mid 90’s. I remember going to get an eye exam. My right eye was fine, but when my left eye was checked they could not find a setting to correct my vision. I remember going through the test – “Which is better… 1 or 2? 3 or 4?” It reached a point where all of the settings were out of focus and none of them corrected my vision. I was referred to an ophthalmologist.

My grandfather had been seeing an ophthalmologist named Dr. Bogorad at Henry Ford Hospital. I became his patient, and he was the one who diagnosed the problem – Keratoconus. I found out that Keratoconus is a very rare disease of the cornea. It is typically diagnosed in patients in their mid-twenties. Thinning of the cornea causes it to take on a cone-like shape that distorts vision. Vision becomes progressively worse, but it does not result in total blindness, and the vision changes slow down over time. It typically only affects one eye. The first course of treatment is rigid gas permeable contact lenses. The last course of treatment is a cornea transplant. There are other treatments available, some of which are still experimental.

When I told my parents, of course they were worried. Was I going to go blind? How did I get it? Is it painful? What options are available? Can I get LASIK? I tried to explain that there was nothing that could have been done to prevent it, and there is nothing that can be done to stop it. For me, it has always been an annoyance, but it isn’t painful. It just affected my night vision at that time. I have friends that have gotten LASIK, and I wish that was an option. Unfortunately it’s not recommended when the cornea is thin.

I tried the hard lenses in the late nineties. They corrected my vision better than the glasses, but the discomfort did not justify the benefit. I found that having vision that was slightly out of focus was more tolerable than the contact lenses. My glasses corrected my vision, but I started noticing distortions in my left eye. I was getting new glasses every two years or so, and when I had my prescription filled in late 90’s, I noticed that objects were skewed. When I held up a piece of paper, it didn’t look rectangular, it looked like this. I had the prescription tweaked a bit, but objects were still skewed. Eventually, from what I’ve been told, my brain began to process the signal differently and objects seemed to straighten out. I imagine that was when my right eye became the dominant eye.

Something else that I began to notice was that I saw multiple copies of objects. It was most noticeable in bright objects, like lights. I would see 4 or 5 instances of the objects, with motion trails, always with lots of glare. During the day I really didn’t notice it, but at night, taillights, headlights and streetlights all had that effect. Around the same time, I started to notice that I was having trouble with my night vision. I was staring to have a hard time reading street signs at night, and the glare from oncoming headlights was blinding. I couldn’t see street addresses from my car, which made it difficult to find houses and businesses. I remember being really late once picking up wedding photos with my wife because I couldn’t see the streets or addresses and went WAY out of the way.

My left eye was getting progressively worse and finally reached a point where the vision out of that eye was completely out of focus and uncorrectable. My right eye was compensating, so I could see during the day relatively well, but I no longer had any depth perception. This made some everyday things very difficult… try threading a needle with one eye! By the mid-2000’s, I was just dealing with it. My wife started doing most of the night driving.

I noticed my overall vision getting progressively worse. I started having difficulty with everyday things. For example, while watching football games on a 32” TV from about 10 feet away, I couldn’t see the score displayed on the television. That gave me an excuse to get an HDTV. I could still read standard sized print in books, but I had difficulty reading small type. To this day I still have to ask my wife to read small type.

I’ve noticed my right eye getting worse, although it is still correctable to 20/30 with glasses. The left eye is correctable to 20/1000 with glasses. I’ve noticed some of the things that I initially noticed in my left eye, such as ghosting and glare off of bright objects. It is difficult to explain to people what I see, especially people like my wife who are blessed with 20/20 vision. The best way to explain the night vision is that it’s like driving in a rain storm. You can still make out what is there, but things are distorted, and you can only see for a short distance. I also created a few pictures to try to illustrate what I see:

About 4 years ago I heard about a new alternative to cornea transplants called Intacs. It involves implanting a plastic ring in the cornea to correct the vision. I found a local cornea specialist who performs the surgery and scheduled a consultation. I found out immediately that my cornea had thinned too much and I was not a candidate. I started to think more seriously about having a cornea transplant. Before going that route, I wanted try contact lenses again. I was fitted for hard lenses, but they only corrected my vision to 20/70. Because they were still very uncomfortable and they still didn’t clear up the issues with night vision, I decided to continue using glasses.

Over the past few years, my overall vision has greatly diminished. My vision is good in outdoor sunlight, but as conditions darken my vision becomes exponentially worse. I am at the point where in an indoor setting it is difficult to recognize faces that are more than 30 feet away. It’s difficult when you can’t recognize people across the room, or when someone waves and you can’t tell who they are. Before this time, my life was only impacted at night. I am now at the point where my overall quality of life is affected.

In the fall of 2008, after trying contact lenses again and talking with my ophthalmologist, my physician and my optometrist, I scheduled a cornea transplant with my ophthalmologist. I have been seeing him for 4 years and he will be performing my surgery on January 26, 2009. I’ve talked with him about the surgery, and I’ve visited tons of web sites to find out more about the procedure. Some days I feel really good about it, and other days I don’t. I realize that this could be the best thing or the worst thing that I’ve ever done. This is a procedure where, once it’s done, there’s no going back. There is a long recovery time, and some risk. It could go very well, and I can have clear vision restored in my left eye, or it could be a procedure that I regret for the rest of my life. I could go on the way that things are, but I would love to be able to see the world with both eyes again.

My pre-operative visit is scheduled for this afternoon. I still have a bunch of questions:

  1. Will I be able to play golf in the spring?
  2. When will I be able to pick up my kids again?
  3. What happens with the prescription in my glasses during my recovery time?
  4. How much work do I need to miss?

I am looking forward to the surgery, which is now less than 2 weeks away. I will try to document my experience to help explain it to family and friends what is happening and how things are going.