Living with bum eyes

People born with perfect vision take it for granted.  They open their eyes and see.  –6.5 diopters is blind enough that I couldn’t see clearly five inches away from my nose. And my nose doesn’t stray far from my face.

I remember the miracle of contact lenses.  For me that was 23 years ago. They changed my life.  More than how I saw my world, glasses effected how I saw myself. I was not a glasses person.

My contacts were like a secret drinking habit.  Day to day, no one knew of my visual handicap.  I wore contacts from the moment I woke up, untill the moment I went to bed.  I’ve worn them as long as 46 hours straight. Hard lenses.  Tough guy.  Live the adventure, fly Garuda.

I got corrective lenses for a SCUBA mask.  Worked okay underwater, but when I surfaced and took my mask off, the dive boat would disappear.

I brought glasses in my flight bag while I taught people how to fly airplanes. I never lost a contact in the cockpit, but why take that chance?

I did manage to lose five contact lenses in freefall during a series of student skydives in the summer of 1990.  During a back flip doing 120 miles an hour in jump number six, I lost both lenses at the same time.  It made for an interesting canopy ride and landing.  I quickly had goggles made to my prescription.

I could not turn my face into the wind with my eyes open.  I could not sleep outdoors, wake up during the night, open my eyes and see the stars.  I wished I could do that.

I followed the news of RK (Radial Keratotomy) with great interest.  The procedure was not recommended for people as nearsighted as I was.  I didn’t care for the idea of relying on the steadiness of a surgeon’s hand to make radial slices the surface of my eye.  I heard about the problems and complications.  "Wait for the computer guided laser procedure and let them get the bugs out", advised an ophthalmologist friend.  I waited.

PRK (PhotoRefractive Keratectomy) might have been the ticket for me, but I kept waiting.  I wanted some time to pass to see if anyone went blind, grew hair on their palms or suffered some other horrible fate.

In November of 1997, I saw a feature story on channel 2 in Los Angeles.  It was a new procedure called LASIK (LASer In-situ Keratomileusis).   People were walking in blind (nearsighted) and walking out seeing.  I saw the news guy get it done on his two eyes.  That was it.  If my vision was a candidate for the LASIK procedure, sign me up.

I researched the subject on the Internet.  There were many choices.  I decided not to go across the border to Mexico to have it done, even if I could save money.  No "homemade" lasers.  They seemed to be a very bad idea.   I also decided not to go to a franchise.  "Okay, that’s two corrected eyes. Would you like fries with that?"

I wanted an experienced Doctor who had made vision correction his life work.  I selected Dr. Andrew I. Caster, author of the Eye Laser Miracle and Medical Director of the Caster Eye Center in Beverly Hills.

Pre-op

During my initial consultation, I was shown a "Patient Education Videotape" and then got to play quiz the doctor.  Dr. Caster was knowledgeable and confident.

Hard contact lenses hold the shape of the cornea to the inside curvature of the contact lens.  Since I had worn hard lenses so long, Dr. Caster said I would have to be out of them for ten weeks prior to my procedure so my eyes would revert to their natural state.  Eight weeks in soft lenses then two weeks in glasses.  In that time my eyes shifted from –5.5 to –6.5. I lost an entire diopter of acuity.

The Friday before my Monday surgery, I went into Dr. Caster’s office for a thorough eye exam.  They made a computer map of the current shape of my corneas, checked my prescription and health of my eyes.  I asked Dr. Caster if he had any big party plans for the weekend.

The day before my procedure, I did something I never had done.  I took a walk with my girlfriend (and seeing-eye person) to a local restaurant for lunch – without wearing corrective lenses.  The walk wasn’t long.  Three miles.  But it was long enough to appreciate what my uncorrected vision was like.

The Operation - May 4^th, 1998

I arrived at 7:30am for an 8:00am appointment.   When Dr. Caster arrived, I asked him to hold out his hands.  He obliged.   They looked steady.  I felt better.

They started me off signing the Mother of all waivers.  I’ve signed shorter waivers to jump out of a plane.  Then, they gave me a Valium.   I couldn’t tell any difference.  I should’ve asked for two.

Then I went to a room where a nurse explained the procedure to me.  Let me tell you, you can’t have it explained too much.  I didn’t want to be startled by anything.  I figured moving while the laser was vaporizing my cornea would be a bad thing.

I received a series of drops to deaden feeling in my eyes.  The nurse gave me a fashionable bonnet to wear.

On the table, my head was held in place by a conforming pillow.  They gave be a stuffed bear to hold so my hands would have something to do.  Had I known, I would have brought my own stuffed bear from home.

They swabbed my face with an antibiotic and put a patch over my left eye. The first step was to cut the flap.  A device was inserted to hold my eye open.  Then he asked me to look at the red light while he used motorized blade (called a microkeratome) a to cut a flap.  As the blade cut across my eye, it obscured my view of the red light.  Now I had no focal point to hold my eye still on. I concentrated on not moving my eyes.  I felt pressure from the blade, but absolutely no pain.

With the flap made and the microkeratome removed, it was time for the excimer laser to start vaporizing tissue from the cornea. 62 seconds looking at a fuzzy red dot.  Some people report the dot getting clearer as the laser does its work.  Not me.   Fuzzy start to finish.  My eye was irrigated and the flap folded back over my eye.  The patch was placed over my right eye and the procedure repeated on the left.   Another 62 seconds.

I got up and looked around. Dear God.  Everything still looked as blurry as when I walked in the door.  Hey, waitaminute.  What’s up with this?

I remember reading the message posts on americaneye.com from frantic post-op LASIK patients.  The worried messages were always answered by other post-op patients who told them to cool their jets and wait a while. It takes time for your vision to stabilize.

Plastic shields were tapped over my eyes so I wouldn’t accidentally rub my flaps open.  I would have to wear them that day and for the next seven nights.  I was sent home with a kit of eye drops that I would be using for the next four weeks.

By the end of the first day, my vision was better but still not good enough to drive.   For the next four weeks, my eyes would get dry, sometimes burn like I had been swimming in an over-chlorinated pool and occasionally itch.  Not pleasant, but never distressing or painful.

Post-op Results

The next day, I drove myself to my first post-op appointment at Dr. Caster’s office.  My vision was 20/40 and I could read a couple of 20/30 letters but at 20/30 I was more guessing than reading.  Is it an S? an E? an X? Come on, gimme a hint!   My left eye was sharper than my right and forget about reading.

My close vision that had been corrected incredibly sharp, was awful.  I would have to hold my face eight inches from my computer screen to make out the letters and even then it was blurry.  Over the next four weeks, my vision would fluctuate.  It was generally worse at the end of a day.  Towards the fourth week the good days would outnumber the bad days and reading was getting pretty comfortable.

Week five: my vision is mostly stable and I read without a problem although not as clearly as before.  I saw Dr. Caster and my vision was 20/25 in both eyes, my left still a little sharper than my right. It takes three months to completely heal and Dr. Caster said I would probably get to 20/20.  I am already thrilled to death with how I see now.  Check back at the end of August and you’ll find out where my vision ends up.

3 weeks after the operation, my girlfriend and I went to visit an old buddy who lives on St. Thomas in the US Virgin Islands.  The SCUBA fun factor went way up with a plain glass mask.  I could face the trade winds with my eyes open.  In the evenings I could watch the clouds blowing across the night sky.  My God, it's full of stars.