Follow-up to cataract and laser surgery

12 12 2020

For background as to how I got to here, see my previous posts on:

I went to the new optometrist (recommended by my ophthalmologist) yesterday. He spent a good hour or so with me and I had tests and images taken of my eyes that I’d never had before. One used a concave instrument with a heap of concentric circles, and was used to assess the curvature of my cornea. I felt very comfortable with him and he ‘got’ the issues I had with living with a strabismus my whole life. Other optometrists have sort of ignored my voice on that.

Bottom line: With prism lenses (one vertical, one horizontal), he reckons that he should be able to correct my wonky vision to about 75 to 80%—he said nothing external will get me to 100%. That’s much better than I currently have, and if the new glasses are as good as the tests yesterday would indicate, they should help with my medium- to long-distance vision (TV watching, driving). He also did some testing for glasses for computer work, but we won’t go there just yet—the magnifiers seem to work OK, and I can zoom in for most programs. However, because I’ll have two different prisms, I still need to be careful driving and watching TV—scrunching up in the recliner will be out as I need to sit straight to get the full effect. And for driving, I’ll need to be careful at T-junctions and do a full turn of the head for the ‘look left, look right, look left again’ procedure.

Oh, and to add to the mix, the curvature on my corneas is different, and likely has been all my life, contributing to my wonky vision. The left one is relatively normal and smooth, but the right one showed a ‘butterfly’ shape on the retinal image, indicating that it’s a bit wavy on the external edge, resulting in the image splitting as it goes to my retina. Lenses are one culprit for this splitting too, but as I have new lenses now (as a result of the cataract surgery), that’s ruled out. So with the wavy edge on the cornea, it’s possible I may need to have further surgery to correct that, as indicated by my ophthalmologist earlier this month. But we’ll see how the glasses go and see what he says at my next appointment in 6 months’ time. (BTW, ophthalmologist is a bloody hard word to type!)

Update 4 January 2021: I popped into the optometrist today for him to formally put the script through so that I can take advantage of this year’s medical rebates. I asked him to test my eyes again, as I believed they had gotten worse in the 3 weeks since I saw him. They had. He had to increase the prism effect in the right eye from 1 to 2 (whatever that means).

Update 29 January 2021: I picked up my new glasses yesterday. They made a little bit of difference, but not a lot. The optometrist told me not to wear them that day, but to start afresh tomorrow. I only need them for medium to long distance activities/views, so I won’t wear them for computer work. In fact, wearing them at the computer was worse than using my magnifiers. I did try them while watching TV last night and the vision with and without was very similar—not a lot of difference, and certainly not a 75% improvement… maybe 10%? I just put them on now (afternoon) to look at the view in the distance, and they do make a bit a difference, perhaps a 25% improvement on looking at that same view without classes. Again, certainly not a 75% difference. The optometrist asked me to wear them for 10 days and if I didn’t notice much improvement to come back. I told him that I certainly didn’t want to be coming back every month or so for new glasses! Meantime, I had to pop into the ophthalmologist’s rooms to correct some info from the optometrist, and I was able to bring forward my June appointment to mid-February, just a few days after I go back to the optometrist. By then, I’ll know if the glasses have helped, and/or if my vision is worse than it was in December and January, and the optometrist will have sent his results through. The optometrist said the corneal work that might have to be done would likely be something called a corneal ablation, something that takes about 30 mins in the specialist’s rooms (in Perth), with most of that being prep time. I’m not sure I’m happy with the idea of more eye surgery, but I’m certainly not liking the deterioration in my vision.

Update 16 February 2021: I went back to the optician late last week and to the ophthalmologist yesterday. The prism lenses in the glasses have certainly helped with driving by reducing the ghost images and making things clearer (a BIG bonus!). However, there’s still minimal difference between wearing the glasses and not wearing them when I watch TV. The ophthalmologist said that the corneal images didn’t indicate that any corneal surgery would help as he believes this is all still related to the strabismus. Essentially and in lay terms, he said my eyes have never played well together, with each competing against the other for dominance. The dominance is an order of magnitude measured in millimetres or less, but it means that my eyes are in constant conflict, resulting in images that go in and out of focus in mere seconds and parts of seconds. He didn’t think that further strabismus surgery would help either. He did offer to refer me to someone for a second opinion, but I trust his judgement on this. The bottom line is that it may take some months for my brain to adjust to the new ‘abnormal’ of the glasses and the lenses from the cataract surgery, and that he doesn’t predict further deterioration. He recommended that I see the optician again in 12 months’ time and if my eyesight has deteriorated further to get a new referral back to him. The real bottom line that I took away (my words, not his) is that this is it and not much else can be done for me. (One other thing he mentioned when I said how bad my grandmother must have had it—her eyes were quite divergent by the time she was 90, with one looking at the ceiling while the other looked at you—was that in some ways she may have been better off because her brain would’ve ignored the messages coming from the wonky eye and only processed those from the ‘normal’ eye. In my case, both eyes want control of my brain.)