Annual Eye Exam – Cataract Update

Had an appointment with my regular ophthalmologist. Here are thoughts on the 2013 exam.

Since last year, my vision in my left eye has been blurry. Read about my followup on that issue here and here.

In general, my eyes are fine. Retina is good. Pressure in each eye was 16. The left eye, however, has a cataract.

Asked the doctor if it could happen quickly, as it wasn’t an issue during my 2013 annual exam.

Yes, they can happen quickly. Of course, if you look back through my posts over the last couple of years, you’ll see that the issue has been mentioned before. It wasn’t affecting my sight, but there was a little clouding and the lens was yellow.

Previously, I thought all cataract-related things I was experiencing has to due with age. Right now, I’m 41. As you get older, your the lenses in your eyes yellow and get cloudy. Still, I’m 41.

Doctor said this is possibly a complication of the ICL, but there is no way to tell. Nearsighted people often get cataracts earlier in life. And there are plenty of people even younger than I am who have had cataracts.

Regardless, it’s definitely a cataract.

I asked him if he thought I’d be crazy to go ahead and have it removed within the next year. He said no.

He said sometimes people wait and everything is fine — the cloudiness doesn’t get worse. But also, as it progresses, it can be more difficult to remove.

It’s not urgent, but it’s something to be aware of. Will be going to see the surgeon to did the ICL/PRK procedures on me over next few months. When that happens, I’ll have more info on how things are progressing and be able to make a better decision then.

Worth noting is HOW the surgery will work…

This doctor said that the ICL would be removed with the correction coming from the lens used to replace my natural (and clouded) lens. I have heard the same thing from another surgeon. However, the surgeon who did my ICL/PRK procedures, unless I misunderstood him, said that he is able to do cataract surgery around the ICL and will replace the natural lens with a plain one, giving me two implanted lenses in that eye.

Knowing what I know now, and going through what I’m experiencing now, I’d still do it again. So far, I’ve heard nothing to make me think I can’t get my vision to where I want it to be.

Blurry Left Eye – Another Followup Exam

Just had a followup on my 3.5-year ICL Followup concerning a bit of blur in my left eye.

The good news is that it’s not pathologic myopic, so my eye is not getting longer.

The bad news is that it’s a cataract. According to my surgeon, people will high myopia are more likely to see them early in life. And “early in life” in this case means 41.

Eye pressure was 12 in right and 19 in left.

The blur in my left eye can be corrected with glasses, so I got a prescription. Right eye is a little nearsighted too.

New prescription:

OD: -0.50/-0.75 x 002
OS: -1.25/-1.25 x 007

What I had before ICL/PRK:

OD: -13.00/+1.75 x 90
OS: -13.75/+2.50 x 90

Obviously, even with a cataract, my vision isn’t nearly as blurry as it used to be. Still, it’s a little frustrating.

It’s worth noting that this cataract is behind the ICL and wasn’t caused during surgery, because my natural lens was touched.

Going back for a follow in six months. Also have an appointment with my regular ophthalmologist in about four months, where I’m going to get another opinion.

ICL – 3.5 Year Followup

If you’re considering ICLs, or already have them, you’re probably aware that endothelial cell loss is a concern. Knowing this, I set an appointment with the office where I had my ICLs implanted.

Endothelial cell count was fine. Doctor told me, “Almost the same as before you had ICLs implanted.”

Eye pressure was 15 in right and 19 in left.

Everything looked good. Doctor looking at my eyes had pretty much the same comments as my normal ophthalmologist. Good vault, a little pigment on the lenses (which had been noted earlier), and “deep and quiet.”

The downside was that the natural lens in my left eye looked a little “yellow.”  Not sure this is ICL related…  I’m now 41 and maybe it’s totally normal for my age.

And speaking of my left eye…

A few months ago, I noticed my distance vision in my left eye was a little blurry. This seemed pretty sudden, but as I’m right-eye dominate, it may have been going on for a bit before I noticed. With that said, I had an eye exam 3-4 months before I did notice and it wasn’t an issue there, as far as I know.

When I did notice, I wasn’t sure what was happening, but it wasn’t enough for me to set another appointment with my normal eye doctor, especially since I knew I needed to go to the surgeon’s office to get endothelial cell numbers.

That’s where I was with it.

Today, the doctor looking at me confirmed that  the left eye is definitely nearsighted. I didn’t ask how much. I was more concerned when the words “pathological myopia” came up. More info on that is here. Scary.

So I had a bunch of extra tests done, maybe seven, including “pictures of the back of my eyeball” and a lot of measurements.

On a positive note, my eye length hasn’t changed since before I started this journey.  In fact, everything seemed to be pretty normal.

I asked the doctor if I should worry. She said, “Don’t worry yet.” Said that if she felt there was a retina issue, she would send me to somebody right away. But she is having me come back in six weeks to talk to the head surgeon.

Will post more when I know something…

General Lifestyle Comments

Having ICLs changed my life. I love not being so dependent on corrective lenses to get around. Even with a little blur in my left eye, it’s nothing like I had previously. Still, it’s a bit frustrating to have a “fix” and not have things working as they should, even if I’m not sure what’s happening right now is ICL related.

 

Annual Eye Exam 2013 – ICL/PRK Update

Just finished my annual eye exam for 2013. (2011 and 2012 reports)

Going in, I was a bit nervous. It’s been three years since I had my ICL surgeries and almost as long for the PRK. Although I feel I’m better with low-light situations, like driving at night (halo issue is getting better), I’m not sure my general vision is what it was right after the surgery was done.

Tests say that everything is fine. No changes for the last two years, which I was happy with. Eye pressure was 15 in each eye. Read the chart just as well. ICL looks good. LPIs look fine. Retina is in good shape.

General Lifestyle Comments

As mentioned above, driving at night is better. I wouldn’t want to get a job with a lot of night driving, but for a quick, after-dark trip, I’m fine.

I’ve heard a few people say that “you get used to halos” since our brains somehow work around them. I saw a statistic that 90% of people have less haloing after a year. For me, I’m not sure if it’s my brain working around the issue or my pupils aren’t dilating as much as they were, but regardless, I’m happy for the ability to get around better at night.

Worth it? Yes. It’s a very freeing feeling to not be dependent on glasses or contacts, which I was for 35 years.

Next step for me is to get a count of endothelial cells, which can be affected by ICLs. Expect that to happen within the next couple of months.

Annual Eye Exam 2012 – ICL/PRK Update

Another year, another annual eye exam. (See 2011 annual exam report here.)

Two years ago, I had an appointment in this same office and finally made the decision to get ICLs. Definitely a scary thing at times and a lot of appointments, from getting into soft lenses for the transition period, to pre-op tests, to the surgery itself, to the post-op followup and recovery…

A couple of months later, after doing all the prep work (including getting out of RGP contacts for a few weeks), I did the ICL surgery, with PRK followed a couple of months after that.

Nothing to report really… While I feel like I’m seeing fine outdoors and in most indoor situations, as long as the lighting is ok, I found reading the chart to be more difficult than it had been right after I had surgery. Didn’t ask how well I did. Did well on the close-up test.

One of my main concerns when I went in was the “hazing” the doctor had seen on my lenses last year. Talked to the tech about this and she said, while there was a little clouding, it was mild and could simply be an age-related issue. Definitely not something to worry about now.

Did the “Which one is better, one or two?” test with a few lenses and pretty much had zero correction in each eye. That was good.

Eye pressure was 16 in my right and 17 in my left, which was within the “normal” range. Higher than it has been in some tests, but from what I understand, this can vary due to who does the testing. If the technician presses hard, for example, it can make the pressure higher.

Doctor took at look at the ICLs. They look fine.

LPIs look good. No problems there.

Retinal attachment  looks fine.

General Lifestyle Comments

My biggest issue with my vision is halos at night. I feel safe driving (for the most part) and it doesn’t keep me home, but if I can schedule to do something at another time of day or get somebody else to drive, I choose that most of the time.

I don’t have major dryness that you sometimes hear about from LASIK patients. I keep of bottle of Systane Ultra (eye drops) by my bed and sometimes use it in the morning, but consider it optional.

Was it worth it? Yes. The lifestyle enhancements have been wonderful; a huge improvement from where I was when I started this. Even with the halos I see at night, I would do it again and recommend it to anybody who is in a similar situation to the one I was in.

ICL – 1-Year Followup

Had my one-year followup with the ICL surgeon today.

First test was to check refraction. Look at the red light, don’t blink, blink, now hold it, etc. Had another similar test after that, which I think was to map my cornea. Honestly, after doing all of these tests (as well as several others) multiple times over the last year, I’ve forgotten what each of them do…

My main concern today was to know whether the ICL/PRK surgeries that I’ve had within the last year have been successful and I had one big question about the “slight” clouding my normal ophthalmologist noticed in my right lens a couple of months ago. Other than that, I didn’t ask too many questions…

Next test was reading letters off the wall. Seeing 20/25. Not as good as I had done previously, which has been as good as 20/15, but not bad. Closeup as about the same.

I’ve read a few things over the years about people getting depressed after LASIK and other vision improvement procedures and I can totally understand why, especially for those that had pretty good vision to start with. These procedures, at least from my experience, aren’t perfect and your vision will fluctuate. Still, comparing things to where I was before the surgeries, I can’t complain. While my vision might not be perfect, it’s still pretty good. Can read the small text on my mobile phone, the small date on my analog watch, etc.

Eye pressure was 14 in each eye.

Had my eyes dilated, then the surgeon came in and took a look. Asked him about the clouding and he said it was just pigment on the lens, which is common with this procedure and nothing to worry about. Implant had good vaulting and wasn’t touching my natural lens, which were both clear. Everything was fine.

Over the last year, I’ve been experiencing halos when driving at night, and, although they’re much better than they were initially and I no longer feel they are a safety issue, they’re still a concern.

Asked if glasses when I drive at night could help that and he said, “Maybe.”  This will probably be something I’ll try, since I already have the frames from my previous glasses and it will be easy to pop some new lenses in.

More or less, everything is good… Next followup is in one year when I’ll go back in for a standard exam as well as a check of my endothelial cell count.

Overall, this has been a great experience and the freedom of not having to worry about losing a contact lens and being able to travel without taking bottles of cleaner, disinfectant, and saline solution has been wonderful. Plus, even though I only tested 20/25, my vision is better than ever.

If I had to do it again, I would.

Annual Eye Exam – ICL/PRK Update

Had my annual exam with my regular ophthalmologist today. This was scheduled last year, before I had been through either ICL or PRK and I kept, even though I have been through several exams and followups since, just to get a different opinion on what is happening.

Started with reading the chart off the wall. Seeing 20/25 in both eyes.

Read off a small card, about the distance I’d use to read a book, and tested 20/30.

Can I see better than 20/30 close up? I don’t know. Not to make excuses, but it was a dimly lit room with a single florescent fixture overhead and not the usual way somebody would read print that small. Still, I was a bit concerned.

Pressure check was 13 in my right eye and 16 in my left.

My eyes were dilated. No signs  of retinal detachment. ICL looks good, although he did advise me that the procedure is still very new and he hasn’t seen a lot of them, so it’s best to ask the surgeon for specific questions about that.

The scary thing about this visit was that he mentioned “slight” clouding in the right eye. Said this was normal for somebody my age (38), but he wanted to mark it down and watch it, to see if it progresses.

Not sure that this has anything to do with the ICL or not. It hasn’t been mentioned in previous visits, but I also haven’t had my eyes dilated either.

Talked to him about halos while driving at night and he wrote me a prescription, which he said might help.  I’ve included it below, along with the other two prescriptions I’ve had in the last year, to give you an idea of the massive change that I’ve experienced this year.

While the “slight clouding” is a little disturbing, I’m waiting until the followup with the surgeon who did both the ICL and PRK procedures before concerning myself with it. Will post that information here as soon as I get it.

Original prescription:
OD: -13.00/+1.75 x 90
OS: -13.75/+2.50 x 90

Post-ICL / Pre-PRK prescription:
OD: -3.00/+2.50 x 90
OS: -4.25/+3.00 x 95

Current (optional) prescription for driving at night:
OD: -0.25/+0.25 x 90
OS: -1.25/+0.75 x 90

 

PRK – 6-Month Followup and Recovery Experience

Had my “six-month” PRK followup today, but it’s actually been almost eight months since I had the procedure.

Vision is 20/20 in both eyes. Eye pressure was 16, which was a little higher than the last check I had, but still within the acceptable range of 12-21. It was also done with a different machine and a different tech, which may have affected things.

Recovery has been good. Still have halos at night, but they’re not as bad as they were a few months ago. This is common with many people having improved results for the first year, so I’m being patient.

In addition to halos, I also experience a little glare at times.

No dry eye issues, although I do use eye drops (Systane Ultra) most days when I wake up and sometimes throughout the day, usually when I am doing a lot of reading or computer work.

ICLs look good.

Knowing what I know, I’d do it again. The vision I have, especially when there is plenty of light, is great. The freedom and convenience is even better.

PRK – 15-Week Followup and Recovery Experience

It’s been about 15 weeks since my PRK surgery.  Vision is great, with the exception of halos at night, so I visited the eye doctor today to get checked out, just to be sure everything is going as it should.

Vision is 20/20 in both eyes.  Pressure is 10 in each eye.  ICL looks good.

I had maybe a week or so of steroids left, but as my vision is stable, he went ahead and took me off them.  So no more drops, other than tears, which I use a few times a day, to (hopefully) help speed up the healing process.  No “dry eye” issues at all.

The only problem seems to be halos at night.  I can drive, but headlights and streetlamps are a big distraction and I’ve been keeping off the road as much as possible when it’s not daylight.  I think the problem is getting better, but it’s not something that happens overnight, so it’s difficult to tell.

This is a common issue with PRK or LASIK, often due to large pupils, which is probably the case with me.  There are a couple of options to help, including “glaucoma eye drops” with the side-effect of reducing pupils and minus lenses, which reduce pupil size because the eye is working harder.

Have read several stories of people having the same issue and it going away.  Hoping for that result soon.

Still happy with both ICL and PRK, by the way.

PRK – 2-Month Followup and Recovery Experience

Just finished up my two-month PRK followup.

Vision has improved from last time.  Seeing 20/15 with both eyes, which is pretty amazing, especially considering where I started.

With that said, I am experiencing starbursts/halos at night and driving after dark is something I’ve been trying to avoid, if possible.  Talked to the doctor about this and it may have something to do with the size of my pupils or it may have something to do with the PRK, which is still in the process of healing.  This situation is common; sometimes this improves, sometimes not.

Have another four months to wait, before we know the final results, so it’s not something that is making me nervous.  If it’s not something that resolves itself physically, it may be that my brain will learn to compensate for it.  If not, worst case scenario is that I get some “minus glasses” for night driving that would make me focus and help to restrict pupil size.

This exam was similar to the other followups in that my vision was tested by reading letters off the wall.  Also had a scan of the surface of my eye done.

Doctor looked at ICL.  Everything is normal.  Vaulting is good, retina is good, etc.

Still on Lotemax (steroids), but am reducing it to 2x/day for the next month and 1x/day for the following month.  After that, I’m done with prescription drops.

Next followup is in six months.