Drop, Drop, Rinse, Repeat

March 24, 2006

On Thursday I had LASIK eye surgery performed on both of my eyes. while the result will be several days, if not weeks, in the making, I am pleased to say that I am already noticing differences.

Being analytical ("You think too much," says P) I spent the days leading up to my procedure looking at things in my life with and without my glasses. I wanted to have fresh memories of what it was like before so as to make the "after" less subjective and more objective. For example, two days ago I could not read the ingredients of my shampoo bottle in the shower, I could not read entries in the phone book (with or without my glasses) unless I used a magnifying glass. Late in the evening after my eyes had lost the effects of the dilation I discovered that out to about six or eight inches I could read anything. Even the fine print on the prescription bottle. Even the phone book. It was an amazing feeling.

This afternoon I had a followup visit, mostly to ensure that the flap made during the procedure was seated properly and to see if I was doing okay. The doctor assured me that in the coming days and weeks, as the incision healed, my vision would continue to improve.

Here then is my story...

Preparation After arriving at the clinic I was taken into the surgery suite so that pictures of my eyes could be taken. Afterwards drops to dilate my eyes were administered and I was taken to a small examination room. There the assistant reviewed with me the post-operative procedures I was to follow. I realize that she has given this spiel hundreds if not thousands of times, but that didn't stop me from feeling a bit put off by the rote, almost sing-song manner she used for her delivery. There are two medicated drops I need to put into my eyes four times a day for the first week. One is a steroid to combat swelling, the other a antibiotic to fight infection. She was very deliberate in telling me that I should place one drop in each eye ("drop, drop") and then wait a minute before repeating with the other drops ("drop, drop"). Doing them too close together might wash the first set out before they had time to be absorbed. We also reviewed the use of artificial tears for the next month to prevent dry eye, and two methods of covering my eyes while I sleep for the next week to prevent accidental rubbing. The final step was to take a Valium.

Consultation Next i met with the surgeon to discuss the procedure and to answer my final question about depth perception. Initially the doctor and I were not on the same wavelength and I was feeling increasingly apprehensive. My fear was that having monovision would destroy my depth perception; I've always had excellent eye-hand coordination and losing it scared me. Eventually we reached a common language and he was able to allay my fears. I fully understand that it will take my brain a while to adapt to the new visual cues it receives from eyes with two different focal ranges, and I am willing to accept some short term clumsiness as I adapt. The surgeon himself has mono vision and leads an active sporting life, so I am confident I will regain most of my prior coordination.

Purple Light and Acrid Smoke Going into the surgery suite and laying down was extremely difficult. Even with the Valium I was very anxious at this point. The assistants were ready for my nervousness and gave me a stuffed tiger to old in my hand while we were underway. Drops to anesthetize my eyes were put in and then the doctor taped my right eyelids open. The tape must have been very mild as I wasn't really aware of it's going on or coming off later. Then a speculum was used to hold the lids completely apart. A suction device was placed on my eye and he wiped the surface with something before making the flap incision. In the consultation he had warned me that my vision would blank out momentarily when the incision was made. When it returned he lifted the flap and asked me to focus on a red light. I could hear the computerized voice of the laser as it worked through the reshaping of my eye's surface. "Acquired." "Twenty-five percent completed." "Fifty percent completed." And so forth. And I could see, haloed around the red target light, faint purple flashes as the laser buzzed on and off. Once the "burn was completed (and I could smell the acrid odor of the removed flesh) the doctor removed the suction, speculum, and tape. I was repositioned for the left eye and the process repeated there.

After a minute or two laying down I was able to sit up and walk to the recovery room on my own. The assistant put in the first set of steroid and antibiotic drops there while I reclined in a comfortable chair. After a minute the doctor came in and had me move to a scope where he could look at my eyes. He explained that the procedure had gone flawlessly, and answered my question about what holds the flap in place. Nothing. Just the natural mechanics of the eye, and the surface tension of the tears in the socket.

Nap time After getting a ride home all I did was sleep for nearly four hours. Wearing the goggles to protect my eyes was odd, but the Valium really wiped me out. Putting the drops in my self proved to be difficult at first. Had I to do this over again I would have practiced before hand. Once I got the hang of it I was able to do the "drop drop pause drop drop" dance without getting my cheeks or ears all wet. Thanks to a poorly timed followup call from the clinic (at 9:30 pm) I was awake for a long time last night, and I found wearing the goggles itchy and uncomfortable. This afternoon, during my checkup I mentioned them to the doctor and he suggested I try the cups which are taped on instead. They fit much closer to my face and don't have a head band to deal with. I'll try them tonight. It is very strange to move about without glasses on at all. I've worn glasses full time since getting out of college, and I wore them most of the time since high school. Not having the world framed by my rims is truly odd. I set aside my last pair, and of course Michele's last pair, but took the rest we had amassed with me to put in their donation bin today. Hopefully someone who isn't a candidate for LASIK, or who can't afford it, will benefit from a pair I no longer need.

Final Thoughts The hardest part now is not rubbing or touching my eyes. When they start to get dry or begin to feel like something is in them, I go apply some artificial tears. I'm sure that being patient while the incision heals and my brain adapts (could be three months) will be a struggle at times. However, the incredible detail I can see now up close is amazing, and as my focal distance returns in the coming days my patience will be rewarded. Driving is doable, but curves seem to sneak up on me. Walking and navigating stairs has not been an issue so far (even with "unbalanced eyes").

Post script: I can only see to type this by hunching over towards the screen. As that is an uncomfortable position to maintain, much of this posting was done in the part of my focal range that is still fuzzy. Please forgive any typographical errors until I can re-edit this piece with fully healed 20/20s.

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Mark H. Nichols

I am a husband, cellist, code prole, nerd, technologist, and all around good guy living and working in fly-over country. You should follow me on Twitter.