As those of you who saw the picture on my personal page may have noticed, I wear glasses. I have worn glasses ever since I was 17 years old. Over that time, I have gotten tired of the discomfort to my nose and ears as well as the headaches that wearing glasses can cause. So, I finally decided to do something about it.
I have very few options since my vision is so bad (between 20/400 and 20/600) that I must wear glasses in order to do my work and to drive. For those of you who don't understand our method of measuring vision, please read my explanation.
As I was saying, my choices are limited. I can wear glasses, but they bother me too much. I could also wear contacts, but I can't see myself sticking something into my eyes. Or, I could have surgical corrections made. For myopia (nearsightedness), you can have Radial Keratotomy (RK) or Photorefractive Keratectomy (PRK - laser). After an evaluation Examination at Memorial Eye Institute, I decided to have the PRK procedures performed on my eyes.
There is only one problem with this. I also have astigmatism. This is when the the lens of the eye is shaped in such a way that it causes two focal points on the retina instead of just one. The maximum acceptable amount of astigmatism for a patient having PRK is 1.5 diopters. My astigmatism is 1.75 in the left eye and 2.5 in the right eye. The only way for me to get around this is to have my astigmatism corrected as well through a procedure known as Astigmatic Keratotomy (AK).
At Memorial Eye Institute, I was told that Dr. Chotiner had done a number of AK and PRK procedures, but he had never had a patient for both procedures. The reason this is important is because a patient receiving both procedures must have a different cut made during the AK using a different diamond blade then is used for someone who is only having astigmatism corrected. If I chose to do this, I would be the first patient where Dr. Chotiner performed both procedures.
I have given it a lot of thought and I feel that the Dr. knows enough and has enough experience to do what needs done to correct my vision. Also, the more I think about having clear vision without glasses or contacts, the more I want to have this done. That doesn't mean I am not scared or worried. I think I would be crazy not to be, especially with something I consider to be so vital, my eyes!
From this point forward, I will continue this in the form of a diary, giving the date and what occurred on that date. I will not make an entry for every day, just those that I feel are meaningful to this page.
If you should have any questions about vision, eye surgery, or what can be done for you, send a message to Memorial Eye Institute.
September 10, 1996 - I had my first surgical procedure today. This was the AK to correct my astigmatism. To help me relax for the surgery, I was given two valium tablets. For those of you who have never had to use valium, it gave me a "floating" sensation. While the valium was dissolving under my tongue, they gave me eye drops to numb my eyes so that I wouldn't feel any pain during the surgery.
When everything was ready for my surgery, they walked me into the operating room and I laid down on the operating table. I am not sure, but I think they strapped my wrists to the table (possibly to prevent any sudden motions from panic). As soon as I was situated on the table, the procedure began.
They first inserted a bracket to hold my eye open during the surgery. Then, they made cuts at the top and bottom of my cornea. I did not see them doing this because it was not in the line of my sight. The only way I could tell they were doing the cutting was because the light seemed to move. You must focus on the light during the surgery, but the cutting causes the eye to move. Although it is really the eye moving, it seems as if the light is moving.
They did my left eye first. While they operated on the left eye, I laid calmly on the table. When they started to do the right eye, I suddenly tensed up and tried to close my eye. I realize now that I must be more protective of my right eye. Maybe it is because that is my dominant eye? I am not sure, but I somehow managed to keep still and they finished the right eye.
After the surgery, they helped me up from the table and walked me to the waiting room where my wife was waiting to take me home. Before I left, they took a picture of me and Dr. Chotiner (see below). I could hardly keep my eyes open because I was sensitive to light at the time.
As they recommended, when I got home I had something to eat, took a pain killer and my eye drops, then went to bed. I slept for about six hours before I woke up. I stayed up for a couple of hours to have dinner and I watched a little TV before going back to bed.
September 11, 1996 - I had an eye examination this morning. They found that both eyes have .25 diopters of astigmatism. This is much better than it was and definitely good enough for me to have the PRK done. They also told me that my astigmatism might fluctuate a little, but it was such a small amount that it is practically negligible.
After my examination, I went to work. It had been less than 24 hours since I had my surgery, and I was returning to work already. My eyes were still a little sensitive to light, and I wasn't supposed to touch them because it would hurt. Sooner or later you accidentally touch them and thats just what happened with me. They were right, it did hurt, but only during the time I touched my eye and for a couple of minutes afterwards.
I have to use medicated eye drops four times a day. I also need to use artificial tears to keep my eyes moist. The healing process uses the moisture that is naturally secreted into the eye.
October 11, 1996 - I had another eye examination today. I was told that my eyes were healing fine and my astigmatism is now 0 in the left eye and .25 in the right eye. They will be able to perform the first laser (PRK) procedure on my left eye next week. I am excited, but nervous and scared as well.
October 16, 1996 - I had my first laser surgery (PRK) today. As soon as I arrived at Memorial Eye Institute, they put drops in my left eye that caused my pupil to shrink. This caused everything to seem darker and fuzzier when viewed with my left eye, but might right eye still saw normally. That really seemed to confuse my brain! It seemed like there was something wrong with my left eye. While I waited for the surgery, I was also given drops to make my eye numb so that I wouldn't feel any pain during the surgery.
As I waited, I talked to some of the other patients in the waiting room. There was a woman there who had already had one eye done and she was there to have her second eye done. She told me about the surgery and that made me even more uncomfortable. Just thinking about having someone do this to your eye is scarey.
When everything was ready, I was walked into the operating room and laid on a chair that would be used for the operation. I didn't have anything to help relax me and that made me even more nervous. I was afraid that I would panic and cause them to make a mistake. That thought made me lay as still as possible because my vision is very important to me.
Once I was situated, they put the bracket in my left eye to keep it open. One of the assistants said they would run me through some tests to prepare me for the actual laser surgery. First, he left me hear how the laser equipment would sound. Then, he showed me how it would look and smell. For this, they just barely touched the skin over my cornea with the laser. At this point, I noticed a burnt flesh smell. I believe it was from the laser burning the skin on my eye.
Next, Dr. Chotiner used a circular shaped blade to cut the skin over my cornea. He then proceeded to scrape off the skin over the cornea of my eye. I lay there completely alert and unable to close my eye, so I could see what he was doing. I don't know what he used to scrape my eye, but I was very uncomfortable watching this. It must have taken 5 to 7 minutes for him to complete this part of the procedure. This was the longest part of the operation. Although I could feel a little pressure on my eye, I didn't feel any pain.
As soon as my eye was cleaned off and dried, they started the laser portion of the surgery. I think the laser was used for only about 45 seconds. I had to focus on a green light in the center of the laser so that the aim on my eye would be correct. Again, there was a burnt flesh smell from the laser.
The worst of it was now over, the whole procedure couldn't have taken more than 10 minutes. Next, I was walked over to the clinic portion of the building where I was given a pain killer and the doctor put a bandage contact in my eye. This is done to protect the healing skin on the cornea from the friction of my eyelid opening and closing. It would give the skin a better chance to heal without damage or added irritation.
Now for the results. They gave me an eye test and I was able to read at 20/50. Although that isn't normal vision (20/20), I was given the impression that it was very good results for immediately after the surgery. They explained that as my eye healed over the next 2 or 3 months, my vision would get better. I had the impression that it is likely I will see 20/20 or better in my left eye once I am fully healed.
Again, they took a picture (see below) of me with Dr. Chotiner right after the surgery. I felt as if my eye wouldn't close because it had been forced open for so long a period of time. Does it look like my left eye is open wider than my right? I think so.
As soon as they were done with me, I went out to the parking lot to wait for my wife to pick me up. I saw her coming and got her attention before she could park the car and get out. I went home and had something to eat before using the eye drops they gave me and going to bed. I basically followed the same procedure that I did after the first surgery.
October 17, 1996 - I had an my post-op eye examination this morning. They said that everything looked good in my left eye and I was able to read at a 20/25 level!!!!! I was amazed. They said that they didn't normally get results this good so soon after the surgery. They also warned my that my vision will fluctuate during the healing period.
October 19, 1996 - As instructed, I removed the contact today. I had never worn contacts and didn't know how to remove it. So, I followed their advice and had my wife use a Q-tip to gently slide the contact down from my cornea until it was at a point where she could flip it out of my eye. Afterwards, I used some artificial tears and everything looked very clear. I think the contact caused things to look a little blurrier than they should have.
October 21, 1996 - I had another examination of my left eye this morning. I was able to read at a 20/40 level. Although this was worse than my last results, I was reminded that my vision would fluctuate during the healing period.
October 25, 1996 - While shaving, I suddenly realized that I didn't need my glasses to see if I was missing any hair! It has been years since I could shave without glasses.
October 27, 1996 - I walked into the bedroom tonight while I wasn't wearing my glasses and I could read the time on my alarm clock. The clock is on the other side of the bed and I normally have to be within a foot or two of the clock to read the time. I find that it is so exciting to notice just what I can see now!
November 1, 1996 - It has been over 2 weeks since my surgery. I had another examination this morning. Great news, I was able to read at 20/20! My eye is healing properly and they will be able to do the operation on my right eye next week.
I am trying to prepare myself for the operation. Although it didn't cause me much physical pain, mentally I don't want to do this again. To have to watch the doctor scrape my eye and to smell the burning flesh. I don't ever want to do this, but I will. Especially when I think about how good my vision is getting in my left eye. I really want to be rid of my glasses.
November 6, 1996 - I had my third and final eye surgery today. This was the laser surgery (PRK) for my right eye. The procedure itself was just like the last one, except I was more relaxed since I knew just what would be done. I even joked around with my fellow patients and the staff at Memorial Eye Institute.
While I was waiting for the surgery, one of the nurses explained that the dominant eye usually heals faster and better than the non-dominant eye. Fortunately, my right eye is the dominant one. I guess that is why they did my left eye first. That way, it would have a couple of weeks to heal before the dominant eye was operated on.
This time, I didn't get to complete an eye examination after the surgery. Therefore, I don't know what my vision was right after the operation. I guess I will get some idea of how well it went when I come in tomorrow for the post-op examination.
I didn't have to wait for my wife to pick me up. She was already there waiting for me. I was surprised that they didn't have her come back to see the surgery. Maybe they offered but she didn't want to see. After all, she saw part of my first surgery and decided she didn't want to see any more!
November 7, 1996 - I had my post-op examination this morning. The vision in my right eye is 20/60. It is not as dramatic an improvement as with my left eye, but from what I understand it is still a very good result. I just keep remembering the woman who told me that her vision was 20/50 the day after surgery. A month later it was 20/30 and another month after that it was 20/15. It takes time to heal from this type of surgery and my vision should get better as it heals.
November 9, 1996 - I removed the bandage contact from my right eye today. After the contact was gone, I noticed that my eye seemed very gritty. I think it is because of the new eye drops that I am using. It seems to have a chalky substance in it.
November 11, 1996 - I had another eye examination. My left eye is still at 20/20 so, it seems to be somewhat stable and at normal vision. My right eye is 20/100. After reading the results from my left eye, you can imagine I was a little disappointed. What Dr. Chotiner explained is that as the skin heals it forms a "suture" where the edges meet and that will make the vision worse. That is what is happening at this time. So, I might still be able to get close to 20/20 vision in my right eye. My next examination is in two weeks.
November 22, 1996 - I had an eye examination today. While I was there, I found out that I have only been giving you information on one of the types of vision they have been measuring. So, here are the results of my latest examination. For both eyes, my distance vision is 20/25 and my near vision is 20/20. I had kept saying that I don't necessarily need to be 20/20, so I am very happy with 20/25. Also, I am still healing and it is likely that my vision will continue to improve. My next examination will be in January.
January 6, 1997 - I had another eye examination today. I had some improvement in my left eye. I was able to read at 20/20 for both distance and near vision! Unfortunately, my right eye appears to have gotten a little worse. My distance vision was at 20/30 and my near vision remained 20/20. This didn't really surprise me, because the last time, I could barely make out the letters at 20/25 with my right eye. So, I feel I am currently borderline between the two.
I told Dr. Chotiner how pleased I am with the results. He seemed to be just as pleased as I am. He explained that as bad as my vision had been, 20/50 would have been good and acceptable results. Fortunately, I am seeing much better than that! I am very happy to be glass free.
March 7, 1997 - I had an eye examination today. My vision seems to have stabilized. I was able to read at 20/20 for near vision in both eyes. The distance vision in my right eye remained 20/30 and in my left eye at 20/20. The good news is that I am almost fully healed. I only have to use the medicated eye drops twice a day for the next month. Then I am done with them! Also, Dr Chotiner explained that with these results, I shouldn't have to worry about needing reading glasses until sometime after I turn 50.
Dr. Chotiner talked about a newer procedure that they are using called LASIK. This is a form of laser surgery like PRK, but it has a few extra benefits. First, astigmatism and near-sightedness can be corrected in the same procedure instead of having to do it separately like I did. Second, it only takes about 5 days to heal from LASIK as opposed to the 6 months I have been healing. Lastly, because it heals so fast and the vision doesn't fluctuate like with PRK, they can do both eyes at the same time! So, now you can get both astigmatism and near-sightedness corrected in one visit instead of 3 like me. It almost makes me wish I had waited, but I am happy with my results and I am glad I have had it done.
The reason for these improvements has to do with the skin over the cornea. During PRK, the skin over the cornea is removed and must grow back. With LASIK, the skin is not removed. Instead, the skin is cut to form a flap which is then flipped away from the cornea. Once the surgery is done, this flap of skin is returned to its proper place over the cornea. This means that instead of completely regrowing the skin over the cornea, it only has to heal the two edges back together like a small cut. I think it is amazing that this can be done so quickly and easily. Now, we don't have to live all of our lives with glasses or contacts. We can go for the surgery and walk out glass free!
July 11, 1997 - I had an eye examination today. My vision has improved in both eyes! Although I have been 20/20 in my left eye, my near-sightedness has still managed to improve. At my last exam, my left eye measured at -.50 and this time it was -.25! My right eye also improved from 20/30 at the last exam to 20/25 this time. If it continues this way, I still might end up with 20/20 vision in both eyes.
January 23, 1998 - I had an eye examination today. I'm now 20/20 in both eyes! After my last examination, I thought this might happen. Makes me very glad I had the surgery. I couldn't have asked for better results!!! Now, I only have to go back for yearly eye examinations.
Although I have had spectacular results with my eye surgery, it is not for everyone. For me, I felt the costs and the risks were worth it. I was tired of all the irritations that come with wearing glasses. For some people, that might not be a problem. But, if you are interested in having corrective surgery, I suggest you check with your eye doctor to see if you qualify and learn about the more current techniques. They are much better than what I went through and the healing time is a lot shorter.