Post-cataract surgery visit #1

My eye still looks good!

• The pressure is a bit higher than expected but not far outside the normal range
• A vision test shows that my vision in my left eye may be about -2.50 (vs. the expected -3.00)

Results of my vision test. Not sure how to read them but I snuck this pic just because :)

Normal procedure is to put one drop each of Maxidex and Acular in my eye (separated by 5 minutes) 3 times daily for 3 weeks; due to this increased pressure, I was instructed to add 3 more Maxidex-only doses per day for the first week only.

My vision will continue to gradually improve in my left eye for the next week or so, but won't be perfect due to my secondary cataract. Even after that is removed, it likely won't be perfectly clear.

My next visit is in 3 weeks; they'll continue to monitor me for 3 months, though, to prep for the secondary cataract procedure.

In the meantime, the expected side effects I will experience include but are not limited to:

• Itchiness
• Slight pain or discomfort
• A feeling like there is something in my eye
• A slight stutter/"flashing" when looking at a light or moving my eyes rapidly (!) - this is definitely already happening all the time and is super fun :)

On a fun note, many have asked me how I'm doing, and my answer has been, "My eye is sore, but I'm doing well!" The rest of this conversation, with Felicity at least, went like this:

Felicity: "What does it feel like to have a sore eye?"

Becca: "I don't know...sort of like you've been punched in the eye?"

Felicity: "I've never been punched in the eye."

Becca: "Huh, me neither."

But I don't know how else to describe it, so... :)

More on cataract surgery and my prognosis

So, what was entailed in my cataract surgery, and how did it go? If you don't like hearing about surgeries or graphic things, don't read on :)

Another successful surgery!

I had my cataract removed today; once I can see better I'll post much more detail :)

Here's a quick post-surgery snap; note my left pupil is back to being black, which is so so good :)

My left eye is dilated and no longer has a cataract in it! This is about 5 minutes post-op.

Before [cataract surgery] photos

Finally got photos from Dr. Shields back, so am retroactively posting these before photos so you can get an idea of how dense my cataract was :)

Trigger warning: basically none. Just close-ups of my eyes :)

The unavoidable cataract

A known side effect of plaque radiotherapy is that in 2-3 years, the patient will develop a cataract.

Well, as predicted, I now have a very dense cataract in my left eye (still working on getting the pics but if/when I do, I'll post them for those interested).

Basically, the radiation has caused the fluid inside of my lens to become cloudy.

The upshot is that the vision in my left eye has grown progressively worse.

I didn't do a good job tracking exactly when this started or how it progressed, but here's what I can say: my left I was formerly my dominant one. Sometime this spring, I switched from taking photos using my left eye to using my right. Over the summer, the cataract became visual to the casual observer of my face. In late September when I went hiking, I realized I had to go much slower than I was used to in order to avoid tripping. In early October, I realized driving might be something I want to do with extra caution (i.e. turning my head all the way around when merging from right to left).

At this point I am practically blind in my left eye. I can't see you if you're on my left side. More importantly to day-to-day life, I have almost no depth perception. This has led to some exciting scenarios in which I a) walk into people next to me or door frames, b) attempt to light a candle by holding a match 1.5 cm away from the wick, or c) pour water onto the table rather than into a glass (the trick for this one is to bring the pitcher in contact with the water first, as a double-check).

This is the closest I could find on google image search to what my vision is currently like in my left eye:

But actually mine's far worse. There is no distance at which I can read out of my left eye. I can only tell how many fingers you are holding up if you are within 6 inches of my face. I can see light and dark, ish, but the light has a yellowish tinge.

The good news is that it's operable! I am pursuing cataract surgery here in Denmark ("grå stær" means cataract in Danish) -- [much] more on that soon. Additional good news is that though the surgery will require a specialist, my lens looks ok. The radiation has weakened its elasticity, which is part of what makes the procedure a bit higher risk, but it is tight, not "wrinkly," which is a good sign.

Sorry for the long hiatus, and more coming soon!

Verdict?

At my 1-year(ish) checkup in Philadelphia, I was pleased to discover that I have "good life prognosis." Let me explain.

At the Shields' practice at Wills Eye Hospital, Dr. Carol Shields is consistently surrounded by students, residents, fellows...generally learners. She is training the next generation, and this takes time. So these helpers often prepare each room and patient for her, to allow her to be as efficient as possible.

Dr. Shields entered my room, was briefed by her crew, and then dictated a letter that contained the quote above, as well as a lot of other precise medical terminology. But the following quotes indicate that I am recovering nicely:

"The affected left eye previously had diffuse iris melanoma...the tumor is very dusky in appearance with no evidence of vascularity and appears regressed...Rebecca has had a good response to plaque radiotherapy."

So there you have it. Yay!

2-month post-op update - addendum

Dr. Rumery called me back to ask that I come back in so he could test the pressure in my eye (a quick and simple test) so we coordinated and somewhat sketchily / awesomely met up at the Dean Clinic on the West Side after hours to get me checked out before he went on vacation (thanks again, Dr. Rumery, for being so flexible and awesome!)

For those interested, after a numbing drop, Dr. Rumery used a hand-held applanation tonometer, which I find to be vastly preferable to the puff of air method:

It didn't look exactly like this one, but this picture was too awesome not to include

Anyways, good news:

• left eye: 8 mmHg (the one of interest)
• right eye: 11 mmHg

Background on this measurement and why it matters from the Ocular tonometry wikipedia page:

Tonometry is the procedure eye care professionals perform to determine the intraocular pressure (IOP), the fluid pressure inside the eye. It is an important test in the evaluation of patients at risk from glaucoma.^[1] Most tonometers are calibrated to measure pressure in millimeters of mercury (mmHg).