Eye Check-up Gone Awry

Gold flashes at the edge of my eyes marked the beginning of my saga after my twenty thousand steps in Machu Picchu in Peru. After the Citadel, we walked around at an even higher altitude in Peru's Lake Titicaca and Puno area. The altitude of 12,810 feet at Sillustani, a pre-Inca burial site, was our highest.

See an eye doctor, female friends said.

The ophthalmologist said the flashing lights were something to watch and weren’t from altitude.

Fast forward to December 22, 2020, Cataract surgery, left eye.

12/31/2020, cataract surgery, right eye. Eye surgery in a pandemic at an Army hospital stateside.

** Army hospital, operating room, and a surgical team dedicated to me – no cattle call for my eye surgeries! Army Ophthalmologists, active duty.

“Wow, I had no idea our neighbor’s house was that color! Everything is so bright and vibrant,” I told my husband afterward. No more gold flashes down the side of my eye, but I did have floaters – tiny dots that seemed to be fruit flies or wavy hair-like lines floating constantly across my vision.

In June 2021, we were having lunch in the Bend, Oregon, area. Suddenly, black vertical lines float down my left eye, like INK. I am at the Army Hospital in Ophthalmology three days later.

Numbing drops. “Look up, look down,” then a probe stuck into my eye. This went on for well over an hour. My husband left the room; he couldn’t listen or look at it any longer.

The resident examined me. A staff physician examined me. Diagnosis: torn retina in the left eye.

“We need to laser it.” Consent forms were signed, and explanations were given.

The surgeon who did my cataract surgery tried to do the laser, but he couldn’t get the laser onto the spot. It was on the far left of my eye, outside the normal radius (like everything with me, strange).

A Retina doctor was called in. Laser didn’t work.

“We need to cryo it,” he told the first doctor.

The surgeon tried unsuccessfully, but the retina doctor did it in less than a minute. Success.

“Let us know if you see a flurry of floaters. You are good to go.”

We closed down the hospital and clinic that day. Over five hours there, my husband patiently waited because that is what he was taught as a young soldier; we called it “hurry up and wait.” They waited for many things, those soldiers, so they were used to waiting.

Six months later, another minor laser correction for a film that had grown. Success. There are still lots of floaters, but I see well.

Regular eye checks are conducted to ensure the retina hasn’t torn or new issues have developed. My distance vision is like an Eagle's, but I need readers and a different pair for the computer (just like the old progressive eyeglasses).

February 7, 2024 – a check-up that went horribly awry

“Oh, I see a little wrinkle that I should laser. I will have my Staff doctor come in and look, and while we wait, I can put a silicone plug into the right eye.”

Six months ago, they could not insert the plug into the left eye. The purpose is to close the tear duct so your tears stay on the eye's surface and reduce dryness. The right eye had a gel inserted that had dissolved. Since, that had improved the right eye; I asked for them to do both at this appointment.

“I will do the right eye first; I have to enlarge the hole.” Numbing drops, then a tool to poke in and make it larger; no problem, didn’t hurt much. She tapped in the plug, which disappeared, only wasn’t supposed to. They are clear in color, and not easy to see. Did it fall out on my cheek? She didn’t think so. The left eye plug definitely fell out on my cheek, and she couldn’t get it in the tear duct.

The senior resident came to do another pokey-eye exam, looking for retina tears. Yikes, it hurt, no matter how many numbing drops.

SURE ENOUGH. She found an issue: a wrinkle of the eye vitreous gel, pulling hard on my retina, which could cause a tear. A DIFFERENT wrinkle than the first doctor found; a concerning wrinkle of the vitreous gel.

** If you have a retinal tear, it can blind you. It must be treated immediately. A flurry of floaters, which can be wavy lines or dots, means it is torn. It is an EMERGENCY.

“Best practice is to laser a circle around this wrinkle so if it does tear, the fluid will be contained within the lasered circle.”

She reinforced the usual explanations and had me sign consent forms. You might have a blind spot, blah, blah. The doctor repeatedly emphasized: LOOK UP TO THE RIGHT, don’t look elsewhere when I laser, don’t blink.

“Ok, there is the spot; now I’m going to laser, ready?” BANG BANG, the laser light continued until I moaned - she stopped then.

Think of a sci-fi movie where there is a nuclear event, and the person is lit up with all their veins showing. That is what you see when they laser your eye. SUPER bright light can HURT; sometimes, it doesn’t hurt.

It HURT. Like someone pounding the eyeball. And she had to do it three times. I saw a green light and all the veins in my eyes before it went to white blindness.

She left the room to see another patient and told me to rest.

I was seriously stressed and needed to scream or cry, but I forced myself to breathe deeply. Had I cried, I wouldn’t have been able to stop, and they couldn’t have finished their treatments.

Then they walked me to another room to look with a different light to ensure the lasered circle was completed to their satisfaction.

Finally, they explained they must get the punctal plug out, so it won’t cause an infection. They had conferred with the oculoplasty doctor. “I’m so sorry, but we must try to get that plug out of the right eye. There are right angles in the tear duct. When I put it in, I could see it, and then your body just sucked in too deep. We will have you wait in the waiting room until we are ready.”

My eyes are red from the drops and poking. My husband looks at me and tries to comfort me, but I tell him no, don’t. I don’t want to lose my composure and if he consoles me, hugs me, I will burst into tears. I want to finish this and go home. I tell him, “Guess what? Now they need to cut my tear duct open to find the plug. They will do it and won’t find it; you watch.” He is rubbing his forehead in stress.

Once ready for me, they again put in numbing drops, and I see two super long Q-tips above my eyes.

“You are going to try and squeeze it out?”

“Ah, ha, yes, how did you know?”

“Because I am old!” was my reply. It doesn’t take a genius to figure out what they intended with the Q-tips. One under and one above, maybe they could push it out of the tear duct.

It didn’t work. I tasted salt. The flushing saline into the tear duct was draining the salt water into my throat.

The story continues:

It's time to do it; we are in Room 10, their surgical room for minor surgery. “We will inject a numbing agent under your eye and make an incision in the tear duct to look for that punctal plug.”

We donned face masks, hair nets, and all the normal surgery prep inside the clinic. The overhead lights were blinding and painful.

"I will put an opaque contact in the right eye, and you close your left eye; don’t squeeze so we can open your right eye.” First the numbing drops, then the injection. “A poke first; here comes the burn.” Yeah, it burned!

“Get me the curette.” It's a good thing I can’t feel this; I’m trying to relax under the pressure of their fingers and tools probing in my eye. Curette? Isn’t that a blade? They worked together in the cutting, poking, and looking, while I was doing my best to control my nerves and the muscle twinge in my back.

~~I have a high threshold for pain. If I am squirming or moaning, it is truly horrid.~~

It was painful enough to make me strain on the table and the resident told me not to move; the senior resident continued prodding in my eye. It felt like she had a knife poking the bone on the side of my nose.

The duct plug was not found. I told them the plugs needed to be colored so that they were easily located, or at least able to be found under ultraviolet light – something to improve all of this (ever the process improvement leader). She then had to remove the opaque contact lens they had put in; she needed forceps to pull it out, which was incredibly uncomfortable.

“I’m so sorry for all of this and how long it all took. We know you are leaving for a three-week trip soon, so we will get you back next week. How about February 15? The good thing is that our minor surgery will cause scarring in the duct, and that will do the exact same thing the plug is meant to do. You will have bloody tears for a day. If there is any swelling or sign of infection or any new floaters, come in immediately. Otherwise, use the antibiotic steroid ointment twice daily, and we will see you next week before your trip.

Of course, I'm thinking, I hope that plug fell out; I hope it isn't in there and going to cause an infection; I hope they don't have to do a more invasive surgery to get it out. DAMN!!

**

The area on my nose beneath my right eye had a dull, burning ache all the way home. I put a cold compress on the side of my nose where it felt swollen, right below my eye. I didn’t sleep well. I can see now, the day after, but the right eye is runny.

2/9/2024 Eye oozing and another exam. Oculoplasty doctor examined me, using two Q-tips, poking around, cleaning eye. No infection, use different drops 4 times per day. Then he said he was confident the plug was not in my tear duct because he would have been able to feel it with his prodding of the area. Later that night, I thought: why didn't he advise them to try and feel it like he did, BEFORE, they cut my tear duct open? That will be my question on my follow up appointment!