After my decidedly nightmarish and farcical cataract assessment appointment at Moorfields in May and the stress that followed due to Moorfields noting down the wrong eye in my post-appointment letter, plus the necessity for herculean efforts to obtain a tiny bottle of prescription eye drops from my GP, I was looking forward to my next appointment on 4 June like a hole in the head. I spent a considerable portion of the interim period gloomily contemplating my fading visual future, and trying to test the vision in my bad eye in an effort to figure out whether or not the eye drops were working. I had absolutely no idea, but this did little to stop my obsessive efforts to determine whether picture frames were straighter than they had been the previous day, or using my Excel document of new course approvals at work as a makeshift Amsler grid. Anyone observing me staring intently at my computer screen might be forgiven for making the entirely inaccurate assumption that I was enthusiastically engrossed in my day job. The only things I was really focused on were whether there would be another train strike on the day of my appointment; whether the consultant would be present; and whether or not it would be postponed at the last minute.
A fortnight before 4 June, I was able to breathe a sigh of relief: no further train strikes had been announced. (Trade unions in the UK are legally obliged to give two weeks’ notice of any industrial action.) The day before my appointment, I followed the advice given to ring the hospital to check that the consultant would be there. After some time spent riding the not-so-merry-go-round of Moorfields’ telephone system once again, I was finally given the information that yes, the consultant would be there. Phew. I assumed from the cheery, “We’ll see you tomorrow!” that they weren’t planning to postpone me at the last minute, so that elicited another sigh of relief. It appeared that the appointment was ON. Now all I needed to worry about was getting to the railway station the next morning and then the small matter of what hideous news might be imparted to me this time…
Standing on the station platform the next morning, teeth chattering together nervously in the warm sunshine, I was surprised to hear my name being called. It was one of my old colleagues who I’d worked with before the really spectacular mismanagement and endless rounds of restructures had begun to kick in at my workplace. She’d managed to make her escape a few years back, and certainly looked all the better for having done so! We chatted for a while about the good old days, before moving onto politics and exchanging podcast recommendations. Listening to her friendly Irish tones made me feel slightly calmer and the train journey seemed to pass relatively quickly as a result.
My sister met me at Moorfields, and after a quick sarnie and scan of my ever-expanding list of questions, we headed into the clinic. It was packed. So packed, that the receptionist asked us to wait at the entrance while she went to scope out a couple of seats before leading us into the depths of the labyrinth of tiny rooms. We settled down for another long wait and weren’t disappointed in that regard. However, this time it really didn’t matter as there were no train strikes.
After a while, I had another set of OCT scans, and following a further wait was called for the visual acuity and pressure checks. My heart sank when, upon holding the occluder up to cover my good eye, I couldn’t even see any of the letters on the screen at all with my bad eye. Off went the nurse to fetch a piece of paper bearing a giant letter, which I was able to read, before she returned to the screen which had been playing up due to an issue with the remote control. Upon completing the rest with my good eye I asked her, with some trepidation, what the numbers were. “6/38 in the right and 6/7.5 in the left”, she informed me. I gawped at her in disbelief. “6/38 in the right?”, I asked, “Are you sure?” “Yes, yes!”, she nodded. “But it was 6/75 at my appointment last month!”, I said, feeling utterly baffled. “Yes – it’s improved!”, she said, nodding again as she assured me that she’d checked the previous reading. “But how can that be?”, I asked, before it suddenly occurred to me: “Ooooh, the drops! I’ve been on drops for fluid on the macula! Might they be working?”, I asked hopefully. She told me that the doctor would talk to me, but assured me that the visual acuity was definitely better, even suggesting that I walk right up to the screen to check the little numbers beside the letters and see for myself. Next came the eye pressure check, which was thankfully fine, followed by the eye-watering sting of dilation drops. I returned to my seat in the overflow area feeling ever so slightly more hopeful.
More waiting ensued, but I couldn’t concentrate on a game of “I Spy” and my vision was rapidly blurring as a result of the drops. There was a debate about whether or not I needed more measurement scans (I didn’t), and then I was eventually called in to see an ophthalmologist. There was also a medical student sitting in to observe. It’s actually quite good when this happens, as it often means that there are additional discussions or explanations for the benefit of the student, which I can learn from.
Thankfully, the ophthalmologist was really good, and we had quite a detailed discussion about the potential pros and cons of cataract surgery, timings, the dreaded potential polar cataract, and the fluid in my bad eye. She had a look at my eyes and then went off to fetch the consultant, who was also really good and pretty much confirmed what she’d already said plus answering some more of my many questions. Basically, the ophthalmologist confirmed that the fluid is macular edema and explained that the likely cause was an epiretinal membrane, causing some swelling and traction. (I still don’t entirely understand this, but she wasn’t worried about it, which made me feel slightly better.) She said the fluid was still there, but had improved due to the drops. They both said that they couldn’t categorically confirm whether or not one of the cataracts is polar, but reassured me that when the time comes for surgery, they’ll make provisions in case it is. That old chestnut of assume the worst but hope for the best. In terms of timing of cataract surgery, I explained that I don’t want to jump the gun and go for it too soon, for fear of complications. Although my life is currently quite negatively affected by the cataracts, I’m acutely aware that if anything goes wrong it could be so, so much worse. This terrifies me. However, equally, I don’t want to risk waiting until the cataracts have got so dense that it would make the surgery more difficult and potentially risk a poorer visual outcome.
This time, I received a relatively straight answer to that question. The consultant said that in terms of density, he’d estimate that it would take one to two years before it would start to make surgery more tricky, but in terms of quality of life, it would be less than this before I’d need surgery. He also said he wouldn’t want to leave it up to the wire of two years, as there was plenty of cataract to be getting on with. Gulp. I’d been hoping that even if I have to give up driving, the density wouldn’t pose a problem in terms of doing the actual surgery for a good few years yet, so this came as quite a blow. But at least he gave me a straight answer, for which I was grateful.
The consultant headed back out into the packed clinic and the other ophthalmologist finished up with instructions about continuing the drops in my right eye. We thanked her profusely for all her time and patience in answering my questions, and she made a comment about knowing I’d be anxious after having read my notes and all the back and forth after the previous appointment, so lord knows what’s on record in my file after all that farce! She finished by telling us to go and relax, and have a croissant…
“How does she know that my post-appointment treat / condolence comfort food is an almond croissant?!”, I muttered to my sister as we made our way to Waterloo station. “What did you make of that appointment, then?”, I asked, through a mouthful of almond croissant as we sat on the platform to wait for the train, with two steaming cups of tea at our feet. “Well”, she said, “polar opposite to the last one, wasn’t it?!”
RD Ramblings 