Hunt the optometrist: round 4

As the day of my annual ‘normal’ eye examination loomed, I decided to continue my quest to find a decent optometrist in Canterbury.  Now, before going any further here, let me explain that I’m talking about what most people refer to as an optician, for a standard eye test.  However, if we want to be accurate about things (and, trust me, I usually do), an optician is actually the person who makes and fits glasses and contact lenses.  An optometrist carries out eye tests, prescribes corrective lenses, and is qualified to diagnose certain eye abnormalities and diseases and prescribe medication for them or refer for further treatment.  An ophthalmologist is a medical doctor who specialises in eyes and is qualified to practice medicine and surgery.

After my first retinal detachment, I stopped going to the high street optometrists I’d been visiting for years, because I realised that they hadn’t given me the correct information about floaters.  (See ‘How it all began‘ if you’re wondering what they told me and why it was wrong.)  If they’d given me the correct advice, it’s possible that things may have been very different for me.  I then began using another popular high street optometrist, until I was informed one day upon going in for a quick eye pressure check, as I’d been doing sporadically for the past year or so, that they could no longer do this.  In my attempts to discover the reason for their abrupt policy change, I became involved in several heated discussions in which they told me that a) the hospital should be doing the pressure checks and was just ‘fobbing off’ their work; and b) as my eyes had so many problems, I might sue them if they got the pressure readings wrong.  Needless to say, my blood was boiling by this point and I vowed never to darken their door again.  In contrast to their customary advertising campaign, I think this behaviour demonstrates precisely why people shouldn’t go to this particular optometrists.

On my next visit to an optometrist, I plumped for an independent one (as detailed in ‘Post appointment panic‘).  Apart from the fact that he reminded me of John Major and had a sense of humour (or lack, thereof) to match, this grey-faced chap put me off by trying to tell me that it was possible to see enough of the retina to check it properly without using dilation drops.  I know that this simply isn’t true – not when checking for tears, anyway.

So it was after extensive research that I set off early on Saturday morning to another carefully selected independent optometrist, to put them through their paces for my eye test.  It started well, as I was greeted by a smiling receptionist and then a polite fellow who bore no resemblance to any politician I can think of.  He began the appointment by asking cheerfully, “So, is everything okay with your eyes then?”  I shifted uncomfortably in the chair as I responded almost guiltily, “Err… no, not exactly.  I’ve had multiple retinal detachments in my right eye, and I’ve got PVR.  I’ve got silicone oil in there at the moment.”  He looked slightly taken aback at this, and went on to ask about my left eye.  “It had two retinal tears which were fixed with cryotherapy and I have a cataract and lots of floaters”, I told him.  He shook his head in sympathy and told me how unlucky I was to have so many problems in both eyes, before asking with a slightly incredulous undertone, “Is there anything else?”  I completely forgot to tell him about the lattice degeneration, although that came up later, and the abnormal blood vessels, and just replied that I hoped that was enough for now, at which he nodded in agreement.

He carried on with the usual business of the eye test, and when we reached the pressure check, we had an interesting discussion about high pressure.  Much to my delight, he told me that he’d be happy to check my eye pressure if necessary, between my appointments at Moorfields.  He even told me that he’d be happy to dilate my eyes and check for tears if I wanted him to, at which point I almost toppled off the chair in shock.  Previous optometrists have been all but backing away from me by this point!  This one told me that he loves dilating because it allows the opportunity to get a proper look at the back of the eye, which he finds really interesting!  He did, however, also say that it was only necessary for him to dilate if there were symptoms suggestive of a retinal tear or detachment: i.e. showers of floaters, flashing lights, or the much-feared ‘curtain’.

He went on to do a spot of digital retinal photography and was happy to show me the images and explain various things.  It was somewhat depressing to see the image of my right retina, which bore certain similarities to a teenager’s bedroom,  but at least the left one looked far more clean and tidy.  He also checked for dry eye.  As he asked me to look up while he put the drops in, I asked what they would do.  “They’ll make all your problems disappear”, he joked, with an air of mystery.  I imagined my future – bright and colourful, with 6/6 vision and no more worries – and told him that he’d be my hero forever if the drops did that.  He clearly decided that his pants wouldn’t look very professional worn over his trousers, as when I’d blinked the drops away, my view of the world was just the same.  Or, almost the same… for I finally seemed to have found a decent local optometrist.  Perhaps he’ll work on those magic drops ready for my next visit…

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I’m not an ophthalmologist, but…

… when one of my work colleagues rang me on a Monday evening a couple of weeks ago to ask my opinion about odd things going on in her eye, I thought I knew what the problem was.  She told me that she’d just got back from dog-walking the previous day when she saw white flashes down the left side of one eye.  She’d also seen two big floaters, squiggly lines, and tiny dots.

I began to feel slightly sick as she described all this and quickly asked her whether she’d noticed any loss of vision or a ‘curtain’ coming across.  “No, I don’t think so”, she said, before asking what I meant by a curtain.  “It’s literally like a black curtain being drawn across the inside of your eye which you can’t see through; or like a shadow obstructing your vision”, I explained.  She was reassuringly certain that she couldn’t see anything like this and then went on to tell me that she’d been to the doctor’s about it late the previous afternoon.  “What did the doctor say?”, I asked, knowing very well that what he should have said was get to an eye clinic at a hospital or to an optician’s PDQ to get it checked out.  But no.  Apparently he just had a look in her eyes, commented that the blood vessels looked healthy and suggested that she pop to the opticians, with no sense of urgency whatsoever, although he did casually mention that it could be a retinal detachment.  “Whaaaaat?!”, I spluttered in response.  “Well, it’s no good just looking at the front of your eye – he needs to look at the back of it, and he can’t do that without dilating the pupil and carrying out a proper examination with the correct equipment!”  As far as I know, GPs don’t have the expertise to do any of this, which is why he should have referred her urgently.  You shouldn’t muck about with symptoms of retinal detachment, as I know very well!  Oh, and he also took her blood pressure, which is unrelated to eye pressure and has absolutely no bearing on a suspected retinal detachment.  Genius…

“Do you think it’s a retinal detachment, then?”, she asked me.  “Well, it sounds like PVD to me”, I answered cautiously, to which she enquired nervously, “What’s PVD?”  I explained that PVD means posterior vitreous detachment and isn’t the same thing as retinal detachment.  PVD occurs when changes to the vitreous fluid in the eye mean that it shrinks and pulls away from the retina at the back of the eye.  These changes happen as part of the natural ageing process but sometimes if the vitreous starts to pull away from the retina, it can cause flashes and floaters as it does so.  As it pulls away, it can also occasionally result in a retinal tear, which can then lead to a retinal detachment.  As any regular readers of my blog should know by now, retinal detachment is a medical emergency which requires surgery to fix.  Unfortunately, as well as being symptoms of PVD, flashes and floaters are also symptoms of  a retinal tear or detachment.

“So what do you think I should do?”, she asked, “Shall I come to work tomorrow and try and get an appointment with the optician?”  “NOOO!”, I almost shrieked in alarm.  “Definitely don’t come to work – you need to get it checked out first!”  Realising that I may have been worrying her further, I tried to stay calm and advised her to get to an optician’s first thing in the morning, and if they wouldn’t look at it then to go straight to the closest decent hospital eye clinic.  “They’ll need to dilate your pupil to have a proper look at the back of your eye.  Don’t let them fob you off by saying they don’t need to dilate!”, I instructed her urgently, all too aware that a certain optician in Canterbury had tried to tell me that he could see enough of  my retina without dilating my eyes.  “How will they dilate my eyes?”, she asked, to which I replied breezily, “Oh, don’t worry – they’ll just put drops in.”  “Oh no!”, she gasped, explaining that she wasn’t very good at having anything near her eyes.  I paused, reflecting that this probably wasn’t the time to tell her that the drops sting quite a lot.  After promising to let me know how she got on, we hung up and I went off to bed wondering if I should have explained about what to do in terms of head positioning in case she did start to see a shadow…

Worry made the next morning drag, but eventually I received a text: “Eyes dilated.  She says it has done what it needs to do and should no longer be a problem but to be aware of any changes and if so go to hospital.  Your diagnosis is correct.”  Phew – it wasn’t a detachment!  The optician referred her to the hospital eye clinic for an appointment the following week, at which they dilated and checked both eyes and issued the same advice about returning if she noticed any changes.

I was hugely relieved that everything was okay, as with those symptoms it could very well have been a tear or the start of a detachment.  So, please be aware and spread the word that flashes or new floaters should be checked out urgently with an optician or hospital eye clinic.  Any loss of vision, blurring, a shadow, or a black/grey ‘curtain’ should be checked out immediately at a hospital eye clinic.  It’s worth bearing in mind that not all hospitals have eye clinics and opening hours vary so check before potentially wasting previous time on travel.

Note: You can find further information about PVD here: http://www.rnib.org.uk/eye-health/your-guide-posterior-vitreous-detachment-pvd/posterior-vitreous-detachment-PVD

Tooth hurty!

One of my friends has an extensive repertoire of eye-rollingly bad jokes – most of them obtained from ‘The Ha Ha Bonk Book’.  That’s a children’s joke book, in case you’re wondering.  Whenever she receives the reply, “Two thirty” to her casual enquiry, “What’s the time?”, she’ll take delight in responding, “You’d better go to the dentist’s then!”.

And that is exactly what I did a couple of weeks ago, after waking up at 3am with stonking toothache, radiating from the area of a wisdom tooth which periodically flares up a bit.  This time, however, it was more than just a bit as it kept me awake for the rest of the night.  When I arose with the dawn I stomped to the bathroom and peered, blearily-eyed, into the mirror with my mouth opened wide, using a torch to illuminate the angry red mass adjacent to my tonsils.  After a few minutes of angling, peering, and yelping, I decided it would be prudent to stop in case I managed to smash the mirror with the end of the rather long torch and so sentence myself to seven years of bad luck.  I breakfasted on lukewarm tea, slurped through the opposite side of my mouth from the offending tooth, tiny bites of soft banana, and a couple of ibuprofen, and then headed off to the dentist’s.  I felt particularly disgruntled by this turn of events as it was the last day of my week of annual leave (which I’d hoped would work miracles on the relaxation front, leading to a renewed and revitalised me), and my birthday was in two days time.  No sweet treats or birthday cake for me, then… 😦

I reluctantly lay back in the dentist’s chair, fearing for my oil-filled RD eye as well as my aching wisdom tooth as I obeyed the dreaded instruction to “open wide” with an internal sigh whilst gripping the edge of the chair.  “Oh dear, yes, I can see exactly what the problem is!”, exclaimed the dentist, which did nothing to calm my frayed nerves as I proceeded to visualise my tooth hanging by a bloody thread with a puscular mass of green gunk welling up from deep inside the gum.  Fortunately, it wasn’t actually that bad: I just had a severely inflammed gum.  “It often happens when you get a bit of food stuck and if you’re a bit low and tired it can cause everything to flare up”, the dentist explained, leading me to wail, “But I’ve only just had a holiday!”.  He was all set to prescribe antibiotics as a precaution in case it got worse over the weekend, but then retreated to ‘The Drugs Bible’ when I told him that I’d had multiple retinal detachments and would need to be sure they were safe for me to take.  I was vaguely aware of recent research which had found a link between certain antibiotics and RD, and so I wasn’t prepared to take any chances.  After deliberating, he decided he didn’t want to give me antibiotics until I’d checked with Moorfields as to which ones would be okay.  When he noted that it would be good to get an updated medical history from me for the records I reacted with surprise, explaining that I’d done that at my annual check-up appointment just a couple of months previously.  “Oh!”, he said, in equal surprise, peering at the computer screen.  “All it says here is, ‘seeing doctor about her eyes'”.  Genius.

Instead of antibiotics, he gave the offending tooth a good clean-out (ouch) and advised continuing with ibuprofen and salt water mouthwashes.  When I got home, I rang the Moorfields advice line about the antibiotics query, whereupon I was put through to their pharmacy.  First, I was told that I’d need to check with my consultant; then I was told that the Canadian study which found a link between certain antibiotics and RD was flawed; and finally I was told that the antibiotics the dentist had suggested would be fine and the important thing was to take whatever was the best for my tooth.  All of this advice was given by the same person and did nothing to ease my niggling doubts on the issue.  I’ll be seeing my consultant in November and so will ask about antibiotics then, but unless I definitely need to take them, I don’t  really want to bother him in the meantime.  I’m pretty sure that the Canadian study led to warnings being included on the boxes of certain antibiotics, which suggests that there is a cause for concern regarding these specific ones.  And as for taking whatever was the best thing for the tooth… surely the whole picture needs to be considered?!  I mean, a decent medical professional wouldn’t just hand out aspirin to treat the heart condition of a haemophiliac, would they?  Okay, I admit that I know next to nothing about haemophilia or heart conditions, but you take my point.

Anyway… fortunately, after dosing up on ibuprofen and swilling my mouth out with the contents of the North Sea, the toothache gradually retreated and the gum seems to have returned to its normal size.  I’m still treating it cautiously and am hoping that it won’t flare up again… or at least not until after my next Moorfields appointment in November anyway.

Note:  The group of antibiotics which have been linked to RD are Fluoroquinolones.

Note 2:  ‘The Ha Ha Bonk Book’ is by Janet and Allan Ahlberg, and comes highly recommended by my hilarious friend.  If anyone can explain the joke concerning Tarzan, Jane, and colour-blindness on page 16, please do let me know.  This has been something which has puzzled my friend since the tender age of 7 and she’s now reached the ripe old age of 40 but so far, nobody has been able to explain it.

Eye-opening facts about our peepers

I’ve learnt a heck of a lot about eyes in the past three years.  The only problem is, as with many things, the more I learn the more I realise there is to learn.  But anyway, I thought it would be fun to compile a little list of some of the more fascinating facts about our eyes…

  • Only one sixth of the human eyeball is exposed.
  • The human eye weighs approximately just under an ounce (28 grams).
  • Our eyes are composed of more than two million working parts.
  • Eyes are the second most complex organ in the human body, after the brain.
  • Our eyes actually project an image onto our retina which is upside down and inverted, and our brain then flips the image.  George Stratton, an American psychologist, conducted an experiment whereby he wore an adapted lens which meant that everything he saw appeared to be inverted and upside down.  After a few days, his brain adapted and he began to see things the right way up once more.
  • The active ingredient of dilation drops is atropine, derived from Deadly Nightshade.  I told my sister this just before one of my eye appointments, and she looked at me with such horror that I felt it necessary to check with the consultant that it’s okay to keep having my eyes dilated.  Fortunately, he said it’s fine…
  • Approximately 50% of the brain is used for seeing and vision.
  • 80% of our memories are determined by what we see.
  • According to research by RNIB, 44% of UK adults said they feared losing their sight more than any long-term health condition, including Alzheimer’s, Parkinson’s, heart disease, and having to use a wheelchair.
  • People generally read text on screen 25 times more slowly than on paper.
  • On average, we blink around 28,000 times per day, and 15-20 times per minute, unless staring at a computer screen, in which case we don’t blink enough.  Now you’re making a conscious effort to blink more as you read this, aren’t you?  🙂
  • 20/20 (or 6/6) vision isn’t ‘perfect vision’ as is often assumed – it’s just normal vision.  However, in my book, there isn’t anything ‘just’ about normal vision…
  • People who were born with sight but later went blind can still see in their dreams, whereas people who were born blind don’t see images in their dreams.  (I feel I need to check this with someone who’s been blind from birth…)
  • Forget 50 shades… the human eye can distinguish 500 shades of grey.
  • Mascacra wands cause the most cosmetics-related eye injuries.  (Maybe that’s why I cringe whenever I see someone applying eye makeup.)
  • One eyelash has an approximate lifespan of five months.
  • The word ‘pupil’ is derived from the Latin ‘pupillus/pupilla’, meaning a little child or doll, as a description of the tiny reflection of your own image which you see when looking into someone’s eye.
  • Don’t share the above facts with someone who suffers from ommatophobia (fear of eyes).  I haven’t yet found a word which means ‘fear of retinal detachment’, but I know a lot of people who have this, so perhaps we should invent one?  Suggestions via the comments below, please!  😉

The curse of PVR

“PVR is from the devil!”, one of my eye buddies frequently declares with feeling, whenever the subject is broached.  She should know.  Her eight-year-old son has had five retinal detachments in his left eye and undergone over thirteen surgeries as a result of PVR.  Currently, he’s lost almost all vision in his eye and is only able to see some motion and colours.  PVR is the cause of my five re-detachments following the initial surgery to fix my first detachment back in April 2014.  PVR is a curse, and those three little letters strike fear into the heart of any RD patient, for we know the devastation and utter misery that it can cause.

“So what exactly is PVR?”, I hear you ask.  When a friend asked me this question recently, I simply answered, “Oh, it’s the thing that keeps making my retina detach – it’s like bad scar tissue, which keeps pulling the retina off again”.  That seems the simplest and quickest way of explaining it to someone who knows little about eye issues, but even the reference to scar tissue can be a bit confusing.  You see, there’s the ‘scar reaction’ which occurs after laser or cryotherapy, which basically welds the retina back together.  I think of this as ‘good scar tissue’.  In contrast, I think of PVR as ‘bad scar tissue’.  I did once have a conversation along these lines with a retinal surgeon, and he agreed, “Yes, I see what you mean”, when I explained my confusion about the difference between the scar reaction of the laser and the scar tissue of PVR.

Okay, so let’s get down to the complicated bit… PVR (or proliferative vitreoretinopathy) is a disease which is a major complication that can occur following retinal reattachment surgery.  It occurs in 5-10% of all rhegmatogenous retinal detachments (retinal detachment as a result of a tear in the retina).  Although PVR can be treated with surgery and reattachment of the retina can be achieved, the visual outcome is often extremely poor and PVR is the main cause of failure of retinal reattachment surgery.

Retinal detachment happens when a hole or tear in the retina results in vitreous fluid seeping through the hole and getting underneath the retina, pulling it away from its place at the back of the eye.  Imagine the retina as being like a wallpaper, lining most of the inside of your eye, apart from a small section at the front.  Now think about when you strip wallpaper off a wall, and how you use an instrument to create a tear in the paper and water to soak through and lift the paper off the wall.  If you think of the wallpaper as your retina and the water as the vitreous fluid inside your eye, that’s sort of what’s happening when a detachment occurs.  Of course, technically the room would be filled with water, but that’s just weird.  ANYWAY… during the process of retinal detachment, the vitreous fluid comes into contact with RPE cells (retinal pigment epithelium) just below the retina.  (In our wallpaper-stripping example, I guess this would be the brickwork, or maybe the mortar.)  As a result of the retinal tear, the RPE cells are able to migrate out into the vitreous.  The cells then proliferate and form fibrotic membranes (or scar tissue), which can then contract and pull at the retina, causing it to re-detach.

To complicate matters further, there are different types of membranes which can form, depending on which side of the retinal layers the cells settle in and which other cells are involved.  One type forms like a sheet and doesn’t necessarily affect retinal reattachment surgery; the other forms as thick membranes which cause traction, thereby pulling at the retina.  These need to be removed before the retina can be reattached.  Naturally, these are the ones which I have.  [Pauses to wail in loud misery.]  Since reading up on all this, I now understand why I’ve had three retinectomies.  A retinectomy is the procedure whereby the surgeon physically cuts away the part of the retina which won’t lie flat due to PVR.  Nothing has ever caused me to assume such a death-like pose as the moment I heard the surgeon utter the words, “Can I have the cutter, please?”, during my fourth surgery under local anaesthetic.

So why do only 5-10% of RD patients get struck down by the curse of PVR?  Although it really does often feel like some kind of terrible punishment for some unknown dreadful crime I’ve committed, I’m assured that this isn’t the case.  From what I’ve read, it seems that PVR is more likely to occur alongside any of the following circumstances: a large retinal hole or tear, a macula-off detachment, vitreous haemorrhage, aphakia (no natural lens in the eye), a long period of time between detachment and surgery, multiple surgeries, and poor surgery itself.  My initial detachment was macula-off and I waited two days for surgery, but it’s pretty normal to have a wait once the macula has detached as a delay of up to a week doesn’t affect the final visual outcome.  My current consultant (who just happens to specialise in PVR) explained to me that once someone has PVR they will always have it.  From what I can gather, the effects of PVR – particularly in the more severe cases, which mine is – can clearly be seen on the retina, but even if the surgeons are able to remove the worst of it and reattach the retina, there will still be cells floating around in places that they shouldn’t be within the eye.  A further huge problem is that PVR is a process, and inflammation can aggravate that process.  So every surgery unavoidably causes inflammation within the eye, which then risks activating the PVR once more.  It really is a vicious circle.  PVR is the enemy of the RD patient, and it needs to be beaten.  Just as Jules Gonin made a massive breakthrough in RD surgery by discovering the importance of locating the retinal tear (have a read of my earlier post, Hurrah for Jules Gonin if you’re wondering what I’m talking about here), now we need a modern day Jules to crash through the PVR barrier and bring hope to those of us who live with its curse.

Note: Please note that I am not an ophthalmologist or an expert in PVR; I have written this simply as a frightened patient afflicted with PVR.  For anyone interested in doing some further reading on the subject, you can find a selection of some of the articles which I’ve found helpful below.  If any of my eye buddies have any interesting/useful information to add, it would be great if you could share it by including it as a comment below.  🙂

RD holidays: first guests

After my ramblings on the idea of setting up some kind of holiday exchange programme together with my eye buddies in my post RD holidays, I was amazed and delighted at how swiftly my first guests contacted me to book themselves in for a seaside break.  My mum had decided to head to Cornwall with my aunt and her family for a week, leaving my sister to dog-sit.  Naturally, my sister and the dogs didn’t see why they had to miss out on all the fun, so they motored down to their very own little holiday cottage on the Kent coast… otherwise known as my gaff.

Now, I know what you’re thinking… “But that doesn’t count – they’re not eye buddies!”.  Ah, but that’s where you’re wrong!  Okay, maybe not entirely wrong, as fortunately my sister’s peepers are practically perfect.  However, much to our distress, poor Gillespie (aka Gill) had to have one of his eyes removed back in August 2016, due to keratitis.  (Have a read of Canine eye removal for the full story.)  Unbelievably and horrifyingly, Gill’s brother, Dizzy (aka Diz) developed the same condition earlier this year, leading to an extremely anxious few weeks, as it seemed increasingly likely that he too would have to undergo surgery to have his eye removed.  Keratitis is an inflammation of the cornea; an extremely painful condition which can progress rapidly and lead to sight loss if not treated urgently.  Keratitis can also affect humans.  Amazingly, the eye drops slowly worked for Diz and he didn’t require surgery, much to our huge relief.  However, he’s still on several eye drops and there will always be the possibility of the condition flaring up again.  So, you see, although they haven’t experienced RD, they are most definitely my eye buddies too!

Diz, having his eye drops put in.

Eye drops time!

As such, they were delighted at the opportunity of a relaxing, eye friendly holiday.  After enthusiastically exploring the garden and fertilising the courgettes (the dogs, that is, not my sister), we set off for a walk along the sea front, where we had to discourage Gill from fertilising a couple’s stripey windbreaker along the way.  As the dogs are rather elderly now, they have the additional problem of arthritic joints as well as dodgy eyes, so they can’t cope with much more than a few minutes walk in one go.  It’s actually more accurately described as ‘a sniff’ rather than ‘a walk’, to be honest.  So after half an hour or so they were quite happy to head home and sprawl out on the sofa for a well-earned rest, until they magically awoke on the very dot of 6pm and proceeded to clamour for their dinner.  It has to be said, they were rather demanding house guests where food was concerned.  And that was pretty much the pattern of the whole long weekend: sniff, wander, eat, sleep, repeat.

A walk along the sea front, past the beach huts.

Oh we do like to be beside the seaside!

It certainly made a nice change to have a spot of canine company for the weekend… as well as sisterly company, of course.  The only downside was that on the Tuesday evening when I returned home from work to a silent house, I opened my front door to the particularly pungent smell of DOG.  It was probably stronger due to the fact that we’d all been drenched in salty sea spray the previous day during our seaside sniff.  The whiff of wet dog is one that is hard to ignore.  However, it was a small price to pay for a fun weekend, and nothing which couldn’t be cured by a few squirts of Fabreeze and windows thrown wide open.   So, if any of my other eye buddies fancy booking themselves in for an RD holiday, just let me know…

Gill, asleep on the sofa.

Snooze time

Note: Fertilising the courgettes and sniffing around the garden is not obligatory.

Note 2: Please pack deodorant.

The dentist’s ceiling

Nobody likes going to the dentist’s; it’s just one of those things in life that we have to grit our teeth and get on with [pun intended].  As with many day to day things which are taken for granted by most people, it’s also something which a lot of RD patients tend to worry about.  “Will the vibrations of the dental instruments affect my retina?”; “Will it be okay to lie back in the dentist’s chair?”; “What if I need treatment – will it be safe to have a filling?” .  I consider myself fairly fortunate on the dental front, unless you count the six extractions to make space in an overcrowded mouth (a clear design fault there!) and the dreaded ‘train tracks’ of my teenage years, which pushed me to the very fringes of ‘the out crowd’ at school.  As I’ve got older, a recurrent fear of my annual trips to the dentist has been, “Oh no – this time I might actually need a FILLING!”   However, one positive of RD and multiple eye surgeries is that in comparison with that horror, a visit to the dentist’s is a piece of cake.  (Cake with reduced sugar content, obviously.)  Also, as I pointed out to a friend, if I ever do need false teeth, at least they’re capable of doing the job required.  Unlike a prosthetic eye, which would function merely to preserve outward appearance.

After my first two RD surgeries, the time between my dental check-ups had stretched to well over a year, but I eventually plucked up the courage to make an appointment.  Upon being asked the customary question: “Has anything changed in your medical history since your last appointment?”, I explained that I’d had some eye surgery for retinal detachments.  “Oh well, I’ll try not to poke you in the eye then”, he said breezily, completely oblivious to my icy glare as he rattled his instruments of torture dental equipment on the little tray by his side.

I haven’t mentioned the eye surgery since that first time, although after surgery number five I did check with the ophthalmologist that it would be okay to go to the dentists, and he said it would be fine.  I still get nervous about going though, and often put off making the appointment.  This year’s reluctant visit took place a few weeks ago.  After scrupulously brushing my teeth in the loos after work (I assumed that the sign declaring, “This sink is for hand washing only; please do not put paint down the sink” for the benefit of the Architecture students didn’t apply to toothpaste), I headed off to the dreaded dentist’s.

As I’m not supposed to lie on my back because of the silicone oil in my eye, I always wait until the last possible moment before lying back in the chair.  If he doesn’t start the examination immediately, I raise my head again until he’s ready.  I shut my eyes against the glare of the huge overhead lamp as he counts and prods and pokes at my teeth.  Obviously, I understand the need for the bright overhead lamp, but something which never fails to astound me is the large flat screen television mounted on the ceiling.  So when I cautiously half-open my ‘good’ eye to peer out at various points and see what he’s doing, I have to avoid the glare of both the overhead lamp and the huge bright television screen.  “Do any of his patients actually watch the television whilst undergoing dental treatment?”, I wonder each time I visit.  Is it there as a method of distraction?  Or because he stacks up so much spare cash from his extortionate charges that it seemed a good thing to splash out on?  I really have no idea, but if anyone does actually watch a spot of telly whilst undergoing their scale and polish, do let me know as I’m rather intrigued!

Fortunately, one good thing about my dentist is that he’s incredibly quick.  So without too much ado, I was able to sit upright again and allow the slight queasy dizziness to subside along with the floaters in my eye which had been stirred up by the oil sloshing around as a result of lying back.  All was fine, although as the receptionist informed me of the amount owing for the ten-minute appointment, I opened wide without being asked to, and had to swiftly catch my chin before it hit the desk.

Note: For a far more interesting story about eyes and teeth, check out the following: http://www.itv.com/news/utv/2017-06-22/glimpse-of-hope-after-rare-tooth-in-eye-surgery/