Tag Archives: 360 degree laser

Visual fields

Living with peripheral vision loss can be a tad embarrassing at times.  It’s caused me to let out a loud girly squeal whilst using the photocopier at work, when the Dean (no less) suddenly appeared on my bad side, seemingly out of nowhere, and boomed “Good morning!” at me.  It’s resulted in me leaping a foot in the air and bashing my knuckles on the hand-dryer in the loo at work, when a student materialised out of thin air at the hand-dryer alongside me.  It’s caused me to berate my good friend when she spotted me in the distance one day and ran to catch up with me, grabbing my right arm as she did so and thereby scaring the living daylights out of me.  I frequently jump violently and then swear with equal violence under my breath when a cyclist whizzes past me as I walk along the paths on campus.  After stumbling over students’ bags in the entrance to my workplace on several occasions, I now walk round and use a different door if I need to enter or exit at the time a lecture is due to start or finish.  Last but not least, I’ve acquired some interesting bruises on my right shoulder due to various minor mishaps.

The loss of peripheral vision in my right eye is due to the 360 degree laser surgery which was done in an attempt to stop the retina from re-detaching and to try and save my central vision.  I suspect the three retinectomies (where part of the retina which won’t lie flat is physically cut away) probably haven’t helped matters, either.  Of course, unless people have actually experienced loss of peripheral vision themselves, it’s difficult to expect them to fully understand.  I thought perhaps a visual interpretation might help, and therefore sought the assistance of my personal patient photographer, who happily doubled up as a person with properly working peepers.  (It’s such a shame that the ‘h’ in ‘photographer’ messes up the alliteration there; however, I digress…)  Our highly scientific peripheral vision experiments when looking at the fields just down the road from my house, followed by extensive jiggery pokery with photo-editing software, led to the following results…

The picture below shows the complete field of vision of a person with properly working peepers, with both eyes open:

Fields

The visual field of someone with ‘normal’ vision.

The following picture shows the field of vision of both a person with properly working peepers and myself, when our right eyes are closed (so looking only through the left eye):

fov-res-w

Visual field of left eye.

The next picture shows the field of vision of a person with properly working peepers, whose left eye is closed (so looking through the right eye only):

fov-les-w-a

Visual field of right eye of someone with ‘normal’ vision.

The final picture (below) shows the field of vision in my right eye, with my left eye closed:

fov-les-w-e

Visual field of my right (RD) eye.

If you compare the last two pictures, you can get some idea of how much peripheral vision I’ve lost in my right eye.  If you look at these pictures in conjunction with the images in my earlier blog post, Do you see what I see?, this gives the most accurate representation possible of my waffy vision as it is at the current time.  So with that in mind, if you could kindly avoid sneaking up on me on my right-hand side, that’d be just grand…

Note: Grateful thanks to the patient photographer for producing these images for me and putting up with extensive peripheral vision analysis in the process.

 

 

 

 

Panic and paranoia

It’s been a bad couple of weeks on the eye paranoia front.  On a scale of one to ten (one = I don’t even think about my eye issues, and ten = ringing Moorfields and looking up train times whilst trying to breathe evenly in order to calm my pounding heart), I’ve probably been about a seven or eight this week.  The fact that it was my first week back at work doing full-time hours probably hasn’t helped matters.  Even on a good day, my eye aches and feels uncomfortable.  After a full day at work on a computer (even with breaks and leaving on time), I’ve been coming home with my eyes feeling scratchy and sore, and so tired that I just want to close them and sleep.  Just to add another dig in the ribs, my companion Insomnia has been rearing her ugly head again, too.  I can’t bring myself to do what a friend was once advised for his insomnia – go downstairs and read the ‘phone book until he felt tired and then go back to bed and try and sleep.  So instead I just shift from one side to the other (still not allowed to sleep on my back), and try to think of happy things… like the day when there will be a miraculous cure for retinal detachments without having to go through multiple surgeries and deal with sometimes crippling anxiety about repeat detachments.

The paranoia of the past couple of weeks started when i parked my car one sunny saturday morning and looked up at the blue sky, blinked, and saw a grey circle hovering threateningly in the sky.  I blinked again and it was gone.  Closed my eyes, opened them, and there it was again.  Blinked, and it was gone.  I must have sat there in the car for a good twenty minutes doing this like some kind of lunatic, before I noticed that there was a circular sign just in front of the car with a white border.  I now *think* that what I was seeing was a kind of after image of this.  I spent the rest of the day at various points stopping dead, staring up at blue sky and blinking, but I didn’t see it again.

I’d just about pacified myself over that, when the headaches started.  Every few days.  Not bad, but enough to feel pants and irritable.  I started to think it must be my eye pressure going up, so I went off to the opticians to get the pressures checked.  18 in both eyes.  Pheeeeew!  That was okay then!  So what was causing the headaches?  Increased hours at work?  Insomnia?  Stress?  All three most probably…

The headaches have improved over the past few days (I hope I don’t jinx it now), but my current paranoia involves looking right then left again, convinced I can see something pulling at the edge of my vision.  I have had this before many times and asked about it at many of my appointments and am always told it’s okay.  I even went and got my little eye book out the other day to check what’s been said about it in the past in the hopes that it would make me feel a bit better.  I’ve never received a satisfactory answer about what exactly it is, but have been told ‘it could be the oil’.  It seems I’m often told ‘it could be the oil’ when they’re not sure what it is.  A bit like going to the GP and being told that you have ‘a virus’.  But until I can ask about it again, it’s worrying me.  Plus I seem to be getting some more flickering in a different area of my eye.  I’m hoping this isn’t more of the retina starting to detach, as is the case with the almost psychadelic flickering which I often get at the bottom of my eye.  I keep obsessively checking my visual field against the various markers in my house, and at the moment, thankfully, it seems to be unchanged.  But I still worry, because I don’t know why it’s flickering.  My next appointment isn’t until 28 September, which seems an age away at the moment.  I fear I may be carted off in a straitjacket before that time.

A Grand Day Out (…at Moorfields Eye Hospital?)

I decided I was going to bite the bullet and actually drive (BY MYSELF!) to Surrey in preparation for my appointment at Moorfields on Monday, so I was delighted when the day dawned grey and rainy.  Perfect conditions for RD patients.  Well, maybe the rain wasn’t so good, but at least the raindrops detracted from all the floaters in my good eye.  I set off in high spirits, enjoying the feeling of freedom from actually being able to make the journey on my own and not having to rely on anyone else or on public transport.  Being very sensible, I stopped off at the service station about half way there, and was mildly intrigued to hear a steel drum band playing as I drove in.   After a stretching my legs and resting my eyes for a few minutes, I set off again and was happily heading out of the service station and back onto the motorway when I realised that the steel band appeared to be following me.  In fact, either the band members had climbed into the boot of my car with their drums whilst I wasn’t looking or… it wasn’t a steel band at all.  It was at this point that the realisation dawned that my exhaust was rattling.  Great.  My first long journey after my last lot of surgery, and my ruddy exhaust decides to fall off on a very wet Sunday afternoon in the middle of the M25.  Well that’s just perfect timing.  After ranting away to myself for a few minutes, I decided that the only option was to adopt the same philosophy as I do with my eyes: keep going and hope for the best.  By the time I reached my destination, it sounded as if I was dragging a long string of tin cans underneath the car.  However, I cheerfully reminded myself that exhausts, unlike retinas, are easily replaceable.  The next morning, I drove it as cautiously as I could to the garage (bearing in mind that my sister was leading the way in her somewhat toned down Formula One driving style), and after this detour we set off to Moorfields, clutching my little eye book and taking bets on how many of my pre-prepared nineteen questions I’d manage to obtain answers to.

It was manic in the clinic – I’ve never seen it so busy.  The scarily grumpy receptionist said that it had been like that ever since my consultant had gone on maternity leave (I knew she shouldn’t have done that), and even the usually chilled-out friendly Irish nurse seemed a bit stressed, telling us after she’d administered the dilation drops that we may as well go back up to the cafe and get a cup of tea as she showed us the huge stack of files for patients in the queue before me. If we hadn’t already found the Moorfields geocache beforehand, we could have killed a few minutes by searching for that, although the dilated eyes would have made it a bit tricky.  Instead, we drank copious amounts of tea before heading back down to the clinic and waiting.  We debated passing some more time by playing a game of ‘I Spy’, but decided it wasn’t really appropriate.

Eventually, I was summoned through by a doctor I’d never seen before, but fortunately the surgeon who did my emergency operation at the end of May was there and so she called him over to have a look as well.  If I were to write a script of the eye examination, it would go something like this:

Ophthalmologist: “Pop your chin on there [indicating contraption] and rest your forehead against the bar.  Eyes wide open.”
My internal voice: “Please let it be okay, please let it be okay, please let it be okay…”
Ophthalmologist: “Now look straight ahead.”
My internal voice: “Please let it be okay, please let it be okay, please let it be okay…”
Ophthalmologist: “Look up.”  [pause]  “Look up and right.”  [pause]  “Look up and left.”  [pause]  “Look to the left.”  [pause]  “Look down and left.”  [longer pause]
My internal voice: “Please let it be okay, please let it be okay, please let it be okay…”
Ophthalmologist: “Look down.”  [pause]  “Look down and left.”  [pause]  “Look down.”  [longer pause]  “Look down and right.”  [longer pause]
My internal voice: “Oh ***** [insert expletive], what’s he seen?!”
Ophthalmologist: “Look down.”  [pause]  “Look to the right.”  [pause]
My internal voice: “Keep calm, keep calm, please let it be okay, please let it be okay, please let it be okay.”
Ophthalmologist: “And rest yourself back.”
My internal voice, wailing loudly: “What’s he seeeeeeeeeeeeeeeeeeeeeen?!”

I have an unwritten rule not to ask questions whilst my eye is being examined as I think it’s best to let them concentrate and save the questions until afterwards once they’ve scribbled the notes down.  However, I’ve somewhat unfortunately got to know the signs which indicate when they’ve spotted something which isn’t quite right.  Sure enough, he went on to tell me that my retina was ‘misbehaving’ at the top and starting to detach again.  I stared at him in dismay and launched into inquisition mode, doing my best to ignore my internal voice which by this time was screaming loudly, “NOOOOOOOOOO!”, along with various other exclamations which are best left to the imagination.  Luckily, he was as patient as he had been before my surgery, and calmly fetched a piece of paper and proceeded to draw a diagram to explain what was going on in my eye.  He seemed a bit embarrassed when my sister asked him if we could take the drawing away with us, protesting that he’d have done a neater job if he’d realised we were going to keep it, but he handed it over nevertheless.  He probably realised that if he hadn’t parted with it, I’d have insisted on copying it down, and this would have taken a considerable amount of time due to the inconvenience of the dilation drops.  (See below for my version of his diagram, attempted with the very limited resources available on my decidedly dodgy laptop.)

He explained that the retina was starting to detach a little at the edge, outside the line of the 360 degree laser.  This was what he had suspected may happen at the time of the surgery, which was why he had proceeded with 360 laser.  If the detachment remains outside the laser line, I should be okay, but if it encroaches beyond that then he told me ominously, ‘we have a problem’.  It’s never good when a surgeon says that we may have a problem.  He then went on to discuss potential complications of silicone oil in the eye, most of which I already knew, but there was one issue which was new to me.  Part of me feels the need to ask Dr Google all about it, but for now I’m exercising my will power (or possibly metaphorically sticking my fingers in my ears and singing, ‘la la la la’) and hoping that I won’t need to find out.  He ended by telling me that it’s basically a waiting game now, as we have to see how the retina behaves.  All this talk of waiting to see how it behaves, as if it’s a particularly naughty child, makes me want to whack it into place with a rolling pin but somehow I don’t think that would help matters.  [Note: I should add here that I’m not in the habit of whacking naughty children with rolling pins, although sometimes it is rather tempting.]

retina misbehaving

Note: 360 degree laser is when a line is lasered all the way around the retina, a little way in from the edge.  The laser causes a scar reaction which seals the retina down.  The surgeon described it to me as being like a thin line of superglue.  This explains why peripheral vision is lost as a result of 360 laser.  A retinectomy is when a small part of the retina is cut away and removed because it won’t lie flat.  This also explains the loss of some of peripheral vision.