Update on Eye Surgery

[puppymommo]

I saw the eye doctor yesterday for the one-week follow up to my eye muscle surgery. Actually saw his resident. The resident said everything looks very good. That's the good news. The bad news is that I will have to have surgery on the other eye, which I expected from the beginning, but it can't be done for 3 months. The worst news is that I am still seeing double, as the surgery was only partially successful, thus the need to do the other eye. Still expected, but what was not expected is that I have to wait another full week to get the temporary prism "stickers" they will put over my new glasses so I can see until May. So I will not be able to drive until March 1st. This really cramps my style as I work two part time jobs, as a church pastor and a hospital chaplain. So for the next week I have to rely on rides. Fortunately people have been really gracious about this, even for my overnight shifts at the hospital. And of course, it is very hard to see well enough to do all the paperwork required for both jobs.

So here's my cautionary tale. I consider myself an intelligent and sensible person. However, I was so excited about the possibility of getting relief from the double vision problem that was getting harder and harder to correct with glasses, that I jumped right into surgery without asking the proper questions. Like: how long before I can get the prism stickers? Turns out two weeks. Yikes! How long before the second surgery? Turns out 3 months. If I had asked those questions, I would have postponed the surgery until AFTER my upcoming trip to Israel. Now I will have to make the trip with the temporary stickers, which from what I read on the internet do not provide as good of vision as regular glasses. My other option is to buy an intermediary pair of glasses ($250-350) that I will only be able to wear until the second surgery. I feel so foolish!

 

[VacationForever]

My husband ended up with prism in his eyes AFTER his cataract surgeries. He was tripping and falling alot and then he was told that it was because of prism when he got his eyes checked. He got a new prescription that were supposed to fix the prism, and got glasses but it did not help. Did that again, with another new prescription and another new set of glasses made. It still did not help. So he continues to live with the double vision and it has been about 10 years already. He got used to the prism in his eyes and hardly trip and fall anymore.

Hope you have better luck than him.

 

[AwayWeGo]

At age 10, I had (successful) surgery for crossed eyes (strabismus). At age 60, my eyes went crossed again. The ophthalmologist referred me to another eye doctor specializing in pediatric ophthalmology & adult strabismus. (Those specialties go together apparently. Who knew?) The specialist added 3 degrees prismatic correction to my eyeglass lens prescription (both eyes -- 6 degrees total) & -- BAM ! -- I could see clearly again, in 3-D & in living color. It was great. Outstanding.

The specialist said that some of his adult patients come back in a few years needing a few more degrees of prismatic correction. Some even eventually need more surgery, he said.

Sure enough, after 10 years or so I got moved up to 5 degrees prismatic correction for each eye (10 degrees total), meaning that I can still see fine as long as I have my glasses on.

Being cross-eyed rules me out as a candidate for laser vision correction, the ophthalmologist said. Ditto progressive bifocal glasses. Cross-eyed patients need straight-line bifocals, he said. Otherwise they're constantly shifting their gaze trying to find the sweet spot when there isn't any sweet spot, he explained. That's OK with me. Straight-line bifocals & even trifocals work just fine. My all-round every-day glasses are trifocals. My computer glasses are bifocals with reading distance & mid-range focal lengths only (no distance prescription). My music glasses are bifocals with elevated insets for mid-range (so I can see the sheet music on the music stand) & distance prescription on top (so I can look over the top of the music stand & see the maestro waving the baton over at his podium) -- no close-up reading focal length. All my glasses include the same prismatic correction, which is a godsend.

Being crosseyed also rules me out as a candidate for high-tech lens implants in cataract surgery. I still need conventional glasses anyway for prismatic correction, so there's no sense implanting my eyeballs with tricky artificial lenses that correct for astigmatism or that involve multiple focal lengths (i.e., internal bifocals). So, right & left, I got the plain-vanilla lens implants that give me close to 20-20 distance vision -- except that I can't see worth a hoot unless I'm peering through my prismatic eyeglasses. (Left eye cataract surgery was done in 2015. Right eye in 2017 -- meaning my vision is as good now as it's going to get.)

BTW, the eye doctor who detected that I was developing cataracts said there was no rush to have surgery for that condition. I could get the operation done any time, even though it might be years before my vision was so clouded as to be noticeably impaired. "So," I said, " does that mean I have to choose on the 1 hand between waiting & having more years of worsening vision due to cataracts, or on the other hand of getting the surgery pretty soon & having more years of clear vision?"

"Exactly," the doctor said. "So just step into the room across the hall & position your chin on the chin-rest of the instrument over there, & my assistant will take the readings needed for ordering your new crystal-clear artificial lens for surgical implant." I did -- & the rest is history.

So far, so good. No problems & no complications. I am satisfied that getting cataract surgery sooner rather than later was the right way to go.

Mean while, I'm still crosseyed. So it goes.

-- Alan Cole, McLean (Fairfax County), Virginia, USA.​

 

[clifffaith]

Cliff, who will be 80 in April, never had an eye exam until he was 12. He always sat in the first row at school, and wondered how the other kids could see the chalkboard from further back. Then his dad took him and his younger brother to a ball game and wondered aloud why any company would pay for advertising on the fences when it was too far away to read. I can see the ads said his brother, and at that point his dad realized Ckiff
was blind as a bat and they took him for glasses. 15 years after that he took a nap on the sofa and watched two flies march across the ceiling in unison. That's when he realized he had double vision. So for years he wore glasses with prisms. When he had to have cataract surgery in one eye, his vision was so improved that he paid out of pocket for the other eye which was deemed "not ready yet" by the insurance company. But he still has to wear glasses with prisms to correct the double vision.

 

[clifffaith]

I saw the eye doctor yesterday for the one-week follow up to my eye muscle surgery. Actually saw his resident. The resident said everything looks very good. That's the good news. The bad news is that I will have to have surgery on the other eye, which I expected from the beginning, but it can't be done for 3 months. The worst news is that I am still seeing double, as the surgery was only partially successful, thus the need to do the other eye. Still expected, but what was not expected is that I have to wait another full week to get the temporary prism "stickers" they will put over my new glasses so I can see until May. So I will not be able to drive until March 1st. This really cramps my style as I work two part time jobs, as a church pastor and a hospital chaplain. So for the next week I have to rely on rides. Fortunately people have been really gracious about this, even for my overnight shifts at the hospital. And of course, it is very hard to see well enough to do all the paperwork required for both jobs.

So here's my cautionary tale. I consider myself an intelligent and sensible person. However, I was so excited about the possibility of getting relief from the double vision problem that was getting harder and harder to correct with glasses, that I jumped right into surgery without asking the proper questions. Like: how long before I can get the prism stickers? Turns out two weeks. Yikes! How long before the second surgery? Turns out 3 months. If I had asked those questions, I would have postponed the surgery until AFTER my upcoming trip to Israel. Now I will have to make the trip with the temporary stickers, which from what I read on the internet do not provide as good of vision as regular glasses. My other option is to buy an intermediary pair of glasses ($250-350) that I will only be able to wear until the second surgery. I feel so foolish!

Can you buy the intermediate glasses, making sure the frames will accommodate the prism lenses after the second surgery? Important to be comfortable on vacation in a foreign country.

 

[puppymommo]

Alan, my story is similar to yours in many ways and I'm so glad you posted. For one thing, I did not know that those who use prism can't use progressive bifocals. Same with the multifocal lenses following cataract surgery. Good to know! My surgeon seems to think I have a good chance of not needing prism at all after my second surgery. But I am still end up with some. Right now I have 10 or 11 in each eye. The surgeon told me they usually do the surgery when it gets to 6 or 7 per eye and that my eye doctors should have referred me rather than keep increasing the prism. But you know how it is, surgeons always think you need surgery, non-surgeons rarely think you do! When I see the doctor (not the surgeon and not the resident, but a third doctor who also teaches at the medical school) next week I will be sure to ask about bifocals and cataracts. I do have 1+ cataracts in both eyes. What I was told is they prefer to do the surgery when the cataracts are bothering you rather than on the number. After I get all the eye muscle stuff worked out, I will deal with the cataracts next. Thanks for sharing, Alan!

 

[bogey21]

So here's my cautionary tale. I consider myself an intelligent and sensible person. However, I was so excited about the possibility of getting relief from the double vision problem that was getting harder and harder to correct with glasses, that I jumped right into surgery without asking the proper questions...

I learned a long time ago that some (and I emphasize some) Doctors and Dentists recommend unnecessary procedures in order to gin up revenue. Two examples. About 15 years ago my Cardiologist told me I needed a pace maker. I researched it and declined. About 6 years ago the same Cardiologist told me I needed a procedure on my heart (ablation) because I have Afib. I researched it and again declined. Obviously I am still alive and kicking.

I then changed Cardiologists. My new one carefully told me that all the testing (and there were a ton of tests) performed by my old Cardiologist was unnecessary! My take on all this is listen to your medical professional but before moving forward with any procedure they recommend research, research more and if necessary get a second opinion before moving forward with it.

George

 

[Passepartout]

I learned a long time ago that some (and I emphasize some) Doctors and Dentists recommend unnecessary procedures in order to gin up revenue. Two examples. About 15 years ago my Cardiologist told me I needed a pace maker. I researched it and declined. About 6 years ago the same Cardiologist told me I needed a procedure on my heart (ablation) because I have Afib. I researched it and again declined.

I figured out a long time ago that if the only tool in their toolbox is a hammer, every problem looks like a nail. Surgeons want to cut. Chiropractors want to 'adjust'. Doc's who own imaging equipment want lots of pictures.

 

[VacationForever]

I learned a long time ago that some (and I emphasize some) Doctors and Dentists recommend unnecessary procedures in order to gin up revenue. Two examples. About 15 years ago my Cardiologist told me I needed a pace maker. I researched it and declined. About 6 years ago the same Cardiologist told me I needed a procedure on my heart (ablation) because I have Afib. I researched it and again declined. Obviously I am still alive and kicking.

I then changed Cardiologists. My new one carefully told me that all the testing (and there were a ton of tests) performed by my old Cardiologist was unnecessary! My take on all this is listen to your medical professional but before moving forward with any procedure they recommend research, research more and if necessary get a second opinion before moving forward with it.

George

So true..............

 

[rapmarks]

My northern doctor only tests when evidence shows something, my southern doctor overtests. But several years ago, my southern doctor ordered a thyroid ultrasound, after hearing the same information I had given my northern doctor, and the oncologist who was treating me. lo and behold, I had third stage, multifocal throid cancer that had become invasive. So I remember that when she orders tests.

 

[vacationhopeful]

I have ONE eye farsighted and the other eye is nearsighted. One has an astigamism ... can't really tell you which. But my parents were confused as to HOW I managed to get into 5th grade and being tall, always got the back row seat from the blackboard and had no problem reading books or the blackboard. The doctor told them I was just using ONE eye at a time mentally and if I did NOT learn to use BOTH EYES together, I might have problems driving or become blind by not using the weaker eye.

Spent lot of time watching TV (on the only TV set in the house) with special glasses which only gave me limited TV viewing of the small B&W screen. I survived and my driver's license does NOT require me to wear eyeglasses.

AND don't ask me about my left forearm. Seems that forearm has a 45 degree twist in it. Makes it HARD to get coin change in the palm of my left hand as my elbow is flat up, my palm has my thumb pointing straight up to the sky. The only handicap there is getting coin change returned to me when going thru toll booths when driving. A doctor years ago, offered to do surgery to FIX it ... it SOUNDED FAR WORST than losing some coin change every 6 months or so.

 

[Conan]

Alan, my story is similar to yours in many ways and I'm so glad you posted. For one thing, I did not know that those who use prism can't use progressive bifocals. Same with the multifocal lenses following cataract surgery.

For clarity (no pun intended), I assume you're all talking about left-to-right prisms that correct left-to-right double vision.

I say that because I have up-and-down double vision caused by fourth nerve palsy. Mine was acquired, meaning it started late in life for no reason that I know of. My eyes aren't visibly out of line, but I did develop the characteristic head-tilt that people use unconsciously to help bring their vision better into line.

https://www.slideshare.net/nilaynp/4th-nerve-palsy

My eyeglasses have prisms to bring the vertical displacement into line, and also they're progressive bifocals for reading with glasses on. (My near vision is actually pretty good so I can also read with my glasses off, but for that I need to keep one eye closed because of the vertical double vision.)
https://www.aapos.org/terms/conditions/52

 

[VacationForever]

For clarity (no pun intended), I assume you're all talking about left-to-right prisms that correct left-to-right double vision.

I say that because I have up-and-down double vision caused by fourth nerve palsy. Mine was acquired, meaning it started late in life for no reason that I know of. My eyes aren't visibly out of line, but I did develop the characteristic head-tilt that people use unconsciously to help bring their vision better into line.

My eyeglasses have prisms to bring the vertical displacement into line, and also they're progressive bifocals for reading with glasses on. (My near vision is actually pretty good so I can also read with my glasses off, but for that I need to keep one eye closed because of the vertical double vision.)

"What is a fourth nerve palsy?
The fourth cranial nerve innervates the superior oblique muscle, so weakness of the nerve is also known as superior oblique palsy. Weakness of the superior oblique muscle causes a combination of vertical, horizontal and torsional misalignment of the eyes. The vertical misalignment is typically the most noticeable feature. Palsy refers to a complete weakness of a muscle while a paresis is a partial weakness. This condition is usually unilateral (one eye) but can be bilateral (both eyes).
....
How is superior oblique palsy treated?
In cases of acquired superior oblique palsy it is important to identify and treat the underlying cause first. Once the cause of an acquired superior oblique palsy has been treated, the ophthalmologist will usually wait 6 months for possible spontaneous resolution of the palsy. During that period, diplopia can be managed with prism glasses. Prisms merge two images into one but do not strengthen the eye muscles. If prism is not effective, patching or covering one eye can alleviate the double vision. If the palsy does not recover over this 6 month period and if prisms are not able to adequately control the diplopia, surgery may be indicated."
https://www.aapos.org/terms/conditions/52

My husband's prism is up and down which has not been fixed with prescription glasses. No one really know the cause but my husband thinks it was some time after he had his cataract surgeries.

 

[clifffaith]

I figured out a long time ago that if the only tool in their toolbox is a hammer, every problem looks like a nail. Surgeons want to cut. Chiropractors want to 'adjust'. Doc's who own imaging equipment want lots of pictures.

We just let our periodontist go. If dentist sees something that needs addressed, we'll happily go back. But she's always wanting to do something every other year or so. Last fall her front desk gal called with Cliff standing there and yet another oral surgery was being suggested. $3K, $5K, whatever it was I said NO because at the time we were busy trying to pay for something else. So when he went to his regular dental cleaning a few months later (we'd both been alternating our 4x annual cleaning between perio and dentist) I made sure he asked about it. Was told she didn't see anything earth shattering at the time. So we've cancelled all perio appts and will just see oral hygienist at dentist's office 4x a year. Dentist always sticks her head in to take a quick look, and the price for cleaning is about half what the perio charges. I'm confident that if we develop gum issues that need to be addressed the dentist will refer us back to the perio.

 

[puppymommo]

Conan wrote: I have up-and-down double vision caused by fourth nerve palsy. Mine was acquired, meaning it started late in life for no reason that I know of. My eyes aren't visibly out of line, but I did develop the characteristic head-tilt that people use unconsciously to help bring their vision better into line.

Yes, yes! I have the up-and-down double vision AND the head tilt. I know I had the double vision since at least my teens because in some of my photos from high school I can already see the head tilt. One of the reasons I got motivated this year to look into surgery is that for the past year I have been working with a personal trainer who keeps telling me to keep my head straight while doing my workouts. The more I hold my head straight (which takes a conscious effort), the worse my double vision gets. The head tilt is a compensatory mechanism. And with age, it gets harder and harder to compensate.

As far as I understand it, "prism" is what is added to prescription glasses to reduce or eliminate double vision, it is not a cause of double vision. That is how it has been explained to me for the past 40 years, anyway.

 

[Bucky]

After several operations I have come to the conclusion that self medication and diagnosis are just plain stupid. If you do your research after a doctors diagnosis you should be aware of the pros and cons and be able to make an informed consent or not. I don’t blindly follow anyone’s recommendations but in more cases than not the doctors have made the correct recommendations. For every person that went against a doctors recommendations and it worked out for them, there are 10 that wished they had paid attention and followed recommendations. Two things I’ve learned with all my medical problems. Don’t self medicate and don’t self diagnose. Get a proper diagnosis from a doctor. Do your research and then make an informed decision.

 

[bogey21]

After several operations I have come to the conclusion that self medication and diagnosis are just plain stupid.

That is pretty strong and I disagree. I'm 83 years old and my Doctor was adamant I should have a colonoscopy. Her reason was that my history said my Father died with (but not from) colon cancer. At my age I am apprehensive about having the procedure so I went to a hospital (UT Southwestern) that is in the forefront of genetic screening to see if I have inherited the colon cancer gene. Turns out I don't have it. Gave my Doctor the Report and she said "You are right. There is no reason for you to have a colonoscopy at your age". I question why she didn't recommend genetic testing before pushing me to have the colonoscopy. Bottom line is I don't take any Doctor's advice without checking it out myself or if it is something really serious without a Second Opinion from a Center of Excellence for the issue at hand. That's just me. To each his/her own.

George

 

[rapmarks]

George, doctors gave my mother a colonoscopy at age 93, I am convinced it was what killed her.