Two Month Update: I Went Blind (and then regained my vision)

Symptoms

• Dry eyes in the morning

• Trouble focusing up close, and headaches when I do try

• Feeling of an eyelash in my eye, which escalated to feeling like my eye was scratched.

• Increased light sensitivity from recent weeks.

• Wanting to keep my eyes closed as much as possible.

• Can't stop blinking and it hurts to blink.

• Frequently using lubricating tear drops, but they don't seem to help (are they making it worse!)

Time to take a break from these posts that talk about slow and steady improvement. About six weeks after the procedure I began to have some pretty significant eye pain and vision loss.

Over Presidents Day weekend in February, my family went down to Florida to visit my parents who had recently moved there. It was a nice change of pace from the cold winter of New York City. It was sunny and warm most of the time. I spent a lot of the first 24 hours driving around running errands for my parents and going to various activities. By the next afternoon, my eyes were bothering me and I was wonder if I scratched them somehow or if I slept on them wrong. I was also wondering if all the time in sun was irritating my eyes, even though I had been wearing sunglasses. It almost felt like my eyes were sunburned. I avoided going outside for the rest of the day and by the evening whatever was bothering me on my eyes seemed to just go away and I was fine. Weird.

The next day, I went about my business in the morning and felt fine, but by lunch time I was in pain again. I put some nighttime tear goop in my eyes before going out to lunch, which seemed like a good idea but I think it just made it worse somehow. I was starting to think that the steroid drops were drying out my eyes, which is what was causing me problems. I used the nighttime tear goop at night and that seemed to help a little.

On Tuesday, I flew back to NYC and my eyes were mostly feeling fine for the week. I figured it was just the Florida sun and I was now safe with NYC concrete canyons and cold cloudy skies that blocked the sun. I was down to three steroid drops a day, so I was starting to feel the end in sight on this PRK recovery business.

That Sunday, February 24th, My eyes started bothering me in the morning. I was noticing that I was more light sensitive than usually and I was having some tunnel vision off and on. It really hurt to look at things up close. By about noon, all I wanted to do was close my eyes and go to sleep. The pain like my eye was scratched had come back and was worse this time. I did my mid-day steroid drop and laid down for a bit, but it was hard to deal with the pain. It got worse throughout the afternoon and I had decided that it was most likely the steroid drops. I skipped my third drop on Sunday night and rationalized that I was moving to two drops the next day anyway, so it's not that big of a deal.

On Monday, I woke up with my eyes feeling OK. Still a little sore, but not terrible. I did my morning steroid drops and went to work. Walking from the subway to my office I noticed that I was very light sensitive, and it was unfortunately a sunny day. I kept moving from one side of the street to the other to stay on the most shaded side. By the time I got to work, my vision had become really cloudy. My computer was harder to read than normal and I increased the font size, but it wasn't really helping much. I called the doctor's office because something just didn't seem right. The receptionist said they could get me in on Thursday, but I said that wouldn't work I needed to see the doctor today. She booked me for 2:30pm, which was still over five hours away, but it seemed like they best they could do. I then told my boss I had to go home. As soon as I walked into his office, he looked at me and said, "what the heck is up with your eyes!" Apparently they had were totally bloodshot and swollen and everyone could see. I grabbed my things and took off.

I got into a cab and could barely read the screen to pay the driver with my credit card. I closed my eyes in the cab and didn't want to open them again. It was super painful, but I had to force myself to open my eyes to make my way from the cab to my apartment building. I tried to text my wife to tell her I had come home, but I couldn't even see my phone screen to do that. When she came home from a PTA meeting a little later my presence startled her a bit… oops! I just laid in bed with my eyes closed for about an hour, but it was becoming clear that I was going to need help to get to the doctor since I could barely open my eyes (and could only see cloudy whiteness when I did). My wife called the doctor's office and insisted that they see me sooner.

So we made our way into a cab with my wife guiding me by the arm. I kept my eyes closed the whole ride, which ended up taking about 30 minutes with all the NYC traffic. When we got out of the cab she had to guide me about half a block, which was really unsettling. I know she wasn't going to lead me into a light pole, but I kept think I was going to slam into something and this day was going to go from bad to terrible. But we made it. My wife is a gem.

They brought me right back into a patient room and I sat in the chair with my sunglasses on and my eyes closed. At first, the nurse did vision test but I couldn't read anything. Even with the letters at the largest, I couldn't see any of them. They were a little shocked and somewhat alarmed by that, I think. Dr Mandel came in and asked me for a recap of what's been going on. I gave him a slightly abridged version from what I've written here because I was in so much pain and couldn't think straight. He put some numbing drops in my eyes and I very quickly felt a lot better and could keep my eyes open. At first, he said he thought it was dry eyes and asked if I've been using the natural tear drops. I insisted that I use them a lot and, if anything, they seem to make it worse. I told him it I thought the steroid drops were irritating my eyes, which at first he didn't agree with, but then he checked my eye pressure and I guess it was off the charts. I reminded him that I had been off the steroid drops for a few days the last time I saw him and then he quickly realized that they didn't check my eye pressure last time because I had been off the steroid drops. He said I was a "steroid responder," which means that prolonged use of steroids causes my eye pressure to increase to dangerous levels. I don't know what these numbers really mean, but he said any level below 20 is good and my eye pressure measured at 44. From the little research I did on normal eye pressure levels, it seems like 44 is a crazy high number, which I guess shouldn't be surprising since that level of pressure had literally blinded me.

Essentially what was happening was that my eye pressure was increasing which pushed out my epithelium layer (the one that was scraped off with the surgery), and it separated from the other eye layers and was sliding back and forth and getting cracked and scared. Disgusting, right?! He also put a clear contact on my eye to help with the healing and sent me home with a prescription for some eye drops that lower my eye pressure (which of course, Duane Reade didn't have, but another store down the street did). I was instructed to keep using the steroid eye drops twice a day, but to use the new eye drops right before to keep my eye pressure regulated.

I used the prescription drops for the eye pressure and within about an hour and a half I had pretty much regained my full vision. However, my eyes were still uncomfortable and now I had to start sleeping in a contact again. Ugh. I worked from home the next day, but was mostly feeling fine. The doctor had me come back in on Wednesday when he removed the contact and checked my pressure again, which was down to 11. My right eye took a little longer to heal, and still has some very mild lingering pain, but my vision has returned to 20/20 in my right eye and my left has improved to 20/20 as well (even though it still seems bit more hazy than the right).

It's been a week since this incident, and I've noticed a few things that I thought were normal PRK healing side effects were more likely increased eye pressure side effects. For example, I no longer have problem focusing on things up close, I don't get tunnel vision when I stand up too fast, and light sensitivity seems to be back to pre-PRK levels. I'm going back to the doctor in about two weeks and he said it might be my last visit with him if everything looks good. He did say that he might do a Glaucoma test, since increase eye pressure is a Glaucoma thing. I'm hoping this whole thing was a fluke and it isn't a sign of some defect in my body that is going to come back to bother me later in life.

One Month Update: The Prescription Eye Drop Refill Drama

Symptoms

• Dry eyes in the morning

• Left eye seems to have some haziness still, but the right eye is almost perfect.

• Starburst around lights at night. Seems to mostly be in my left eye.

• Looking at objects up close gives me an almost instant headache.

The second half of the month was mostly uneventful. I was able to resume long hours at work staring at a computer screen. I was driving when I needed to, which was no problem at all during the day (with sunglasses), and doable at night, but not really fun because I had some significant starbursting with car lights. The starburst effect was stronger in my left eye, which has also be slower to heal. I noticed when I closed my left the starbursting, while still there, was much less significant. Another annoying side effect was an inability to focus on things up close because it would give me a massive headache really quickly. I could look at my computer screens because they were two or three feet from my eyes, but if I was holding my baby boy in my arms and looking at his face up close, then I'd quickly get these headaches. Looking at my phone too close would have the same effect. I'm hoping this isn't a long-term side effect because it can be really annoying.

Keeping up with steroid drops four times a day was starting to get annoying. A few times I forgot to take them to work with me, so I'd miss my mid-day drop. Didn't seem like that big of a deal to me. On a quick day trip to DC, I forgot to take the drops with me and my vision seemed to improve. I started looking into the science behind the steroid drops and found that doctors use them to promote healthy healing of the eye and minimize the chance of corneal haze, but the side effect is that healing happens slower.

Before surgery I was told to fill a prescription for two bottles of the steroid eye drops and that I would use them all. On the Friday before my one month checkup, I ran out of the steroid drops and figured that I wouldn't worry about since I was seeing the doctor next week and he was probably going to tell me to stop using them anyway. Well… turns out the doctor likes to ween his patients off the drops and I still needed to do four drops for the next week, and then three for the week after, and so on until I was done. I asked for a new prescription and they looked at me like I was an idiot and said I could have just gone to the pharmacy and asked for a refill. I'm not one to take very many prescription drugs, and I can't remember a time I had to get a refill, so I'm going to blame the doctor's office for not be specific about that in advance… that's fair, right?

The next problem was getting the steroid drops refilled, which turned out to be harder than anticipated as none of the Duane Reade pharmacies had them in stock. I went to three pharmacies and then the last one called three others, but they ended up telling me I'd have to wait a day because it was on manufacturer back-order and they'd need to get it from a wholesaler. The next day, I hadn't heard from the pharmacy and called them around 6:30pm and they told me they did get a bottle in stock, but it was 15ml, not the 10ml that the doctor prescribed… so I needed to get a new prescription from my doctor. Ugh. I called the doctor, but they had closed for the day, so I sent an email. The next morning I got a somewhat angry email from the nurse that I should have tried other Duane Reades and that the doctor is very concerned that I'm compromising my vision. I responded with the full story on how they were on back-order and that she should probably let their other patients know that they can't be found anywhere (and I wanted to tell her to get off my back, but I was polite).

Anyway, I got the drop and started gradually weening off the drops. In total, I was off them for five days before I started again, and frankly, my eyes felt great. Oh yeah, at my one month appointment I was 20/20 in my right eye and 20/25 in my left, which the doctor said was due to a slight corneal haze that might have developed when I went off the steroids. I told him that the vision in my left eye had actually gotten much better over the weekend after I stopped the drops. He didn't seem to believe me and shrugged it off. More on that in my next update…

Another thing I finally got around to was purging my apartment of all the eye still I would no longer need since I wasn't going to be putting in contacts anytime soon. I have fun finding bottles of eye drops for contacts and overnight solution and chucking them in the garbage. I held on to the actual contacts for a few weeks.. For some reason I struggled to actually throw them away because I know how expensive they were. I used dailies and would spend more than $600 a year on them and I still had a couple month's supply. Eventually I chucked those in the garbage too.

I think coming to terms with a life without glasses or contacts take more time with PRK than with Lasik because the first week or two are so painful and annoying that you don't really have time to sit back and enjoy your improved eyesight. That said, I think I'm starting to get there. A life with no contacts, no glasses, (hopefully) no eye drops, sounds amazing. As I've mentioned before, I travel a lot, so I love the idea of packing for a trip and not stressing out over whether I remembered my glasses or contacts.