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When good eyeballs go bad

This week I learned yet another one of those things they don’t tell you when you’re younger. In this case, it’s that your eyeballs may spontaneously decide to stop working one day, without any prior warning or causation on your part. So if you’re still young, remember this, so you’re not overly startled if it happens!

Executive summary version

A new “floater” in my right eye on Monday morning turned into near blindness in that eye by Monday evening. A night in the ER and a diagnosis by an ophthalmologist indicated I’d had a hemorrhage and partial ripping of my retina.

But that wasn’t the scary part. The scary part was that this isn’t rare or unusual, and is part of the aging process. It can happen to anyone, at any time. To make a long story short, my eye should eventually be fine (though it’ll take it 30 to 90 days to get back to normal).

Ah, the joys of aging…read on if you’d like the (really) long version.

The (really) long version

I woke up Monday morning with a new eye floater in my right eye. I am getting older, so floaters aren’t unexpected. But this one was large, and was shaped almost like a maze of thin lines, as opposed to the usual small blobs I see. I was a bit concerned, but not overly so. As it was near time for an eye exam anyway, I decided to just schedule one, and have them look at it when I went in.

Life being life, most of the day slipped by without my scheduling the appointment. Finally, near the end of the day, I was going to call, so I thought I’d first research what I’d been seeing, so as to provide more info for the appointment booking. The first link I found, though, startled me:

Immediate medical attention is especially important if the floaters are accompanied by flashes of light or a loss of side vision. If you have these symptoms, see an eye doctor right away. If available, choose an ophthalmologist with retinal expertise. Without immediate treatment, you can have permanent vision loss.

It wasn’t until reading this bit that I remembered I had occasionally been seeing flashes of light in my right eye. They weren’t there every time, but they had been there enough to register on my mind. Now, instead of booking an appointment, I found myself trying to find a retina-certified ophthalmologist who was open late in the day. As expected, I had no luck.

I was now faced with either going to the emergency room, or waiting until the morning to try to find a specialist. The WebMD entry sure made it seem like sooner was better than later. Seeking more advice, I called my step-brother, who is not an eye doctor but is an emergency room doctor. I also called our insurance company’s nurse hotline.

My step-brother suggested I’d be fine waiting until morning (he sees lots of similar eye injuries, and that’s how they handle them most of the time). The nurse hotline, on the other hand, suggested visiting the ER to get it seen immediately. So much for advice! In trying to decide what to do, I also had to deal with my wife being out of town this week, which meant getting help for our kids that night. In the end, I decided to visit the ER, just to be sure about what was going on in my eye.

After finding some friends who could watch the girls and get me to the hospital, I planned on bringing our kids to our friends’ house once our eldest daughter’s rec center class ended in about 30 minutes. I’d then head home to get some stuff (with my friend driving), and then go to the hospital.

Then I blinked and everything changed.

That escalated quickly

I was eating dinner with our youngest daughter, waiting on the rec center class to end. I had just hung up after talking with our friends, finalizing plans regarding the kids and the ER. Then, in literally the blink of an eye, my floater was replaced by what could best be described as a series of black smokey streaks that made my right eye mostly useless.

While hard to describe, these streaks appeared similar to the smoky wisps that often accompany evil creatures in movies, such as the dementors in the Harry Potter series; here’s some of the smoke seen just before the dementor appears:

Picture a number of those shapes, moving around and changing shape with every blink. Sometimes they’d completely obscure my vision, sometimes not. But there was no doubt that something had changed for the worse.

In a mild panic, I called our friends right back and said “Change of plans. Can one of you pick up our eldest from class, and the other take me to the ER now? My eye just got much worse!”

During the course of the drive to the ER, the smokey black wisps multiplied, and what I could see (when not obstructed) became really blurry, like someone was holding a sheet of gauze in front of my eye.

Knowing I had an eye issue, I wanted to be sure the ER had an eye doctor on site, so I called while we drove there. Over the phone, I was told there was an ophthalmologist on site, and that they had retinal experience. (If they had answered no, there was a second ER we could have used.)

When I arrived at the ER, I explained that I was relatively certain I had a detached retina, and that my vision was actively deteriorating. There were tons of people in the waiting area, and I shuffled off to a chair, expecting to sit there for hours. Thankfully, that wasn’t the case—they found a room for me within a couple minutes.

In the ER

Once situated in my room, there were the usual blood pressure and heartbeat tests (yes, I’m nervous as hell and still alive), and then the nurse asked me to explain what had happened that day, starting with my noticing the floater in the morning. So I went through the whole thing while she typed notes into the computer system.

After going through the story, she made sure I was comfortable, then left for a bit. A second nurse came in and said we were going to go do an eye test, which I thought was odd given I’d told them I couldn’t see anything much out of the right eye. Before the test, though, I was asked to (for the second time) explain everything that had happened to the eye.

Next we shuffled off to a corridor with an eye chart at the end. My left eye tested out at 20/20 (better than it normally does). When it came to the right eye, all I was able to tell them was “there’s definitely something on the wall that’s not the same color as the wall.” So much for the eye test.

Back in my room, there was lots of waiting interrupted with occasional nurse visits to make sure everything was OK. Eventually—probably an hour or so after I got back into the room—I saw a doctor for the first time. He asked me to (surprise!) go through the entire story again, so I did. That’s three times for those keeping score at home.

While not an eye doctor, he did bring in a slit lamp machine, where you rest your chin on a chin rest so they can shine bright lights into your eyes while looking through a magnifying lens to check things out.

But…the bulb in said machine was burned out, or not functional. So he called in a tech. The two of them fussed over the machine for a few minutes before giving up. They then left to find another machine, and again I was left alone for a good chunk of time.

Eventually the doctor returned alone, sans machine. “Sorry, we can’t find another machine.” Sigh. Instead, he had a small flashlight in his hands, and used that to try to look into my eyes. By now, I’ve been in the ER for over two hours, and I’m getting frustrated. I said, “I asked before I arrived, and was told there was an eye doctor on site. Is that not true? I’m sure they could diagnose this quickly and either get me into treatment or send me home.”

The doctor replied “Not actually here, but on call. I’ll be talking to her shortly about your eye, and I’ll let you know what she has to say.” Exit doctor, enter even more waiting time. And more waiting time. During this time, some other person came in—not a doctor or a nurse, but some admin type. They, too, wanted the whole story from start to finish (that’s four tellings).

Finally, after nearly three hours in the ER, the doctor returned and said that the ophthalmologist was coming into the office. They’d dilate my eyes, then I’d hike across the hospital to her office, where she had functional eye machines.

The ophthalmologist

Once I got to the ophthalmologist’s office, things went quite quickly. After a few minutes in front of her slit lamp, she diagnosed not a detached retina, but a hemorrhage (caused by the gel moving away from the retina, and tearing a blood vessel) and a rip in the retina. Rips are worse than the hemorrhage, because they can lead to a detached retina.

She made some phone calls (at 10pm) and got me an appointment the next morning with an eye doctor who could take a closer look at my eye, and repair the rip.

In summary, I was in the ER for just under three hours, and in the ophthalmologist’s office for maybe 10 minutes…if they had simply called her first, the ER would have had a room available for someone else much sooner. Sigh.

The next day

I walked and took the light rail to the eye doctor’s office—which turned out to be in the same building as the ophthalmologist from the prior evening, just three floors lower down. After filling out a multi-page new patient form (what’s with paper in this age of modern medicine?), I was given an initial eye exam (same as in the ER: 20/20 and not very much), then my eyes were dilated with some industrial strength drops: I was told the dilation could last up to three days!

After waiting for my pupils to dilate, it was time to get reacquainted with the slit machine—this one had a working light bulb. The doctor checked out both eyes, and—probably because some blood had dissipated—was able to see that my retina was actually torn in four spots, not just one. Ouch. Except that’s the odd part about this: there is no pain. Even with a fully-detached retina, you’ll feel no pain. That’s why it’s important to be aware of flashes of light and perisperhal vision issues with floaters: You want to get your eye looked at quickly if you have these symptoms.

The doctor reiterated the same advice I received the prior night: The cloudy blotchy vision would clear up on its own, anywhere from 30 to 90 days from now. Ugh. But the rips were a bigger concern; if they’re not fixed promptly, they can lead to a detached retina.

Fixing the rips

To repair the rips, the eye doctor used a head-mounted green laser. The laser burns the areas around the rips, forming scar tissue that prevents fluid leaks, hopefully keeping the retina attached. To prepare for this procedure, the eye is first numbed with drops. I had no problem with this step.

Next, though, a numbing agent is injected directly into your eye. Even though my eye was numb, watching the doctor approach my eye with a hypodermic needle sent a shiver up my spine. “Every horror movie EVER!,” my brain was screaming at me. Thankfully, the injection was relatively painless. This is where I also learned the eyes are connected to the throat, as I instantly tasted the medicine as it was injected into my eye (ewww, and yech).

With drops and injection done, it was laser time. And wow. I hope I never have to have that done again! While the doctor is holding the bad eye open, you’re supposed to keep the other good one open, too. But every few seconds, there’s a tremendous bright green flash of light, and the eye instinctively wants to close. After a couple hundred such flashes, my eye started preemptively closing! These flashes are incredibly bright, and though hard to describe, there’s a physical element to them, too—it’s almost like I felt each one thumping against my optic nerve.

With four rips to repair, I got the laser treatment for about 15 minutes—and who knows how many hundreds or thousands of flashes. All I know is that I was very thankful when it was done.

The laser is so bright that the treated eye is basically blind for five to 10 minutes after the procedure—instead of grainy and blob-covered, my bad eye saw only dark black. Slowly, my distorted vision returned, and eventually, I walked back to the light rail and home.

The future

Supposedly my eye should heal back to normal vision…but it could take a long while. As I write this, it’s been about three days, and the eye is perhaps marginally better than it was on Monday night. I can occasionally read larger words on signs, and I can distinguish more colors and shapes. But there’s still a fuzzy gauze filter over everything, and floaters come and go with regularity. A follow-up appointment in two weeks will make sure all the rips are probably repaired, but only time will take care of clearing the blood from my eye.

What’s most distressing about this whole event is that there’s nothing I can do to prevent it from occurring again, in either eye. Only luck of the draw will determine if this is a one-time thing, or if it’ll happen again. I don’t like not knowing, nor being able to control the odds.


Image of Sauron’s eye created by SELUXKANAUR, used under a Creative Commons license.

2 Comments

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  1. Wow – I am so sorry you had to deal with that but so glad the doc believes all will return to normal! Absolutely no idea why this happens???

    Love you-

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