Saturday, 11 October 2008

One damn thing after another

Sea urchins and soreness: I visited the Manchester Eye Hospital yesterday for a 2-month checkup. I was ready for it because my eye has been becoming increasingly sore - especially in the evenings - for some weeks. This was despite putting in various drops and ointments which make dry eyes more comfortable. But the eye didn't seem to be dry. For all the world, it felt as though there was a badly-fitting contact lens in there but without the remedy of being able to remove the lens. There's more: when I first open my eye in the morning, I see a strange black object right in the centre of my vision. It looks like a rather flattened black sea urchin, complete with spikes. I close the eye again and there's a negative after-image. As the day passes, this manifestation becomes less obvious but I notice that I can see more clearly (that's a relative term; the vision is just a total fuzz) when I don't look at an object directly.

Some good news: Those were the symptoms which I recounted to Miss Fenerty. Firstly, though, she checked the pressure. It was 10 (and had been 12 three weeks ago when I had it checked at the local optician). So there's some good news: it really does look as though the glaucoma problem which has affected me since Fiji days in the early 1970s (though I didn't then know it) is solved. Big plus for Miss Fenerty's surgical skills and knowhow.
The soreness seems to be related to the loose ACIOL (anterior chamber intraocular lens) about which I am being seen in early November by another specialist. This is constantly causing low-level damage to the eye which then reacts by becoming inflamed. Some steroidal eye drops, she thought, would help: Prednisolone. Twenty four hours later, as I write this, it looks like she's right. I'm using the drops and, so far, the eye has stopped being sore.

Introducing a new player: macular oedema To get a diagnosis of the 'sea urchin' issue, Miss Fenerty at once sent me off for a laser scan of the affected area of the retina. This remarkble procedure, which took about 20 seconds, resulted in weird-looking 3D images and cross sections of my macular (the central area of the retina which is packed with cone cells giving the acute vision we all need for detail like reading) which I then whisked back to Miss Fenerty. I have fluid which has accumulated underneath the macular, lifting the retinal layer like a hill (in the images) where no hill should be. The result is the symptoms I have described. The first line of defence is a non-steroidal anti-inflammatory called Acular - which I am now also using. The likely cause of this oedema (aka 'edema' [US] meaning 'waterlogging' and which already affects my damaged cornea) is this lens and the inflammation it is causing.
So I await my next visit in just over 3 weeks to see the ACIOL specialist, Mr Charles. By that time, we'll know whether the oedema is reduced and, if it's not, I would expect that another operation to remove the injurious lens and, I hope, replace it with a new and stable version, will be very soon after. The saga will continue...