Thursday, 29 January 2009

Good eye news... for now

It's Thursday evening and I can see better with my damaged eye than I've been able to do for months... and that just over 24 hours after being out for the count in the operating theatre at the Manchester Royal Eye Hospital. Yes, I've had my operation and it went better than expected.

Val and I drove to Manchester on Monday early evening, a horrible busy drive when you're just used to seeing the postman and a few sheep. We stayed with my nephew Dale and his partner Deb, as previously when I was to have a major operation nearly a year ago. They live within easy public transport access (walk, tram, walk or bus) of the hospital to which I had to report by 12 noon the next day. Being there a day early made the journey much less nerve-racking. Val stayed with them while I was in hospital.

After being admitted on Tuesday, Mr Charles, the consultant examined me and we talked about the gravity of the operation. I fully understood that there were a whole raft of horrors which could occur because of my tricky eye which has been so much damaged by earlier operations. I reckon this was my 12th! There were three things to be done: an injection of Avastin to arrest the swelling of the macula (the central spot of the retina with the greatest concentration of light-detecting cells) which had been causing a semi blind spot in my central vision; removal of the old and displaced anterior chamber lens (ACIOL) and its replacement with a new one to be supported by suturing to the sclera which would also require the removal of all the jelly-like vitreous humour at the back of the eye (vitrectomy) which would be naturally replaced by the salty aqueous secretion from the ciliary body close to the iris.

Operation day came and I was gently knocked out by a very kind anaesthetist who was, he said, exactly the same age as me. A short time later, I came round and was soon back up in the ward amid rumours that things had gone rather differently than expected. I was puzzled by the lack of pain for a start and the short time in which this long and complex operation had been carried out by Mr Charles and his team. Later in the afternoon, Mr Charles appeared and after being introduced to Val - who was, of course, there with me - told me what had happened. He operates on the principle of 'do no harm' which could be paraphrased in my case as 'if it ain't broke, don't fix it'. After making one small incision with which to remove the misplaced lens, he found that the lens would actually very easily slip into the place it should have been and seemed quite secure. He was very happy at this point to not open up the eye any further for, as he had explained to me, every time this is done, more damage is done to the non-repairing endothelial cells of the inside of the cornea. This damage causes oedema, or waterlogging, of the cornea which results in the vision being variably foggy. So he decided to leave well alone, administered the Avastin injection to the macula and patched me up. And that was it. The incision, I understand, is so small that no stiches were needed. Hence the almost total absence of pain.

How long this will last is unknown. It could become displaced again in a few weeks or go on for 10 years. We just don't know. Mr Charles saw me again this morning for a final check before discharging me. All seemed to be well and no damage had been done to Miss Fenerty's fine handiwork (the tube implant, done nearly a year ago to control the glaucoma) with the pressure coming in at 10 (it is now normally between 10 and 15 whereas it used to hit the upper 30s when the glaucoma was out of control). I return to see him in 2 weeks for a routine check. I'm on the usual antibiotic and antiinflammatory drops and have to not stoop for about a week only. The eye - as I write - is painless and for the first time for months, I don't see multiple images. This means that the images from both eyes fuse properly and I get some rudimentary stereo vision. I can also just about see the letters on my laptop's keyboard. I couldn't before and as the Avastin does its job, I hope my central vision will improve some more. But with this much improvement already, I feel very pleased.

When I was waiting to be discharged this morning, I heard a cheery, "Hello Mr Lynas" in a familiar voice: it was Miss Fenerty who has so successfully sorted out my glaucoma. She remembered all about me (astonishing in my view since she must see dozens of patients every month) and we chatted briefly about her photovoltaic panels which are successfully feeding electricity into the grid. She wanted to know about the vegetables and how the weather had been for them. The upshot of this chat is that she plans to take up my invitation, proffered some time back, to come and visit Mur Crusto farm. I would, I said, be honoured!

Finally, I have to record with pleasure that my stay in hospital was made almost enjoyable by the kindly staff, male and female of all races and creeds. The food wasn't bad either, not something you hear many people say. There's lots of laughter on this eye ward, good therapy for any patient.