Let's recap. I had a consultation for laser eye surgery with Optimax on Monday.
At that time I was pretty sure I wanted the epi-LASEK procedure (involves no cutting of the cornea, instead an alcohol solution is used in order to move the epithelium aside).
I was told I was eligible for either epi-LASEK or LASIK, and my chances of having 20/20 vision after surgery was around the 95% mark. So why haven't I booked my surgery already?
Well, first off, my friend who had epi-LASEK late last year is currently investigating whether he needs to have re-treatment, and has to wait 3 months to see if his vision has improved from the -0.50/-0.75 or so that it is now. As far as I am concerned, this is not great. This has put me off slightly.
Also, my gut instinct, my women's intuition, the feeling in my water... whatever you want to call it...was not giving me a good feeling. I'm not talking about psychic feelings here, I'm talking common sense alarm bells that something just wasn't right. I'm sure he is a perfectly brilliant doctor but do I trust him with my eyesight? I'm not so sure.
So... today I have booked a free consultation with Ultralase at their Chelmsford clinic.
First impressions of the company are excellent. I completed a form online for them to give me a call to book a consultation and a really nice man phoned and talked me through everything: Whether I have any medical conditions that mean surgery would not be an option, how long the consultation will take, the fact that they'll put in blurry eye drops, the fact that I won't be able to drive home. He was very thorough, very friendly and I'm already impressed.
Ultralase are much more expensive. But what price do you put on your vision, or even, your peace of mind?
Thursday, April 27, 2006
Tuesday, April 25, 2006
Optimax consultation
Here's what happened. (Imagine this like a movie, where I'm played by Keira Knightley, only with a slightly less posh accent, and more meat on my bones, and with blonde hair...oh and I'm also wearing glasses. Goodness it's like you were there with me!)
5.15 Arrive
What does the Optimax laser eye surgery place look like? I think I'm expecting a standard doctor's surgery but I'm greeted by a room filled with comfortable-looking chairs, with a few doors and corridors off it and a long reception desk.
Immediately the receptionist has me over at a little computer in the corner of the room filling out a health questionnaire - am I on any medication, do I have any allergies and then I scan through options and tick boxes that apply to me. These are things like do I have a family history of glaucoma, have I ever had a heart attack, am I epileptic, etc. etc. A few of them I tick yes to: yes I have hayfever, yes I am due to have surgery soon (having a mole removed). Worryingly it says at the top of the list that any ticks might mean I'm unable to have the surgery.
Once I've finished I go and tell the receptionist and she then leads me off to have some tests done. I sit at three machines in turn and have to stare straight ahead and try not to blink. It's quite hard not blinking when all you can think about is not blinking. Mostly I tried to blink a bit before what I thought was the crucial time - but two of the tests she needed to repeat quickly so I was probably rubbish at predicting when the crucial time was! One of the tests was also one I'd read about where a puff of air is blown into your eye. Even though I knew it was coming it still made me jump the first time.
After that the show really started. I guess the time now is about:
5.30
The doctor comes out and calls me in. He's short, not of English origin and wearing a suit. I couldn't tell exactly where he was from, not that it matters of course. I enter the room.
First impression is that he's a typical, professional, no-nonsense doctor. On the one hand you could say he is abrubt, with poor beside manner I suppose. But on the other - and this is my experience with most doctors - he's just doing his job and he isn't there to hold my hand or make me feel at ease. He's not a salesman. If he were, if he was sitting me down asking how I am and am I ready to change the way I view the world and make my life ten times better?... I'd be running out the door right now.
He does some standard tests you get with glasses or contacts - looking at my eye, my prescription etc. He asks if I brought an old prescription along and I give him my old glasses which he goes off to measure to get the prescription.
When he comes back he puts drops to numb my eyes and then uses this instrument to measure the depth of my cornea. To do this he puts something against my eyeball for a few seconds. It's weird to have a numb eye - my eyelid feels kind of bouncy when it closes. Then he puts yellow dye in my eyes to have a look at their health through the microscope.
Next we go through my health form and I discover that my hayfever is not a problem, my upcoming surgery won't make a difference. Then he tells me that from his tests he can tell me that I am a candidate for either epi-LASEK or LASIK laser eye surgery. He asks if I know the difference between the two and I nod and say that it's basically the start of the procedure flap cutting with one, alcohol solution removal with the other. He nods as if he can tell I'm 'one of those ones that does their research' and asks which I prefer.
I say that epi-LASEK appeals more because of the lower risk factor. He then tells me that it is a surgery and as such can never be 100% guaranteed or safe. In my prescription case he tells me that there is a 95% chance I should have 20/20 vision. He informs me that when I reach 45 or so, I will need glasses for short distance again, as do the majority of people who have good eyesight for most of their lives.
I ask him about night vision problems. He tells me that my pupils are actually on the smaller size of normal so this is unlikely to be a problem for me. I say that while 20/20 vision is important, I also do not want to lose any contrast sensitivity. I ask if Wavefront would lessen the chances of this. He tells me that if this is not a problem now, it is unlikely to be a problem after surgery, and because the shape of my eye is pretty much average Wavefront is unlikely to make much difference to me. I ask about how long before I'm comfortable at a computer and he tells me it will depend on my personal recovery - most people can be fine after about a week to ten days but others can be more.
Mostly I get the impression from him that it's impossible to predict exact times. Every case is different in the pain threshold / speed of recovery etc.
After this we get to the fun part - where I get the pupil enlarging drops in my eyes. He tells me this is so he can view inside my eye. It feels fine for a few minutes but once he turns the lights back on after looking through the microscope at me I realise my close vision is a little blurred. Lights have also started to be a little bright.
He asks if I have any more questions and as we've covered all the ones I could think of I say no. And that's it, I'm done and dusted. The receptionist asks if I'd like to make a booking, I ask her to write a few available dates down at the end of May / early June as I need to check with work for booking a week off that will be followed by a few quiet days.
It's about 6.20 at this point and I walk back to the car with my boyfriend. The lights are hurting my eyes and my long distance and very close vision is blurry so there's no way I'd be able to drive. I start to wonder how weird it would be actually having surgery. I decide I have to give myself a few days to let everything sink in before I make a decision.
5.15 Arrive
What does the Optimax laser eye surgery place look like? I think I'm expecting a standard doctor's surgery but I'm greeted by a room filled with comfortable-looking chairs, with a few doors and corridors off it and a long reception desk.
Immediately the receptionist has me over at a little computer in the corner of the room filling out a health questionnaire - am I on any medication, do I have any allergies and then I scan through options and tick boxes that apply to me. These are things like do I have a family history of glaucoma, have I ever had a heart attack, am I epileptic, etc. etc. A few of them I tick yes to: yes I have hayfever, yes I am due to have surgery soon (having a mole removed). Worryingly it says at the top of the list that any ticks might mean I'm unable to have the surgery.
Once I've finished I go and tell the receptionist and she then leads me off to have some tests done. I sit at three machines in turn and have to stare straight ahead and try not to blink. It's quite hard not blinking when all you can think about is not blinking. Mostly I tried to blink a bit before what I thought was the crucial time - but two of the tests she needed to repeat quickly so I was probably rubbish at predicting when the crucial time was! One of the tests was also one I'd read about where a puff of air is blown into your eye. Even though I knew it was coming it still made me jump the first time.
After that the show really started. I guess the time now is about:
5.30
The doctor comes out and calls me in. He's short, not of English origin and wearing a suit. I couldn't tell exactly where he was from, not that it matters of course. I enter the room.
First impression is that he's a typical, professional, no-nonsense doctor. On the one hand you could say he is abrubt, with poor beside manner I suppose. But on the other - and this is my experience with most doctors - he's just doing his job and he isn't there to hold my hand or make me feel at ease. He's not a salesman. If he were, if he was sitting me down asking how I am and am I ready to change the way I view the world and make my life ten times better?... I'd be running out the door right now.
He does some standard tests you get with glasses or contacts - looking at my eye, my prescription etc. He asks if I brought an old prescription along and I give him my old glasses which he goes off to measure to get the prescription.
When he comes back he puts drops to numb my eyes and then uses this instrument to measure the depth of my cornea. To do this he puts something against my eyeball for a few seconds. It's weird to have a numb eye - my eyelid feels kind of bouncy when it closes. Then he puts yellow dye in my eyes to have a look at their health through the microscope.
Next we go through my health form and I discover that my hayfever is not a problem, my upcoming surgery won't make a difference. Then he tells me that from his tests he can tell me that I am a candidate for either epi-LASEK or LASIK laser eye surgery. He asks if I know the difference between the two and I nod and say that it's basically the start of the procedure flap cutting with one, alcohol solution removal with the other. He nods as if he can tell I'm 'one of those ones that does their research' and asks which I prefer.
I say that epi-LASEK appeals more because of the lower risk factor. He then tells me that it is a surgery and as such can never be 100% guaranteed or safe. In my prescription case he tells me that there is a 95% chance I should have 20/20 vision. He informs me that when I reach 45 or so, I will need glasses for short distance again, as do the majority of people who have good eyesight for most of their lives.
I ask him about night vision problems. He tells me that my pupils are actually on the smaller size of normal so this is unlikely to be a problem for me. I say that while 20/20 vision is important, I also do not want to lose any contrast sensitivity. I ask if Wavefront would lessen the chances of this. He tells me that if this is not a problem now, it is unlikely to be a problem after surgery, and because the shape of my eye is pretty much average Wavefront is unlikely to make much difference to me. I ask about how long before I'm comfortable at a computer and he tells me it will depend on my personal recovery - most people can be fine after about a week to ten days but others can be more.
Mostly I get the impression from him that it's impossible to predict exact times. Every case is different in the pain threshold / speed of recovery etc.
After this we get to the fun part - where I get the pupil enlarging drops in my eyes. He tells me this is so he can view inside my eye. It feels fine for a few minutes but once he turns the lights back on after looking through the microscope at me I realise my close vision is a little blurred. Lights have also started to be a little bright.
He asks if I have any more questions and as we've covered all the ones I could think of I say no. And that's it, I'm done and dusted. The receptionist asks if I'd like to make a booking, I ask her to write a few available dates down at the end of May / early June as I need to check with work for booking a week off that will be followed by a few quiet days.
It's about 6.20 at this point and I walk back to the car with my boyfriend. The lights are hurting my eyes and my long distance and very close vision is blurry so there's no way I'd be able to drive. I start to wonder how weird it would be actually having surgery. I decide I have to give myself a few days to let everything sink in before I make a decision.
Wednesday, April 19, 2006
Laser eye surgery - pre consultation jitters
My consultation for laser eye surgery at Optimax is next Monday. I'm both excited and nervous. I'm hoping by then I'll have a much clearer idea of whether I'd like LASIK or epi-LASEK surgery. Realistically, I probably won't know until I've chatted with the consultant and then thought it all through.
When I booked the consultation I received a letter which advised me not to wear contacts for up to 2 weeks before the consulation. But I haven't worn my contact lenses for ages now, actually I think the last time was Christmas, mainly because they're just uncomfortable. One of my eyes is astigmatic (rugby ball shaped) so I have to have a weighted contact in that eye to keep it in the right place, except it still moves and I have to blink to get it back.
Also with the documentation was a risk form - part of the contract you have to sign when you undergo treatment with Optimax. It outlines all the possible risks and side effects and you have to initial each item to show that you have read and understood. It's quite a daunting list but it's standard legal stuff. Just imagine if you had to sign a contract before you were born and you had a list of all the horrid things that could happen to you in life - injury, financial struggles, heartache etc. etc. It's not often you have all the risks of your decision laid out in front of you like that, and of course they don't mention the benefits, because that makes it look like they're trying to give it a positive spin.
But I'm not too concerned. The idea of facing freedom from all that blinking and dry eyes in contacts is like a dangling carrot. And glasses can be a pain too: endless lens cleaning, slipping in hot weather, freezing metal on your face in cold weather, eyelashes brushing on the lens. Yes it would be great to be free of these things. People who don't rely on glasses have no concept of what it's like. I feel like a completely different person when I wear contacts, I'm sometimes amazed that people recognise me - not because I look different but because when you wear glasses it can feel like you're hiding behind them.
Here is my updated list of questions for the consultant:
- Which would I personally be most suited for - epi lasek or LASIK surgery?
- What is the success rate for my prescription on either surgery (my prescription is -2 sphere and -2 cylinder in my right, -4 sphere in my left)
- How long does pain last on average?
- How will I control the pain?
- How long before my vision would be at driving standard?
- How long before I'll be able to use a computer comfortably?
- How long should I take off work (will probably be determined by the answer to the previous question)
- What happens if my vision is not improved, or is improved but still needing glasses?
- What about hayfever, will sneezing or itching eyes be a problem - will I be able to take Clarityn as I have done for about the last 5 years?
When I booked the consultation I received a letter which advised me not to wear contacts for up to 2 weeks before the consulation. But I haven't worn my contact lenses for ages now, actually I think the last time was Christmas, mainly because they're just uncomfortable. One of my eyes is astigmatic (rugby ball shaped) so I have to have a weighted contact in that eye to keep it in the right place, except it still moves and I have to blink to get it back.
Also with the documentation was a risk form - part of the contract you have to sign when you undergo treatment with Optimax. It outlines all the possible risks and side effects and you have to initial each item to show that you have read and understood. It's quite a daunting list but it's standard legal stuff. Just imagine if you had to sign a contract before you were born and you had a list of all the horrid things that could happen to you in life - injury, financial struggles, heartache etc. etc. It's not often you have all the risks of your decision laid out in front of you like that, and of course they don't mention the benefits, because that makes it look like they're trying to give it a positive spin.
But I'm not too concerned. The idea of facing freedom from all that blinking and dry eyes in contacts is like a dangling carrot. And glasses can be a pain too: endless lens cleaning, slipping in hot weather, freezing metal on your face in cold weather, eyelashes brushing on the lens. Yes it would be great to be free of these things. People who don't rely on glasses have no concept of what it's like. I feel like a completely different person when I wear contacts, I'm sometimes amazed that people recognise me - not because I look different but because when you wear glasses it can feel like you're hiding behind them.
Here is my updated list of questions for the consultant:
- Which would I personally be most suited for - epi lasek or LASIK surgery?
- What is the success rate for my prescription on either surgery (my prescription is -2 sphere and -2 cylinder in my right, -4 sphere in my left)
- How long does pain last on average?
- How will I control the pain?
- How long before my vision would be at driving standard?
- How long before I'll be able to use a computer comfortably?
- How long should I take off work (will probably be determined by the answer to the previous question)
- What happens if my vision is not improved, or is improved but still needing glasses?
- What about hayfever, will sneezing or itching eyes be a problem - will I be able to take Clarityn as I have done for about the last 5 years?
Monday, April 10, 2006
LASIK or epi-LASEK laser eye surgery?
Having booked my consultation I'm now finding myself thinking more and more about laser eye surgery. From a hazy 'oh yes, that would be good' to now really concentrating on the risks and benefits, the pain, the recovery time, the after care treatment, the chance of success... and all those other things that start your head swimming if you don't organise your thinking.
My main question at the moment is whether I prefer the idea of LASIK or epi-LASEK laser eye surgery. Here are the basics of the two as I understand them:
--------------------------------------LASIK----------------------------
Anaesthetic is dropped into your eyes to prevent any pain. You will then have a layer of your cornea surgically cut and 'flapped over'. The laser reshapes your cornea beneath and then your 'flap' is placed back onto your eye. It will stay in place by natural suction but you will need to wear a protective eye shield for around 24 hours to prevent yourself from rubbing your eyes and disturbing the flap as it settles back.
Pain: Less than epi-LASEK laser eye surgery as the flap of cornea is put back right where it was before. Pain is usually said to come on a few hours after surgery and last for around 24 hours. Most things I've read have likened the 'pain' to just a level of discomfort - like having grit in the eye or an uncomfortable contact lens.
Recovery time (when can I go back to work?): I've read that people can often go to work the next day after LASIK laser eye surgery! Realistically I think I could have the surgery on a Thursday or Friday, have the weekend off and then be fit for work on the Monday - obviously so long as all goes well. Clear vision is usually within 2-3 days.
Risks: Because there is a physical cut made into your cornea there are much more risks with this form of laser eye surgery. Besides the potential for surgical mishap (who doesn't shiver at the idea of someone cutting into their eye?) there is also issues about the flap growing back not exactly as it was before. The cornea is also thought to be weaker following the surgery and it's not recommended for anyone likely to encounter physical contact - sportsmen / police officers etc.
Next after care appointment: You go back the day after your surgery to check all is well.
My concerns: Potential for dry eye and concerns about working with VDU's.
---------------------------------------Epi-LASEK--------------------
After anaesthetic drops are put in your eyes, an alcohol solution is put into your eye to weaken the cells so that a layer of your cells (epithelium) can be moved aside. The laser reshapes your cornea and then the cells which were moved are replaced. You wear 'bandage lenses' non stop for 3 days to keep your epithelium in place.
Pain: Little is felt for the first 24 hours thanks to the anaesthetic drops, but then it comes on a lot stronger for around 3 days. I have yet to read what people compare the level of pain to - but then we all have different pain thresholds so it wouldn't be a great guide anyway.
Recovery time (when can I go back to work?): I would need to take at least a full week off and possibly would only just be able to drive again after 7 days following epi-LASEK laser eye surgery.
Risks: Much less than LASIK laser eye surgery because there is no cutting made, but the risks of the laser and vision - overtreatment, undertreatment, halos etc are all still there.
Next after care appointment: You go back after 3 days to have your 'bandage lenses' removed and to check all is going well.
My concerns: Length of time for recovery - will I be fit to drive after a week?
Pain - how much and how controllable will it be?
Links:
Royal College of Opthamologists - Patients Guide to Excimer Laser Refractive Surgery [PDF download]
www.optimax.co.uk
My main question at the moment is whether I prefer the idea of LASIK or epi-LASEK laser eye surgery. Here are the basics of the two as I understand them:
--------------------------------------LASIK----------------------------
Anaesthetic is dropped into your eyes to prevent any pain. You will then have a layer of your cornea surgically cut and 'flapped over'. The laser reshapes your cornea beneath and then your 'flap' is placed back onto your eye. It will stay in place by natural suction but you will need to wear a protective eye shield for around 24 hours to prevent yourself from rubbing your eyes and disturbing the flap as it settles back.
Pain: Less than epi-LASEK laser eye surgery as the flap of cornea is put back right where it was before. Pain is usually said to come on a few hours after surgery and last for around 24 hours. Most things I've read have likened the 'pain' to just a level of discomfort - like having grit in the eye or an uncomfortable contact lens.
Recovery time (when can I go back to work?): I've read that people can often go to work the next day after LASIK laser eye surgery! Realistically I think I could have the surgery on a Thursday or Friday, have the weekend off and then be fit for work on the Monday - obviously so long as all goes well. Clear vision is usually within 2-3 days.
Risks: Because there is a physical cut made into your cornea there are much more risks with this form of laser eye surgery. Besides the potential for surgical mishap (who doesn't shiver at the idea of someone cutting into their eye?) there is also issues about the flap growing back not exactly as it was before. The cornea is also thought to be weaker following the surgery and it's not recommended for anyone likely to encounter physical contact - sportsmen / police officers etc.
Next after care appointment: You go back the day after your surgery to check all is well.
My concerns: Potential for dry eye and concerns about working with VDU's.
---------------------------------------Epi-LASEK--------------------
After anaesthetic drops are put in your eyes, an alcohol solution is put into your eye to weaken the cells so that a layer of your cells (epithelium) can be moved aside. The laser reshapes your cornea and then the cells which were moved are replaced. You wear 'bandage lenses' non stop for 3 days to keep your epithelium in place.
Pain: Little is felt for the first 24 hours thanks to the anaesthetic drops, but then it comes on a lot stronger for around 3 days. I have yet to read what people compare the level of pain to - but then we all have different pain thresholds so it wouldn't be a great guide anyway.
Recovery time (when can I go back to work?): I would need to take at least a full week off and possibly would only just be able to drive again after 7 days following epi-LASEK laser eye surgery.
Risks: Much less than LASIK laser eye surgery because there is no cutting made, but the risks of the laser and vision - overtreatment, undertreatment, halos etc are all still there.
Next after care appointment: You go back after 3 days to have your 'bandage lenses' removed and to check all is going well.
My concerns: Length of time for recovery - will I be fit to drive after a week?
Pain - how much and how controllable will it be?
Links:
Royal College of Opthamologists - Patients Guide to Excimer Laser Refractive Surgery [PDF download]
www.optimax.co.uk
Tuesday, April 04, 2006
Blooker Prize Awards 2006
I only just heard about these by reading about them on the BBC news site.
For anyone even less clued up than me (if that's at all possible?) a 'Blook' is a book based on a blog or website. I knew that many bloggers somehow manage to get book deals based on their blogs, but didn't realise just how big this thing is getting. Can you hear my mind clicking away as all this information is processed?
The winner, Julia Powell, spent a year cooking from some French cookbook, because I'm such a good person and I like to share the information I find out, I will even give you a link to her blog here.
The official website for the Blooker Prize is http://www.lulublookerprize.com/.
For anyone even less clued up than me (if that's at all possible?) a 'Blook' is a book based on a blog or website. I knew that many bloggers somehow manage to get book deals based on their blogs, but didn't realise just how big this thing is getting. Can you hear my mind clicking away as all this information is processed?
The winner, Julia Powell, spent a year cooking from some French cookbook, because I'm such a good person and I like to share the information I find out, I will even give you a link to her blog here.
The official website for the Blooker Prize is http://www.lulublookerprize.com/.
Monday, April 03, 2006
I've booked my laser eye consultation!
I'm going to my local Optimax branch - which is Ipswich - on the 24th April. It's only a consultation but I'm already excited. Oh but what if it turns out I'm not suitable for treatment because my cornea's are too thin / thick or, I don't know, they find out I have some rare genetic thing which means I'm destined to wear glasses for the rest of my life? That would be awful. Fingers crossed I'm an 'elligible candidate'.
It could have been as soon as this Wednesday, but as the consultant advised me I wouldn't be able to drive home afterwards because of the solution they put in my eyes I need my boyfriend to come with me. He also wants to be there to be sure I'm not going to just get all excited at the prospect of not wearing glasses or contacts, and be blind to any general dodginess of the place. Yes that was intentional use of the word blind. No I am not thinking about going blind.
Tell someone you're thinking of having laser eye surgery and what's the first thing they say? "Oh I couldn't do that, I'd be scared of going blind!" Do you know anything about laser eye surgery and the chances of blindness? "No, but going blind, that's a scary thought?" So is getting run over by a bus but it doesn't stop me crossing roads. You get the idea.
The consultant asked me if I wanted to book my surgery for the same day, but I opted out because if I have epi lasek I believe I'll need to book a week off work to allow for my eyes to be of driving and computer work standard.
Questions I will be asking the Optimax consultant:
- Which would I personally be most suited for - epi lasek or LASIK surgery?
- The success rate for my prescription on either surgery (my prescription is -2 sphere and -2 cylinder in my right, -4 sphere in my left)
- The recovery rate
- The length of time before driving
- The length of time before vdu work (I have read that near vision can take longer to recover, particularly with epi lasek treatment)
- The risks of complication (yes, that does include blindness)
And others which I have yet to think of but will post on this blog later....
It could have been as soon as this Wednesday, but as the consultant advised me I wouldn't be able to drive home afterwards because of the solution they put in my eyes I need my boyfriend to come with me. He also wants to be there to be sure I'm not going to just get all excited at the prospect of not wearing glasses or contacts, and be blind to any general dodginess of the place. Yes that was intentional use of the word blind. No I am not thinking about going blind.
Tell someone you're thinking of having laser eye surgery and what's the first thing they say? "Oh I couldn't do that, I'd be scared of going blind!" Do you know anything about laser eye surgery and the chances of blindness? "No, but going blind, that's a scary thought?" So is getting run over by a bus but it doesn't stop me crossing roads. You get the idea.
The consultant asked me if I wanted to book my surgery for the same day, but I opted out because if I have epi lasek I believe I'll need to book a week off work to allow for my eyes to be of driving and computer work standard.
Questions I will be asking the Optimax consultant:
- Which would I personally be most suited for - epi lasek or LASIK surgery?
- The success rate for my prescription on either surgery (my prescription is -2 sphere and -2 cylinder in my right, -4 sphere in my left)
- The recovery rate
- The length of time before driving
- The length of time before vdu work (I have read that near vision can take longer to recover, particularly with epi lasek treatment)
- The risks of complication (yes, that does include blindness)
And others which I have yet to think of but will post on this blog later....
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