Cataracts


Cataracts
By Brenda Diskin ©2008-07-29

Ever since I was a child I have struggled with my eyesight. I had extremely good vision in my left eye and astigmatism in my right. I have always worn glasses to correct my far sightedness. Being a little vain in my teenage years (and because there were no designer frames then and contact lenses were expensive) I used to remove my spectacles when I went out which meant I was constantly aware of trying to keep my right eye ‘straight’. Over the years my ‘good’ left eye has never let me down, allowing me to see quite long distances, to read numerous books, to sew, draw, paint and pursue various hobbies and handicrafts. I first noticed a definite change about 8 years ago, although I could still pursue the rest of my hobbies I found reading started to get difficult due to the fact my eyes became extremely tired. I would read a few lines and my eyes just wanted to close, which meant I found myself reading the same few lines over and over. It took an eternity to read a book and started to become more of a chore than a pleasure.
I have always loved to write so I thought that would be the answer but slow typing speeds and arthritic fingers make transferring stories and poems to the computer a long and arduous job. Nevertheless I still gain a lot of pleasure from my writing.

About a year ago I started having to use buses on a fairly regular basis and noticed that I was having difficulty seeing the numbers unless the bus was extremely close. I put this down to wrong prescription on my spectacles and the fact that the bus numbers aren’t lit up like they are in London. Even when I missed a few buses because I couldn’t get my hand out to stop them in time because they were so close I still didn’t think there was a problem.

About five months ago I noticed that my spectacles seemed to be constantly dirty, especially the left eye, and was constantly cleaning them. Again I didn’t think there was a problem I presumed I wasn’t cleaning them properly or that they were scratched. I was told by the optician at Vision Express about four years ago that I had the start of a cataract but I have visited the optician (a different company) several times since and been assured that I did not have a cataract. I would like to add that although I was using the same company I had seen three different opticians so thought they couldn’t all be wrong.

About four months ago we were out shopping in Huddersfield market when I asked Mick to check if my spectacles were dirty. He said they were a little dirty. As I looked up I realised it wasn’t my spectacles, which Mick was still holding, it was my eyes.

From then on my eyes continued to deteriorate. I could see black on white writing fairly easily and if something was up close, although it was hazy, I could see it. Anything more than 6 – 8 feet away was a blur, I could not make out the features on someone’s face. It was like a Sci-Fi film, everyone looked like they had blank faces as I could only see the outline of their heads.

I went along to the optician and asked if they could check my eyes for problems. The optician I saw said my eyes were normal and my vision hadn’t changed hardly at all as I could still see the letters on their board the same as before and could read the little card they gave me with the various size sentences on while wearing my spectacles. He did various tests and said there was nothing wrong, definitely no cataracts. He told me I had to expect my vision to be blurred when I took my spectacles off. I insisted I knew my eyes and there was definitely something wrong. Because I was so insistent he sent a letter to my doctor asking for me to be referred to hospital.

I waited three weeks for an appointment and on June 3rd 2008 I attended Royal Hallamshire hospital. By this time I was looking at what other things could be wrong with my eyes as the optician had insisted that I did not have cataracts, the other options were not good. I started to resign myself to the fact I was possibly going blind.
My appointment was for 8.30am and they saw me on time. The nurse checked my eyesight and escorted me to another waiting area. I only waited about 5 minutes before the doctor called me in. He asked me some questions and asked what I thought the problem was. I told him I thought it was cataracts but the optician had told me it wasn’t. He examined my eyes and said that he also thought it was cataracts which was quite a relief. He then put some drops in my eyes ready for another test which he told me was to make sure that he had given me the right diagnosis. I returned to the waiting area for 15 minutes then I was called back in. He asked me to look at some lights and looked into my eyes. The whole process was absolutely painless. The doctor then told me exactly what they would do if they operated what the success rate was (about 95%) and went through the recovery process. He then asked if I would like the operation, when I said I did he put me on the waiting list which is about two months.

On July 10th 2008 I was called to Weston Park hospital for a pre-operation check. Again my appointment was for 8.30am. The nurse called me and tested my eye sight I was then sent to see the theatre nurse who went through the operation procedure and made me an appointment for the operation on 31st July and also made the post op appointment. The whole consultation only took about 30minutes. I am now two days away from my operation; I have to be at the hospital at 7am. I am having a local anaesthetic which is drops in the eyes to make them numb.

Part Two (The operation and recovery).

My partner Mick took me to the hospital we arrived exceptionally early and waited about an hour and 20 minutes for them to call me. The nurse called me and told Mick I would be ready to go home about 10am and that they would call him when I was ready. The nurse took me upstairs to the ophthalmology department. I was shown to a waiting room. There were three of us waiting for the operation. I was told I was first and was taken in to an office where I was asked to confirm my personal details, my blood pressure was checked and three lots of drops were put into my left eye. I was told the first drops were to stop the others from stinging and the others were to dilate my pupil. I was then called in to see the surgeon who explained everything and marked above my eye with a felt tip pen to indicate which eye was to be operated on. I had to have another two lots of drops in my eye as my pupil was not dilating quickly enough so my operation was put back to second. A male nurse came to collect me; he introduced himself and checked my details again. He then took me along to the theatre where I was helped onto the couch and my head laid on a specially shaped pillow to stop my head from moving. A cover was placed over me and a heart rate monitor was attached to the centre finger of my right hand. I was told to keep my hands by my sides. The male nurse held my left hand and explained that if I was uncomfortable or needed anything I was to squeeze his hand. A paper sheet with a hole around my eye was placed over my face and taped around my left eye. A tube blowing fresh air was placed under the paper sheet. I bright light was switched on and I was told to look straight ahead. All I could see was the light.

The Operation
The lens is located immediately behind the pupil and consists of several parts. In the centre there is the core which becomes opaque with increasing age. There is a soft skin which lies around it. The whole lens is surrounded by the lens capsule. The lens capsule is hung up by elastic fibres, the zonula fibres, from the ciliary body of the eye behind the iris
Today during the cataract operation the entire opaque lens is mainly no longer removed from the eye, and the lens capsule is if possible left in the eye. In the case of the most frequent form of the cataract operation the lens capsule is opened circularly by means of a small incision, the harder lens core is liquefied by ultra sound waves and subsequently sucked out together with the softer lens skin.
Instead of the natural lens an intraocular lens is then implanted into the eye.
In order to insert the artificial lens as well as the necessary operation instruments into the eye, a small corneal incision is made, which closes again after the operation without any artificial stitches.
The surgeon started the proceedure. He cleaned around my eye with antiseptic, then put in a drop to make the anesthetic drops from being painful. He then put in the drops to numb my eye. He put a clamp on my eyelid to stop me from blinking. This was slightly uncomfortable but not painful. The surgeon made the first incision which I did not feel at all, I couldn’t even see the instruments coming towards my eye, all I could see was the light. He then told me that the next instrument would make a buzzing noise but not to be alarmed. Again I felt nothing just heard what sounded a little bit like a very quiet dentist drill. Next, the surgeon said I would feel a slight pressure when he put in the new lense. The pressure was only very slight and did not hurt at all. He then asked if I could see anything, to which I answered I could see orange and purple lights and the shape of his head. He told me the operation was successful and taped a patch over my eye.
The Recovery
Day 1 (Operation Day)
I left the hospital with a blue tinted patch over my eye which I had to keep on until the following morning and then put back on each night for a week (to stop me rubbing my eye in my sleep). I noticed my eye was very sensitive to light and being as my right eye has always been so I had to stand and wait for Mick with both my eyes closed. I was told to take paracetemol for any pain. I felt no real pain in my eye but a little discomfort as though I was wearing a very uncomfortable contact lense. Did not feel the need to take any painkillers. Towards the evening I noticed an improvement in my sight even though I was still wearing the patch.

Day 2
When I woke up my eye was stuck together. I removed the patch and bathed my eye with cooled boiled water and cotton wool as instructed by the nurse. I put the first drop in my eye (1 drop four times a day for 4 weeks). My eyesight had improved considerably, in fact so much that I could actually see with my left eye without glasses ( for distance, I could not read or use the computer) but I felt a bit ‘off balance’ as my right eye has very little vision.. I asked Mick to take me to buy some cheap reading glasses (will buy some decent ones when my eye has healed and I know what prescription I will require) and some sunglasses. My eye was still very sensitive to light and I noticed some light flashes to the left hand side which are quite annoying. My eye was quite swollen around the eyebrow and cheekbone. I bathed my eye and put in the drops throughout the day. I was able to sit and watch some films quite comfortably. Towards the evening my eye felt a bit sore and very tired.

Day 3
Took off the patch this morning (no stickiness). We took Mick’s dad out shopping; I had to wear my sunglasses as my eyes were still very sensitive to light. Once again I had a little soreness during the day which eased with bathing and the drops. Still haven’t had to take any painkillers. Watched some more films tonight. Not able to focus on the computer enough to catch up with my work. Once again my eyes got tired and sore towards the end of the evening but this was only mild discomfort and to be expected.

Day 4
Went for a ride on Mick’s motorbike today I was a bit worried about going over any big bumps in case it jarred my eye. I found the cold air blowing up my helmet quite uncomfortable on my eye so had to close my eyes while we were going at speed on the motorway. No problems or mishaps. Still got the light flashes and sensitivity to bright light.

Day 5 (Monday)
Went to the Gym today to work out. The hospital said this was okay but not to go swimming because of the risk of infection. Still got the flashing and light sensitivity.
My eyes are still getting tired and sore at night but I expect this.


Day 6
The swelling around my eye has gone down a bit so I don’t look so much like Neanderthal man (or woman). Still got the sensitivity and the feeling of a slipped contact lense. Went to the gym – no problems. Eyes still getting very tired.

Day 7
Eyes are looking more normal. Will be really glad when I can put a bit of mascara on. Off to the gym. Still got the sensitivity and flickering light to the left of my eye.

Day 8 Post Op Appointment.
Arrived 8.30am. Got seen more or less straight away. The nurse tested my reading ability in my left eye. Which was quite good. They then put me on a machine to check my distance sight. I returned to the waiting area where I remained until I was called to see the other nurse to check my eye to see if it was healing properly. I asked the nurse about the sensitivity, flickering and feeling of a slipped contact lense and was assured this was quite normal and would pass. The nurse checked the slits made in the cornea to see if they were healing (one is where the instrument is inserted to suck out the old lense and the other where the new lense is inserted). She put some drops in to numb my eye and removed two lower eyelashes which were growing into my eye. A drop of orange dye was put in my eye to check everything was healing properly . I was told I had a couple of broken blood vessels which were quite normal and nothing to worry about and that my eye was healing well. I mentioned the problems with the focus in my right eye and was told the doctor I saw at Hallamshire had said that although I have a slight cataract in my right eye they were waiting to see if it caused a problem before doing anything about it so I have been referred back to the Royal Hallamshire to see what they intend to do with my right eye. I was given a note for the optician in case they decide not to do anything with my right eye. Left the hospital and went to the gym. My left eye was a little achy and sore but no real problem.

Days 9, 10, 11 Soreness and sensitivity easing. Finding more of a problem focusing with my right eye and whether it is imagination or not, I seem to be noticing the cataract more since my left eye has improved.

Day 12 Monday (11th Aug). Went to the gym today (my right eye is very achy) and when I got home I had received the appointment to go to the hospital to see about my right eye. I have to go back to the original consultant at Royal Hallamshire on 3rd September at 8.30am.

Day 13 – Day 18 Still a prickly feeling in my eye and quite sensitive to light

Day 19 (Monday 18th Aug) The sensitivity in my left eye seems to have quietened down and it is only feeling prickly when I am tired. Eyesight in my left eye is extremely good. Still using the drops. Last day for using them will be 28th August. I highly recommend the operation. I have got the best eyesight I have ever had, without glasses, in my left eye.

I have now got to wait until 3rd of September to see if they are going to do my right eye. I will update when I get the results of the consultation.

Update I actually did get my right eye operated on and have the best eyesight I have ever had.

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