The Bionic Eye Adventure

From Cloudy to Clear

2009-06-24T20:48:00.000-07:00

No, "cloudy to clear" doesn't refer to a change in the weather. In 2007 Dr. Liu told me that the lens capsule inside the eye tends to become cloudy after cataract surgery, at which time a simple laser procedure could be done right in the office to clear things up. When I asked him when the cloudiness would be likely to appear, he told me it would probably happen in a year or so. Two years went by, and I thought maybe I would be one of those lucky people whose lens capsules stay clear forever. Probably the clouding was something that just happened to "old" people, not to a young 51-year-old like me.

A few weeks ago I began to notice a distinct lack of clarity in my right eye. When I closed my left eye, everything looked blurry. Uh-oh. I went online and Googled "lens capsule clouding" and "lens capsulotomy." I found out that clouding of the lens capsule happens to almost everyone who has cataract surgery, and it usually happens more quickly in younger people. (Hmm, maybe I'm not as young as I thought. It took two years for my right capsule to cloud up, and the left one is still fine.) One website compared it to "looking through wax paper instead of Saran Wrap." Yes, that was an apt description of what I was going through. Thanks to the wonders of YouTube, I was able to view a video of an eyeball undergoing the procedure. Zap, zap, zap, and you're done. It didn't seem too bad, but I was still nervous.

In a lens capsulotomy, the eye surgeon uses a laser to open up a hole in the back of the lens capsule. There's no need to remove the capsule altogether--just open a window and you're fine. The clouding can't come back if there's nothing for it to stick to. I called Omaha Eye & Laser to make an appointment. Dr. Liu was on vacation, so I had to wait a few weeks to come in for a checkup. The exam revealed what I already knew--it was time for a lens capsulotomy in my right eye. "They do those on Mondays," the appointment scheduler told me. I took the last available opening on Monday, June 15 at 12:45 p.m.

On the appointed day, I showed up a few minutes early. A staff member put a hospital bracelet on my arm, even though the procedure requires no anesthesia. That spooked me a little bit. Did they think I was going to pass out? How bad was this going to be?

I sat in the waiting room pretending to be calm until my name was called. Then I walked back into the surgery area, where Dr. Liu was waiting. He greeted me and asked if I had any questions. Just a couple: "Will I feel anything?" No. "Will I notice any differences besides better vision?" More floaters, but they usually settle down in time.

The actual procedure reminded me of a glaucoma test: sit down, put your chin in the chin rest and press your forehead up against the forehead thingie. An assistant put some gel into my right eye and inserted a special contact lens to keep the lid open during the procedure. (You don't want to blink when the doctor is shooting laser beams into your eye.)

Was I nervous? Yes. I had to swallow a few times, and each time my head moved up a tiny bit. It's hard to swallow when your chin is pressed into a chin rest. I tried to make sure each swallow occurred between the laser pulses. Dr. Liu politely inquired if I was okay, and I said, simply, "Yes." (Scared shitless, but otherwise fine, Doc.)

There was no pain, and the procedure took only a few minutes. Dr. Liu told me to expect some cloudiness for a few hours, after which my vision would be clear. I was instructed to put a drop of Acular in my right eye four times a day for the next week, then come in for a follow-up exam. Acular is a special eye drop for people who have gone through laser eye surgery. The retail price of the medicine is $143, but thanks to my husband's insurance we paid only $29. I don't know how much the procedure cost, but Tom's insurance covered part of it. We had to pay a deductible of $500.

A few hours after the procedure I was marveling at the improved clarity of my vision. Wow! I had forgotten how good the distance vision had been in my right eye. The lens clouding had happened so gradually that I had accommodated to it without really noticing.

When will the left eye decide to cloud up? Who knows. When it does, I will be a lot less nervous.

New hairstyle?

2009-02-12T21:21:00.000-08:00

It happened again yesterday. Someone who had met me before my eye surgery complimented me on my new hairstyle. I used to wear my hair chin-length, and I got a shorter style about a year before my eye surgery. I've been wearing my hair the same way for almost three years, so this is not a recent change.

I think casual acquaintances recognize that something is different about me, but they don't know what it is. Instead of noticing what's NOT there (glasses) they notice my hair. At any rate, the comments have all been positive!

Seeing and being seen in new ways

2008-03-31T11:42:00.000-07:00

Switching from glasses to contact lenses at age 18 made me feel more attractive, more approachable and less "bookish." It gave me the little added boost of self-confidence I needed as a brand-new college student. I wore contacts until I was about 40, but the last few years were rough. My eyes would get red and irritated more quickly (the optometrist said I had "thin tears"), and I grew tired of the process of cleaning and storing the lenses after each wearing. When we adopted Philip in 1998 I gave up on contact lenses because I was too busy to deal with them and I decided they were no longer worth the effort. Appearance became less important than taking care of the needs of my family, including all the demands of a newborn baby.

When Philip was 4 or 5 years old I tried wearing disposable contact lenses, but they irritated my eyes almost as much as the gas-permeable lenses and were more expensive. I resigned myself to the fact that I would have to wear glasses "forever." I never felt attractive in glasses, and there were incidents that confirmed these feelings. For example, in January 2007 I was writing an article for B2B Quarterly and made a phone call to a person I had spoken with at a local event. At first she couldn't remember who I was, and then she said, "Oh--you were the one with the glasses." Ugh. It didn't help that she was a willowy, attractive blonde. I hated the fact that my glasses were the only thing she could remember about me.

Then in the spring of 2007 I was interviewing Dr. James Liu for an article in Women's Edition and I learned about refractive lensectomy. Finally, a way to get rid of glasses AND contacts forever! The cost seemed prohibitive, but my husband Tom was supportive. Finally I decided to "go for it" as a celebration of a new stage in my life.

On April 12 I will be 50, and it will be almost a year since the first surgery. Was it worth the expense? YES! I love the freedom of not wearing glasses or contacts, and I feel more confident when talking with new people in situations like networking events. Now there is no barrier between me and the world.

"You looked weird, Mom!"

2007-08-24T19:48:00.000-07:00

When I first told my younger son Philip (age 8) that I was going to have eye surgery so I would no longer need to wear glasses, he protested that he didn't want me to look different. He wanted me to stay exactly the way I was.

More than four months have passed since I stopped wearing glasses. About a week ago we were watching part of a videotaped TV interview in which my husband and I talked about transracial adoption. The interview was taped in November. Philip saw me on the videotape and commented in surprise, "You looked weird, Mom!" Today I look normal to him without glasses. It feels "normal" to me, too, and I love it!

Aging, etc.

2007-05-28T22:38:00.000-07:00

In some ways, clear lensectomy is like turning back the clock (or calendar). Unlike most people my age (including those who have had LASIK), I don't need to use reading glasses. It's as if I'm getting away with something! I also love the fact that I will never need to have cataract surgery. Been there, done that--albeit a few years early.

I went to Billings Photography on Saturday to get an updated business photo sans glasses. I will post it as soon as I have the JPG.

A New "Normal"

2007-05-22T22:25:00.001-07:00

I'm amazed at how quickly it has become "normal" for me to be independent of glasses or contact lenses. I have almost--but not quite--begun to take my new freedom for granted.

Another source of amazement is how "invisible" the change has been when it comes to people outside my immediate family. No one has said, "Hey! How come you're not wearing glasses anymore?" But when you think about it, I probably wouldn't notice the same kind of change in anyone outside MY immediate family. I haven't become a raving beauty overnight. I look like myself, only better (in my opinion!).

My biggest worry is retinal detachment. I've had vitreous floaters for most of my life, but now they seem more ominous. Being a defensive pessimist, I need to have something to fixate on!

Janet

Zones and Focal Points

2007-05-07T20:18:00.000-07:00

My new bionic lenses operate differently from natural lenses. Each lens has five different focusing zones, and the lenses in the two eyes are different. My brain is adjusting to this new way of focusing. Distance vision is easy; I don't have to do anything special to see faraway objects with crystal clear sharpness. The lens in my right eye seems to be especially good with distance vision. If I'm driving and I close first one eye and then the other, I can see a difference between the two. I'm certain that my distance vision with the right eye is better than 20/20. It reminds me of when I got my first pair of contact lenses at age 18, except that these lenses are a lot more comfortable and require no maintenance except for eye drops 4X daily as my eyes are healing from the surgery. I'll be done putting drops in my left eye on May 17 and my right eye on May 31.

For near vision, the two eyes have different focal points. The lens in the right eye was implanted only four days ago, and the two eyes haven't yet figured out how to work as a team with maximum efficiency. If I close one eye and then the other, and if I hold a page of text at varying distances from my face, small type will be sharp and clear with the left eye at one distance (about 10 inches) and with the right eye at a different distance (say, 12 inches). I also notice that I have to wait a bit for the text to come into focus. It's blurry at first and then clear if I'm holding the text at the right distance. For intermediate-range work (looking at my computer monitor), the left eye is a little better because it's had more practice over the past couple of weeks. The right eye is still a rookie!

Self-indulgent? You decide...

2007-05-06T13:39:00.000-07:00

Is it self-indulgent of me to opt for multifocal lens implants so I can stop wearing glasses? It IS a major purchase, but it's also a once-in-a-lifetime expense that will actually improve the quality of my life every waking hour for the rest of my life! I feel very lucky.

Self-indulgent? Maybe. Do I feel guilty about the expense? A little, but not too much.

Is this type of vision correction "artificial"? Any type of vision correction is artificial, when you think about it. You can wear your corrective lenses in metal or plastic frames perched on the bridge of your nose, or as little discs floating on a layer of tears on top of your cornea, or as implants inside the lens capsules in your eyes. No matter where you put them, they're still corrective lenses. Lens implants are certainly a lot more comfortable and convenient than anything else I've tried!

May 4, 2007 Balanced Vision

2007-05-04T13:07:00.000-07:00

Over the past two weeks I have enjoyed being free of glasses, but my right eye was still uncorrected so my vision was a mixture of clear and blurry. The effect is a little hard to describe, but it was like having a haze around everything. Also, if I would reach up to scratch my forehead and accidentally cover my left eye, everything was blurry.

Yesterday morning I went to Omaha Eye and Laser to get the new lens implanted in my right eye. I was still nervous, but not nearly as nervous as I was on April 19th. I thought I knew what to expect this time, and that was true for the most part. A few things were different this time, however.

First, I did not go directly from the waiting room to the surgery area. Instead, I was taken to an examining room to have both eyes checked before the surgery. Dr. James Liu wanted to get a final refraction to make sure the new lens would be appropriate for my right eye. Dr. Bergman (an optometrist on staff) did the refraction. I also saw an intern who was working with Dr. Bergman.

Second difference: when I was being prepared for surgery, I was able to admire the view through the big plate-glass windows on one side of the room. Prior to getting the left lens implanted, I couldn't see much of anything without my glasses.

Third difference: I wasn't entirely "out" at any time during yesterday's procedure. I didn't feel any pain or anxiety, but I was definitely aware of seeing a bright light and hearing background sounds such as a radio playing. Lou was my anesthesiologist again, and he said he would give me the same amount of sedation as the first time. I'm not sure what would account for the difference--possibly shifting hormone levels (yesterday was the first day of my period) or a reduced level of anxiety. I remember the nurse putting the oxygen "thingie" into my nostrils. I asked her if I'd had oxygen before, and she said I had. I don't remember breathing in the oxygen the first time, but I do remember someone talking about oxygen. Shortly before the procedure yesterday, I remember Dr. Liu asking me to move up about an inch. Then he put something over my forehead to immobilize my head. This time I remember answering the nurse when she asked me what I wanted for my post-op snack. However, Tom said I made an identical comment to him twice yesterday (asking him about his errands) but I only remember asking him once. So I was more "with it" than before, but still a little vague. I was definitely groggy when I got out of bed and walked to the recliner in the recovery area.

I went back to Omaha Eye and Laser for my one-day followup on the right eye today, and both eyes are doing well. Dr. Liu asked how I liked having balanced vision, and I said it was an improvement although my right eye is still settling down. Yesterday Dr. Bergman said the left lens was "stable" and today Dr. Liu told the nurse that my eyes were "quiet" (a good thing--you don't want your eyes to have a lot of activity going on inside them!). He noticed a few stray cells (floaters) but nothing abnormal. I'm hoping for an uneventful recovery.

This morning I took the dogs out in the backyard and just stood there for a few minutes admiring the view. Every day with my new vision is a gift for which I am grateful--a miracle of modern medical technology. I love the freedom of having clear vision without wearing glasses or contacts.

Making Adjustments

2007-04-21T16:59:00.000-07:00

I went to my one-day followup examination with Dr. Liu yesterday, and no problems were evident. I told him that my only complaint was about the protective eye goggles that I have to wear at night. He suggested cutting off the elastic and using surgical tape to position one goggle over my left eye. I tried it last night and got a much better night's sleep.

My other challenge has been working on the computer and reading at my desk. I tried popping out the left lens of my glasses, but the combination of ReZOOM in the left eye and glasses over the right eye was too distracting. The two eyes were sending different signals to my brain, because the images produced by glasses are smaller and somewhat distorted compared to images transmitted to the brain by an intraocular lens (IOL) like ReZOOM. It was like seeing double. I tried working without glasses, but the sharpness of my near vision was not good enough with one corrected eye and one uncorrected eye. Today I tried a new tactic: putting the left lens back in my glasses and covering it with a piece of cardboard cut to fit over the lens. I can wear the glasses to see with my right eye and give my left eye a rest. It works OK, but Tom keeps teasing me about looking like a pirate wearing an eye patch: "Ahoy, Matey! It's the one-eyed editor!"

At my followup appointment, Dr. Liu talked about the symptoms of retinal detachment: floaters, flashing lights, sudden changes in vision. I went home and Googled "detached retina." I learned that the risk of retinal detachment is much higher for very nearsighted people than for the general population: 1 in 20 lifetime risk versus 1 in 10,000. I'm focusing on the fact that 95% of highly nearsighted people DON'T experience retinal detachment, but if I do have symptoms I will seek treatment immediately.

A Whole New World!

2007-04-20T05:51:00.000-07:00

"A whole new world... a new fantastic point of view!"

When I woke up this morning, the theme from Disney's Aladdin was going through my head. My left eye has its new "bionic" reZoom multifocal lens, and I can actually function without glasses or contact lenses most of the time. My right eye will get its reZoom lens on May 3. Until then, my vision will be half clear and half blurry. This morning my husband Tom asked, "Can you see me?", and I told him, "Yes, but you're not in high-definition mode yet!"

Having surgery under anesthesia was a new experience for me. Scary, because I didn't know what to expect. My blood pressure was higher than usual (140/80 instead of 120/70) as I was being prepped, and the nurse asked if I was nervous. "Yes!" I replied. She asked if I wanted her to bring my husband in from the waiting room, I said, "No, because then he'll think something's wrong and he'll get nervous, and I'll be more nervous because HE is." When my doctor (Dr. James Liu) stopped by my bed before the surgery to ask if I had any questions, I asked him what I would feel or see when he was operating on my eye. He said I might feel some pressure but no pain, and depending on how awake I was, I might see bright lights and colors.

When my bed was wheeled into the operating room, I had my eyes shut. The left eye was taped shut to keep the eyedrops in place, but I had my right eye shut on purpose. The anesthesiologist, Lou, asked me if I was nervous. "Yes!" I said. "Do you want sedation?" he inquired. "Yes!" (I thought: Bring it on!) Lou did a good job. I was asleep throughout the procedure, which was fine with me! Let's save the bright colorful lights for the Fourth of July.

No pain during or after the procedure. During my pre-operative Internet research on cataract surgery, I learned that it's normal for everything to have a pinkish cast as the eye is healing. Yesterday evening the sky was the most amazing shade of violet!

This morning I carefully took a shower, making sure that no water got in my eyes. (Fresh water after eye surgery can cause infection or irritation.) It was startling to be able to notice details inside the shower stall, like a piece of sock lint. I might be forced to clean the shower more often from now on.

So far, the worst part (besides the cost and the anxiety) has been wearing protective goggles at night. They're cumbersome, and they leave red rings around both my eyes. My close-up vision with the new lens could be better, but it's not bad. It will be interesting to see if the visual clarity increases over the next couple of weeks as the eye heals.

April 14, 2007 Five days pre-op

2007-04-14T12:14:00.000-07:00

Am I scared? Yes. Excited? Yes, that too.

Here are my biggest fears (realistic or not):

I'll lose part or all of my vision.
We won't be able to make the payments for the surgery.
I won't wake up from the anesthesia.
It will hurt a lot.

Here are my hopes:

I'll be able to see well without glasses or contact lenses FOR THE REST OF MY LIFE.
I will look better, feel better about myself, and enjoy life more without glasses.
I will actually make more money because of my higher level of confidence.

Hope outweighs fear, but it doesn't erase fear altogether.

April 12, 2007 One week pre-op

2007-04-12T17:31:00.000-07:00

Today is my 49th birthday. One week from today, the lens of my left eye will be suctioned out of my eye and replaced with a multifocal lens implant (trade name: ReZOOM) in a procedure called a clear lensectomy. Two weeks later (May 3), the lens of my right eye will be replaced with a ReZOOM lens.

Basically, I will undergo cataract surgery about 25 years earlier than the average cataract patient. The goal: life without glasses or contact lenses.

This morning I had a preoperative medical exam to ensure that I will be able to tolerate the anesthesia.