Thursday, April 28, 2022

Doctor, my eyes... *

* (old Jackson Browne song from the 1970s, for those of you too young to get the reference...!) 

The tl/dr:  Anyone had any experiences with keratectomy (eye surgery) to share??  :(   Or with dry eye syndrome? How about Restasis (eye drops)? 

The long version:  Dh & I went for our routine eye checkups last Friday in midtown Toronto, near where we had our first apartment. Our optometrist is one of the best-rated in the city. We both love him, and we've been seeing him for more than 35 years. (Dh asked him if he's thinking about retirement anytime soon and he said no, he's still having too much fun. ;)  ) I have rather wonky eyes (see this post, for (one) example) -- and he's always been very reassuring. 

I've had my current glasses for more than 7 years, and I've noticed the vision in the right eye has not been great, particularly over the past few years. I remember telling him this the last time or two we've been there, but he never thought there was enough of a difference to change my prescription. 

This time, however, there was a change -- a noticeable, significant change. He asked one of his colleagues to have a look to confirm what he saw. 

They told me I had something on the cornea of my right eye, in the inner corner -- some cloudiness -- an abrasion or infection, perhaps? They asked if my eye had been irritated recently. In retrospect, I guess it has. I did mention it's been very dry in our condo over the winter. 

Dr. Optometrist said he wanted to send me to Dr. Opthamologist, a cornea specialist at one of the hospitals downtown. "He's the best, there's no one better,"  he promised me (and I do believe him, because I think HE's the best).  They were able to book me an appointment on Tuesday, which is pretty darn speedy these days. I figured he'd look at my eyes, probably prescribe me some drops and that would be that. 

So, late Tuesday morning, dh & I trekked alllllll the way downtown, to a very old section of Toronto, found parking, found the registration desk, and eventually found the right place to go and checked in there. (Unlike some recent medical procedures & appointments during covid, dh was able to come inside with me this time, although he had to show his proof of vaccination first.)  Eventually I got called into an exam room, and gave my history to a young resident, who dilated my eyes (for the second time in four days!) and took some photos. 

Then I got taken into another room where another two young doctors had a look at me (both young women). The main one told me I had dry eyes and scar tissue on my cornea. (!) She told me the clinical term for it. (My optometrist called it "Saltzmanns," but she called it something different.)  Both she & the earlier guy asked me if I wore contact lenses -- I told them I had, but I haven't worn them in 15-20 years. 

She told me that I needed to have a surgical procedure done to remove the scar tissue. I did not catch the term at the time, but I have since learned that it's called a keratectomy -- and when did I want to schedule it?  

To put it mildly, I was flabbergasted. I was prepared for drops, but surgery?? (On my EYE??!) (Needless to say, I've always been squeamish at the prospect of laser eye surgery -- not that I would probably be a good candidate for it anyway.)  She told me it was elective and I didn't HAVE to have it done. I honestly didn't know what to say. She suggested I talk it over with Dr. Opthamologist, when he came in. 

Then (while I was still reeling at the prospect of surgery -- on my EYE!) she rattled off four things I needed to do to remedy the dry eye: warm compresses twice a day for 5-10 minutes at a time, eye drops four times a day (she gave me a prescription for Restasis), gently scrub my eyelids & lashes twice a day (first thing in the morning and again in the evening) to remove debris, and take omega vitamins. I asked her if she was going to write this down for me or give me a handout and she just repeated the four things, rapid-fire. (I'm amazed I remembered it all.) 

Finally I got to see Dr. Opthamologist. I will say, he was a very nice man. He asked me how I was, and I told him frankly that I was quite caught off guard, that I did NOT expect to be told I should have surgery! -- and he was very sympathetic and nice about it. He said I wasn't going to go blind or anything from this condition, and that I don't have to have the surgery if I really don't want to -- but it's recommended, and he'd be happy to do it for me. It takes about a week for the eye to heal and then another 4-6 weeks for your vision to adjust -- after which you can check and see if you need a new prescription for your glasses. Seeing my reluctance/hesitation to commit, he suggested I should talk it over with Dr. Optometrist. (He also reinforced some of the points the young female doctor had made about my dry eye, and gave me a handout that included some of those things in print that I could refer to -- thank you!)  

Needless to say, I was beat when we got home (and in bed by 9:30 p.m. that night!).  

So I called Dr. Optometrist yesterday to see what he thought. (Left a message and he called me back later in the afternoon.)  He'd already received Dr. Opthamologist's report. Contrary to what they'd told me at the hospital, he told me -- nicely, but bluntly -- that I NEED to do this, that it's not going to get any better, and that Dr. Opthamologist was the best there was for this kind of thing. 

By then I'd had some time to think about it and sort of resigned myself to the fact that I was probably going to have to do this. So I called and left a message with Dr. Opthamologist's office asking to book the procedure. Hopefully the wait won't be too long... 

(I felt even better after talking with my sister last night. She is at my parents' house right now -- coincidentally, my dad had cataract surgery on one eye yesterday in the city, and she drove him home and is staying there for the next few days to help out while he recovers.  I'd forgotten that -- also coincidentally! --  she had a very similar procedure last year for a "wrinkled cornea." (Yes, that's a thing!) She told me she hadn't realized until after she had it done just how bad her sight had gotten in that eye. She also gave me some tips -- e.g., keep your eyedrops in the refrigerator, and use a cold pack to minimize swelling.)  

I started doing the Restasis drops yesterday. I actually got the generic version -- it was $3.50 with my medical benefits plan, versus $32 for the brand name version. The instructions on the box say twice a day, but the doctor prescribed four times a day. There are 30 ampoules/doses in each box. At this rate, I'll be going through a box a week! The dr warned me there might be some stinging, but encouraged me to keep at it, it will eventually get better.  I didn't feel any stinging, but my eyes do feel dry/raw and a bit achy/swollen after using it. I did some Googling & some say it's just as effective to use regular drops like Systane (which is what I generally use). I asked Dr. Optometrist about this too. He said he's generally not a fan of Restasis -- he doesn't think it's bad, he just doesn't love it. But he encouraged me to give it a try for a while. I'll see. I may just go back to the Systane. 

Sigh.  This getting older stuff is not for sissies...!  :p  

(I'm STILL waiting for the results of the biopsies on the three polyps that were removed during my colonoscopy, 5 weeks ago!  And I finally called back the office of the surgeon I spoke to, two weeks ago, about scheduling my gallbladder removal surgery.  From what he told me, I thought someone was going to call me back within a day or two, and that the surgery would be scheduled within about two months. The receptionist kindly explained they booked surgeries in three-month blocks, and wouldn't be booking until June for surgeries to be done in July, August & September. Of course, they are backlogged right now because of covid. She sent me some paperwork to complete, after which I will be put on the waiting list. Sigh, again. So much for doing any advance planning for summer holidays until at least June...!)

So -- anyone with any experience with keratectomy (or any other kind of eye surgery)? (I'm pretty sure this is a laser procedure, although I'm going to have to confirm that.)  Or with dry eye syndrome?  Restasis?? 


  1. I had LASIK surgery... 22 years ago! I was extremely freaked out about it and it was fine. I understand being nervous about medical procedures, especially eye surgery. I remind myself that this is what the doctors and nurses do all of the time. So, even though it is out of my comfort zone by far, it is actually common for them.

    Wishing you the best with your current treatment plan and the surgery if you decide to have it!

  2. Finally I can bring something useful to the conversation! Disclaimer: I AM NOT DOCTOR. You seem to believe that you have been diagnosed with dry eye syndrome, but then you mention "Saltzmanns" and I presume you are referring to Salzmann nodules, which is a different condition from dry eye syndrome. Have a look at this:
    The regime you mention (omega 3, warm compresses etc.) suggests that they believe that your SND is related to Meibomian gland dysfunction (evaporative dry eye). The fact that they have also prescribed Restasis suggests that they might want to try conservative treatment as an alternative to surgery, which is a bit puzzling if imminent surgery is on the table anyway. I would definitely try to get more information on your diagnosis and treatment options. SND means a long road ahead and you should absolutely take your time to understand what it means and how they propose to treat it.

    1. Thanks for the advice! My understanding was it's both. The handout the opthamologist gave me was on alleviating blepharitis (sp?) = dry eye, and they wanted me to do these things in addition to the surgery, not as an alternative. But they used a different term when referring to the patch of scar tissue they saw. When I talked to my optometrist again later, he said they had confirmed his diagnosis but he called it Salzmanns.

  3. No experience of any of this. Just wanted to send hugs! I can imagine you were shocked at the suggestion of surgery. And it sucks that the gall bladder surgery can't be booked in earlier.

  4. Oh, my. A bigger bit of news than you were expecting -- that's never easy.

    I am a squeamish one. I wrote about laser surgery on one of my eyes about a dozen years ago. Here it is and I hope it helps.