This is the third in a series of posts by my husband following his cataract surgery in late 2015, hopefully it will be of use or interest to someone going through the same experience. You'll find the first post, about the consultation process and the second about the operation in my sidebar.
Travelling back from my in-laws on 27th December I started to get
flashes of light when I moved my eye. Due to my previous retinal detachment I knew this wasn’t good news, so
early on the 28th we were in A&E at the Bristol Eye Hospital. Due to the way Christmas fell that year this was
a Monday but was the Boxing Day Bank Holiday. The place was deserted of staff but quite full of patients.
When we finally got to see a doctor she looked as if it was
all she could do to keep her eyes open. She looked like she was hanging. She barely looked at me, got confused about which eye she was talking
about and sent me home saying she could see no problem but that I should come back in a
fortnight for a review. I knew there was
something wrong but what can you do.
Over the next couple of days I still had my flashes and then
the ominous black shadow appeared. On
New Year's Eve we were back in A&E which was thankfully better staffed. We saw a doctor (coincidentally the one who had dealt with my complaint several months earlier) who quickly issued a verdict
– “Go straight to theatre, do not pass ‘go’ do not collect £200.” I had a retinal tear and detachment.
That was how I found myself on New Year's Eve lying in bed in
a private room waiting for my slot on the emergency surgery list. Apparently there had been a number of
emergencies come in that day so it was a full list. Between patients the surgeon came to see me
to assess what he had coming through. I
asked him at what point would I get bumped to the next day's list as it was too
late to operate. His reply was that his
theatre team weren’t going home until all the patients on the list had been
seen to. For all the faults within the
NHS you have to admire the dedication and professionalism of the clinical
staff.
It was late, I don’t remember how late, when I was wheeled
back to my room. I was lying on my right
side which is a position in which I would spend most of the next few months. The operation performed consisted of sucking out the
vitreous humour and replacing it with a gas bubble. They then laser around the tear to “spot
weld” it back in place. The bubble will
hold the retina in place whilst the blood vessels reattach hence the posturing
to keep the bubble in the correct place. This was the simpler of the two options and was performed under local
anaesthetic and block. My original
detachment had been treated with a silicone buckle stitched to the back of my
eyeball and was performed in a lengthy operation under general anaesthetic.
As an added bonus whilst they were in there they cut away
the rear lens capsule thus treating my PCO in that eye. Apparently it gives better results to do this
surgically rather than laser but is too invasive to do alone.
Once back in my room I had to lie face down for an hour and
a half, I assume to prioritise pressure direct onto the area around the optic
nerve being the most critical area to get attached securely. At this point my lovely wife went home. She had been through a lot, always by my side
and now she had to get to bed. For the
first time since we met we saw in the New Year separately. Rachel was asleep and I was too until woken by
the fireworks at midnight.
I woke in the morning hopeful that I was going home. They had said I would only need to be in for
one night and I wanted to escape as soon as possible. My eye had other ideas though. When they removed the patch I could see absolutely
nothing. Not light and dark, not
movement – nothing. The consultant
couldn’t see anything either and this was potentially not good news. I had a clot in the front of my eye that was
obscuring all attempts for him to see the back of my eye and whether the
surgery had been a success. Added to
this the pressure in my eye was also very high. “We can’t send you home like this….” This was a real kick in the guts.
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| The morning after |
I was now started on hourly drops for the pressures and antibiotics. Doing this from 6am to 2am meant I had very
little sleep despite spending 50 minutes out of every hour lying on my right
hand side.
At 2am in Friday night / Saturday morning the nurse came in
for my hourly drops to find me rocking on my bed in agony. I begged her for whatever pain relief she
could give me. A dose of paracetamol as
well as codeine was given and still didn’t take it away. It helped though. My pressures had gone through the roof. I don’t know what the scale is but under 10
is “normal”, 10-20 is cause for concern and I was over 30.
The next morning I started a regime of regular tablets to take
the pressures down. These had an adverse
effect on kidney function so now I needed daily blood tests as well. I also had an oral steroid to take the
inflammation down but this attacked the stomach lining so I had a third tablet
to protect my stomach. In my sleep
deprived state I was starting to lose track of it all and just resigned myself to their care.
I was kept in for a few more days. At this point the pressure had come down but
they still couldn’t see into my eye and I couldn’t see out. It is very scary when they shine a light in
your eye and you can’t tell. They still
couldn’t tell if the operation had been a success but there was little to be
gained from keeping me in so I was released back into the wild. Being at home helped my morale greatly and after a couple of
days I started to see light and dark and then colours. A few more days and I had shapes and could
count my fingers. Small things become
great achievements.
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| Our homemade drugs chart |
As I started to see more I became aware of the bubble in my
eye. It consumed about 90% of my eye so
the interface between bubble and aqueous humour (which slowly displaces the
gas) was a dark shadow across the top of my vision. As images are inverted in the eye and then
corrected by the brain this was at the bottom of my eyeball.
Depressingly as my left eye vision started to improve my
right eye started to deteriorate with the PCO. It's not major but it takes the clarity away.
A week after release and I was back at the hospital for a
check-up. Progress, I am told, is
good. They can see in and the retina
looks flat. Pressures are down but the
inflammation is still there along with the clot. It's now a waiting game.
The steroids I took gave me terrible indigestion but have to be reduced gradually. I hadn’t really thought about how serious a
medication they were. To be honest at
the time they started I was in so much pain I would have taken anything they
gave me just to make it stop. Every time
I decreased the dose I was taking I had terrible withdrawal symptoms. I was
absolutely wiped out each time and had stomach cramps. Googling it revealed that the steroids reduce
the production of adrenaline and it can take up to four weeks to start again
after you stop taking them. Knowing this
didn’t make me feel physically any better but it did reassure me that there
wasn’t something else amiss.
The horizon in my vision gradually dropped as the gas was
absorbed. It was very off-putting
because when you move your eye the fluid / gas “sloshed” in your eye and the
horizon breaks into waves. It can make you feel
quite sick. The gas was supposed to be completely
absorbed in 4-6 weeks. Six weeks after the
operation I was back at the hospital for a check-up and was discharged despite
still having the bubble remaining. We
didn’t see the consultant and weren’t filled with confidence by the doctor we
saw but I was due to see Ms Bailey again, so wasn’t too concerned.
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| Gas bubble in the eye means no flying |
9 ½ weeks after the operation the bubble finally
disappeared. The final bit went quite
quickly and then one morning it was gone completely.
Mid March I saw Ms Bailey again and was given the all
clear. She performed the PCO laser on my
right eye and finally discharged me. From first operation to discharge ended up being four months. From Optician referral to discharge it was thirteen months.
At the beginning of April I had my long awaited post
operative eye test. I could have done it
earlier but I had to wait in order to get an appointment with an optician I
trusted. I’ve had so many bad eye tests
over the years that I am very selective about who I see as it is a complete
waste of time if they don’t do it properly.
The results were good. I was given the all clear to drive without glasses. My official distance prescription is now +0.5
in my left eye and 0.0 with slight astigmatism in my right. This is a hell of an improvement over -14 in
each eye. Ms Bailey said she was
aiming for slightly short sighted in each eye but that it was difficult to
predict exact results. I was very
pleased. My reading prescription is
+1.75 mid distance and +2.25 for close reading. I was prepared for it to be in the +3-3.5 range so I was again pleased. I got some “Office” glasses which are amazing for computer
use. They are a bifocal split between
the mid-distance and reading prescription so I can see computer screen and
papers. I also got some standard varifocals. These took a bit of getting used to and the
first pair had to go back and be adjusted as the vision zones were in the wrong
places and I couldn’t see anything out of them. After the adjustment they were much better. I don’t like them for reading (a book or magazine)
as the reading zone is so small but for reading labels etc. they are ideal.
So roughly fifteen months after being referred I can see again
and get on with my life. It would be
easy to say the whole experience was unnecessarily stressful and took too long
but that would be too broad a generalisation. More specifically, the administrative side of the NHS is too bureaucratic and it's
an uphill struggle to get anywhere. The
clinical staff from consultants and nurses to porters and caterers are a
fantastic and dedicated bunch. They work
hard under difficult circumstances and I think we probably take them for
granted. The NHS is undoubtedly
under-funded. If extra funding went
straight to the front line then I would happily pay more tax to support
it. However, too much is absorbed by the
administrative hierarchy and more is wasted in non-critical areas.
It's easy to get annoyed and exasperated by the NHS but
remember that it isn’t the nurse in front of you who is to blame. She’s doing her best to treat your ailment and
make you feel better.
