Or, “How I Learned To Stop Worrying And Love The Laser”

About 65 hours ago from when I started writing this post, my vision changed rather radically. Some backstory first:

I started wearing glasses when I was three years old. For the last 41 years I’ve always worn glasses of one kind or another, save for a stint of about a week in my mid-20’s when I attempted to wear contacts…and failed. I never mastered that whole “putting your finger in your eye” thing, unfortunately. I wouldn’t say I’m phobic about things touching my eyes, but I am certainly extremely uncomfortable about it. I don’t know what my vision was without my glasses specifically, but I was very nearsighted – anything more than 18″ away was a blur, and after six feet it was just hazy, indistinct shapes.

About five years ago, Dan and I started talking about LASIK for me, first as a 40th birthday thing, then as an ongoing possibility as we got our finances in order. This year we finally decided to pull the trigger.

I’m covered under Dan’s eye care insurance, offered through the otherwise-execrable Davis Laboratories (ask me about the pair of glasses it took them four tries to get right). Davis got me a 25% discount on the doctor’s charges (though no discount at all on the surgical center’s charges). So it was off to the doctor listed in their coverage list, one of the few in Lake County (i.e. a 15-mile radius): Dr. Walter Fried.

Dr. Fried’s office is busy but the staff is extremely friendly and helpful, and this made the overall experience much better. The first exam took about an hour, filled with various measurements, assessments of my current prescription and astigmatism, and a consultation about the current state of my eyes and where they’re going in the future. I was an ideal candidate for PRK or LASIK, however like most people over the age of 40, presbyopia is in my future sooner than later. A new procedure called presbyopic inlay is in the pipeline and should be available by the end of the year: did I want to wait until that was available or go ahead and do the surgery now?

I took some time to think about it and do some independent research. I work in the medical devices field, so I know a little bit about what it takes for a new device/procedure like this to come to market. There’s a lot of research, clinical trials, and reviews before it ever sees the light of day. Nevertheless, I didn’t feel comfortable undergoing a procedure like this until it has a track record of several years and thousands of patients. What this means is that sometime in the future, maybe even as soon as a year from now, I will need reading glasses. Or I may opt for having the presbyoptic inlay added in the future, though like any surgery the more times you operate somewhere the greater risks you incur for side effects like scarring, etc. My decision was made, though: Let’s do this thing.

About three weeks after the first exam I found myself back in at Dr. Fried’s office for a final pre-op visit. This took three hours (!) but part of the problem was that the measured correction for my astigmatism and what I reported when tested with the lenses (you know – “Is 1 better, or 2? 1 or 2?”) didn’t match. This caused some consternation until I was tested with my pupils dilated and everything matched. I was provided a big kit with various eyedrops, a pair sunglasses, and an eye shield to wear while sleeping after the surgery.

There was a bit of confusion when they realized they had me down for PRK when I was actually getting LASIK done. Oops – different informed consent forms, and unfortunately a higher price by $800. The end result is the same for both procedures, but the healing time for LASIK is faster; PRK requires you to wear a hard contact lens for four days after the surgery and the healing is a much more delicate process. I opted for the LASIK. With the additional cost taken into account, the entire thing came to $4,575. Fortunately, they take CareCredit, so I quickly opened an account there and the whole thing is now financed 24-months-same-as-cash.

I want to note that during this visit and in the days thereafter, Joanne, one of the assistants in Dr. Fried’s office, was extremely helpful. She called me back several times to confirm the pricing, and answered some of the questions I had. She really made the experience a good one for me.

The day before the surgery, I got a call from the surgical center: Please arrive by 2:15 PM the following day. While Dr. Fried’s office is in Gurnee, the surgical center is in River Forest – a bit of a drive for us! Not the end of the world, though.

The day of the surgery, we arrived at 2 PM. The check-in was quick. It appears that NovaMed shares the same facilities with Kirk Surgical Center – only the waiting rooms were different, everything else was shared. We were Dr. Fried’s last patients of the day, so I felt I got a little extra attention, which was nice.

A little after 2:15 PM, they called me back into the pre-operation area. This was an institutional-looking area, kept very chilly (of course – I regretted wearing shorts!), bustling with 4-5 nurses, a patient being prepped for surgery, and a patient just out of surgery. My nurse asked me if I was nervous, and I replied, “Very.” She gave me a couple of Valium and had me relax in a comfortable recliner while they took my vitals. They also gave me several rounds of numbing eyedrops. As I lay there under a comfy blanket, I listened to the nurses chat (one of them was starting clinical work in a hospital’s OB-Gyn section soon) and eavesdropped on another patient receiving aftercare instructions.  After 20-30 minutes, it was time to start. (Note that during the entire procedure I was still in my street clothes – the only gowning was an elastic cap to cover my hair.)

The first step of the procedure was cutting a flap in my corneas. They walked me into the first surgery room that had a form-fitting bed that had the head slightly tilted downward. I lay back and the doctors (Dr. Kirk was assisting/providing guidance to Dr. Fried) positioned my head just so. They covered one eye with a plastic shield taped into place. The other eye they propped open with a spring-loaded speculum. I suspect that without all the numbing drops (and the Valium) this would have been incredibly irritating to my eye, but it really just felt like an odd pressure. Next, my head was moved under a large instrument and a cone was lowered over my eye, where it was then held by suction (again, yay for numbing! No pain, just pressure). With my eyeball thus immobilized the cut was made – I doubt it was by any handheld instrument instrument, but more a blade within the big device over me. I think this was the most disconcerting moment of the whole procedure, because there is a very brief moment when your eyesight is just…gone. Completely black. And then it comes back a moment later. This was also the first real pain I felt, but it wasn’t terrible – I would say maybe a 4 on a scale of 1-10. They then covered the first eye and repeated the procedure on my other eye.

Now they had me stand up and walk out of the room. This was terribly odd, because while I could see, it was as though through a very dense fog. I was escorted back to the recliner and the nurse asked me if I was OK. I mentioned I was experiencing a bit of pain, and she gave me 10 mg of Vicodin (!). Well, that certainly did the trick! I only sat there for maybe a minute or two because then it was off to the second part of the procedure.

They had me walk into another room that had an instrument that reminded me very much of an MRI machine, though the hole was just big enough for someone to put their head in. They had me lie on a bed and then put my head under the laser apparatus. Again, they covered one eye and put in a speculum to hold my eyelids open. This time my eyeball wasn’t immobilized, which was a bit disconcerting (the laser uses a tracking mechanism so wherever the eye moved, the laser follows). In this step, the newly-created corneal flap is opened and the vision prescription is cut into the flap by the laser. There was no pain involved, just a lot of “look at the blinking green light” (a point provided to keep your eye in place). Much is made of the disconcerting smell of burning tissue, but in hindsight really all you’re smelling is ozone from the lasers. This step took about five minutes of prep for each eye and about 10 seconds of actual laser operation per eye. Dr. Kirk especially provided a calm and reassuring voice during both procedures.

And then it was done! I was walked out to the pre-op area again and Dan came in from the waiting room to join me. We were given aftercare instructions, most of which Dan got because by then the Vicodin was really kicking in 🙂 At that point, I could already see improvement in my vision. Although everything was hazy (imagine wearing glasses with Vaseline smeared on the lens), certain details like the awful abstract print on the upholstery of the chair eight feet away from me was shockingly clear. The doctor did make a final check of my eyes before I left and notice that the flap in the right eye didn’t quite lay flat on the edge. A quick touch-up with a brush-like instrument (thank heavens my eyes were still numb!) and everything was just fine.

Dan drove us home, and I suspect I was drifting in and out of sleep as we drove. Once we got home I relaxed for a bit but was even able to watch some TV, though using a computer or iPad was a struggle. Once the first round of Vicodin wore off, I did have some low-level pain and, I admit, some anxiety over how hazy my vision was. The doctor thoughtfully gave me a Vicodin prescription we had filled on the way home and that took care of both issues nicely.

On Friday morning, I woke up and the first thing I could see was the alarm clock in perfect clarity! That made me extremely happy. We went to Dr. Fried’s office on Friday morning for a followup and while my near vision is fantastic (20/12.5, better than 20/20), my distance vision wasn’t quite what it should be. A couple of test later and he confirmed that the issue was more with healing and that the prescription seemed correct – it just needed a little more time. I have a followup visit scheduled for Monday morning just to double-check everything. Shockingly, by Friday morning I was judged to be legal to drive day and night, and I have a letter to prove it! (I need to get by the DMV soon to have them correct my license.)

So, where do things stand right now? I would say I’m at about 90%. I can use the computer if I magnify the text a few steps (I could probably use it without the magnification, but it would be a greater strain on my eyes). The quality of my vision comes and goes – sometimes it’s extremely sharp, sometimes, it’s a little out of focus. This is function of the healing, and the fact that I need to remind myself to use the artificial tears eyedrops (my vision is always sharpest right after using the eyedrops).

Driving in the daytime is a piece of cake. I can see all street signs with excellent clarity, and my depth perception is totally unaffected. Last night was my first experience with night driving (though Dan was driving). I do indeed see some halos around bright lights, but it’s not debilitating – I could certainly drive at night comfortably. The main thing I noticed is that bright light tends to make things in or near it lose focus, but as long as I don’t need to determine if the oncoming car is a Ford sedan or a Toyota sedan (Dude, it’s an oncoming car – just don’t hit it!) I’m just fine 🙂

If you asked me right now if I thought the surgery was worth it, I would say absolutely yes. I anticipate that it will only get better from here on out. The first few days at work might be a bit rough (time to up the font size some!) but within a week I anticipate that things will start to even out. All accounts I’ve found say that it may take a month or two for my vision to stabilize but I can deal an occasional bit of blurriness in the service of long-term improvement.

As for restrictions from the surgery, well, there aren’t that many. I could shower the day after the surgery, although they do suggest waiting a month before swimming (due to possibility of infection). Roller coasters may have to wait a month or two as well, and even then I’ll probably wear sunglasses to protect my eyes. And while I’m wearing sunglasses when I go out in the bright sunlight, that’s more of a comfort thing – I could go out without them just fine.

So there you have it! I’ll update with more as time goes on, but that’s the initial account of the fun, anyway. Questions?