Thursday, February 02, 2017

Reasons I hate going to doctors...

In December, when I saw a new optometrist for my annual eye exam, the IOP in my right eye was measured at a whopping 37. Normal range for adults is generally considered to be anywhere from 12 to 22, and previously, except for a couple of days after having eye surgery, my readings have fallen within the normal range.

I liked the new optometrist a lot, but she didn't exactly have state of the art equipment for measuring IOP, so I was pretty sure the measurement of 37 couldn't be right, and requested they measure again. They measured 2 more times, and by the end of the visit, they got readings of 9 in my left eye and 23 in my right eye. The doc was concerned about the discrepancy (and rightly so) and talked about prescribing glaucoma medication. 

I refused to consider starting glaucoma medication based on the discrepant results from that visit, but I did agree to follow up with an ophthalmologist. Yesterday I did so. I'd been to his office several times before, but I'd always seen one of his partners, not The Man himself. He's highly regarded, but (or maybe because of that) his office always overbooks. I arrived at 9:30 for a 10:00 appointment. To their credit, they began processing me immediately, and within 5 minutes of arriving, I was seated at a small machine engaged in a task to assess my peripheral vision. But although I started half an hour early, like most of the other patients, I spent approximately 3 hours in the office before finally finishing up at a little after 12:30.

I have no idea why, but most of the patients were, like me, older women ranging from late 50's to mid seventies. There were a couple of male patients and a number of male spouses accompanying their wives to help with things like reading from a list of questions for the doctor, which can be very difficult if not impossible to do once your eyes are dilated. I noticed one old guy with a bad case of bed head wandering around the waiting room. He was wearing blue jeans, tennis shoes, and a Slytherin sweatshirt, causing me to wonder why on earth anyone would buy, let alone wear, a Slytherin sweatshirt. I decided it must have been a gift from a grandchild, so imagine my horror when this turned out to be the esteemed ophthalmologist himself.

When everything had been done and my eyes had been dilated, after a wait of about 45 minutes, he wandered into the exam room with the very bright eyed, very likeable young assistant whom I'd met earlier. I was happy to see her again. He sat down on a chair in front of a huge computer monitor and reviewed the scans of both eyes. He asked me about my medical history. I gave him the quick and dirty history of my left eye, in which I already have an IOL, and told him in the past month I was also diagnosed with Type II diabetes, but that with my doctor's OK, I hadn't yet started any meds for that, but was attempting to manage it through diet and exercise. I told him so far by doing that, in just 30 days I've dropped my fasting blood glucose by 62 points. His response was to instruct the assistant to write "Advised patient to increase compliance regarding her diabetes."  


"What were the results of my peripheral vision tests?" I asked. 

He said, "They're fine; no loss of peripheral vision in either eye."  

I said, "Great! I know I have a deep cup to disc ratio, but that's genetic. My daughter has it too."

He then said "You have moderate glaucoma in both eyes." 

"What?" I yelped. "Even in my left eye? Even though the pressure is only 17 in my left eye?"  

"Good point," he said, and he then mumbled to the assistant, "I agree with the patient. Modify the note to read 'low tension moderate glaucoma in the left eye'"

He crooked his finger at me. "C'mere!" he commanded. "Lookit this!" 

My eyes were fully dilated, and I didn't have my contacts in and wasn't wearing my glasses, so I sort of squinted at the screen, where I saw the scans of my left and right eye, side by side. I couldn't have read the writing to save my life, but I could see that there were large green sections (which is what you always want to see); however, on both scans, to my dismay, there were also noticeable yellow and red sections. He pointed to those. "These indicate damage that has already occurred to the retinas of both eyes," he said. "And based on this, I am diagnosing you with moderate glaucoma in both eyes, or rather, low tension moderate glaucoma in your left eye, moderate glaucoma in your right eye. You'll have to start on drops. I don't want you to be alarmed, because with drops you'll be fine, but these scans tell me if you don't use drops you will eventually lose all sight in both eyes".  

I was stunned. He prescribed latanoprost, which he couldn't spell (but I can). His assistant handed me a script for the latanoprost. He told her to instruct me how to use it, and told me he wanted me back for a new scan next week, and for a new pressure check in 30 days. 

All I could think was that even though it lowers pressure (and thus saves eyesight), a lot of people refuse to use this product because of the side effects, including bloodshot eyes (think alarmingly red), skin discoloration, eyelash growth (how can that be bad you ask? Think of eyelash growth to the point where you have to TRIM YOUR EYELASHES) and change in eye color. Yes, this is a product that can literally turn your blue eyes (or in my case, my green eyes) brown. Grrr. I was appalled by own reaction, because I know if the side effects were that it made the sclera really white and turned my eyes more green, AND saved my vision, I'd be fine with it. The ugly truth is, I'm that vain and I know it.

I put on my prescription sunglasses, and despite their being polarized, I had to squint to keep the light out as I drove back streets to the pharmacy where I got the prescription filled. Last night, just before going to bed, I instilled 1 drop in each eye for the first time. As instructed, I held each eye shut for 3 minutes afterward. I then wiped the excess off with a clean wash cloth, to avoid skin discoloration. I didn't experience any particular discomfort and so far my eyes aren't particularly bloodshot. I'm keeping my fingers crossed.


pam said...

Wow, this column was very packed w/ info. Thanks!!

Rufus Wilkerson said...

Sorry to hear about your diagnosis of moderate glaucoma. At least you will be able to take the drops, which should save most of your eyesight, like the doctor said. I do not know what I do if doctor told me I faced the possibility of losing my eyesight. You are very strong to be facing this in such a way.

Rufus Wilkerson @ Find Clarity Vision