Eye Trauma Drama

Photo by MJ Klein

Some of our loyal readers have been asking what is going on, since we haven’t had an update in some time.  We sincerely apologize to our loyal readers, but something was going on that I’m about to tell you now.  There were a few updates on Facebook recently that told some of the story but this is the official story of the entire ordeal that I experienced.

It all began on Tuesday, January 18th, 2011.  Our company had some parts to ship to the USA and I was busy with details of shipping, labeling, etc., preparing a few thousand pieces of a part we manufacture, for shipment.  I noticed some peculiarity with my eyesight which seemed to be limited to my left eye only.  When I would move my eyes rapidly from side to side (which is a normal action) my field of vision seemed to be “torn” or as if I were looking through broken glass.  The break or tear in my vision would appear as a white flash followed immediately by a black jagged line.  This phenomenon happened very quickly and was very difficult to quantify.  After observing this occurrence several times over the course of the afternoon, I was able to see that a black line was visible as well as white flashes.  I continued with my shipping duties and tried to not let the visual anomalies interfere with the tasks at hand.  The truth be told, I didn’t really give it much thought at the time, as I was very busy with our business activities.

Wednesday morning found me doing more shipping and I got busy right away with preparing more parts for shipment.  I occasionally noticed that the flashes of light and the dark line that looked like a piece of broken glass would make it’s appearance.  It didn’t seem to correlate to anything except my eye movement.  I could induce an instance of flashes by rapidly moving my eyes from one side to the other.  I thought that probably wasn’t a wise thing to do, so I hesitated doing it just to observe the effects.  It seemed to happen enough during the course of my duties and that was good enough for me.  I didn’t really have any idea what was going on though.

I did notice that I had some dark material floating around inside my eye, that wasn’t there before.  It was quite annoying and appeared right in my field of vision so it was hard to ignore.  It was then that I started to realize what might be happening.  I decided to lay down and rest for awhile to see if that would help the situation.  When I woke up, having that dark “floater” in my eye really drove home the point that something bad was happening to my eye.  I recalled that my good friend Grady recently suffered from a detached retina, so I decided to look up the symptoms of a detached retina on Wikipedia.  It was then that I became very concerned.  I don’t mind saying that I got a bit scared because the described symptoms were remarkably like what I was experiencing.  I decided that I should go for an eye exam tomorrow morning.

I tried to sleep but I couldn’t.  What I read on Wikipedia kept going over and over in my mind: “without rapid treatment the entire retina may detach, leading to vision loss and blindness. It is a medical emergency“.  That was enough to make me get out of bed and drive to the local ER.

I arrived at Mackay Hospital ER at 6:00 am on Thursday.  They informed me that no doctor was on duty from 12 midnight until 9:00 am each day!  There was no one who could see me until 9:00 am!  The nurse at the front desk booked me for an appointment in the morning.  The Ophthalmology Department would open at 9:00 am, and I was appointment number 54!  They didn’t understand the term “medical emergency” apparently.  I chose to wait around the hospital rather than drive home and wait, just to have to battle with traffic again a few hours later.  I had my Samsung Galaxy S phone with me and I spent some time researching detached retina treatments (thanks to Mackay’s free wifi).  That might not have been the wisest way for me to spend my time while waiting to be seen.

Finally, the office opened at 9:00 am, and I told the nurse what my suspected problem was.  She asked me to wait.  At that early in the morning, many people weren’t there for their appointment yet, so I was seen a lot sooner than #54.  I was tested for internal eyeball pressure, and general visual acuity, then given eyedrops to dilate my pupils.  I sat in the waiting area with my eyes closed until I was called.

Dr. Wang examined my eyes with the slit lamp and biomicroscope.  Because she was examining my retina, she had to use the additional hand-held lens which is placed right up against the lens of the open eye.  I had been given some numbing drops so the additional lens wouldn’t irritate my eyeball when placed up against it.  Dr. Wang took my symptoms very seriously and gave me a thorough examination.  She told me that she could not see any retinal detachment, and in fact that my retinas looked to be in excellent condition (she examined both eyes).  Dr. Wang explained that what I was seeing and experiencing was probably the result of vitreous deterioration.  As we age, the clear gel in our eyes, begins to liquefy.  The gel can pull away from the retina and move about within the eyeball, sometimes causing bright flashes to be seen.  Sometimes the gel can exert suction on the retina and cause detachments, so it’s important to check out instances of bright flashes to make sure that nothing has happened to the retina.  In my case, Dr. Wang couldn’t find anything wrong with my retina, so she sent me home with instructions to come back if my symptoms got any worse.

Friday found me back at work, and even though Dr. Wang had not found anything in my eye exam, I was still seeing the unnerving flashes.  Another thing was that my eye was developing more floaters and that had me more concerned than anything else.  I didn’t want a bunch of material floating inside my eye and interfering with my vision.  I decided to keep a very close watch on my symptoms.

Saturday, my left eye decided to eject a huge streamer of a floater into my vitreous.  Imagine, if you will, a huge furry dustball with several long hairs attached to it.  This floater was larger than both hands outstretched at arms length!  This one made reading and seeing in general, very difficult.  Not only that but now I also had several thousand tiny black dots that were distributed throughout my visual field.  In bright sunlight, all of these tiny floaters are illuminated and cause what I’m seeing to appear grainy, as if looking at high speed film.  At times the distraction was so great that I found myself closing my left eye and looking only with my right.  On Sunday this appeared to get worse, if you can imagine that.  Yes, it was time to go back to the eye doctor!

I went back on Monday morning, and this time my number was 23.  They knew who I was and as I handed my insurance card to the nurse, I was able to mention to the doctor that my symptoms had indeed gotten much worse.  I was treated to more tests as before, and this time the basic visual acuity test was more difficult because of the floaters.  I was given the eye drops and asked to wait in the waiting area.

About an hour later Dr. Wang examined me again with the slit light apparatus as before, and this time she did see some kind of trauma to my retina in my left eye.  She described it as some form of “abrasion.”  There was no crack or split in the retina, which would have been more critical, since vitreous can leak behind the retina and work it loose from the rear of the eye wall causing a detachment.  This had been a major concern of mine since the beginning of the ordeal!  Dr. Wang assured me that this wasn’t happening, but she recommended laser treatment to “weld” the retina to the eye wall in the vicinity of this abrasion, to prevent it from ever becoming a problem in the future.  As soon as I was finished with the exam, they took me over to the laser treatment room, thanks to Taiwan’s very efficient health care system.

Hui-chen was on her way to the hospital as once I had treatment I wouldn’t be able to drive a car for the rest of the day.  Once she arrived Dr. Wang personally handled the laser and went to work on the treatment.

The actual laser used to treat my eye.

I describe the laser treatment as “trying to look at God.”  It was the brightest experience I have ever had!  The laser treatment machine, shown to the left, has a stereoscopic viewfinder that the doctor uses to look at the eye being operated on.  In order to see the retina, Dr. Wang had to use the same hand-held type lens that she uses during the exam.  There is also a slit-light, so getting a laser treatment is very much like getting an examination, only more intense.

So, imagine that your eye is open, and there is a lens pushing up against it.  Dr. Wang then asked me to hold very still, and a nurse came up behind me and actually held my head up against the forehead strap (the white strip above the chin strap) so I wouldn’t be able to move.  Then Dr. Wang moved the slit light around so she could clearly see the retina and the area of interest.  During that part, while she was moving the light around, the light would occasionally come into my direct field of view and it was like looking into the sun!  This was pretty much the same experience as the exam, but then Dr. Wang would fire the laser.  A flash of light, brighter than the slit light and a beautiful shade of green, would suddenly fill my entire eyeball with it’s blinding luminescence.  My automatic reaction was to close my eye, which was impossible as it was being held open by the lens pushing up against the surface, and jerk my head back and out of the way of that blinding light.  Again, my head was being held tightly by the nurse, and with good reason!  I’m sure that not a few people have violently reacted to that blinding green flash!  I found that it took all of my reasoning and concentration to not over-react to those blinding flashes of light.  Another thing that Dr. Wang had warned me about (in Chinese) was heat.  When she had said the laser would make the inside of my eyeball hot, I wasn’t sure what to expect.  After a couple of shots, I could sense that the inside of my eyeball felt hot. Dr. Wang fired the laser in bursts, a series of 2 to 4 shots and then waited.  Now I understand the methodology, because the laser actually does generate heat that one can feel inside their eye.  That was a very unnerving sensation!  I also felt some form of pain inside my eye.  The laser was basically spot-welding that section of retina to the back of the eye wall.  Over the next few days, scar tissue would form and the scar tissue would knit the retina and eye wall together.  I lost count of how many shots there were altogether.  Dr. Wang was working around the periphery of the abrasion and there must have been between 25 and 30 shots of the laser to accomplish that.  It was only a few minutes total, but during the entire time I knew that if I moved my eyes while she was firing the laser, bad things would happen.  No matter how bright, how hot and how painful, I had to resolve to not move.

After the treatment, I could see out of my left eye, but everything was blurry due to the lens that had been pressed up against it.  But, what I could see was the most beautiful shade of purple I have ever seen.  This purple color was the opposite of the green color of the laser and a reaction to the green laser light.  This purple effect lasted for about 15 minutes.  I was sent home to rest and recover and was scheduled to return on Friday for a followup examination.

On Friday, January 28th, Dr. Wang used the slit-light apparatus with the hand-held lens again, and examined my eye once again.  She found that the laser treatment had worked very well and I was healing exactly as anticipated.  She scheduled me for another exam a month from then.

I still see flashes of light off to the far left field of my vision, occasionally.  I’ve been told that this is normal for me from now on, due to the degeneration of my vitreous.  I am to keep on the watch, however, for any changes to these flashes that might indicate a change in condition; in other words, a detachment.  Retinal detachments are often caused by head trauma, so now I’m also doubly careful to not bump my head on anything.  I can still see very well out of my left eye, and my visual acuity has not degraded at all.  My floaters seem to be less intrusive than before, and Dr. Wang said that the body has a tendency to absorb some of them.  When looking at things, as soon as my eye becomes stationary, I automatically ignore the floaters and I forget they are there.  Other times when I see the floaters, they remind me that I have a lot to be thankful for, living in a time and place where such technology exists to repair my eye.  Yes, it certainly could have been worse.  A lot worse.

I would like to publicly thank Dr. Wang and the staff at Mackay Hospital in Hsinchu, for taking my situation so seriously and working hard to resolve the problem and save my eyesight.