Whiskey Tango Foxtrot!?

So some time ago (two years ago? three?) was diagnosed with Glaucoma. Fortunately, it was detected very early. In fact, I'd gone to see my eye doctor because of a new and rather prominent floater in my left eye--which turned out to be a speck of blood from a torn retina. The eye doctor lasered it back into place at that same visit. The floater is still there, but as he told me I would, I've learned not to notice it. But in the course of testing, he discovered my Glaucoma.

He started me on eyedrops to control the pressure in my eyes and prevent the Glaucoma from advancing. The drops worked pretty well, but not quite as well as he'd have liked. So we added a second set of drops. If we couldn't control the pressure with drugs, the next option would laser surgery--or actual surgery. So I really wanted the drops to work.

And they worked for a while--until I developed an allergic reaction. So we switched out the drops. And thus began the long, laborious process of determining (through trial and error) that I am unable to tolerate any of the eyedrops for Glaucoma, with one exception: a preservative-free version of Zioptan. (Each day's dose comes in a disposable, one-use dropper.) But that one drug alone isn't doing enough. So my eye doctor referred me to a glaucoma specialist.

Who happens to be his wife. (And technically, he only referred me to clinic upstairs, where his wife is one of several glaucoma specialists. I chose her.) So on Wednesday I spent about two and a half hours in the clinic getting extensively tested. I was rather anxious about this; giving up on finding a combination of drugs to do the job meant surgery of some kind.

They tested my vision. They tested my color vision. They numbed my eyes and did a pressure check. They dilated my pupils and had me wait until everything was bright and blurry, then examined the interiors of my eyes with the aid of very VERY bright lights, and with lenses they actually placed ON my eye. (All of this was wonderful fun for a guy who has always been extremely sensitive to glare and to having anything near my eyes.)

They did a visual field test. You stare with one eye (the other is covered) at a tiny light in the center of a hemispherical machine and click a button every time you see a flash of light anywhere). Then you do the other eye. And you fear all the while that you're missing way too many of the flashes (some are bright, some are barely perceptible). They examined my eyes again with the aid of bright lights and lenses, and took pictures while they were at it. I saw three different technicians/doctors in addition to my primary. (The technician who administered the visual field test bears more than a passing resemblance in appearance, manner and voice to the actor John Malkovitch. It was a bit odd.)

The end result of all this testing was to determine that I still have undiminished field of vision in my right eye (no loss of peripheral vision at all), and very minimal loss in my left eye (but there is some). Also, that I was a good candidate for laser surgery. So sometime in the next month or two I'll get scheduled for an in-clinic procedure. I asked the doctor how it works. Apparently, on the interior of your eye, right where the iris (the colored part) meets the white, there's a lip or groove or something. This is where, assuming it works correctly, the fluid inside your eye can drain away so that the pressure doesn't get so high that it starts damaging the optic nerve. The procedure will use a laser and some mirrors to zap fifty spots around the perimeter there, causing some inflammation. Then, when the body sends it's healing agents to deal with that, it will usually (in about 80% of patients) also cause it to start draining more effectively.

Why? I don't know. And neither does my doctor. She said they don't know why it works, they just know that it does. And it works better in patients who start with a higher pressure inside the eye (like me, so I'm almost certain to get a beneficial effect). In conjunction with eyedrops (which I'd still be using), it should lower the pressure enough to prevent any further damage.

It's not a permanent fix, though. The effect generally lasts from two to five years, and can be repeated once. So it could good for anywhere from four to ten years. And then? Well, there will probably be some new glaucoma drops on the market I can try. And if not, there's still actual surgery.

So...laser eye surgery sometime in the next couple of months, a follow-up visit at two and then eight weeks post-surgery (to compare pressure to see if worked) and then we'll see. I'm relieved that I can try laser surgery and not have to jump (immediately) to going under the knife, but it's still daunting. It doesn't help that I was definitely the youngest person in the waiting room by a good margin--at least amongst actual patients and not loved ones waiting with patients. I'm not pleased by that at all.