Shawn Falchetti, CPSA

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Hindsight is 20/20

I've thought about writing a post about this before, and had some reservations, but it's something going on in my life right now, and something I had some good news on today, so I thought I would write about it.  It takes a little bit of storytelling. In 1985, I got together with a couple of friends after school for a game of football.  It was a half-day of school, we had an actual field to play on, and it had just rained, giving us some nice, muddy ground - all in all, perfect.  In the course of the game, I got whacked in the eye.  The injury caused the lens and iris of my eye to fill up with blood, and I lost vision in my left eye.  After a week in the hospital, my vision slowly returned.  It took another month before my pupil undilated. After assorted follow-ups, the eye doctor said that everything was fine, but that 20 years from now, I may have some problems.

As it turns out, he was correct.  There is a tubing meshwork that moves fluid through your eye, and some of my meshwork was permanently damaged by the injury.  When I was younger, my eye was able to better compensate for the damage, but in my late 30's that changed.  As a result, I developed glaucoma in my left eye.  Three years ago I was upset when I learned I had a condition which had no cure, that caused blindness, and would require daily medication for the rest of my life.  Other than the knowledge of it, however, there were no other symptoms - no pain, no noticeable loss of vision - just a routine of visual field tests, retinal imaging, and pressure measurements every 6 months, plus eye drops to try and keep my eye pressure down.  There are different types of glaucoma - for those interested, mine is secondary open angle.

About 2 years ago I noticed my eyeglass prescription seemed to be changing.  Even though I am nearsighted, I was losing the ability to focus on near objects in my left eye.  At first, my eye doctor thought I needed bifocals.  After ordering glasses and discovering the prescription was still wrong, I started to become frustrated when no eyeglass prescription would allow me to see clearly.  Not only was my near vision affected, but so was my distance.  Everything in my left eye was blurry, even with glasses.  An examination with dilated pupils revealed that I had a nuclear cataract.  Although cataracts are common for people later in life, injuries, as in my case,  can cause them to occur earlier.  As mine progressed, it was like looking at the world through a dirty windshield; sunlight, or headlights at night would wash out the entire scene. Colors became progressively shifted towards yellow and brown.  The distortion caused double and triple images of text and lines.

Although cataract surgery is routine, for someone with glaucoma there is additional risk, I was hesitant.  In the spring of this year, however, my routine check up showed that my eye pressure had elevated further, and my doctor was considering laser surgery to reduce the pressure.  He also suggested the option of having the cataract surgery, which may also reduce eye pressure.  We talked through the risks, and I chose the cataract surgery, since it was inevitable.  I had the surgery this past Tuesday, and Kiersten was there with me (and has been taking great post surgery care of me)

In cataract surgery, your existing natural eye lens is completely removed, and replaced with a synthetic one.  In the process, they also give your new lens the correct prescription so you're no longer nearsighted (I chose to also have my astigmatism corrected).   The downside is that it's fixed focus; like most middle aged people, you will need reading glasses for text closer than arm's length.  Considering I couldn't read anything with my left eye, this sounded pretty good to me.

Today was my post op appointment, and I was a bit nervous.  I showed up with the plastic clear eye patch and giant sunglasses that LASIK patients are probably familiar with. My eye surgeon told me that everything went perfectly, and he was pleased with the outcome.  We checked my vision on the eye chart, and we were both surprised that I had 20/20 vision in my left eye, one day after surgery.   A measurement of my eye pressure yielded the lowest pressure to date for me, even lower than my right, healthy eye.  The surgery wasn't a cure for my glaucoma,  but I'm happy that it helped. It was a cure for the cataract, though. The colors I see in my left eye are crisp, and clear, and untinged. I really can't voice what it's like to get your vision back, or to go from not being able to see clearly with any glasses to seeing 20/20 with no glasses.  My next follow up appointment is Monday.