.@ Tony Finch – blog

Previously, I wrote about my cataract and its assessment at Addenbrooke’s cataract clinic.

I had my cataract removed a couple of weeks ago, and so far things are going well, though there is still some follow-up work needed.

timing

My cataract op was originally planned for the end of November, but it got delayed to the 30th December. I wasn’t planning to do anything for new year’s eve, so nbd - but I did feel that xkcd was trolling me personally with a couple of cartoons areound the turn of the year:

clothing

I had the op under general anaesthetic, because my cataract was unusually difficult. The cataract clinic normally avoids the extra risks of a general anaesthetic becase their typical patients are much older than me.

So I was kitted out in a hospital gown (I was allowed to keep my underpants on), compression socks, and the ugliest non-slip slipper socks I have ever seen.

preparation

I first spoke to the more junior of the surgeons, who examined my cataract and discussed thigs like the target focal length.

Because my cataract was so dense, it was difficult for them to accurately measure the size of my eye, so there’s a greater chance than usual of a “refractive surprise”, in which case I will need more correction in the left lens of my specs. The surgeons seemed a lot more concerned about my need for specs than I am!

After some waiting, a nurse conspiratorially said to me “the consultant is coming!” and I was ushered into the examination room again.

The consultant surgeon examined my eye. “Interesting cataract,” he said. He had a disconcerting habit of sucking his teeth when looking at my eye, like a plumber who is about to give you some wallet-lightening bad news.

The surgeons had a high-bandwith discussion involving lots of ocular anatomical jargon, as they made a plan for how they would go about the operation.

I was given a list of probabilities of possible bad outcomes; in some cases I might have had to return in a week or so for a second fixup operation.

bedside manner

Everyone adhered to their assigned stereotypes.

The nurses were cheerful and appreciated my little jokes at my own expense.

The anaesthetist was more business-like. When he asked if I had previously had a general anaesthetic, I said, “not since I had my wisdom teeth out 30 years ago”, and told him a little anecdote:

A large and serious nurse made me lie on my front, and gave me a pre-med injection in my bottom. I’m not sure if it was the drugs or the indignity, but I was giggling foolishly until they wheeled me through.

“In your bum!”, he responded with surprise.

The surgeons were very serious, seeming to focus more on the technicalities than on the patient.

cross checking

There was a reassuring amount of double- and triple-checking.

In the first examination, the surgeon drew an arrow on my forehead pointing at my left eye, and got me to sign a consent form.

I was asked several times, “do you have any allergies?” (no).

I was asked a few times, by the anaesthetist and the surgeouns, “what are we going to do to you?” (I did not attempt to use any jargon when replying!)

In the operating room, one of the nurses found that I had signed the wrong consent form (it did not cover the general anaesthetic), so I had to sign a replacement. (A bit awkward with a cannula in the back of my writing hand!)

And when they got the new lens the surgeons examined the specification on its box and agreed with each other that it matched what they expected.

I admired the attention to detail.

afterwards

The consultant came round to chat after I had woken up.

He was much more cheerful than before, and seemed quite pleased with himself - a definite improvement compared to his demeanor before the op!

He told me that out of caution they had not removed absolutely all of the cataract, because there was too much risk of damaging the lens’s supporting structures. The remaining “plaques” can be removed by laser surgery after my eye has healed up. No need for a second invasive op.

A nurse gave me some eye drops (antibiotics, 4x daily for a week, steriods, 4x daily for 4 weeks) and instructions on looking after my eye - when to wear the eye guard, how to clean the eye, etc.

Rachel came to help me collect my things and chaperone me home in a taxi.

recovery

The first day or so after the op, my eye was sore enough that I needed painkillers. But after then it was tolerable, mainly itchy / irritated, and the eye drops helped with that.

I had a glimpse through the eye when I came round in the operating room, before they put the eye patch on, and it was immediately apparent that the eye could see better than it ever did before.

There were some odd visual effects at first:

I spent a lot of the first week with my left eye closed except when the light was subdued enough. I usually have a lot of bright lights in my study, but they have remained off!

The surgeon I spoke to back in February had been very cautious about whether my eyes would be able to work together after surgery, so the double vision was not a surprise, though it was disappointing.

But after a week or so, it settled down: colours appear the same and up is in the same direction with both eyes. My left eye still gets tired much more quickly, but it can cope with normal indoor lighting levels comfortably.

I have got some extra “lubricating” eye drops to help soothe the eye when it gets irritated between steroid drops.

what's next

At the moment, my left eye can see relatively well, much better than it could ever see before. (I had the cataract since birth; I had surgery because it became worse in recent years.) It is still blurry, though, comparable to my right eye without my specs, and not good enough to read with. (My right eye is very short-sighted, about -7.5 diopters.)

As far as I can tell, my brain is now doing a reasonable job of integrating vision from both eyes. Based on a brief game of catch with the offspring, my depth perception seems to be working. Yay!

I am due back at Addenbrooke’s in a couple of weeks for a checkup, and I expect that in February I will return again to have the remnants of the cataract removed with LASERS (pew pew). After that, I got the impression from the surgeons that I might be able to see well enough to read, which would be truly magical.

After that I expect I will get some new specs. I think I will get a general purpose pair, and separate pair for looking at computer screens.