Arthur and Melissa’s Notes on Everything

This morning, a bright and early 7:40 am follow up exam. I drove, since the medicine was long worn off. Dr. Mitchell says my eyes are looking good. The irritation you feel after LASIK is from the edges of the flap not being healed on to the cornea, which is a major reason they tell you to take a 3 hour nap when you get home. This morning, the light fog is still hanging around, and the doctor says it should get better over the next four weeks. With both eyes together, I’m already working on 20/15, which is outstanding considering my corneas are still swollen from the surgery.

There’s an odd mental tension in this state — I keep wanting to put my glasses on to make the fog go away, but things are already in focus, so that won’t do any good. There’s also the classic indicator for needing glasses — if I really needed them, I’d have one killer migraine by now. The absolutely most unusual experience for me in all of this (apart from the surgery itself) happened earlier today in the one place I’ve never been able to see clearly: I took a shower. If you wear glasses, you understand.

Four hours later… I’m still a bit woozy from the medication, but my vision is interesting. I’m seeing through an odd fog; most anything with a little brightness to it has a halo around it, and not in the manner I expected. When I wore contacts, the halos I saw when the contacts dried out were concentric circles. This is more like a foggy night, where you see a diffuse cloud around a light source. It improved over the evening, although everything is still about as foggy as the streetlights outside, since it’s a fairly humid night as usual. An interesting aspect of this, to me, is that there was no acclimation to the new “prescription” of my eyes as with a new set of glasses. I guess since there’s not an extra lens suspended in front of my eye this makes sense.

I bit the bullet this morning and headed out to the Huntsville Laser Center to have LASIK done on my eyes. As it turns out, it really wasn’t all that bad, despite being rather squeamish about eyeballs, particularly my own. Wearing contact lenses for a year probably helped a lot with the squeamishness, since that required lots of poking myself in the eye.

As it turns out, everything about LASIK is pretty darn quick. The pre-operative visit to collect measurements of my eyes was only a few minutes of data collection by the wavefront analyzer and the corneal analyzer. Another hour or so spent repeating a more typical eye exam twice (once with a nurse, once with the doctor for independent confirmations), and another corneal measurement to make sure I have enough cornea to cut in to.

First things first, I had to turn in my consent form (the bill was already paid), then down a Lorazepam tablet to take the edge off and prevent freaking out while lying under a big machine with my eyelids pried open. Oh yeah, Lorazepam also makes for a great nap about 2 hours later, which just happened to be when I got home. Anyhow, my turn rolled around after 15 minutes or so. First to an exam room, where I took off my glasses for the last time and nurse Kimberly started the prep work – hair bonnet, gauze to keep the eye drops & irrigation out of my ears, and a scrub of the area around my eyes. Then Dr. Mitchell came in to review the procedure, make a few reference marks on my eyeball, and the first of many numbing drops to come was administered.

The actual procedure goes by in a hurry. The whole job is done lying down on a flat exam chair. First, since Dr. Mitchell only does blade-free LASIK, we began under the IntraLase machine which cut the flap in my eye. One eye at a time, he put a suction ring on my eyeball to immobilize it, which is probably the most painful part of the procedure. It’s really more discomforting pressure than painful. When he asked how I was doing after the flap cutting, I told him I felt like something hit me in the face.The IntraLase machine was targeted on my eye, and for 40 seconds, it scanned across my cornea. From the business end of the procedure, it looked like a little blob of gray paint spreading across a piece of glass in front of my eye, blotting out the blue lights of the laser head above. After 40 seconds, the suction was released, and I was swung out from under the machine. The ceiling now looked like a posterize effect was applied, or the world was in 8-bit color (or worse). Rather strange and unexpected, after seeing the progression of gray sweeping across my vision.

Next, the actual LASIK procedure. Again, one eye at a time, my eyelids were taped back, and an eyelid speculum was inserted to hold them wide open (think A Clockwork Orange). Dr. Mitchell made a few more marks to ensure the correct alignment of the corneal flap when putting me back together. While under the Visx laser, I was looking at a flashing red dot inside a crisp white ring, and some bright work lights around the periphery. As he moved the flap aside, my view of everything wobbled all over the place. It’s a bit tricky to keep focused on a particular point when you’re on your back, with Lorazepam building in your body, and your vision is moving all around outside your control. With the flap out of the way, the iris tracker locked on to align the procedure with the actual location of my eye. Did you know that human eyes tend to rotate sideways when you lie back? It was news to me too. The laser cutting for my prescription took about 26 seconds per eye. The excimer laser fires pulses in rapid succession that sound like electrical sparks shooting inside the machine next to your head. Most descriptions say you’ll see dancing lights across your eyes; I saw the reflection of the blue light of the laser pulses on the edge of the white ring above me. I think I saw some dark spots form and dissipate in my field of view. Presumably that was the pieces of cornea being vaporized away. There was an ever so slight whiff of smoke toward the end of the lasing. After the laser finished its work, Dr. Mitchell moved the corneal flap back in to place, repeating the whole wobbly world phenomenon.

Once both eyes were finished, they were uncovered, and I was told to close my eyes gently. I sat up, and Kimberly guided me back to the exam room, where I sat in the chair, reclined, with my eyes closed for about 20 minutes with regular check-ups. Right after the procedure, they expect you to have burning and scratchy sensations. I only felt a little burning after the second check-in. Dr. Mitchell was next in to make sure my corneal flaps stayed in place and no injuries occurred. After careful cleanup of my eyes and face where all the drops ran down, we went over the post-operative directions, and were all done. In at 8:30am, home by 11:00am, and that’s with half an hour to get home. In the few moments my eyes were open in the office, walking to the car, and getting in bed for the recommended nap (and who’s going to argue with the Lorazepam?), everything was pretty hazy, like a thick fog, but seemed like it should be clear.