Eye Update: Improving Vision

At this time, vision in my left eye is hovering around 20/40, while my right eye seems to have reached about 20/30. While not the highly coveted 20/20 vision, this result is dramatically better than before the surgeries, where vision in my right eye was maybe 20/50 (on a good day), and my left eye was worse than 20/70 (yes, that bad! I could read the big "E" at the top of the Snellen chart and also the next line down, but after that, everything was turning to fog). The doctor says I probably can't expect better than 20/30 until after we address the cataracts. 

Even so, I am absolutely thrilled with the progress so far. I am seeing the textures on tree trunks, the shapes of individual leaves and blades of grass, even the dust I missed while cleaning the house. I can read books without a magnifying glass. I can see drawings and paintings on the walls that I have not seen clearly in years. Colors are more vibrant, and I am definitely seeing a fuller range of contrast (whereas lights and darks were previously grayed down). 

I am still trying to process the impact of my vision problems on my art. I have been collecting my thoughts and planning to write about how my drawing habits changed as the Fuchs Dystrophy progressed. I will post those thoughts when I'm ready.

Eye Update: Post DMEK surgery on Right Eye

About 2 weeks ago, I underwent DMEK (partial thickness cornea transplant) surgery on my right eye. The surgery was successful, but there were some issues following the surgery, so I held off writing this update until I was sure my eye was OK. 

At this point, I have undergone cornea transplants in each eye, so I have some basis of comparison, and I better understand that there can be a range of experiences among cornea transplant patients. The biggest difference between my 1st and 2nd surgery experiences is that I have more distinct memories of the first surgery (as documented in my earlier blog post). With the second surgery, I seem to have lost consciousness until it was all over. I do remember arriving early at the surgical center. I remember the nurses preparing me for surgery. I remember chatting with the anesthesiologist, but he did not start applying the anesthetic until after I was inside the OR (compared to last time, when I was already fading in and out of consciousness as they wheeled me into the OR). This time, I was wide awake as they wheeled into the OR, and I remember thinking, “Oh no, did they forget to numb me?” I remember being inside the OR and being much more aware of sounds and what the room looked like (compared to my last experience where everything seemed to be lost in bright lights and fog). From somewhere out of my sight, a music player began playing some pop music. I remember looking up and seeing the face of the anesthesiologist, who seemed to be enjoying the music. Then I remember looking at bright lights. From this point forward, I have no memory, until I heard my doctor’s voice saying, “That’s it. We’re done.” I remember being surprised that it was over so quickly. I have no memories of the surgery itself. (This was mildly disappointing, as I was hoping to compare what I saw with my previous observations of eye surgery from the patient’s point of view – but I was very relieved it was over!)

Following the surgery, I was sent home with instructions to lie down, facing up. This is so that an air bubble in my eye would push the transplant graft up against the back of my cornea. The next day, I went back to the doctor for my fist post-op visit; the eye patch was removed, computer scans of my eyes were performed, and my vision was tested. I was pleasantly surprised that vision in my right eye was not as bad as I expected (compared to last time when I was almost totally blind in my left eye following surgery). I learned that the reason my vision was so bad last time is that the doctor had used an “aggressive air bubble” (meaning higher air pressure) to hold the graft in place at the back of my cornea. This time, the graft was attaching right away, so the air bubble was “less aggressive”. Hence, my vision was comparatively better this time around (this was something that concerned me my after the previous surgery: everything I had read about DMEK suggested my vision would be “blurrier than normal” for a few days – not almost totally blind). With the graft fully attaching from day one, I seemed to be well on my way to a speedy recovery.

However, my vision began to worsen over the next couple days, and I noticed redness – even brownness - around my right eye. To make matters worse, about 2 days after the surgery I read an email notification (which had been sent the day of surgery but I hadn’t yet read it) which stated that a lab test of the donor tissue yielded the results: “rare white blood cells” and “gram stain positive cocci”. I looked up these terms; the news was not good. These results likely meant infection and probably redoing the surgery. Fortunately, on my next visit to the doctor, I learned that the lab test had been taken from the rim of the donor tissue, but was not a culture of my eye. In fact, my cornea seemed to be healing nicely. Much relieved by this good news, I went home feeling better.

Nevertheless, the vision in my right eye continued to worsen over the next few days – but this wasn’t the “ghostly fog” I experienced previously, this was more like looking through a Gaussian blur filter in Photoshop. My eye became increasingly reddish, itchy and was constantly tearing. Knowing these were signs of potential graft rejection or infection, I returned to the doctor fearing the worst. Well, it turned out that my eye had become too dry following the surgery, and the top surface of my cornea had become irritated or inflamed. While this condition was uncomfortable, it was actually very good news (no graft rejection and no redoing the surgery). The solution was simple: moisturizing eye drops. Over the next few days, the itchiness went away and my vision improved.

At the forth post-op visit, the doctor removed the suture (he used only one for this surgery, but its removal resulted in some additional irritation and tearing over the next few hours). He confirmed the graft transplant is fully attached and my cornea is healing nicely. My vision is improving.

One more difference in this surgery compared to last: the doctor placed this transplant graft slightly above my center of vision in order to avoid an area of corneal scarring. He said this might take a little longer for my vision to recover, but it meant less chance of graft rejection. 

Today, the vision is my right eye is still blurry, but significantly better than it was before the surgery. I will post more eye updates as my vision improves. I also want to post some thoughts on how the loss of vision was impacting my life and my artwork.

Eye Update: Next DMEK Surgery

This will be my last eye update before undergoing DMEK cornea transplant on my right eye (see my post on my left eye DMEK here). I post this info in hopes of encouraging those struggling with Fuchs Corneal Dystrophy and other eye problems.

My current situation is a mix of good and bad news. Following the DMEK on my left eye, my vision in that eye was getting dramatically better, but then stopped improving, and actually started to get just a bit worse (although still vastly improved compared to before surgery). The doctor believes this regression is due to my cataracts growing worse, and I might possibly be developing keratoconus (thinning of the cornea). Typically, patients with cataracts and Fuchs Dystrophy are treated with a double surgery: cornea transplant + cataract surgery combined. But my cataracts were so mild that the doctor recommended we do the DMEK first and then address the cataracts later (probably years down the road, or so we thought at the time). But recently the cataracts have worsened much faster than expected and will need to be addressed sooner rather than later. The keratoconus is new, and hopefully can be treated with contact lenses designed to support weakened corneas. The plan for now is to just get through the next DMEK surgery (and subsequent recovery process), and then address the cataracts and keratoconus.

The good news is that all of my eye problems are treatable; it’s just that the road to anything resembling a full visual recovery will take longer than expected. I hope to document my recovery process here on this blog, and share any info that might be helpful to those suffering with eye problems.

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One caveat to Fuchs Dystrophy sufferers: don’t wait too long to do the cornea surgeries. The longer you wait, the more chance of permanently scaring your corneas. My first doctor thought it was too soon to do the cornea transplants, so I put it off… and then I put it off some more… I waited almost slightly too long, and now I may have some mild cornea scarring in each eye even after successful DMEK surgeries. Fortunately, it’s not bad enough to significantly impact my vision too much, but I do wish I had done the surgeries a bit sooner.

Eye Update

This is an eye update for almost 2½ months post DMEK cornea transplant surgery on my left eye (see my previous posts about my experience with Fuchs Dystrophy and DMEK here and here). I have attempted to show my current state of vision with this diagram. Vision in my left eye is dramatically improved, but I still have a slight double vision effect. Otherwise, I am able to see details and textures that I have not seen in quite a few years. Colors are brighter and more vivid. My right eye has not yet had cornea transplant, so vision remains blurred, with images fading out as illustrated on the right side in this diagram.

I am able to read fine print again without resorting to a magnifier. Also, I am getting back to drawing on actual paper (as opposed to drawing on a Wacom screen where I can enlarge everything 200x).  I am absolutely thrilled to be getting back to things which I had to set aside as the Fuchs Dystrophy progressed. However, my left eye is doing all of the work right now, and I still get this haze coming in from my right side. I look forward to the second cornea transplant which is scheduled for next month.

Eye Update

I posted this recently on social media, but I want to post it here as well, in order to keep a record of my recovery from eye surgery. I hope to document the recovery process in the months ahead.

Eye Update: My left eye is healing up nicely and my vision in that eye is dramatically better. I can see details and textures which I have not seen for many years. Vision in my right eye is still a hazy fog and I will be going in for the surgery on that eye next. With DMEK surgeries, it can take up to 6 months for vision to stabilize in each eye, so I still have a ways to go before my vision is fully restored, but I am very happy with the progress so far.

Eye Surgery

I posted this on other social media over a month ago, but I will post it here as well, just to keep a record of my progress.

In late January, I underwent eye surgery to address Fuchs Endothelial Dystrophy, a condition that breaks down the inner layer of the cornea, causing loss of vision. The following was my effort to depict eye surgery, and the recovery process, from the point of view of the patient.

DMEK is Descemet Membrane Endothelial Keratoplasty, a technique that removes a thin layer of the cornea and replaces it with donor tissue. Compared to full thickness cornea transplant, or even partial thickness cornea transplant (DSEK or DSAEK), DMEK involves only the thinnest layer of the back of the cornea, resulting in less chance of rejection, faster recovery, and better visual outcomes.

So far, I’ve only had the DMEK in my left eye; my right eye has yet to be done. At the time I made these drawings, my vision was still quite blurry, but was improving quite a bit compared to the days immediately following surgery.