Theresa's Story

Pre-surgery

I was in my mid-40s, was nearsighted with astigmatism in both eyes, and wore bifocals (R eye -7.00 + 1.50 x 105 degrees; L eye -5.75 + 1.50 x 70 degrees). I had tried all three types of contacts with limited success. My glasses (even with thin lenses) were getting to be too heavy for my nose. And I felt limited by vision when I swam or engaged in other sports. I had considered RK for at least five years before I had it done. I had just finished my Ph.D. and was re-charging my career. I performed a literature search on RK surgery and a new review article had just been published in one of the major medical journals attesting to its safety. I attended two seminars on RK and laser (which had not yet been approved for general use). The seminars assured me that there were very few complications and that after surgery some people experienced halos around lights and that usually improved after 6 months to a year. I spoke with a respected eye surgeon who said that I was a good candidate.

Surgery

I scheduled surgery for January 1995. I did not see the consent form until they had already inserted the first eye drops as a preparation for surgery. I remember being concerned when it said that your vision could be worse after the surgery and based on what I had been told and had read, I assumed that it meant whatever was worse could be corrected with glasses. I never thought that if it was worse it couldn't be corrected by any means. I trusted that they knew what they were doing. The surgery was performed on both eyes at same time. Since I do a lot of computer work, it was planned that my left eye would be corrected so I could see my computer. My right eye (dominant eye) was to be set for distance. I had surgery on a Thursday and I remember that I couldn't see anything but vague shapes throughout the weekend. I later discovered that my right eye had grossly overcorrected and the left eye was undercorrected.

Immediate Post Surgery

Since I had no glasses that would work, I was blind for the first three days after surgery. Nothing was clear. I could not work, read, watch television, or do anything where I needed my vision. I was scared. I remember that I was unable to contact my surgeon until Monday at which point he requested to see me. The surgeon fitted my right eye with a soft long wearing contact lens, hoping to help it heal. He wrote a prescription for glasses for my left eye. I wore the contact lens for about two months. The following week I went to work but I could not easily see the top of my desk. I remember going out and buying many magnifiers to allow me to see anything. They helped a little but didn't alleviate my terror. I kept making weekly visits to the surgeon. Over the next 9 months I had one more correction in my left eye which eliminated the astigmatism and corrected the nearsightedness to the planned amount (so I could see my computer). I had two enhancements in my right eye. For a week after the second enhancement I could see out of my right eye and then it became blurry again. The only thing that I was told was to push on my eyeball to encourage my eye to return to its intended configuration. This did not help. The surgeon had me fitted for a gas permeable lens, hoping that would stabilize my right eye. I could not wear it because my eye is no longer round and it sat up on the white of my eye.

Current Status

Currently, my vision in both eyes fluctuates during the course of the day. The surgeries have left me with unstable corneas. That means that my eyes change from 3 to 5 diopters throughout the day and so the quality of my vision keeps changing throughout the day. And each eye changes in different ways and at a different pace. My right eye is always blurred as the surgery has also left me with an irregular astigmatism in that eye which cannot be corrected with glasses. In the early morning, I still need 200+ reading glasses for my left eye in order to read. I can actually see distance out of my left eye when I first wake up. However, that changes over the course of four hours after I get up. I still cannot clearly see out of my right eye. In the morning I can only see vague shapes out of my right eye. At night I see irregular light rays around bright lights. The rays I see out of my right eye are about 5 feet long. The rays I see out f my left eye are only about 2 feet long. I have tried to explain this to people and they just give me a blank stare.

Function

I was and still am unable to read for long periods of time. I was becoming increasingly frustrated with working full time and coping with my vision. In August of 1997 I quit my full time job and started a consulting business. Fortunately my marital situation allows me to work part time. My work involved and still involves moderate amounts of travel. Each new situation brings new challenges. It is always very difficult for me to go into new situations because while I appear to everyone else to be able to see well (since I can't always wear glasses), there are times that I can't see clearly out of either eye. The clarity of my vision depends on things like amount of light, how soundly I sleep, dryness in the atmosphere, and fatigue. Again, all of these variables have different effects on each eye. Early morning meetings are almost impossible. Because of my fluctuating vision and the inability of my brain to readily adapt to my changing eyesight I often miss things, especially in the evening when my right brain gets tired and neglects to tell my nondominant left eye to take over. People make snide remarks to me all of the time about something being posted and implying that I should have seen it. Those situations are difficult for me-simple things like buying coffee at the airport. If I ask what the sizes and prices are, I often receive nasty comments. When I travel I must set up my morning routine at night as I know that I will be unable to find things in the morning. Before I quit work, one of my co-workers was frustrated and said, "look at me when I talk to you!" I realized that I was not using my right eye at all.

Hobbies

One of my hobbies was nature photography and I still cannot take close-up pictures. I have no depth perception and this makes playing tennis very difficult. I make jewelry and paint with watercolors. I need and extremely bright amount of light to do either of these things and many different pairs of reading glasses. In fact, there must be twenty pairs of reading glasses (all different corrections) placed throughout my house. I can still play the piano in the middle of the day.

Current status

In December of 1998 I went to see an Optometrist in another clinic for an eye exam and he told me about an optometrist who was an expert at fitting contacts in people who have problems like mine. In February of 1999 I was fitted with a contact lens for my right eye. After three lenses, I finally have one that I can wear from 6-12 hours a day (depending on the variables). I can see fairly clearly out of my right eye when I wear my lens. I can even read some with my glasses. This helps take the strain off my left eye. Unfortunately, I can't see well out of my left eye the first thing in the morning so I really can't use my regular glasses to read out of both eyes. I have to choose which eye I want to read with. I schedule most of my heavy duty reading for late morning as that is when I can see best out of both eyes with my regular glasses and my contact lens in. The lens also allows me to see the road more clearly early in the morning as I drive to the airport. The biggest problem with my contact lens is that when I have to take it out and return to my non dominant left eye, it takes several hours for my left eye to re-achieve dominance. During that time I am completely blind in my right eye and can not see anything very clearly.

Psychological Impact

The most difficult thing to cope with is that there is the inconsistency of my vision and the inability to plan my day. I cannot do things when I want to do them because everything is dependent on which eye works at a particular time of the day. Some days I see better than others and during the day my vision continually fluctuates. The most trying experience of all is trying to explain my eye problems to my friends. They ask me what is wrong with my eyes but as I explain, their eyes glaze over and a quizzical look appears on their faces. I have stopped trying. I simply say that I have unstable corneas and leave it at that.

It is also difficult to conceive of a very uncertain future for my eyesight. I am living one day at a time. I do not know if I will be able to continue to wear my contact lens. I do not know what will happen to my eyes as I age further and develop cataracts. How much more surgery will I be able to tolerate before I am completely blind? I do not know the answers to these questions.