“How about pain? What should I expect while I’m recovering?” I asked the wrong question. What I should have asked is “Will it flipping work?” The other day, Susan drove me to the Lancaster Surgery Center, an hour-and-twenty-minutes away. A well-respected ophthalmological surgeon cut and shortened the muscles that control my eyeballs. This is strabismus surgery, an intervention for double vision.
Shortly after I moved to Gettysburg, I sat in the eye doctor’s office waiting to discuss my increasing double vision. Jennie Knox, a board member of the company where I worked was also there. At the next board meeting, she asked me about my appointment.
“I saw the doctor because I’ve been having double vision.”
“Oh wow, what did he say?”
“He told me not to drink so much.” Ba-dum-tss.
My vision has been in a slow slide for years. I first had strabismus surgery in 1997. In 2006 my vision began to double again. It’s been held in check by eyeglasses that include prescriptive prisms. The prisms bend light, causing my eyes, which drift to the outer corners, to see what’s directly in front of me. As my vision worsened, the prisms became thicker. Eighteen years later I’ve hit the point where adding additional prism is no longer possible. I’ve reached the correctable limit. So surgery.
The day turned out to be uneventful. The hardest part was enduring sixteen hours without food. And of course my inability to see anything after the surgery. I needed time to get used to my new eye muscles. Everything was still doubled, just less double than before. But I was also wearing new glasses without prisms, so my vision was way worse after surgery than it was before surgery with the prism glasses.
Yesterday, still seeing everything in duplicate, Eli took me to see the eye doctor. As we waited at the stop sign to exit our neighborhood, a powder blue convertible from the fifties passed in front of us. An eight-wheeler! Two back wheels on each side, one in front of the other, and two front wheels too. I told Eli, and he was distraught that he missed it. He just didn’t notice. A few minutes later, I realized that I was just seeing the wheels in double. Eli and I had a good laugh.
My vision actually improved a little as we traveled back to Lancaster. Possibly looking at a variety of distances (rather than just trying to read my computer screen) helped teach my eyes to focus. The doctor measured my double vision and declared his work ‘perfect.’ “Oh, but I might have over-corrected a bit on the right side.”
My rapport with the doctor seems to have crumbled. It was unclear whether he acknowledged that I am still seeing double vision, and he gave no indication if that was expected. He didn’t give me any hopeful information, and when I asked if my vision would improve, he didn’t answer. He suggested that I don’t drive a car until I feel comfortable with that. It sort of felt like a CYA by a doctor who knows he botched a job—but I might be reaching here.
What the doctor never said is something Susan and I looked up on the internet last night. It might take a couple of weeks for me to be able to reliably see single images again. Right now, if I’m sitting still and looking straight ahead or on an angle to the left, my double vision is gone. When I’m on the move—walking or riding in a car—or looking on an angle to the right everything is doubled (that over-correction he mentioned). I went for a walk this morning. Because of the constant movement, everything was double all the time. Disconcerting, and kind of scary crossing busy roads. I wasn’t confident that cars weren’t coming.
So what’s my prognosis on a full recovery? God, I sure hope so. I’m a long way off from being able to drive a car or ride a bike. I think I can sit in my office and do my work with reasonable visual acuity. My next appointment is 5/06. I think the doctor expects my vision to have mostly corrected itself by then, but again, he never actually said that. I’m going to see how things are working on Monday. If my vision isn’t improving, I plan to reach out to him again, this time in writing, listing all my concerns. Maybe I’ll just send him a link to this post.
Update – Surgery plus four days: All objects straight ahead and off to the left are crystal clear, single images. All objects off to the right side of my field of vision are doubled.
Surgery plus six: This is still improving.
The Other Stuff 
Oh man, a doctor’s ‘perfect….but…’ yet with no discussion of the things that matter to you. How has this guy managed to bypass the contents of the twenty plus presentations on communicating with clients that he must have seen at conferences over the years?
For example, the bit about allowing things to settle down for a couple weeks – that’s so important; and I’m hoping it does.
~
Not for the first time, I’m in awe of your commitment to work, read, comment, write your own stuff and generally get on with things whilst this type of stuff goes on.
I’m hoping you are back on the literal bike soon. Real soon.
Kind regards
DD
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My blog friend crustytuna who is a neurologist gave some encouraging words. Hopefully this will all resolve itself quickly and I can move on. I think what you see as commitment might actually be addiction.
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An addiction to life affirming activity does not seem like addiction to me.
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Hang in there! Your brain needs to relearn a bit, and it’ll all take time. For nerve and brain stuff, I tell people 3-6 months minimum, and all bets are off on if you’re done recovering until at least a year out. I imagine with a surgery like this it won’t be quite so long, but I’d give it at the very least a month or two. Unfortunate your doc didn’t give you a chance to review concerns, or give you a sense of what to expect 🙁 You can always tell which doctors have been patients themselves…
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The eye doc who referred me to him gave fair warning. He said most people find him hard to get along with. I actually just rode to the store with Susan, and looking out towards the left is crystal clear (especially without all the prism mucking things up). I hope the view to the right comes along quickly. I’m really ready to put this chapter behind me.
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Also, Susan was doing some research on my vision and she learned about how cranial nerves can be damaged in a TBI and effect things like vision, hearing and facial expressions. Do you know if those deficiencies would show up immediately after the TBI or if they might build over time. Sorry I’m always trying to bum free neurological advice. There’s really no place else to turn. We tried to google this answer without success.
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So most TBI deficits show up shortly after, can recover up to 2 years post injury, then tend to plateau with respect to recovery. I wouldn’t expect any progressive deficits in your vision now to be due to such a remote injury. But you are going to be more sensitive now to any changes because your TBI would have lowered your ability to compensate for any neurological injury in future…. Does that kind of make sense?
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Yes. Thank you. I can just blame my father for faulty genes.
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Jeff, I can only relate that a friend who had lasik surgery thought it had been screwed up 48 hours later, but by the ten day mark he was astonished at his improved vision. Having patience may be worth the stress.
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Yes, I’m thinking this will go that way too. My vision out to my left was shockingly clear this evening when Susan and I drove to the store. I hope my vision on the right starts moving the same way.
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Jeez Jeff, you are such a trooper. I loved the line”I asked the wrong question.” As a person who gathers a lot of information, I’m always wondering if I’m too myopic. Now bear with me while I do my sisters cousins best friends uncle knows someone who blah, blah. But, my 88 year old mother has macular degeneration and we’ve been dealing with it for years and years. Recently she experienced “Charles bonnet syndrome” where hallucinations appear because the brain is filling in space where there is vision loss. It’s so fascinating to me, but I’m not the one with vision loss. We saw an incredible neurological ophthalmologist in Boston named Dr. Tom Hedges, so if you ever need a second opinion, he’s your guy. But here’s, the thing, I think sometimes doctors who are a bit brisk with they’re explanations and lack color commentary is because he believes your gonna be fine. I’m not excusing him but that’s my read. Time takes time and that’s what your eyes need to heal. Rooting for you Jeff.
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Thanks Biz. I need the encouragement right now. My eyes hurt, my vision is funky and I can’t blow off any steam with exercise because the doctor said ‘don’t exert yourself.’ I suspect you’re right about the everything is going to be fine in due time part.
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If only doctors were better communicators. I hope your vision improves soon, Jeff.
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Thanks Mark. Recently, I haven’t been communicating well with the doctors I’m seeing. I should probably look a little closer at my side of the conversation. They can’t all be poor communicators.
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I’m stunned that the surgery happened already. I remember thinking after you post that you had to wait 5 weeks was a long time away. And bam – all of a sudden, you’ve already done it. I’m glad you are through the surgery part and the recovery part goes quickly. It does sound so disconcerting to try to cross streets with double vision. Wowsa – so I’m glad to read in the comments that is already getting better! Sending best wishes!
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Well, for me the 5 weeks moved pretty slowly. I *am* happy to have the surgery behind me. Fingers crossed that things keep improving.
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I have had my own double vision issues,nothing like this though. You were brave to take the surgical route. Or, maybe, desperate enough. I have taken to driving with one eye closed, so I can tolerate the distance vision issues.
May I ask, do you have double vision close up? Or just distance?
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Yes, my double vision was at all distances. I thinkm surgery was really the only reasonable option. I was having a lot of trouble driving and reading. Have you looked into prisms in you glasses? They are sort of expensive, but they can correct a pretty wide range of double vision.
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I have the prisms, but maybe I need a stronger prescription. Or perhaps I should limit my phone time? (Guess what I’m typing on right now!)
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I remember you describing this on your blog a while back, got to hate doctors when they talk like that. Hang in there and hopefully he didn’t overcorrect.
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Thanks Bill. Time will tell. I need to keep reminding myself that it’s better than it was and still improving.
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Cheering for your full recovery, Jeff. And for the way you so often manage to pull great writing from frustrating experiences (a true artist. . . reminding me of how many say that DaVinci, too, had strabismus). I love the way you present the anecdote of the eight-wheeler, letting us see exactly what you are seeing and be amazed (and disappointed that Eli missed it) before you reveal what is happening. Hoping you continue to see improvement : )
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I didn’t know that about DaVinci. I wonder if they had the ability to grind prisms in lenses back then. I’m hoping that I can focus on a happy piece now and set the complaining aside for a while.
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Alas, too many doctors are useless (or worse) when it comes to helping us patients manage our expectations during recovery process (among other failures). I have too many such traumatic stories to share, but just wanted to say hey and hang in there, man.
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Thanks for that, Frank
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I realise I’m late getting to your post so things might be different, hopefully, better, with your vision a couple more days down the line since your operation. So, how are you, and how is your vision today? I do hope it has improved and that it continues to get better and better as each day passes. I can imagine it must be scary to have double vision in the one eye, especially when you’re on the move. Can you cycle or drive now, or is it far too early for that yet? Can you exercise yet, or is it too soon in your recovery? I can guess how frustrating that must be for you. I’m glad you can write to let us know how your operation went and what progress you’ve made so far.
When you mentioned the light blue convertible, I just accepted that it did have eight wheels (shows you how much I know about cars!) It must have been frustrating to realise that it wasn’t the case.
We have to trust doctors and surgeons to know what they’re doing and hope for the best. My faith was destroyed when I got diagnosed with sciatica by my previous, now retired, doctor a few years ago. I was in absolute agony. He didn’t arrange for X-rays or scans until several months later. It turned out to be six pelvic fractures, as I think I mentioned in a previous post or conversation. Thinking back now, I should have sued him – I could have been a rich woman by now!
I hope your sight continues to improve, Jeff. I wish you well. Do keep us updated.
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I did actually drive a mile today to loan a car to my niece. It went well, but as I pulled onto the busy road outside my neighborhood, I had a flash of panic of whether I saw everything correctly and worried for a couple of seconds about an impending accident. I’m not allowed to ‘exert’ myself until next friday which incorporates pretty much anything I want to do around the house (gardening, vacuuming, etc) as well as running and biking. I’ve been taking some epic walks which are fun. Back to work tomorrow, and I have a busy week professionally, so I’ve gotta get my game on. My vision is improving. I think I’m going to wind up with some double vision when I look off to the right, but that will be correctable with lenses. It’s pretty amazing that I’m operating without prisms now. A week ago, I couldn’t function without glasses on. It’s really maddening when doctors make the wrong call about laziness. Susan is reading a book right now about biases in the medical field where male doctors dismiss the complaints of women, minorities, over weight people and disabled people. She’s been giving me reports on what she reads. Sounds like your doctor pulled that on you. Probably deserves a lawsuit. It might make him pay attention in the future.
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