My Eye Story Part #3 – Laser Retinopexy

On the 10th October, I suffered an eye injury which left me blinded in my right eye for several hours. No words can describe the wave of emotions that overcame me during my temporary loss of vision. Currently, my vision is still blurred, but it is getting better day by day and my Ophthalmologist (eye doctor) is confident that I will recover fully. Looking back, I’m glad this incident happened as it has given me an opportunity to reflect on my life and the things which are most important to me. My experiences as a patient seeking medical care in a foreign country has also given me some things to think about as I prepare to embark on a career as an Orthopaedic surgery resident.
I had an uneventful follow up on Sunday and Monday with Dr Gustave and in view of the good progress I was making with my vision returning to 20/20 (but still blur due to remaining blood in the eye) and normal eye pressure, I was asked to return 2 days later on Wednesday.


 

This is a continuation from Part #1: The Accident and Part#2: Seeing the Eye Doctor


I had an uneventful follow up on Sunday and Monday with Dr Gustave and in view of the good progress I was making with my vision returning to 20/20 (but still blur due to remaining blood in the eye) and normal eye pressure, I was asked to return 2 days later on Wednesday.

By now, the hyphema is slowing clearing but I still have blurred vision. Dr Gustave is now able to see past the anterior chamber into the vitreous chamber at the back. He notes that there is some blood in the vitreous but he cannot tell for sure if it is a spill over from the hyphema or if the bleeding is from a source in the vitreous chamber. As a specialist in cornea and refractive surgery, the retina is not his cup of tea. He did a cursory check but did not find any obvious tears. However, he was still concerned about the bleed and recommended that I return the next day to see his colleague, Dr Tilton, who is a retina specialist.

During my appointment on the next day, Dr Tilton proceeded to examine my eye thoroughly. At some points, he pressed hard on my eye to indent it so that he could see the anterior parts of the retina. It was rather uncomfortable as he did a 360 degree assessment of the retina. I was a little concerned when he took quite a long time looking at the upper pole of my eye. I could sense something was wrong but he was tight lipped.
Upon putting down his tools, he told me that he was concerned that I have a small retina tear and that I was lucky that it is not in my visual field. My heart sank immediately and my mind was immediately filled with questions and fear. He reassured me that this will have no long term effects of my career but he needs to intervene now to prevent a full blown retina detachment which can leave me permanently blind. In other words, I needed to do a laser procedure now to “weld down” the piece of flapping retina to prevent further progression.

I have seen laser done on patients before during my medical electives and the only thing I remembered was the ophthalmologist telling me that this is just like a computer game – you aim at the enemy and zap it down with the laser. I had never thought of what the patient must have felt during the procedure and now it is my turn. Even though Dr Tilton told me all I would see is a very bright light and a dull ache when the laser impacts the retina, I could not help but still be scared of what was to come.

I was then ushered to the surgical center where I was assisted by the nurse on duty, Debbie, who got me onto the trolley and took my vitals. Dr Tilton proceeded to take my consent and prepare his laser settings. Once ready, I was made to lie flat and he started to look in my eye. When the first shot of laser came, it wasn’t as bad as I thought it would be. But I was still breaking into cold sweat. Some of the shots gave me a dull ache at the back of my eye which was really uncomfortable. They felt like punches in the eye but coming from the inside. He again had to indent my eye pretty hard at some points so that he could shoot the lasers at the hard-to-reach areas. The procedure took about 10 minutes and it left me blinded in the right eye for a while due to the laser’s brightness. By the end of it, I was almost drenched in sweat that Debbie commented that I looked like I had just ran a marathon.

I was given an appointment to see Dr Tilton again 4 days later on Monday to see if the laser has been successful in preventing progression of the retina tear. I was advised not to run for one month, to avoid dynamic movements of the eye to avoid stressing the tear. This is a real bummer for me.

The cost of the laser was not cheap at about $1200 + $400 for the surgical center fees and fortunately I will get this covered with my NTUC PA Assurance Insurance. (Link HERE)

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This encounter also made me realise the importance of being compassionate with our patients. When the nurse Debbie noticed how scared I was, she told me that this will do me good. She said that she had several procedures done on herself and she found that each time she went through them, she came out more understanding and compassionate to her patients. As doctors, we are taught to describe everything about the procedure to the patient, the risks, the benefits – all these hard facts but we often forget to ask about the patient’s feelings and fears. This incident will remind me to put myself in the patient’s shoes to understand what he or she feels before a surgery and do our best to reassure them.

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