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[Health] Eye exam
Aug. 2nd, 2012 05:52 amReposting an aggregate of Facebook posts from last night since I know a bunch of people on DW/LJ don't have me on Facebook... Also, gives me the chance to add Wiki article links.
So, back from the optometrist. Long appointment, eyes still dilated so I have my text size at crazy levels to type this.
a) I have small cataracts. They have either just started forming, or have always been there and simply been missed before. Something to keep an eye on.
b) My right eye, which has always sucked and was lazy as a child, is apparently lazy once more. Not much they can do about it; it's really only something they can correct as a child. Joy. [Clarification: I had eye surgery to correct my amblyopia when I was 2 1/2 years old. It just never got up to par with my left eye, and now it's gone lazy again because my left eye is more predominant.]
c) My prescription from 2008? Horribly, horribly out of date. For the last decade plus, I've had minor tweaks and twiddles to my prescription. This is MAJOR. I'm a full _diopter_ off on each lens (overcorrecting on one lens and undercorrecting on the other). They think this could be causing some of my migraines. The lady I was speaking to went as far as to say "Want to take my glasses home? They'd probably do you more good than yours would." Ouch.
d) New doc has a number of questions about my glaucoma / Pigmentary Dispersion Syndrome (PDS) diagnosis from when I was a child/teen. He doesn't see virtually any pigment on the cornea-- between "trace and 1", definitely not what he expected. It's also apparently not possible for the pigment molecules to filter out through the Canals of Schlemm; they're too big. They can get absorbed and broken down by the eye, but they shouldn't filter out; in people with PDS, even those who have gotten LPIs (laser peripheral iridotomies), they expect to see a lot more pigment build up.
Going to see if I can get my records from Dr. Moverman, the doc I saw back when I was living with my parents, who diagnosed me and performed the LPIs (which, everyone who has seen them has commented on what a clean job he did on them). The exact details of why he did them need to be sorted out, but they fixed the problem I had at the time and he did a phenomenal job, so that part isn't in question. Just whether he got the reasoning wrong, or I remember how he explained things wrong. Given how many years ago, I'm thinking (and hoping) the latter.
e) He was also unable to see where the pigment would have been worn off of the iris. He shone a light through the pupil and checked for light reflecting off of the back of the eye through spots in the iris, and found very minimal "transillumination"... also calling into question why the LPIs were done.
f) He's having me come back in a week to check my IOP (intraocular pressure) again, and to do a full visual field test to get a baseline (I just did a basic matrix test, apparently).
g) He also measured the width of my corneas, which is something I don't remember any other doctors doing (and it's something he's been doing for the last 15 years, so this is not new. Oh, did I mention he specializes in glaucoma? BONUS!). Apparently, I have thick corneas, and cornea thickness is not something that really varies with age. Average is something like 5.45 I think he said, mine were about 6.30. This is actually a good thing, because when they measure IOPs they actually press against the cornea; the thicker the cornea, the more they need to adjust the IOP value. So for me, an IOP of 20 actually means 16. (Granted my IOP of 60 as a teen is still CRAZY HIGH even corrected, but still... means my more recent readings are much more normal than I thought.)
All in all... I really like this doc. Think I'm going to keep him. Now I just need to see when I can find the money to get a new pair of glasses... and then endure the "fun" part-- adjusting to a new prescription. I fully expect that I'll have a _wicked_ headache for a few days with the new script once I get them...
Have to say, the cataract part scares the shit out of me, especially since Grandma Hill had them. One of my biggest fears after dealing with my eye issues as a kid was that I would go blind. And the doctor at Cambridge Health did a pretty comprehensive exam back in 2005-ish when they were checking to see if my optical issues could be causing my migraines, so I would be surprised if he missed them. Which if they weren't there then...
I had Dr Rouse write down the type of cataract for me (which I can't read at the moment, but I believe it is "anterior athrosclerosis"). He did comment on the fact that I'd been on prednisone, which can cause cataracts, but usually a specific form ("capsulary"?), and this isn't that. Could still have been from the prednisone, though, just not likely. [Update: "Anterior cortical sclerois". Close. :) No wiki link available yet, I need to do some research on this...]
They did an optical CT and my retina/optic nerve are great, so that's at least not a concern right now (previously it was, high IOPs can damage the optic nerve). But the idea of going blind is just my personal demon, given how much I've been fighting eye problems all my life.
Anyways, the important part to remember is that this is now something I know about and can work to correct the prescription issues, and monitor the cataracts, and get the old records from when my LPIs were done, and sort out the confusion around why they were done and what I need to monitor for the future. Forewarned is forearmed, and now I know I can't go a few years between eye appointments, and I shouldn't skimp and go to fucking Walmart to get my eyes checked out, I should have a real doctor look at them instead of an assembly-line rubber-stamper.
So, back from the optometrist. Long appointment, eyes still dilated so I have my text size at crazy levels to type this.
a) I have small cataracts. They have either just started forming, or have always been there and simply been missed before. Something to keep an eye on.
b) My right eye, which has always sucked and was lazy as a child, is apparently lazy once more. Not much they can do about it; it's really only something they can correct as a child. Joy. [Clarification: I had eye surgery to correct my amblyopia when I was 2 1/2 years old. It just never got up to par with my left eye, and now it's gone lazy again because my left eye is more predominant.]
c) My prescription from 2008? Horribly, horribly out of date. For the last decade plus, I've had minor tweaks and twiddles to my prescription. This is MAJOR. I'm a full _diopter_ off on each lens (overcorrecting on one lens and undercorrecting on the other). They think this could be causing some of my migraines. The lady I was speaking to went as far as to say "Want to take my glasses home? They'd probably do you more good than yours would." Ouch.
d) New doc has a number of questions about my glaucoma / Pigmentary Dispersion Syndrome (PDS) diagnosis from when I was a child/teen. He doesn't see virtually any pigment on the cornea-- between "trace and 1", definitely not what he expected. It's also apparently not possible for the pigment molecules to filter out through the Canals of Schlemm; they're too big. They can get absorbed and broken down by the eye, but they shouldn't filter out; in people with PDS, even those who have gotten LPIs (laser peripheral iridotomies), they expect to see a lot more pigment build up.
Going to see if I can get my records from Dr. Moverman, the doc I saw back when I was living with my parents, who diagnosed me and performed the LPIs (which, everyone who has seen them has commented on what a clean job he did on them). The exact details of why he did them need to be sorted out, but they fixed the problem I had at the time and he did a phenomenal job, so that part isn't in question. Just whether he got the reasoning wrong, or I remember how he explained things wrong. Given how many years ago, I'm thinking (and hoping) the latter.
e) He was also unable to see where the pigment would have been worn off of the iris. He shone a light through the pupil and checked for light reflecting off of the back of the eye through spots in the iris, and found very minimal "transillumination"... also calling into question why the LPIs were done.
f) He's having me come back in a week to check my IOP (intraocular pressure) again, and to do a full visual field test to get a baseline (I just did a basic matrix test, apparently).
g) He also measured the width of my corneas, which is something I don't remember any other doctors doing (and it's something he's been doing for the last 15 years, so this is not new. Oh, did I mention he specializes in glaucoma? BONUS!). Apparently, I have thick corneas, and cornea thickness is not something that really varies with age. Average is something like 5.45 I think he said, mine were about 6.30. This is actually a good thing, because when they measure IOPs they actually press against the cornea; the thicker the cornea, the more they need to adjust the IOP value. So for me, an IOP of 20 actually means 16. (Granted my IOP of 60 as a teen is still CRAZY HIGH even corrected, but still... means my more recent readings are much more normal than I thought.)
All in all... I really like this doc. Think I'm going to keep him. Now I just need to see when I can find the money to get a new pair of glasses... and then endure the "fun" part-- adjusting to a new prescription. I fully expect that I'll have a _wicked_ headache for a few days with the new script once I get them...
Have to say, the cataract part scares the shit out of me, especially since Grandma Hill had them. One of my biggest fears after dealing with my eye issues as a kid was that I would go blind. And the doctor at Cambridge Health did a pretty comprehensive exam back in 2005-ish when they were checking to see if my optical issues could be causing my migraines, so I would be surprised if he missed them. Which if they weren't there then...
I had Dr Rouse write down the type of cataract for me (which I can't read at the moment, but I believe it is "anterior athrosclerosis"). He did comment on the fact that I'd been on prednisone, which can cause cataracts, but usually a specific form ("capsulary"?), and this isn't that. Could still have been from the prednisone, though, just not likely. [Update: "Anterior cortical sclerois". Close. :) No wiki link available yet, I need to do some research on this...]
They did an optical CT and my retina/optic nerve are great, so that's at least not a concern right now (previously it was, high IOPs can damage the optic nerve). But the idea of going blind is just my personal demon, given how much I've been fighting eye problems all my life.
Anyways, the important part to remember is that this is now something I know about and can work to correct the prescription issues, and monitor the cataracts, and get the old records from when my LPIs were done, and sort out the confusion around why they were done and what I need to monitor for the future. Forewarned is forearmed, and now I know I can't go a few years between eye appointments, and I shouldn't skimp and go to fucking Walmart to get my eyes checked out, I should have a real doctor look at them instead of an assembly-line rubber-stamper.
