Why We Wed (without a tiara)

Today I’m over at happy sighs, talking about Why We Wed and sharing a photo that should never see the light of the internet. Honestly, you might find it hard to get past the photo and onto reading the wisdom that grew deep under those hairsprayed solid curls and that regal little tiara, but promise me you’ll try.

You must, for my sake, because as you are reading this I will be at home, juggling eye drops and painkillers, probably cursing the day I though having lasers shot into my eyes was a good idea. Chances are I won’t be able to read or respond to any comments today – this post is coming to you from the past – but I’m pretty sure there are clinical trials showing lovely comments speed healing. Though it’s possible I confused “blog comments” with “omega-3 fatty acids.” Oh well, they probably work the same way.

Thanks Rachelle for dreaming up the idea and Liz for hosting this fantastic series!

Laser eye surgery – the before

This is my experience – the specifics will differ by clinic so it’s only here to give you a rough idea of what you might expect and clearly I’m not a doctor, so blah blah blah, warning warning warning.

Step 1: Research. Start with Google as an appetizer, followed by healthy helpings of PubMed/Google Scholar for the hearty stuff. This is not essential but it helped me understand the procedure and risks better, ask the right questions, and know what to expect. You’re reading this so yay, you’ve already started!

Step 2: If you haven’t seen your optometrist for a couple of years, go see them. They’ll check your prescription to make sure it is stable enough for you to be a candidate (very roughly speaking they don’t want to see more than 1 D of change in the past couple of years). They are also a great resource for information: they know your eyes, they know the procedure, they know the local clinics and surgeons. I felt a whole lot more confident going forward after seeing my optometrist, asking lots of questions, and walking away with a clinic recommendation.

Step 3: Book a consultation at a laser eye surgery clinic. It was free and in my very limited experience, pressure free. The appointment consisted of technicians taking various measurements of my eye, a corny video showing smiling patients and diagrams of eyeballs, and then a question-answer period with a ‘patient advisor’ who appeared to know less about the surgery than I did.

Finally I met with the actual surgeon, which by this point felt a bit like meeting a celebrity. He went through my file with me, confirmed I was eligible, and made a recommendation on the type of surgery I should have. Because my cornea is on the thinner side, he recommended PRK for me.

In brief, this is what that means:

The objective of all laser surgery is to remove microscopic layers of your cornea (the lens) so that light going through it will focus correctly on your retina (the back wall) and this can be done one of two main ways (though variations exist):

(click for source)

LASIK (the ninja method)

A tiny flap is made on the top surface of your cornea, the laser zaps underneath to reshape your eye, and then the tiny flap gets put back in place, much like a bandage.

Pros: Much quicker healing time – your vision will be shiny and new within a few days so you only need a couple of days off work and eye drops for a week or two.

Cons: Due to flap-making, it is a more complicated surgery so it’s extra important you pick skilled surgeons. You have to be careful not to rub your eyes for a few months afterwards because the flap could dislodge and I don’t think I have to tell you that would be non-ideal.

PRK (the action hero method)

They just shoot a laser at your cornea. That’s it. Since there is no corneal flap to act as a bandage, they put contact lenses on your eyes for the first 4 days instead.

Pros: The safer (and sometimes only) option for the thin cornea-ed, less risk of experiencing dry-eye afterwards, and no flap-related complications to worry about.

Cons: Longer recovery – your vision will take 1-2 weeks to sort itself out and as a result you need about a week off work, there might be more pain involved for the first 1-4 days, and you’ll be on a strict regimen of eye drops for 3-4 months.

Besides those differences, the risks and success rates of the procedures are basically the same.

At the very end of the appointment, they gave me a price estimate and an idea of their next available surgery dates, but no one pressured me to book. I was happy with the clinic I first went to but if you weren’t you could very easily go have a consultation elsewhere.

Step 4 (a couple of weeks before surgery): Back to the optometrist. This appointment was to thoroughly examine my retinas to make sure there is absolutely nothing funky going on that would interfere with the success of the laser-ing.

In order to get an unobstructed view of my retinas, they put dilating drops into my eyes that caused me to look like this for the next 6 hours:

Also, my optometrist showed me pictures of my retinas! Mine are apparently quite dark – which is a good thing – and look more Mediterranean than Finnish (I thank the mixing of Lappi blood into my gene pool for that).

Step 5 (one week before surgery): Stop wearing contacts because they tweak your eye shape slightly. Get nervous and re-read all the statistics* again to convince yourself you’re not nuts. Buy audio books that will be essential to entertaining yourself while your eyes are healing (turns out 90% of my usual activities are eye-ball dependent). Finally, make plans for someone to take you home from the clinic as YOU WILL HAVE HAD LASERS SHOT INTO YOUR EYES!!

I’ll be going under the laser Monday morning – wish me luck!!

*This article is not available without a subscription to the Lancet so if you are interested contact me.

To see

One day when I was around nine years old, my mom asked me why I was watching TV on the floor. It was a habit I had developed over many months, gradually slipping off the couch and onto the floor where I lay on my stomach with the tip of my nose about two feet from the screen. I had no answer for her – it certainly wasn’t more comfortable – so I got up to watch from the couch. Pretty soon I found myself back on the floor.

The next stop was the eye doctor’s office. At the end of the exam, he put lenses in front of my mom’s eyes to show her what the world looked like through mine and I remember she was genuinely shocked. We find ways to adjust to lots of things.

I wore glasses for many, many years. I hated the rain, because it made little spots on my lenses that made it hard to see. Cold days meant disappearing behind a layer of condensation whenever you came inside. I loved to swim but always felt very vulnerable because without my glasses, I couldn’t make out people’s faces. I squinted a lot because my rapidly changing prescription made it hard to keep buying updated sunglasses. Each season had its little obstacles.

My attempt to use contact lenses in grade ten ended quickly with a horrible reaction to something in the solution or lens. Scared away, I continued dealing with the discomfort of glasses for many more years while my nearsighted peers gradually shifted to contact lenses. When a friend suggested that I get contacts for my walk down the aisle as her bridesmaid, I indignantly told her I look great in my glasses and would be wearing them to her wedding thankyouverymuch.

Then finally, in 2004, I went to volunteer in Costa Rica with a friend and decided this was one trip my glasses could not take with me. I simply could not fathom trying to swim in the ocean and hike through the rain-forest reliant on these clumsy pieces of glass. I faced my fears and got contacts – which had come a long way in the six or seven years since I first tried them – and have never looked back.

Now I’m about to face another major fear: laser eye surgery.

As an elective procedure, I set the safety threshold for laser eye surgery very high. When I first researched it about five years ago it wasn’t there yet; there was still a small but not insignificant percentage of people who faced serious complications. But as the technology has improved so have the statistics: less than 1% of people now face any serious complications.

But though statistics and studies comforted me, they didn’t convince me. Like with so many other life experiences, in the end it was hearing about the positive experiences of my coworkers, family and friends that finally persuaded me.

So with that in mind, I will document my experience here, starting this week with a description of the pre-operative bits. My surgery is next Monday, followed by a healing period of about a week or two during which I won’t be able to write because I WILL HAVE HAD LASERS SHOT INTO MY EYES!! But after that I hope to be able to give you an update completely unaided by lenses.