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Category Archives: Diary Entries

Trying Different RGPs – My lens tolerance is only a few hours.

Well, as usual, this is going to take some trial and error!

I have tried three different RGPs (Essilor Perimeter Lens) and cannot tolerate any of them – the mini-scleral was pushing a “grove” into my sclera – apparently my eye was swelling around it?

I can wear them 7-8 hours, but my eye is very sore afterward.    I am now going to be trying a custom-profiled soft lens.  The manufacturer apparently uses my topography to construct them.  I was hoping I could use a soft lens, so we’ll soon know.

Koffler Vision Group is doing a great job.

photo:  Lee J Haywood

 
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Posted by on May 24, 2012 in Diary Entries, Recovery, Vision Improvements

 

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Lens Difficulties (New lens ordered with different edge profile.)

Well, my first post-graft contact lens is wonderful, but I think the fit needs adjusted.

The insertion and vision have been just fine, but I’ve been having difficulties with removing the lens.  I’m competent with mini-Sclerals but this one seems too tight.  It’s nerve wracking to pull a “stuck” lens off a grafted cornea with a plunger.  I have this nighmare image that I’ll rip the graft off (I know, probably impossible.)

But this lens is too tight, so I’m going back to discuss it with the fitter.

Still thrilled!

Postscript:   Another great appointment at Koffler Vision… New lens with slightly different edge “roll” was ordered.  Also we looked at my topography to decide where it best for me to apply the plunger to remove the lens (cool use of technology!) … the traditional 6-oclock position may not be best for me – 4-oclock looks like a flat area I can use.   Will post again if I have new news!

Allergy News:  My eye has been getting red – allergies I’m pretty sure.  It’s not “rejection-red” but just red around the edges.  Any corneal transplant recipient will be hyper-vigilant about redness, so this causes some anxiety.  The best thing to do is just take some Zyrtec and check again in a day.    I’m now taking Zyertec daily again.

 

 

 
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Posted by on April 30, 2012 in Diary Entries

 

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Contact Lens after Corneal Transplant – Trying a Mini-Scleral

Well, after a fair bit of anxiety and dread, I found my visit to Koffler Vision Group* for the fitting of a new mini-scleral RGP contact lens on my grafted eye to be quite uneventful.  We tried several diameters and shapes until one felt, well, like it wasn’t there.  (*My choice for contact fitting in Lexington.  I’m still Dr. Holland’s patient.  I would link to their site but it is not great and crashed my browser twice.  I will link to their Google Place page though)

Turns out the one with most comfort was a mini-scleral.

I hadn’t considered mini-scleral for my grafted eye, but it makes sense.  It forms a “helmet” over the graft and rests well outside my cornea.  It keeps the corneal hydrated and provides good vision.  I think I had put mini-sclerals out of my head after my less-than-stellar experience with them before my graft.  But that was not due to the lens, it was due to the cone and abrasiveness.

Anyway, I have my lens ordered and will post again when I get it in.  As usual, the Koffler staff were terrific.  By the way, Dr. Koffler was my second choice for my graft – but I just clicked better with Dr. Holland’s attitude about DALK options.  I feel confident either would do a great job, especially on a PK or other surgery.  I did apologize for being such a grump during my last visit to them 2 years ago (I was frustrated with trying to find a contact lens with a steep cone.)

Oh yes, they did a new topography.  Said it was “beautiful.”

 
 

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New – DALK Transplant Chronology

Quick post to let you know that I just made a new page which covers the chronology from my first Dr. appt to one year after the surgery.  Same posts, but in chronological order.

http://corneanews.com/about-kerataconus/chronology/

 

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DALK Transplant – One Year On

photo by Celia Clark

March 9th is the anniversary of my DALK transplant in my left eye, the subject of this blog.  I’m posting a bit early as I have a few moments.  As of one year, I am thrilled that I had the surgery – and forever grateful to the donor and their family.  I’m certain that the posts will slow down now unless I have good reason to post – changes, vision, etc. but I want to thank you for being a part of my story.  I will still monitor for comments and do my best to offer a layperson’s response.  When reading the story – try to go back in time and read the older posts first.

I will be returning to Dr. Holland in a month or so, and I think he’ll be asking me if I was fitted for contacts.  Thus far, I have not built the courage to put anything on my grafted eye.  Soon I will.  I am going to get a new glasses prescription first from my regular eye doctor.  It will be amazing to be able to see with glasses, and I’m thinking that will prompt me to move forward with a RGP lens (Dr. Holland’s recommendation.)  I’m in the primary rejection period for DALK – so am extra vigilant for the RSVP symptoms.  So far, all’s well.

One little aside:

Sometimes we all just forget how precious life is.  How precious love is.  My DALK eye has not forgotten how to shed a tear.  I’m sure those tears are a combination of my own and the loved ones of the donor.  Take today and give someone in your life a hug or a thank you.  It’s easy.  Sign your donor card.  That’s easy, too.

I want to thank my wonderful wife Heather for all of her support, both before and after the surgery.  She was my crutch when I was in pain and always was there to give me the support that only a truly caring wife could give.  She was awake with me that night after surgery when I thought everything was going wrong.  We went on a date recently – at night – and I could see her clearly in the dim dinner light.  Candle fumes used to burn like fire.  Not this time.   I drove there and back – dark outside.  The eye didn’t even come into play.  It was just our date.  This is the combined gift of the donor and my good fortune for meeting her.

 
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Posted by on March 4, 2012 in Diary Entries, Recovery, Surgery-Story

 

11 Month Checkup – Graft Clear, Pressure Down – “Go” for Contact Fitting

Had a good appointment with Dr. Holland today.  Especially amazing was the clarity I got on the vision test.  We went through the usual blur-blur-blur series as the technician flipped lenses and asked “now?”.. “now?”…”now?”   Here we go again… but then, almost startlingly, she flipped a lens and the eye chart snapped into focus.  “Whoa!” I said.  “Ah, we found the sweet spot” she said.  In 15 years I’ve never seen so clearly through that eye and any correction device.  It was almost overwhelming.

Dr. Holland examined the graft and said it was completely clear and that my eye pressure was down.  I’m reducing the pressure medicines to once daily, and staying off the steroids.  I’m reminded that I am at the peak rejection period for my graft (many, including me, thought that the rejection period peaks right after surgery, but it doesn’t.)

I have bad nearsightedness, even with the astigmatism getting resolved, so vision correction will be part of this plan.  It’s time you could get fitted for a RGP lens….   that scares me.  I have this graft which I have been treating like a delicate piece of crystal.. and now I’m to put a lens on it?   I’ll have to get over this.  Will schedule my fitting in the next couple of weeks.   There is still a possbility that I’ll go with PRK if recommended.

No sutures out this time – and the ones in there now may remain a while.

Next Appt, early Spring.

 
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Posted by on January 27, 2012 in Diary Entries, Dr. Visits, Recovery, Vision Improvements

 

Allergy Season, Ughhh!

 

 

The eyes are itching something awful right now.    I think the Restasis is helping my grafted eye stay less itchy than my ungrafted one.  Eye rubbing has been partially implicated as a cause for Keratoconus, so those of us who suffer with allergies must remain vigilant – possibly even wearing glasses as a reminder – to avoid rubbing the eyes.   Lucky for me, it happens only a couple of times per year for 2-3 weeks.

The view from my iPhone allergy system:

20110902-014305.jpg

 
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Posted by on September 2, 2011 in Diary Entries

 

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Corneal Transplant Grafts and Autumn Allergies

Lexington, KY AllergyWell, I looked at my iPhone Allergy App today and it says 10 out of 12 “Very High” for ragweed pollen – my nemesis.   Lexington is the Allergy Capital of the USA (at least in Spring,) and ragweed is the worst.  I take a daily Zyrtec which helps a lot, but several weeks out of the year it’s overwhelmed by the environment.

One interesting thing I noticed this Fall (my first with a corneal graft) is that my grafted eye doesn’t itch.   My ungrafted eye is itching like crazy.  I’m guessing it’s the nerves on the eye making the difference?  Or something about the surface that is dispersing the allergen?   Whatever, it’s a real blessing.

No matter what, I will always avoid rubbing.  Even though my right eye is past the highest risk for developing Keratoconus (I’m age 45) I still know that my corneas have a genetic weakness somewhere in there.

Everything is going great otherwise.  I’ve had a few headaches and some throbbing on my left eye.  I’m hoping it’s not eye pressure but as of the last visit that was on its way down.  I have another appointment in a couple of weeks.

 
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Posted by on August 26, 2011 in Diary Entries, Surgery-Story

 

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Little Things #3: Ability To Really Get Back into Mountain Biking

Mountain biking in Kentucky is generally called “Cross Country” riding.  The terrain is made up of undulating hills usually 150-200 feet maximum.  A good 10 mile ride will take several hours and offers a tremendous upper and lower body workout.  It’s more like cross country skiing than downhill skiing for lack of a better example.  The reward for a long climb is usually a roller coaster ride through a tunnel of vegetation, airborne some of the time, making split-second decisions on how to manage what’s coming at you.  You’ll encounter wildlife and get away from the city in a very special way.

The wooded trails require depth perception.  Things come at you and you must make a decision, react and adjust your “line”  to overcome it.  Branches can be low, rocks can be loose, and alternative paths through difficult terrain can make the difference between a thrill and a spill.  It’s definitely possible to ride with one bad eye, but you must ride slowly and carefully or choose “open” trails like the fire-roads I rode in CA.   Kentucky has very limited trails compared to most states (go figure) and most are of the wooded variety, so this is great for me.

I’d say ride wherever and however you can, good eyes or not, and adjust your pace and path.  As my surgical eye gets better and better, I crossed a “binocular” threshold where I am comfortable on cross country wooded trails again.  When I stop in the woods to enjoy a babbling creek or to watch a white-tail deer , I’ll say “thank you” again for the priceless gift that my donor gave me.

<photo by trailsource.com used under CC license>

 

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Another Appointment Friday

This is a really short update to let everyone know I’m doing fine.  I have another appointment Friday with Dr. Holland when I assume he’ll do another topography and remove more sutures.   I’ll report back then with a usual update.  My only concern is eye pressure, but I’ve been diligent at meds and hope it’s stable.

 
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Posted by on August 2, 2011 in Diary Entries, Recovery, Surgery-Story

 

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