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Have a Graft? In the Aisle Seat? Cover Your Eyes While Passengers Seating/Deplaneing!

luggage

I do a bit of business travel, and I always ask for the isle seat.  I also carry a small overnight bag and laptop bag, checking anything else.

Since my corneal transplant, I have become acutely aware of the hazard to my eye/graft caused by inconsiderate passengers coming through the isle or packing their luggage into the overhead bin.  The problem has gotten out of control with the airlines charging $25-50/bag for checking.  People are bringing everything they can onto the plane – even knowing that they’ll likely not fit (and require *free* gate checking, possibly delaying the flight.)

Twice in a recent trip did I get hit on the head by the bottom of a roll suite case, a laptop and in one case, some kind of strange musical instrument.

So, if you have a graft, I suggest that you cover your eye while people lumber down the isle with all manner of luggage.  I actually put my head down on my recent flight – taking a hit to the back of my neck!  I’m considering wearing my safety glasses!

photo: USA Today

 
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Posted by on July 25, 2013 in Interesting Stuff, Tips

 

Final 4 Sutures Removed

This morning I went back to Cincinnati Eye Institute and met with Dr. Holland and had the usual run through of tests. I was there 1.5 months earlier than planned because a month ago I had a suture breakage and Dr. Holland said if we start having issues with sutures that I should come see him.

The broken suture was no fun, and I have to travel some on business – was worried that would happen in an airport or in front of 200 people.

So today, he cut the last four from my graft.  There are now no mechanical connections between my body and the donor’s cornea.  That made me anxious for some reason, but I was reassured that it would be fine (unless I got boxed in the eye!)   We tested my eye pressure, vision and did a topography.  All good.

Time to remove the sutures…

dalk-cross-section

The normal drops for numbing and within 5 minutes he’d removed them.   We talked again about PRK surgery in 5-6 months and I was on my way.

Ow.

After the numbing drops began to wear off, I took a couple of Tylenol.  But it was pretty painful.  The longer sutures are in, the more they seem to hurt after removal and numbing meds wear off.

Ow. Ow. 

By 4-5 pm I was very uncomfortable, and took 1/2 of a stronger pain pill which helped.  Also added some Systane to my eye – because the pain is likely caused by the inner eyelid rubbing on the freshly cut areas of my eye.

My plan is to medicate myself liberally tonight and hope that things are better in the morning.

Our PRK discussion was about trying to get my left eye free from the need for any contacts at all.  I asked about risks and Dr. Holland made the point that the risks for PRK are about the same as long term contact lens use (infections.)  So I am strongly considering it, despite the out-of-pocket costs and another procedure on the eye.  We will discuss in 4 months.

Follow up:  2 days later.

Pain is gone and only a residual dryness remains.  I have been doing my antibiotics.  Went metal detecting Saturday and Mountain Biking Sunday and it was great.  Safety glasses for sure!

 
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Posted by on July 12, 2013 in Dr. Visits, Recovery

 

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Hundreds lose Vision Each Year to Fireworks in the USA

The 4th of July is tomorrow in the USA, and with it comes neighborhood and community fireworks displays.  Most of the people setting off fireworks have little to no training, and there are many injuries – including serious damage or destruction of the cornea.

 400 Americans lose vision in one or both eyes each year because of eye injuries caused by fireworks.

Some facts:

  • Approximately 8,500 Americans are treated in emergency rooms each year for fireworks-related injuries. Of these, it is estimated that 20 percent are eye injuries.
  • 4150420449_811289d8b9_zAs many as 400 Americans lose vision in one or both eyes each year because of eye injuries caused by fireworks.
  • Children, 16 years and younger, account for 60 percent of fireworks eye injuries in the United States.
  • 80 percent of fireworks injuries occur around the Fourth of July holiday, between June 29 and July 5.
  • More than 40 percent of injuries happen to bystanders.
  • By far, the most dangerous type of firework is the bottle rocket. The bottle rocket flies erratically, frequently injuring bystanders, and the bottle or cans used to launch them often explode, showering fragments of glass or metal in all directions.
  • Sparklers burn at 1,800 F (hot enough to melt gold) and cause third degree burns.
  • The typical victim is a male, ages 13-15, at home with a group of friends, no adults present. The typical firework is a bottle rocket, which leads to severe eye damage. The treatment is immediate surgical intervention; multiple follow-up surgeries. The probable outcome: permanent visual loss; frequently, loss of an eye.

The American Academy of Ophthalmology warns that fireworks related injuries are dangerous and provides these guidelines for fireworks

  • Never handle fireworks without protective eyewear and ensure that all bystanders are also wearing eye protection.
  • Never let young children play with fireworks of any type. If older children are permitted to handle fireworks, ensure they are closely supervised by an adult and wear protective eyewear.
  • Clear the area of flammable materials and view fireworks from at least 500 feet away.
  • Leave the lighting of professional-grade fireworks to trained pyrotechnicians.

For those who attend professional fireworks displays and/or live in communities surrounding the shows:

  • Respect safety barriers at fireworks shows.
  • Do not touch unexploded display (show) fireworks; instead, immediately contact local fire or police departments to help.

If an eye injury occurs, don’t touch or rub it, as this may cause even more damage. Also, don’t flush the eye out with water or attempt to put any ointment on it. Instead, cut out the bottom of a paper cup, place it around the eye, and immediately seek medical attention!

 
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Posted by on July 3, 2013 in Tips

 

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Broken Suture on Cornea Transplant Graft – How I Handled It

 

itm_l_1144Had a bit of an issue last night.  After taking out my contacts, my grafted eye started to sting like a really, really bad eyelash.  I immediately knew what it was – a suture had broken during the day.  I still have four sutures that Dr. Holland had wanted me to leave in for as long as possible.  No panic.  But time to put the plan into action.

The sensation was a sting, worse than an eyelash in my eye.  I looked at my eye carefully in mirror under magnification, and I could see a tiny little spot where the suture had been moving around.  In the center, a tiny, tiny little suture sticking straight out.   I noticed it after contact removal because my contact was acting like a bandage lens preventing the little suture from moving around.

At a previous appointment, I had asked Dr. Holland what to do if this happened, so when it did, I tried not to freak out.  I went ahead and put a drop of Vigamox (antibiotic) in before heading to bed to keep bacteria from growing in the micro-wound – with a plan to call in the morning.

Dr. Holland had previously told me that I didn’t need to drive to his office (90 minutes away) if this happened, but to just go to a local surgeon in Lexington.  I contacted Dr. Koffler’s office near my house and they had me in at 8:45, and the problem suture was out (or part of it) by 10 AM.

But the suture didn’t come out cleanly.  As you may remember from a previous post, the cornea is getting stronger all the time, and the sutures are getting pretty cemented in and losing some of their strength.  When the Dr. grabbed the eroded suture to pull it out, it broke into two pieces at the knot, and only the protruding section came out on his tweezers.  He tried to get the other one, but it was “scarred in” and he thought it better to leave it there rather than cause too many scratches on the graft.  He guessed that it would never be an issue.  Fine by me.  It would not be painful because it was under the skin.  I’ll let Dr. Holland look at it when I’m up there next.

I’m on a 4×4 regimen of Vigamox and have to leave my contact off for 48 hours, but I think all is okay.  Once this is settled, I’ll call Dr. Holland and see if he’d like to take out the rest of the sutures (so they don’t give me trouble during a business trip or otherwise inconvenient time.)

So… inconvenient, but no panic.  Rather straightforward resolution.  On with the day.

Here is an illustration of what happened to the best of my ability… the (A) is the protruding suture that was getting moved around and where things hurt.  The black dots are the knots.

graft-broken-suture

 
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Posted by on May 22, 2013 in Dr. Visits, Recovery

 

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A Boring Two Year Checkup (Boring is Good!)

Well, had my two year checkup with Dr. Holland and it was a boring visit.  No changes, no sutures out.  Boring is GOOD.

He says that we will leave the sutures in until they cause issues, and eventually one will break.  I’ll just go to a local surgeon to have them removed.  Here’s a boring image of my topography.

Everything feels fine – still using Restasis for dryness and as an anti-inflammatory –  It’s almost allergy season, so I will start my daily Zyrtec soon.

Dr. Holland re-iterated that my graft is looking good and should last the rest of my life.

2-year-topography

 
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Posted by on April 2, 2013 in Dr. Visits

 

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Two Years!

I just realized that it’s been over two years since my graft was completed.  Wow.  It seems like such a short time ago.  All’s well, and I have an appointment with Dr. Holland this week.

The image below shows me participating in the Montpelier Archaeology Team in Virginia as a metal detector expert.  Despite dusty conditions and wind, I never had a single issue with my eyes.

IMG_1302

 
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Posted by on March 20, 2013 in Diary Entries

 

Little things: PAN-STARRS comet viewing

It happens every 110,000 years.  And I saw it thanks to my improved vision.

pan-starrs

 
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Posted by on March 20, 2013 in Little Things That are Better

 

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Article: Things I learned by pretending to be blind for a week

photo by David Ball

photo by David Ball

I’ve been so busy at work lately that I’ve not been able to breathe…. but when I saw this article, I just had to share it with my readers especially since I work in this industry (user interface.)  I’m sure the low vision audience already knows this – but the others may find it very informative.

“… I started using a screen reader to see (I suppose I should say “experience”) how a blind user navigates a website..”

Read the entire post here.

 
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Posted by on January 7, 2013 in Interesting Stuff

 

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Pre Holiday Update – New Contacts Prescription

Okay this will be a short one as I’m heading home to be with family for the holiday.

After having the most recent set of sutures out, the shape of my eye shifted (as predicted) so I needed new lenses.  This presents a challenge for fitters, but one thing has made the difference… The “auto-refractor”…a device that helps contacts fitters get “close” quickly using a computerized measurement.  If your eye care provider is not using one, ask about it.

Using that piece of equipment has helped my fitter get closer to my vision needs than she seems to be able to do with manual adjustments.  Then, after the device has spit out its numbers, she refines it to the last degree by hand.  My numbers shift rather radically over time.  I previously went to see my fitter within a few days of the suture removal, and then again today (3 weeks later.)   My vision had shifted even more – so next time I will wait longer before making a fitting appointment.

I did have one nagging quality issue with the lenses – two of them got little notches around the rim for no apparent reason.  It created a mild itch, and when I looked up under the light, I could see it.  Luckily, the manufacturer will stand behind them.  This has me inclined to have an additional backup on hand.  Otherwise I’m thrilled.

A new set of lenses is on order now, to be to me after the first of the year.

Happy Holidays!

 
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Posted by on December 21, 2012 in Diary Entries, Tips

 

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Graft Looks Great – 2 More Sutures Out (and they were stubborn.)

Well, 4 months elapsed since my last visit to Dr. Holland, so I had an appointment today.  I had the usual check ups and topology.  Their office was a *zoo* … I waited 2 hours.  Thank goodness their office has Wi-Fi and I was able to do some email and watch a bit of YouTube.  Not an empty seat in the waiting rooms – and I had asked for “first appointment of the day.”

My eye pressure was 18, totally normal.  The graft was crystal clear.  No problems.  I complained about my dry eye at night and he suggested I change to a gel based lubricant and gave me some samples.  I’ve used them before and not liked their goopiness.

The topology (right) showed that it was time to remove two more sutures, so I was numbed up and Dr. Holland started the process.  It seemed to take longer than usual to cut and pull them out.  I was stone-still during this process.  Anyway, after the numbing drops wore off, it was pretty sore – yowch!  The sutures seemed to be a bit stubborn.  I think that the longer they’re in, the more they integrate into the tissue of your eye.  I took some Tylenol and started my weekend a bit early

Anyway, the usual Vigamox antibiotic dose for 3 days and go back in 4 months.

Now I will make an appointment to get fit for contacts to match my new Rx (suture removal changed my astigmatism levels.)

postscript:  Eye was completely normal the next day.  No discomfort at all. And I think my vision has improved a bit, especially with my glasses.

 
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Posted by on November 16, 2012 in Dr. Visits, Recovery

 

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