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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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New Lens In!!!! Binocular Vision! The World is in 3D Now!

Everthing was in 3-d today!

A very big day on this long journey.  Today, I inserted the mini-scleral lenses in my grafted eye at Dr. Koffler’s office…and, for the first time in 15+ years, I had clear vision in my left eye.  My brain and eye muscles are not sure what to do with the new information so the crispness came and went, but here are my unfiltered first impressions:

  • Wow.  I can read the doctor’s diploma across the room.
  • The world is sparkly!
  • Everything’s in 3D!
  • Look at the birds!
  • Look at the clouds!!!
  • I don’t want to take this out!

I was only at a 3-hour wear limit today, so pulled them out mid-morning.  I’m looking forward to inserting them again tomorrow.

The removal was touch and go because I’m out of practice, and the eye is just slighly “dry-sore” tonight.  Nothing bad at all.  Totally expected.

I got a ‘care package’ with new plungers and other solutions, etc from the office.

NEXT UP!!!

Postscript:  Day 2, 3 of lens were tricky.  Eye was a bit sore from lens and insertion / removal was difficult.  I’m clearly out of practice on this.  Still feel a lot of anxiety about damaging my graft with lens effort.

 
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Posted by on April 24, 2012 in Recovery, Surgery-Story, Vision Improvements

 

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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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Anime, Manga, Pop-Star Contact Lenses – A great way to damage your cornea

My daughter is totally into Anime and Manga characters, so I’m going to pass this through to my readers…  Please share this with those you know with tweens or teens.

Postscript:  Apparently these lenses are now making their way into the child pageant circuit.  Unbelievable!!!

FDA issues warning about decorative contact lenses

Silver Spring, MD – People who use decorative contact lenses as part of their Halloween costumes should consider risks such as an eye infection, cornea damage, vision loss and blindness, according to a consumer update released Oct. 12 by the Food and Drug Administration.

Classified as medical devices, decorative lenses must be specially designed and fitted to a patient’s eyes and are not “one size fits all,” according to FDA. The agency warns consumers to be wary of vendors that do not require a prescription or provide thorough instruction for the lenses.

[youtube http://www.youtube.com/watch?v=H45GYPAuTdg]

FDA recommends the following for people wearing decorative lenses this Halloween season:

  • Schedule an appointment with a licensed eye doctor, who can properly measure your eyes and provide a valid prescription.
  • Follow up with a doctor if you experience redness, pain or a decrease in vision.
  • Practice proper usage and storage instructions.
  • FDA also warns consumers about anime-inspired lenses, which typically are larger than normal contact lenses and not FDA-approved.
 
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Posted by on October 22, 2011 in Interesting Stuff

 

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NPR Covers Keratoconus

National Public Radio gives Keratoconus some much-needed publicity today in the US.  Sadly, they didn’t mention some of the most important points of the disease, such as DALK vs. PK, advances in contact lenses, or encouragement of organ donation.  Still, it’s great to have such a big increase in awareness.

 
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Posted by on July 11, 2011 in Interesting Stuff

 

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Keratoconus Contact Lens Archeology

Check out all the contact lenses I’ve tried in my journey with keratoconus. This is probably 1/3 the actual count.

 

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Corneal Transplant – 2nd Follow Up with Dr. Holland

Cross-section of Corneal Tissue (approximate)

It’s now been 8 days since the surgery.

I worked half a day and went, with Heather, to Edgewood to see Dr. Holland for my “1 week” follow up appointment.  The Cincinnati Eye Institute office was very busy.  We waited 2 hours to see the doctor – so I will never go there in the afternoon again and never on a Friday!  Lesson learned.  The rest of my appointments will be early morning and early in the week.

After we finally got in, the technician checked my vision (strangely, the test was conducted with the band-aid contact lens inserted and affecting my vision.)  I did not get the exact measurements, but I had improved three steps beyond last time on the pinhole.

After Dr. Holland came in, he checked the epithelium (see illustration, top section) to see that it had healed over properly so he removed the bandaid contact lens after numbing my eye.  He used tweezers to remove it, and it did not hurt at all.  As soon as it was out, however, I could feel the dryness start.   Unexpected.

Transitions are always tough.  It was not really pain I felt, but a tickle-itch sort of feeling with a mild burn.   Dr. Holland said that the bandaid lens was holding moisture in before, and I would need to supplement that from here on – these lenses have pros and cons.  But cell growth was great.

This solution works for me during the day... I use a gel-tube version of it at night.

Dr. Holland looked me over well with slit lamps with and without florescent die, checked eye pressure and gave me a clean bill of health.   The cornea is clearing, the sutures looked fine, and I was good to go.  I am now to stop using the antibiotic but continue with the steroid and Restasis (tear medicine.)   Now, he said I should expect fluctuations in vision – and that we’re in the long slog of a slowly-healing cornea.

I will be going back in a month, and he may do a topography for the first suture removal, but the decision to remove them will be made on the fly based on the topographies.  I knew this.   He also said that Heather did not need to come with me for those appointments.  I’m glad because it’s a lot of trouble for her to come and wait for me.

I’m to continue wearing my shield at night, and he said sunglasses during the day.   This “wound” is still fragile and I need to take care of it.

We had Buffalo Wild Wings and headed home.  I got very dry on the ride and wished I had brought lubricant.  Once home, I added Systane and it helped a lot.   As I write this, the irritation seems to be fading after a Tylenol

The journey continues…

Click kitten to see my eye on Day 8 - with bandage lens removed. You can see sutures more clearly.

Postscript: 3/19/11.    Eye really feels raw today.  Hoping this is temporary.   Last night I used a gel-type lubricant before bed and that worked really well.   Steroid drops definitely have a burn now when they go in.   These are some things to expect I guess.

 
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Posted by on March 18, 2011 in Dr. Visits, Recovery, Surgery-Story

 

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Corneal Transplant – 1 Week On

Night Driving Has Improved - I can now see everything much more clearly.

The big news here is ITCHINESS.   I am not talking mosquito bite-level, but poison-ivy level.   It’s distracting and keeping me awake.  Benadryl did not help it… I’ve got high hopes that Zyrtec will.   I have decided to wear my glasses in order to remind myself not to rub the eye.  At night, I’m still wearing the protective patch.  The doctor says itch is a normal symptom, and will look at it during my appointment this Friday – so long as I don’t have any RSVP (rejection) symptoms.

For those unfamiliar, these are the RSVP symptoms that require you to immediately go to your doctor about potential rejection after initial healing period.  Have your Dr. explain them.

  • Redness that gets worse  (eyes will be red after surgery and should slowly clear, but if they suddenly go red again, take action.)
  • Sensitivity to light suddenly (again, immediately after surgery you will be sensitive to light, but this is an increase later.)
  • Vision (foggy or cloudy, or “curtain” effect)
  • Pain increase (aside from small, normal twinges that everyone has.)

Since I don’t have these symptoms…I have a hunch my itch related to this (wretched) 18mm bandage contact lens and/or dryness.   Friday I have my follow up, and am hoping that this lens will be removed for good.

A few random facts I’ve picked up others might benefit from

  • I also learned that you’re supposed to allow 5 minutes between antibiotic drops and steroid drops, but this is not on the post-op sheet.   Also, one of the staff at Dr. Holland’s office said the drops can be done immediately after one another (wrong.)   I’m going to suggest that Dr. Holland’s staff update this info for future patients.
  • Eye pressure increases often include nausea.
  • Rinsing the eye with preservative-free saline (Unisol-4) feels great.  I lay back on a towel and just flow it in while blinking.

The last thing is that my night driving is transformed.  The dark mornings due to Daylight Savings Time meant that I drove my daughter to school yesterday in the near-darkness.  It was great to be able to drive without huge luminescent blobs in my field of vision.

I found a nice PDF handbook for patients about corneal transplant surgery at University of Michigan’s site.

 
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Posted by on March 16, 2011 in Diary Entries, Recovery, Surgery-Story

 

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Keratoconus and Eye Rubbing – Which came First?

Scott Clark on Motorcycle

Scott out making his eyes itch, among other things.

The idea that Keratoconus is caused by eye rubbing has been around a while.  I’ve talked with 5-6 corneal surgeons and they’ve had differing opinions on it.   There was consensus that one should be more safe than sorry and advise kids to avoid hard eye rubbing – and to treat the underlying condition.   My daughter’s itchy eyes are treated with Patenol, and I advise my kids to avoid doing it.  I asked them to report it to me when they have itchy eyes and I guaranteed to help them get rid of the symptom.  When I was a kid, I rode motorcycles a lot.  In the dust, dirt, mud, fields of corn, fields of grain, fields of dreams.  But I don’t recall rubbing my eye that much.. but why would I?

“For example, a case control study of 120 subjects with KC involved assessment of potential risk factors, including atopy, family history, eye rubbing, and contact lens wear. In the univariate analysis, there were associations between KC and atopy, family history, and eye rubbing. However, in the multivariate analysis, only eye rubbing was still a significant predictor of KC.” – Charles W. McMonnies, M.Sc., University of New South Wales, Kensington, Australia  (see more)

Here are some other articles/citations on the issue:

This quote from one physicians’ advice puts it in plain English:

Keratoconus has been associated with eye rubbing and eye allergies. Don’t rub your eyes!!! It is believed that eye rubbing can help to distort and thin the corneal surface. To help you with not rubbing your eyes you can use eye drops that lessen the symptoms of eye allergies. Some of these are available over the counter and some need to be prescribed. A good over the counter anti-histamine eye drop is “Zaditor”. Cool compresses help. There is also some evidence that using cooled tea bags and even cucumber slices help to calm the symptoms of eye itching.  – Dr. Jon Vogel

I may extend the list of links above if I find anymore.

Tomorrow:  My pre-surgery physical.

 
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Posted by on February 22, 2011 in Diary Entries, Interesting Stuff

 

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