Have You Had Your Angles Checked?

I recently had my normal yearly eye exam.  I have an excellent eye doctor.  He mentioned that he needed to check my angles….have you ever had that done?  As you “age” it becomes very important.

Turns out I had “narrow angle glaucoma”. This does not mean I have glaucoma but the narrow angles could cause glaucoma. As my baby cataracts grow and because of the shape of my eye, it is putting pressure against the trabecular meshwork which is the “drain field” for fluid that washes the inner eye (behind the part that we see). Who knew? Too much pressure and you will begin to experience intense pain that would send you to the ER and then? Blindness within 24 hours. Oh joy. Surgery is scheduled for a week later (which leaves you wondering if at any moment that pain will begin and you will go blind.). Can we say s.t.r.e.s.s.?

What’s the fix for this? Something called an Iridotomy, which means they take a laser and puncture a hole in the top of the iris to release the fluid, just in case pressure begins to build. Oh…and they tell you it doesn’t hurt…just a little pressure.  Right……

You can read more about this procedure here: https://www.glaucoma.org/treatment/laser-iridotomy-and-narrow-angles.php and here: https://www.glaucoma.org/treatment/laser-iridotomy-10-commonly-asked-questions.php You can watch a little video here: https://www.glaucoma.org/treatment/video-laser-iridotomy.php

So, I thought I’d tell you the experience I had this morning with my FIRST Iridotomy – yes…there is another one to come.

I got up at 4:30 am to get ready and travel to the BIG city which is about an hour away…yes, I live in the boonies.  Even my grocery store, farm store…any store really is at least 30 min. away.

I arrived promptly at 6:20 am, as I was instructed to do, to find an empty parking lot,  lights off and doors locked. I should have gone home then….

In a short bit, someone showed up to turn on lights and open the door.  I paid my fee and shortly my name and another person’s name was called.  We were led to a large, brightly lit room with 3 HUGE medical looking armchairs in a tight semi circle.  Another person arrived to fill the third chair just a few minutes later. We were all hooked up to O2 meters, BP machines and three nurses began asking us questions and calling out test results.  Yes…HIPPA would have been horrified. I can tell you that gentleman #1 is allergic to codeine, gentleman #2 has diabetes and high blood pressure and the details went on. 

We were all given eye drops.  Some discussion ensued because mine were different – they needed to constrict my iris but my fellow patients need to have their irises dilated. The nurses referred to us affectionately as their production line.  Seriously!

I was called first, taken to a room where I was placed in another medical easy chair with eye equipment similar to what my regular eye doc had.  In about 10 minutes the doctor arrived and then things began to go slightly downhill.

This nurse informed him that he was there to do an Iridotomy in the left eye.  His answer?  “Yes, we are!” He’s a nice guy, he asked me how I was and how I was doing since he had done my other eye. 

“Ummmm…you haven’t done the other eye?

“Oh!  Right, Yes.” 

They had me place my chin in the little cup and forehead against the strap – then they strapped me in around the back of my head. A nurse placed her hand on the back of my head and applied light pressure. He then picked up something I couldn’t really see and told me he was going to put the lens against my eye ball. He began moving towards my right eye. 

I tried to back off and the nurse began to push against the back of my head.  I put my hand up to stop him…

“That’s the wrong eye!”. 

“Oh…right…thank you”. That’s when I began thinking I should just go home.

He placed some sort of glass lens on top of my eyeball – not an easy thing to do because evidently my eyeball likes to blink when some large object is honing in on it.  Maybe it’s just me…but my eyeball is evidently into self-protection.  I kinda think it’s a good thing.

“Just stare at the flashing red light, this won’t take long, you will feel pressure but no pain.”

Right…. next thing  I see a flash of red light and  I hear a pop and it feels like a static shock to my eyeball.  You know the kind…especially in spring and fall when you walk across a room and touch something and you get that static electricity shock…only this feeling is in my eyeball people!  Ouch! Pop/Shock…Pop/Shock….Some shocks hurt more than others but they definitely hurt. Not horrible pain, and definitely better than blindness but I think I would have been better prepared if someone had said “this might hurt a wee bit”.

As he is shocking my eyeball he is also pushing against that lens that covers my eyeball. The pressure is intense.  I feel like he is going to push my eyeball out of it’s socket.  I’m wondering if those numbing drops the nurses were supposed to use were ever put in. 

Maybe I’m weird, but I like a doctor, or a nurse, to tell me what they are going to do before they do it.  My regular eye doctor and his nurses do this.  “Ms. Cheri we are now going to put some Tropicamide in your eyes to dilate them….or Ms. Cheri we are  going to put Ophthaine in your eyes to numb them. 

Not at this office….

He let me know when he was about half way done.  From what I understand, they are wanting to see fluid come through the hole they are trying to create.  After a few more moments, he said we were done. All in all, it didn’t last 10 mintues. Both eyes were watering like crazy. 

He rubs his hands together and says “It was successful!”

My response…”I can’t see anything out of that eye – it’s black”. My brain is telling me…”we gotta problem Houston!”

He seemed a little surprised, offered no explanation and told me it should clear up by end of day.  Should people…not would.

Here is a picture later that evening of the eye that had the Iridotomy…can you spot the little hole? I’ll show it to you at the end of this….

Have You Had Your Angles Checked?

Nurse told me to follow her back to the other room.  Now…they have my glasses (which I need to be able to see by the way) AND I’m totally blind in one eye and light sensitive in the other. As she is trotting down the hallway, I am trying to follow while keeping one hand on the wall so I can make sure I’m navigating correctly and don’t fall down. She seems frsutrated that I’m not trotting as fast as she is down that hall.

They place me back in the production line.  Put some more drops in my eye and then come at me with what looks like a thermometer for the ear.  I put up my hand and politely inquired what she was doing (because no one here was going to offer any info – after all we were just a production line) “Oh…I’m going to measure the pressure in your eye by tapping your eyeball with the tip of this”. ….Ok then.

Once measured and recorded I was told I could go home and don’t forget to use my eye drops 4 times a day for a week.

“What eye drops?”

“The prescription we gave you last week.”

“No one gave me a prescription last week.”

Which she promptly shared with someone else in another room at the top of her lungs. 

“Then I will call one in and you will have to go pick it up, I’ll do that right now”.  Yep!  Just what I wanted to do right after eye surgery – drive to another city 30 min. away to pick up a prescription and who is going to be open at 7 am?  No One.

It took about 45 min. to get to the pharmacy they had called it into.  We waited about 15 min. for that pharmacy to open.  Nope.  No one had called anything in.  They checked the other location in this town.  No one had called it in there either.

Called the doctor’s office and was put on hold for 30 min. Seriously.

When they came on, they said they were doing it right then. 

Went in to the pharmacy to get the med – pharmacist says the doctor specifically requested non-generic and it would be $300 for this tiny bottle of eye drops.  Nope!  Can’t afford that. 

Back out to the car and called the eye doctor back. Another 30 min. on hold.  I asked what the name of the medicine was – she didn’t know. I asked why they couldn’t use a generic. She didn’t know.  Back on hold. Someone got back on 25 min. later to tell me they called something in. 

I might have been a little bit irritated by this point.  I’ve been sitting in a car in the pharmacy parking lot for over an hour and a half in bright sunshine with both eyes being light sensitive. And….I still can’t see although it is beginning to look dark gray instead of intense black.

“What are you calling in?” She tells me Prednisalone Acetate. “What is the difference between that med and the first one that cost $300.”  Same med…just a generic. Cost? $36. I asked why he specifically said no generic on the first one. “Ummmm ….because he just always asks for the brand name.” Now, my hubby is a retired Optometrist and he used this stuff all the time.  I asked him about the generic vs. non-generic.No difference in them at all honey – just the brand name.” I opted for the $36 bottle of drops

I got home, finally, 4 hours after my surgery. I went to bed and took a 3 hour nap. I get up and what do you think the first thing I do is?  I’m searching for another doctor because I’m not going back there. 

Here are some things I didn’t mention:

*First visit for eye exam I was told I would have a 20% discount for paying in cash. The cost of the visit was $200 (ouch). I was told it would be $190.  I mentioned that there was a 20% discount.  I was told that WAS the discount. I explained that 20% of 200 was $40. They were confused. The three young ladies at the front desk can’t do math well enough to figure out 20% off the price.  I tried to explain and finally they told me they would “give it to me” since that is the number I was quoted. Seriously? GIVE it to me? They appeared to think they were doing me a favor but they weren’t happy about it.  Maybe someone needs to make them a chart?

*Met several techs who do all the main work then doctor comes in laughing and joking but very little info.  I have to ask a lot of questions not to get the pre-digested fluff talk.  I understand that a lot of elderly people just say ok and aren’t into details but not all patients are like that.

*The person who sent us home with the paperwork for surgery had a hard time finding any paperwork. Her “office” looked like it used to be a small closet and she had a desk with tons of “pigeon holes”. She also had a hard time finding out what it would cost.  Evidently, if you have insurance, no one cares what it costs.  However, not all of us have insurance and that really throws this office into a tizzy! Of the few sheets of paper we got, none of that paperwork had a single phone number on it.  None. Nada. Zip. Guess they really don’t want you asking questions.

* The surgical post op papers they sent us home with today had a number to call if anything goes wrong, if your vision doesn’t return etc. I would think that was a very important number to have.  It was the number we called when there was no prescription called in.  That number was a discontinued number.  Seriously.

And the list goes on.  I will write this gentleman a nice letter informing him of why I am canceling my surgery with him and choosing another doctor.  I would want to know if my staff worked this way, if my paperwork was off  or if my staff couldn’t  complete basic math to help someone pay their bill. Maybe it will help improve things for the next patient….or maybe not.

I’m looking forward to the next doctor checking his work. It will be interesting to see what he says.

I share all of this with you to make you aware of “narrow angle glaucoma” and to make sure, if you are approaching 55 or over, to have YOUR doctor check your angles. (This could also happen to a younger person but it would unusual).  If you had sudden eye pain that was bad enough to send you to the ER, please tell them you need an Ophthalmologist. Evidently ER doctors are not always trained in this and by the time they figure it out – you have permanently lost some or all of your vision in the affected eye(s)!

We all want to keep our vision till the end of our lives!  Blindness is a game changer.  I could loose almost any other sense with little life impact.  I’m grateful for the technology that prevents this issue.  Check out the red circle on the next picture that shows you the little hole they created. Oh!  And get your angles checked!



Have You Had Your Angles Checked?