Snellen Chart
Wednesday, September 28, 2005
I almost forgot...
...I downloaded a Snellen Chart the other day to test my eyesight and to keep a check on it post op.
Various eye charts can be downloaded here, but the easiest eye chart I found to download and print out is Joel Schneider's 3-page Snellen Chart plus near vision testing card.
By the way, at 20 feet I can't even read the top letter with my specs off (what chart!!!)
posted by Alan and Maxine @ 11:32 am,
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Wednesday 27th September 2005 - Becoming Nervous
I know I said I wasn't going to post now until the big day, but...
It's only six days left now and I'm getting quite nervous about it all, but not in a bad way. The only way I can describe the way I'm feeling is that it's the kind of feeling you get when you are about to get married and your wedding day is approaching, or you're about to give a speech. Butterflies in the stomach and images in your mind about hoping it will all go well and that you've made the right decision.
Marrying Maxine was definitely the right decision for me. Two years on and life couldn't be better. But if only I could see without specs :-(
Reading all the posts on the Ultralase forum website www.lasereyeforum.co.uk has been good. A source of comfort almost. Not only is it a great source of information and inspiration, reading about all those people who have been through it and come out the other side, but also reading about what to expect just before and after treatment. I have also taken the liberty of replying to posts as well has having my query about Cataracts answered. It appears having Cararact surgery after laser eye treatment is possible. Not only do the experts tell me it is, I've also had contact from someone who's mother is going through it soon.
posted by Alan and Maxine @ 10:18 am,
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Sunday 22nd September 2005 - Ultralase Consultation
Sunday, September 25, 2005
I asked the Cataract question at my consultation this Sunday and was told the same as my research had indicated, that having Cataract surgery after having laser eye treatment is just the same and carrys the same risks as it would had laser eye surgery had not been performed. So I am still suitable for treatment.
Now down to the Ultralase consultation:
Ermm... Not as impressed as I was when I had the consultation at Accuvision. They were friendly enough, and carried out pretty much the same tests as Accuvision, but they just seem a bit more lacksadaisyical about it.
I always wanted Accuvision to perform my treatment due to their superior technology but thought give Ultralase a try, you never know. What has really put me off Ultralase was equipment failure. I am only considering treatment because of the new Wavefront technology and during my consultation, the piece of equipment that is used to measure the Wavefront decided not to play ball. After several attempts only one of my eyes was measured. They said I would have to go back for another consultation to see if I would be suitable for Wavefront treatment. All I can think of is; if the testing equipment fails, what's the actual surgery equipment like... I don't think I'll be going back.
My treatment with Accuvision is still booked for Tuesday 4th October at 11.00 am.
posted by Alan and Maxine @ 5:57 pm,
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Laser Eye Surgery and Cataracts
Friday, September 23, 2005
My Dad read my blog yesterday and phoned me to tell me there is a history of Cataracts within the family and that I should get this checked out before I have surgery.
Having done more research, the consensus of opinion is that you cannot have laser eye surgery after having cataract surgery, unless it is YAG laser, which removes the haze that may develop after cataract surgery. On the other hand having cataract surgery after laser eye surgery is fine.
I currently do not have cataracts and have no idea when they will occur if they ever do. Since most people develop them in their late 50's to 60's or even later, if I had laser eye surgery now I would be without glasses for some 15 to 20 years before I had to consider cataract surgery, by which time I could have IntraOccular lens implants so that I may remain without glasses.
This has raised a few doubts but has not put me off and am still going ahead with the surgery, unless I find out any thing to the contrary or anyone can tell me otherwise.
posted by Alan and Maxine @ 12:13 pm,
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Questions Answered by Accuvision
Thursday, September 22, 2005
I wasn't going to post until next Sunday after my consultation with Ultralase, but thought I'd better post the answers to my question I asked at Accuvision before I forget what they were. So here goes...
Q. What if I go swimming, will the Chlorine get inside the corneal flap?
Will it cause irritation or worse infection?
A. No
Q. Does the corneal flap ever heal?
A. Yes, the flap seals itself within about 4 hours of being replaced. The seal can be broken at a later date should a re-treatment be necessary.
Q. Will I always have to avoid rubbing my eyes?
A. No, after about a week or month depending on the individual, it is ok to lightly brush/clean the eyelashes with the tips of the fingers. Rubbing the eyes with your knuckles is not recommended.
Q. Will I lose some near vision? By this I meant without wearing my glasses. I have a habit of taking my glasses off and bring the page closer to read it.
A. Yes, you will be able to read at the same distance as you current do with wearing glasses.
Q. Do you use a freshly sterilized keratome and a new blade for each eye?
A. A new blade is used for each eye but the keratome is sterilised and reused
.
Q. From which direction is the keratome make the cut? i.e. where will the hinge be, at the top, side or bottom of my eyes?
A. In my case the hinge will be at the top of the eye.
Q. I could feel all the soft contact lenses I ever wore, will be able to feel the flap after surgery?
A. No
Q. Will the flap be visible to other people?
A. No not to the visible eye and possibly not even under a microscope.
Q. What are your qualifications?
Do you have:
A medical degree?
Ophthalmology training?
Are you a corneal specialist?
A refractive surgery fellowship?
A. CV obtained for surgeon Brett Halliday
Q. How long have you been performing refractive surgery?
A. 12 years.
Q. Do you audit your outcomes and do research?
A. Yes
Q. Will I be treated with wavefront technology?
A. Yes, wavefront guided.
Q. Can I have a copy of the assessment/records wavefront maps after surgery?
A. Yes they will be posted to me.
Q. Visual acuity and visual quality are different. You can be 20/20 or better, and still be severely compromised. How would you comment on this?
A. A visual acuity of 20/20 means you will be able to read the characters of height 20 on a snellen chart from 20 feet away. However, if visual quality is impaired you will not be able to read them clearly, some may appear to be ghosted or hazy.
Q. What is my corneal thickness?
A. 585 microns for one eye and 560 microns for the other.
Q. How much will you need to create a flap?
A. 100 microns
Q. How much will be left?
A. At least 300 microns
Q. What is the diameter of the area to which the laser is applied? In other words, will the laser be applied to an area greater than the widest part of my dilated pupil?
A. The diameter of my pupils are 6.5 mm and 6.2 mm. The area applied by the laser will be 8 mm and then smoothed off towards the edge of the cornea.
Q. What is the difference between Wavefront Optimised and Wavefront Guided?
A. Wavefront optimised is a best guess, given the patients data at where the laser will attempt to remove the high order aberrations. Wavefront guided will exactly remove the high order aberrations.
Q. What is the diameter of my pupil?
A. 6.5 mm and 6.2 mm
posted by Alan and Maxine @ 6:21 pm,
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Wednesday 21st September 2005 – Accuvision Consultation
Wednesday, September 21, 2005
Having read Nurse Owens Lasik Dairy who commented on the quality of care taken by Nick Dash at Accuvision, I was hoping it would be him I'd see. It was and I can honestly say he was very thorough, measuring and checking and then re-measuring and re-checking some of the tests he performed on my eyes. The consultation was very thorough and took an hour and three quarters in the end. While Nick was performing the tests he was constantly explaining what he was doing, why he was doing it and what the results meant for my eyes and possible treatment. I was asking questions all the way along about my eyes and it turns out I have a corneal thickness of 585 microns in one eye and 560 in the other. Since most people have an average thickness of 535 microns for both eyes I have plenty of corneal tissue to have the procedure. Nick also showed me a topology map of my corneas where it showed several high order aberrations towards the bottom of my right eye but less on my left eye. Owing to these aberrations I was a suitable candidate for wavefront guided lasik treatment. During the tests, Nick asked me how I came to know about Accuvision. I told him I'd done a lot of research on laser eye surgery and had read Nurse Owens Diary, which lead me to Accuvision. He remembered her quite clearly saying he'd spent a lot of time with her.
Having done a lot of research on lasik eye surgery and wavefront guided treatments, Nick said I sounded well informed. After all the tests had been performed I handed him a sheet of paper with questions on that I wanted answers to. I couldn't read it as I was still getting a green glare from the lights he had shone in my eyes moments earlier. He went through them answering them all one by one, skipping questions I had already asked.
At the end of the consultation there was no pressure to have the treatment, in fact quite the reverse. I had already decided beforehand that I wanted Accuvison to perform the surgery unless it turned out I was unsuitable or I took a disliking to them, for whatever reason. I wanted it and asked when I could have the procedure performed. Nick said the earliest it would be is Tuesday 4th October. When I said I wanted it done, he said they could fit me in tomorrow as there was a free slot, but advised against making any decision now and recommended I have some time to reflect on what we had discussed. I said I had been waiting for over 10 years for the technology to get as good as it has for me to trust it and decided to book the procedure.
I'm booked in for Wavefront Guided Lasik eye surgery on Tuesday 4th October at 11:00 am.
I told Nick about my consultation at Ultralase on Sunday and said I still wanted to go as I wanted to compare the different technologies. Nick recommended I keep the appointment, because if nothing else it would give me a second opinion.
As I requested, on my way out I was handed the CV of the surgeon who will perform my procedure; a Mr Brett Halliday. His CV is nothing less than I expected and very impressive, even by my own level of qualifications.
I'll post again on Sunday after my consultation with Ultralase.
posted by Alan and Maxine @ 5:59 pm,
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Today is consultation day with Accuvision. I'll post back later today, with my thoughts, deliberations and decisions.
posted by Alan and Maxine @ 7:29 am,
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Tuesday 20th September 2005
Tuesday, September 20, 2005
I have to be frank and say I’m a little scared. Who wouldn’t be? After all, someone is going to be cutting into my eye. Because of this I got up just before midnight and spent a couple of hours surfing the internet for pictures of the Lasik procedure and eventually found them here: http://lazybastard.ehuna.org/archives/000042.html. I thought this might put me off, seeing some scary/ gooey/ messy pictures of the operation in progress. To my surprise it had the opposite effect. I went back to bed and slept soundly.
Another question I thought of when I woke up this morning is: What is the diameter of the area to which the laser is applied? In other words, will the laser be applied to an area greater than the widest part of my dilated pupil? I’m only guessing here, but I can only imagine if the area were less than my dilated pupil, I might see halos when the light dissipates through the edge of the area where the laser was applied, similar to looking through a piece of cut glass crystal.
At work now and found this useful website: http://www.sharpervisioncenters.com/lasercorrection.asp
More questions. What is the difference between Wavefront Optimised and Wavefront Guided?
What is the diameter of my pupil?
posted by Alan and Maxine @ 4:47 pm,
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Laser Eye Surgery Diary Monday 19th September
Monday, September 19, 2005
I have pretty much decided that I'm definitely going to have the surgery unless I'm told that I'm unsuitable.
This morning I told my manager that I have decided I want laser eye surgery and asked for some time off. She said that because it is health related, it wouldn't be a problem and the company would accommodate me having the time off.
I then phoned Accuvision to see if I could get an earlier appointment and to ask that if I am suitable what would be the earliest date I could have the procedure. My appointment has now been brought forward to Wednesday 21st September (Aahhh only two days away) with the possibility of having surgery on the 4th October. My heart has started to race and my stomach feels uneasy. I know I wanted to bring things forward and I'm grateful they have been, but now it has started to become a reality I'm feeling very nervous.
posted by Alan and Maxine @ 5:44 pm,
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Laser Eye Surgery Diary Sunday 18th September
Sunday 18th September 2005
Decided to put this diary on both my Blogs.I spent the rest of the day contemplating whether or not to re-arrange my Accuvision appointment for an earlier date. I don't want to wait a month in between consultations. I tried phoning Accuvision on the number they gave me to re-schedule the appointment, not really expecting anyone to be there on a Sunday. To my surprise someone answered. I was told the phone number I phoned was redirected to an emergency helpline and I would have to phone back Monday to Friday to re-schedule my consultation appointment. It's nice to know that you can get through to someone at Accuvision in an emergency even if you phone the re-schedule phone number. I'm becoming even more sold on Accuvision.
Here is the website of the manufacturer of the laser equipment used by Accuvision
http://www.wavelight-laser.net/
posted by Alan and Maxine @ 9:18 am,
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The start of my Laser Eye Surgery Diary
Sunday, September 18, 2005
My name is Alan.
I have been wearing glasses since I was 11.
I'm now 42.
I have moderate myopia with slight astigmatism.
A few years after I got my first job, aged 21 or 22 I tried soft contact lenses.
I thought they were great, very comfortable and a real release from the bind of having to wear glasses, even if I did have to take them out every night and clean them and then de-proteinise them every weekend.
I then saw and advert for contact lenses that you could wear for a week without having to take them out to clean; only taking them out at weekends to clean. After a month you threw them away and popped in a new pair. You could even sleep in them, they were fantastic. More freedom from glasses, I had to have them.
About a year later I went to a night club in Birmingham where there was lots of white smoke (dry ice) drifting over the dance floor. I went to bed a usual wearing my contact lenses. I woke the next morning and couldn't open my eyes; they were stuck together like glue and felt like I had sand in them. I was taken to the eye hospital where they fixed me up, put cream in my left eye and bandaged it and anaesthetic in the other eye so I could at least see where I was going. I was told to lay off the contact lenses for a while. Humph…Back to glasses then!
At 28 I decided to go back and finish my education (and become a computer geek...another story), during which I tried contact lenses again, this time daily disposables. They were great to begin with but soon made my eyes tired. This was probably due to the late nights I put in studying, having been told by the optician that my eyes were unaffected from my previous encounter with contact lenses. Upon graduation in 1995, I began reading news articles about the latest laser eye surgery. I discussed this with my fellow graduates. We concluded it wouldn't be worth while doing until we had evidence that opticians started having it done. After all if they weren't convinced, why should we be? I continued to wear contact lenses for a while, but soon went back to glasses yet again. Oh to be free!
I had still been thinking about laser eye surgery on and off for the next 10 years. Just before I got married in May 2003 I mentioned it to my Fiance, but the old worries about if opticians had it done, so might I. It was soon forgotten as other priorities surfaced, like getting a house together and organising the wedding.
Laser eye surgery seemed to crop up more and more over the next two years. Then in late August 2005, Mike, a friend from University visited from America. (He's the one who first mentioned about opticians having it done first). He mentioned he was thinking of having it done, mentioning all the benefits and probably trying to convince himself it was a good thing to do now. I said nothing, but it got me thinking about it again.
Research, Research, Reserch...One thing I'm good at, having two degrees (B.Sc. Hons and an M.Sc.). I decided it was time to use my skills for myself and find out more about laser eye surgery.
Monday 12th September 2005
Using Google I searched for "laser eye surgery". I couldn't believe how much this industry had grown. There were loads of companies offering it in the UK. Sure I'd seen advertisements on the TV for Ultralase, but I had assumed most if not all the companies would be in London. I found three companies in Birmingham within a few minutes. Wow...I had to find out more, discuss it with my wife. No more glasses pulled of my face by my 9 month old daughter... Being able to go swimming and see people in the pool... that would be great.
Tuesday 13th September 2005
More research to find out who has had the surgery done and what kind. It appears that a lot of ophthalmic surgeons are having it done. Not just the head of the companies and their sons and daughters, the kind you'd expect to be in glossy brochures, but the surgeons who are putting their reputation on the line and performing the surgery too. I've read that at least 2-3 surgeons from the top 5 well known clinics have had laser eye surgery done. Most favour Epi-Lasik, but just less that half have had Lasik performed, what ever that means.
Wednesday 14th September 2005
It still seems expensive at around £1500 per eye. Would it be worth it? Having spent over £550 on glasses in the last two years alone, I'm beginning to think it might. Some companies are offering it from only £395 per eye. Are they inferior? What if things go wrong? I couldn't care about the money if it went wrong, my eyesight is what matters. I'd think about it (forget about it more like).
There are so many different type of surgery; PRK, LASEK, EPI-LASEK, LASIK and Wavefront. Which is best? What's the difference? Is any one more risky than the others? What about night vision... I'd read a lot about people seeing halos and haze afterwards?
Contacted Ultralase via their website for more information.
Thursday 15th September 2005
I was becoming more and more intrigued. I had to find out more. Ok, so if, if, I had it done, which one would I go for?
I learned about LASEK and EPI-LASEK. Both remove the outer surface of the eye known as the epithelium, before applying the laser treatment. With standard LASEK they scrape it off and it grows back. With EPI-LASEK, they soften it with alcohol and fold it back, replacing it afterwards. The structure of the eye stays intact but is weakened by the process. From reading various results of people who have had this done, the recovery time seems to vary between 1-2 days to over a week before you can see properly again. But the pain, oh the pain…no it's the time off work I'm more worried about, not to mention not being able to see clearly for a few days. But I suppose it would be worth it. There is also another kind of LASEK where the epithelium is lifted with a blunt instrument that weakens the eye structure much less. Don't really fancy being poked with a blunt instrument until they lift the outer surface of my eye.
LASIK. A blade slices a thin layer of the cornea, which is folded back before the laser is applied. No pain, because of the anaesthetic. I've experienced anaesthetic before during my contact lens days... sounds good to me. And the recovery time is much less, about a day in most cases. Surely this would be the one I'd go for.
Wavefront. (Tailored eye surgery) This is supposedly better than standard LASIK. With standard LASIK and LASEK for that matter, the laser is calibrated according to your specific prescription. With Wavefront, the laser is further calibrated according to the specific undulating surface of your eyes. Wavefront smoothes out the surface of the eye providing an even curvature rather than leaving an uneven one. The advantage is supposed to be less risk of halos and haze during poor light conditions at night.
Ok, fine, but which company offers these treatments and would I need Wavefront. Time to have a consultation I thought nervously, but which company? The three most prominent companies that seem to crop up are, Ultralase, Accuvision and Optimax (reminds me of the type of petrol I used to put into my car, before I converted to diesel).
Contacted Ultralase via their website for someone to contact me for a consultation. Feeling a little anxious and apprehensive.
Optimax don't recommend Wavefront saying it's untried, but not from what I've read. They supposedly have the equipment but won't use it yet. Why buy it if you won't use it? Maybe they don't have anyone who can use it yet? Would I actually need it anyway?
Ultralase offer Wavefront as do Accuvision. I've read a lot about the standard of the laser equipment, with people saying make sure you find a company that uses a good quality laser. Ultralase use Bausch and Lomb lasers which are highly recommended and supposedly one of the best.
Time for bed.
Friday 16th September 2005
Woke up at 2:45am thinking about laser eye surgery again. Thinking... What if I go swimming, will the Chlorine get inside the corneal flap? Will it cause irritation or worse infection? I must find out about the type of lasers Accuvision use. I've read they use a laser that is supposedly twice as fast as the Bausch and Lomb laser, but I must find out the name of the manufacturer and get independent evidence of this.
Having read a diary of a previous patent of Accuvision last night http://www.nurseowens.clara.net/lasik_diary.htm, I decided I should start my own diary of events also. It's now just gone 5.00 am and time I went back to bed.
Got to work for 8:00 am and started looking on the internet (again) for laser eye surgery. Still not heard from Ultralase, so I visited the Accuvision site and filled in the online form to request a consultation. Feeling a little nervous now I know someone will contact me.
More research... Accuvistion use "Wavelight Allegretto Wavefront Optimised Technology, 200Hz gaussian beam profile, shorter treatment times, less corneal dryness, minimised night vision problems, twice as fast as the Bausch & Lomb Zyoptix 100Hz wavefront technology."
I've never heard of Allegretto, I'll find out more. Searching again I found the http://www.biglasikguide.com/ website that has a link to the FDA website containing a list of approved lasers used for eye surgery: http://www.fda.gov/cdrh/LASIK/lasers.htm. It appears the laser used by Accuvision is approved and you can even download information about the approval order given by the FDA.
12:50 I get a call on my mobile at work from Accuvision. Can I come in for a consultation between Monday to Friday, but I would need someone with me to drive me back home. I said I could only make a Saturday and could they make an exception. They could but the soonest day would be the 22nd October at 9am or 10am. Then I remembered my wife doesn't work Tuesday and I might be able to take a flexiday in September, but the soonest Tuesday they had available was 4th October. Since I can only take one flexiday per month, I opted for Saturday 22nd October at 10am. Feeling very nervous now. Must phone and tell my wife.19:04 Phone call from Ultralase. Booked a consultation for Sunday 25th September 2005 at 3:20 pm. Eeek, only 1 week away.
Saturday 17th September 2005
I've been awake since 06:21. It's supposed to be my day to have a lie in, but I can't sleep, there are too many questions going round in my head that I still don't have answers to. I'll have my lie in tomorrow!
Although I have to wear glasses because of short sightedness, when I remove my glasses, I can focus really close up, which is great for reading. Will I still be able to do this?
I must compile a list of questions to take with me on my consultations.
I received confirmation from Accusvision of my consultation today and an information pack from Ultralase with an Ultralase experience DVD inside. I will watch this with Maxine later.
QUESTIONS
What if I go swimming, will the Chlorine get inside the corneal flap?
Will it cause irritation or worse infection?
Does the corneal flap ever heal?
Will I always have to avoid rubbing my eyes?
Will I lose some near vision?
Do you use a freshly sterilized keratome and a new blade for each eye?
From which direction is the keratome make the cut? i.e. where will the hinge be, at the top, side or bottom of my eyes?
I could feel all the soft contact lenses I ever wore, will be able to feel the flap after surgery?
Will the flap be visible to other people?
What are your qualifications?
Do you have:
A medical degree?
Ophthalmology training?
Are you a corneal specialist?
A refractive surgery fellowship?
How long have you been performing refractive surgery?
Do you audit your outcomes and do research?
Will I be treated with wavefront technology?
Can I have a copy of the assessment/records wavefront maps after surgery?
'Visual acuity and visual quality are different. You can be 20/20 or better, and still be severely compromised.' How would you comment on this?
What is my corneal thickness? How much will you need to create a flap? How much will be left?
Useful Websites
http://www.biglasikguide.com/
http://health.howstuffworks.com/lasik.htm
posted by Alan and Maxine @ 7:50 am,
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Laser Eye Surgery
I am seriously considering laser eye surgery and have been on and off for many years. While I consider this I am planning to keep a diary of events to let everyone know of my progress (or lack of it - but hopefully this won't be the case), if of course I decide to go ahead with it.
I started keeping a diary about a week ago which I'm going to publish later today, then keep it up to date as the days go by.
I will publish my research, choices, fears, and decisions leading up to surgery, if that's how far I get, whenever I have something to add. If I decide to go ahead with surgery this will increase to daily postings to keep everyone up to date with my progress.
Wish me well!!!!
posted by Alan and Maxine @ 7:42 am,
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Re-moving Blogs back to Blogger
I'm beginning to feel that moving Blogs was a mistake. While MSN spaces has a good and easy layout, and I've never had problems posting. I have had problems with emailing photos from my phone. Having had several emails from the MSN space helpline and technical helpline, it just seems I keep getting fobbed off. As a software developer myself I find this unacceptable as I and my company always do as much for our customers as we can.
For the time being, while this issue is being resolved, if it ever is, I shall post to both Blogs, MSN spaces and Blogger. I am also re-directing the main Maxalan website back to Blogger.
posted by Alan and Maxine @ 7:23 am,
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