My friends in Denver had to put down their little Scottie named Annie on Saturday.
Windblown Annie in the window
Annie was 15, a good, round number for a dog’s life, but not long enough. My friends and everyone else who knew Annie will miss her.
I have had too much experience losing dogs, as have my friends. It’s never easy. I always feel guilty, not just in the cases where I had a vet end a dog’s life, but in every case. We are completely responsible for our pets’ live, and when their lives end, I feel like I haven’t done enough; I have failed them.
On the night back in 2000 when my father died, I felt as if I could step back and look at his life from beginning to end, a perfectly contained living history, separate from his current state and from me. His life was like a pearl on a necklace, and like a spherical pearl, it had no beginning and no end — a little bubble of existence floating away from us.
I can’t accept that my father, my mother, and my brother no longer exist. I don’t believe in god or in an afterlife, but I am incapable of accepting not that they are dead, but that their existence is gone. I feel like they must be back “there’, somewhere in the past, still existing as I remember them, and they would be there if I could somehow go into the past.
I feel that way about the dogs I have lost, and I feel that way about little Annie. She’s still back there, out of reach for us, but still sticking her head out the window to see the sights and catch the scents
Goodbye, little Annie. Hope to see you on the other side.
I decided that rather than try to describe what my vision has been and currently is, I would post some images. You may find this hard to beliee, but these images are not from a biology textbook; I drew them myself.
First, this is what normal vision (sort of) looks like:
Each of your eyes see its own image of this odd-looking dog with the odd-looking gait. They are slightly different, but your brain seamlessly merges them into one coherent image. You are normally not aware that there are two separate images in the overlapping area, but the differences in the images are what allows you to perceive the different distances to various objects that you see.
After my surgery, the vitreous in my right eye was replaced with sulfur hexafluoride (SF6). The optical properties of SF6 are different from that of the vitreous, and the eye can’t focus an image through it. That means that my right eye’s image was blurry, and objects in my field of view seemed to be in a different place from what my left eye was reporting. This yielded an image kind of like this:
Imagine that I was looking at a table. My left eye saw it clearly, while my right eye saw a blurry, displaced images. My brain couldn’t figure out how to merge these images, so it basically didn’t. It just gave me two different images at the same time. This made it essentially impossible to read or to drive. Since I spent Thursday afternoon after the surgery through Sunday with my head down, reading was about all I could do. I solved this problem by closing my right eye.
As the body absorbed the SF6, the bubble shrank. For several days, this is what I saw with my right eye:
The very top of my visual field was clear, while all of the rest was blurry. There was not enough clear vision to allow my eye to focus at normal distances, so I still had to close my right eye to read, and I couldn’t drive.
Eventually, the bubble shrank to the point that it was beneath almost everything I needed to see, leaving something like this:
This image is from what I imagine driving though the foothills of the Sierras would look like.
And this is what my vision is like as I write this on Saturday night. I can look up where I’m writing and can see the mess of objects on our dining table, and, most importantly, i can tell where they are. I can reach out and touch the salt shaker without making several tries. Unfortunately, if I look down, I am looking through the bubble and I have no depth perception. A Walmart employee had to help me put my credit card in the reader tonight because I kept missing the slot
If I look straight down, I can see the entire bubble as a circle filling maybe 80 percent of the entire field of view. The bubble jiggles when I shake my head, like a bowl of Jello. When I look up, the bubble reminds me of the bubble in a spirit level, finding its own level as I move my head around.
But, you are wondering, if this is a gas bubble within an eyeball otherwise filled with fluid, why is it floating at the bottom of my eye rather than the top? That’s an astute question, and I’m glad you asked. I wondered about that myself for a while, and then I remembered that the image the eye’s lens projects on the back of the eye is inverted; it’s upside down. The brain perceives it as right-side-up. Since the bubble is at the top of an upside down image, the brain thinks the bubble is actually at the bottom of my eye, thus fooling both itself and me.
Since I am still recuperating, I continue to spend a lot of time reading on my phone. Looking down still moves my bubble up (actually, down) into my field of view, so it’s still a real distraction. My solution now is to put blue masking tape on the right lens of a cheap pair of reading glasses.
I can still see the bubble in my right eye; in fact, in a lighted room, I can see the bubble with both eyes closed. But I can do a pretty good job of ignoring it. Right now there is a ghost image of the bubble covering about the bottom third of my laptop’s screen. It’s somewhat distracting, but much less than it would be without masking tape on my glasses.
There is one discouraging development. At my post-op appointment, while waiting for the doctor to come into the examination room, I discovered that I could focus on an object very close to my eye. I put a medical alert bracelet I was wearing up close and could read the fine print. It seemed to me that the blind spot and distortion I had been experiencing were gone. That made me very happy. Unfortunately, I have since determined that I still have a blind spot and distortion at my fovea. If I look at a straight line, I see something like this:
The images is blurred and distorted, and whatever is at the very center of the fovea is not visible. If I look directly at a small object, it disappears and is replaced by whatever surrounds it in my visual field. A small stone on a concrete surface disappears, and where it should be looks like more concrete. The effect might not be quite as bad as before my surgery, but it’s still there.
I have read that one’s vision after a vitrectomy can continue to improve for up to six months, so maybe it will get better. If it doesn’t, I suppose, and hope, that my brain will accomodate that deficiency and begin to ignore the blurring and distortion, replacing it with the better image from my left eye.
I had my right eye’s vitreous removed on Thursday. The surgery center is in Chattanooga, which is not Rome. It is, in fact, about an hour and a half away from our house. A long-time friend of my cousin was volunteered by my aunt to drive me. We left our house at around 5:30 AM, a time with which I am only theoretically familiar.
I was told beforehand not to eat after midnight before the surgery, so I expected to receive anesthesia. Imagine my delight when they told me I would only be sedated with Versed, and would be awake while the surgeon stuck sharp instruments into my eye. It was already to late to run, so I just accepted it, probably the way a condemned prisoner accepts that he is being led to the firing squad.
They draped my good eye, and possibly my bad eye, so I couldn’t see the team as they prepared their foot-long syringes and scalpels, or whatever they used. In fact, I couldn’t really see or feel anything they did. They did tell me that Versed induces amnesia, so it’s possible I just don’t remember. But it certainly seemed that I didn’t feel anything. I felt no pain, and my eye has not hurt since, except for a little twinge that feels muscular when I move my eyes around.
I got home before lunch, and proceeded to keep my head facing down as instructed for the rest of the day. This is because they injected a gas (sulfur hexafluoride, if you’re curious) into my eye to help press the retina up against the back of my eye, as I think I mentioned in my previous post. They put a patch on my eye, unfortunately not a black patch, so I was blind in that eye for the evening. As the evening progressed, I began to see a light display in my right eye. There were blue lights that looked like stars, and bright blue lines that looked like refugees from a neon sign. There were also what looked like wrestling black cats around the periphery of my field of view. That worried me a little. Not just the cats, but the whole thing.
Today, Friday, I went back to Chattanooga for a post-op checkup. We left at 6:15, a more civilized hour. More civilized, but not really civilized. They dilated my eye and looked inside, and then the doctor said it was good. They left the patch off and I found that all the literature I had read that said my vision would be very blurry after the surgery was true. I could actually see better with my right eye completely covered than after they removed the patch. The blurry eye’s vision was competing, and pretty successfully, with my better eye’s vision. I now know what people mean when they say they can see only vague shapes.
I also keep seeing someone sneaking up on my right side, but they disappear when I turn to look with my good eye.
The surgeon told me that the lights and lines are normal after retina surgery, so I am just relaxing and enjoying them. They had disappeared by Friday morning, but they have come back this evening as I write this. Now if I close my eyes I see a very pretty Christmas display, with strings of blue and white lights across my chest and a starry heaven above. I saw a big orange pumpkin that went all the way around the periphery of my vision just a while ago, and the black cats were back. At this moment, the residents of the surrounding hills have put up Christmas lights all along the ridge lines, and there is a large spherical ornament above, kind of like the moon, but with white lights inside.
Now that’s gone and I see orange bat wings.
It’s all quite amusing, but I hope not too long lasting. The surgeon said I can expect my vision to improve as the gas in my eye is absorbed. Right now it’s like looking through an aquarium. only worse. If I look straight down, my vision is slightly less blurry, but not enough that you would want me to drive you to the grocery store. They put a green, plastic bracelet around my wrist warning everyone that I have a gas in my eye which could cause permanent eye damage if I’m forced to go on an airline flight or drive to high altitudes. I discovered that if I brought the bracelet right up to my eye, close enough that it probably looks scary to anyone watching, I could read the text. It’s like using a magnifying glass. That was interesting, but the most interesting part is that I had to use the sharpest region of my eye to do that, the part that was damaged by my vitreomacular traction.The part that was completely blind before my surgery.
So, I can now see with that part of my eye, at least a little. It’s enough to give me some hope for a reasonable recovery.
In the meantime, I will keep everyone posted if I see anything more interesting in my bad eye.
Copyright 2013 Mark V. Paris
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