How I Spent My Wednesday

Today I'm taking a break from our usual focus on publishing in order to offer a sort of public service announcement (PSA). I had an experience yesterday that I want to share ... in the hope that someone out there will benefit from what happened to me.

Every spring, I schedule my annual exams: OB/GYN, ophthalmologist, and internist as well as my semi-annual exams: dentist and dermatologist. April and May are cluttered with appointments.

Yesterday was the ophthalmologist. Sarah, my tech, is a twenty-two year old single mother of a five-year-old, and I look forward each year to hearing how her precocious daughter is doing.

Midway through the exam, Sarah said, "I can't dilate your eyes."

I said, "Excuse me?"

She said, "Let me go find the doctor. I'll be right back."

My doctor, a lovely Asian woman who barely looks older than Sarah, came into the room and checked the results of whatever test Sarah had been running. She told me I had developed NAG--Narrow Angle Glaucoma.

This explanation of NAG comes from the Southland Eye Clinic website here:

A watery fluid is generated inside the normal eye. It circulates through the eye and drains out of the eye in the "angle" between the cornea (the clear window of the eye) and the iris (the colored part of the eye). Some people are born with narrow, slit-like draining angles. In such people, anything that further narrows the angle prevents adequate drainage and causes the pressure to build up. The patient then [may] experience/s an acute attack of Narrow or Closed Angle Glaucoma.

Fortunately for me, my visit to the ophthalmologist had preceded my having an acute attack. My doctor told me that she wanted to do surgery on one eye immediately and on the other eye within two weeks.

We agreed I would go on to work while her front office contacted my insurance company for an authorization to do the surgery. By 3:30 I was back in the office. Here is a description of the surgery:

In this office procedure, a small drain hole is created in the iris, the colored part of the eye. The hole is of microscopic size. The operation is painless.

Well, not totally painless. My right eye was deadened by drops. A lens was glued to the eyeball. The doctor then manuevered a laser which emitted clicking sounds while it cut through my iris. I felt a pinch and an immediate headache behind the eye. It took about three minutes for the doctor to cut through the iris and then to widen the hole to permit drainage. I had no bleeding at all although some people do experience a bleed.

Afterward I remained in the office for several hours while they checked my eye pressure and sight. I drove myself home and went to bed. When I woke up at 9:00 PM, the headache was mostly gone although my eye ached a bit. I have drops to put in the eye four times a day for the next five days.

I'm scheduled to have surgery on the other eye next Wednesday.

Here's the PSA part of this post. Narrow Angle Glaucoma (NAG) can present suddenly as opposed to the more chronic or Open Angle Glaucoma, which develops slowly over years. Here's the description of a NAG attack, again from Southland Eye Clinic:

An attack of this type of glaucoma is an emergency. Untreated, it may cause blindness in a day or two. Between attacks the eye pressure is normal and there are no symptoms. During the attack there are often eye pain, nausea and sometimes vomiting. The eye may be red, vision may be blurry and patients may see halos around the lights.

... people may delay treatment until it is too late because they do not recognize that they are having a glaucoma attack. They often think that they are just having a headache, or a migraine. Because they do not suspect glaucoma, they fail to seek treatment and damage to the nerve takes place. Once the nerve fibers are dead, the damage cannot be reversed.

I've known there was an issue with the shape of my eyeballs since I was in my late thirties and tried to get fitted for contacts because I was having trouble reading. The contacts simply would not stay in my eyes. I'd put them in and, within an hour, they would flop over and fold in half while still in my eyes.

My ophthalmologist told me my eyeballs were flatter than most people's (the only flat part of my body, I might add). I wear contacts that are the equivalent of coke-bottle-thickness glasses. However, no one ever told me the shape of my eyes put me at increased risk for NAG.

I was fortunate. My eye appointment permitted my physician to catch the condition before I suffered an acute attack. My ophthalmologist stressed that NAG attacks are often mistaken for migraines. She said hospital emergency rooms frequently misdiagnose the problem.

Once my left eye is operated on next Wednesday, I'll be free of the condition. In a few rare cases, the hole in the iris closes over, but my ophthalmologist will monitor for that possibility.

The entire point of this post today is to remind you not to neglect your eyes. Get regular eye exams. You don't have to have flat eyeballs to develop NAG. A friend of mine told me last night that her cousin developed it when she was only thirty, long before she needed glasses.

NAG and the more common form of glaucoma--open angle--are not the only conditions you need to be checked for. A friend of mine is gradually losing her sight from Retinitis pigmentosa. She is already legally blind and cannot drive. Her prognosis is eventual total blindness.

Imagine total blindness.

Take care of your eyes. I care about you.