Starting about a month or two ago, I was occasionally getting a blurry patch in my vision. I kept thinking it was just that I had something in my eye. I'd typically rub at my eye for a bit, then after a few moments, my vision returned to normal. Then, one evening (June 26th to be precise), I happened to look in the mirror during a blurry moment and noticed my pupil had gone a weird shape... like one side had a bulge. (Yes, I was pretty freaked out. Thanks for asking.) Then a few seconds later I watched my pupil return to a normal shape.
So I rang
Nurse on Call and after asking me a million questions, the nurse put me through to
After Hours GP (I never knew this service existed!). The GP asked me all the same questions again, then said he didn't know what it was and that I should go to see my own GP as soon as possible. So I did. The GP puzzled over me for a while and eventually looked at me and said I'm stumped". Then he referred me to an ophthalmologist. He also said to try and get a photo if I could. (I had already had
DeepSpice try to photograph it but my pupil only stays a funny shape for a few seconds at a time, so it's not easy to capture).
Whilst waiting for my appointment with the specialist, I did of course conduct many, many google searches. None of which provided me with any clue about what might be going on. But I did learn a lot about various eye conditions.
Dr O.
One week later (it's July 4th by now, are you keeping up?), I had my appointment with the ophthalmologist (Dr O.). The appointment commenced with an orthoptist checking my vision and prodding around at my eye (checking pressures and so on). Then I saw Dr O. who did more prodding and lots of looking into my eye with various lights and machines. The worst of which was the gonioscope.
After all this he looked at me and said "I'm stumped." Luckily he was bulk billing so I didn't feel entirely ripped off. I was also informed that my optic disc is more curved than usual but that this is probably nothing to worry about (well, I wasn't worried, but now that you have mentioned it...) and that he is worried about my 'angles'. He referred me on to a glaucoma specialist ("Just to rule things out - if it's not glaucoma, I'll refer you to a neuro-ophthalmologist.").
I think he was trying not to worry me, but he stood over the receptionist and asked her to call the glaucoma specialist and to make sure I got in to see her as soon as possible (ie. within a week), so I could tell that this could be something serious. An appointment was made for 9 am on the following Tuesday.
Dr B.
Tuesday (which would be July 10th, correct?) rolled around and I dutifully took my freaky eye off to the glaucoma specialist. This was to be quite an experience...
The building in East Melbourne was an old terrace house. A brass plaque at the gate simply stated Dr B., Eye Specialist. And what can I say? It had atmosphere. Inside, there was a classic timber hall stand, with a beige trench coat hanging on it. I wandered past the front room (which was set up as the waiting room) and down the long, dark (and spooky) hallway to find the reception at the back of the building. After filling in my paperwork, I was directed back to the waiting room. I didn't have to wait long before I was taken upstairs to do a "field of vision" test.
The upstairs room looked like it belonged in an historic home... like it should have been roped off at the doorway so tourists peer in at how people used to live. Long beige drapes ensured no natural light would ever fade the delicate floral sofa or carpets. Interesting but unidentifiable pieces of timber furniture cowered in the corners of the room. The orthoptist indicated that I should put my bag down 'over there', pointing to an old-fashioned doctor's examination table, upholstered in dark brown leather and a dark timber base made up of numerous drawers and a fold-out footstool. It was a bit like this one, but more gothic looking:
The only thing that looked out of place in the room was the piece of equipment that I was about to use for my test. It looked pretty much like this:
After the Field of Vision test (which I passed with flying colours, I might add), I returned to the waiting room for a bit. Next stop was another round with an orthoptist. I was escorted back down the long, dark and spooky hallway, past the reception, and into a recently-digitised medieval torture chamber. Or at least that's how it looked... against one wall was a heavy and dark timber cabinet with lots of tiny drawers in it, like the old card catalogues that libraries used to have. Opposite was a modern desk with banks of computers and screens and other machines that go ping. The orthoptist directed me to sit in a chair that looked kind of like the ones you see in movies where they execute a death-row prisoner, but without the manacles that strap your wrists to the arms of the chair.
She then proceeded to do all the same eye-prodding tests that Dr O's orthoptist had done. Two eyes. Check. Can read the tiny letters at the bottom of the eye chart. Check (I'm long-sighted). Eye drops (anaesthetic) in. Blink. Poke in eye with a blue pokey thing. Uncomfortable but it didn't hurt. Some more looky-pokey things (I think I have successfully blocked the rest of this part out)...
Back to the waiting room. Then a little while later, I am ushered in to see Dr B. It's hard to believe that this doctor is one of Melbourne's best glaucoma specialists when clearly her rooms are located somewhere in the 1950s. The room is dark (and spooky), lit only by a small desk lamp with a crystal shade. A lovely old timber desk with a leather top sits at one end of the room. On top of the desk is a silver pen tray with a horse figurine, and a dome clock, ticking loudly as if to reinforce that I have just stepped back in time.
Dr B. indicates that I should sit in the leather tub chair facing the desk. I'm already feeling intimidated and then as my eyes adjust to the darkness I begin to be able to make out the torture device lurking in the shadows. Dr B. is very efficient. She peruses the notes she has about me, takes a quick look at my eyes then tells me to go up to the Eye and Ear Hospital to have another image taken of my eyes (some kind of ultrasound apparently).
The hospital is just a short walk away and after a few wrong turns I eventually find my way to the imaging department. The most painful part is when I am told that this imaging will cost $70 and there is no Medicare rebate. The imaging is uncomfortable because one person holds my eyelids open with some cotton buds while another does the imaging, but it doesn't hurt at all and only takes a few seconds per eye.
I return to Dr B. with my eye-images in hand. She takes a looks at them and mutters about my angles being narrow... pressures OK... cornea is thin... She assaults my eyes with more drops (anaesthetic and dilating drops this time), does another quick prod, then it's back to the waiting room for 30 mins to wait for my pupils to dilate. Eventually I am summoned back in and Dr B. sits me at the slit-lamp microscope and repeats all the eye testing that Dr O. did (including the unpleasant gonioscope - but she is much quicker and more matter of fact than Dr O. and it is all over and done with very quickly).
Then we resume our formal seating arrangement either side of her desk where I get my diagnosis: closed (or narrow) angles, pre-disposing me towards closed angle glaucoma. Recommendation: laser eye surgery, an iridotomy specifically. Here's a brochure. Come back in two weeks when you have thought about it. (Code for "come back in two weeks so I can laser a hole in your iris".)
I ask about my weirdo pupil that goes oval-shaped from time to time. Hmm... well, that's probably just an eye migrane, nothing to do with your 'angles' and nothing to worry about. I am ushered out the door to the reception where another appointment is made and I am handed the account for $330. Now that really does hurt!
So to get this straight. I have just spent 3 hours having my eyes uncomfortably poked and prodded, plus $400 on tests, imaging and specialist consultation. The problem I was concerned about (my weird pupil) is brushed off as not really important, and I am leaving with a newly diagnosed problem that I am told could escalate at any moment (though it probably won't) into a medical emergency... the kind that could result in loss of vision. Just great.
I stumble out into the street. It's an overcast day, but my pupils are still dilated so everything is blurry and oh so bright! I feel silly wearing my sunglasses but it's the only way I can cope with the light.
The next day...
After a few weeks of behaving normally, my eye does it's thing again, and this time DeepSpice manages to capture it:
And since this photo was taken, I haven't had a repeat episode.
Dr O. again
I went back to see Dr O. again today (yep, that would be July 18th). He told me I should definitely let Dr B. shoot lasers into my eye... that he would do so if he was in my situation. And that I should come back and see him again in 3 months.
He was also very excited to see the photo of my wonky pupil. Apparently this is quite rare and unique (but just something to monitor... not to worry about). Easy for him to say.
YouTube links
Thanks to the Internet, I have been able to find out a lot more about all of this closed angle stuff. These YouTube clips have done a far better job of explaining the situation to me than either of the ophthalmologists did:
So I have decided to go ahead with the laser surgery. As for my weirdo pupil, I will have to see if I can train it to go wonky on command - maybe there's a career in the circus waiting for me.
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