When the strobing started at the edge of my vision, I expected a migrane. The first for 47 years. I was very wrong. As the day passed no pain erupted, no nausea but the disturbance intensified. Having lunch with The Old Gentlemen ex-colleagues I saw progressively increasing debris, discontinuities and a dark shadow in my right eye. At that point I suspected the nature of the problem. Waiting for the result of the LFT to visit Mum in her room, I told the care worker “I think I have a detached retina”. She told me her husband had one but had recovered well without treatment. I now find that odd. After my visit, I felt I needed examining to check for other possibilities such as a bleed or tumour and started working through the NHS 111 site. “Go to A & E” it said, “select a time”. This seemed a bit drastic, so I phoned the Doctors, feeling very stupid when the receptionist said I should go to A & E not them if NHS 111 said so. I selected a time.
A & E was busy. I checked in, found a corner but only had to wait 30m before being triaged by a wonderfully friendly Ward Sister who checked the obvious neurological and physiological signs and found nothing observable awry. In conversation, she told me she was on a 14hr shift. Brutal. After a further short wait, she handed me to Urgent Care, another wait, another exam then a wait whilst the medic called opthalmology. Result: a fast-tracked appointment in eye-clinic and a suggestion of a vitreous bleed (burst blood vessel leaking into the eye jelly). I drove home.
The next day, I was called by eye clinic to attend on Monday (5 days since the event, 2 working days since A & E attendance), I drove over the weekend. Carefully. I now had very poor vision in my right eye and a dark shadow in the corner. I should not have driven. On Monday, I walked.
It took a minute of examination after my description including notes and diagrams (once a scientist….) to confirm several retinal tears and detachment. Also, thin, stretched parts with some small holes in my left eye. I was relieved. It wasn’t cancer, I had a diagnosis, there would be a treatment plan. The treatment was surgery. When? Tomorrow. That was a shock. Pre-op exams to be done now. ECG. B.P. & Bloods. A hike across hospital to the Opthalmic Surgical Unit. A retinal scan. A choice of Local or General anaesthesia. Local obviously, much less risk. I just have to keep still while someone fiddles in my eye. I can do that.
Operation day. Timing delayed by a phone call (it turns out I was one of 5 detachments that day that burst upon a crowded surgery list). More waiting. Then a lovely nurse, Steven, took me through more pre-op exams described the missing details of procedure (the doctor had explained the general procedure yesterday and given me the inevitable leaflets. I had squinted despairingly at the spelling and grammar errors). Then the numerous eye drops. Stingy little drops, every 15m. A chat with the Consultant surgeon, a little offhand and distant but hey, he’s the only game in town. Then walk to the anaestesia bay and up on the trolley.
CW: graphic detail of eye surgery
I was wheeled into the Theatre after the identity and procedure checks. The protocols remind me of flight safety: everything is checked, called, responded to and monitored by all present. Clearly, if anyone thought there was a problem they are expected to challenge. A whiteboard held my details, they checked with me again, a recorder noted events, I waited for the trauma. It started with a wash over my eye, quite brisk but painless, then a rather long needle to deliver the anaesthetic. Just like the dentist, a small puncture and the pressure of the fluid. I went blind. An antiseptic wash by pad and forceps then my face was covered with paper and plastic which was sliced over my eye. The surgeon stood at the top of my head, the trainee at my left observing through the microscope, the theatre Sister at my right hand, to be the surgeon’s ‘right hand’. “Clockwork Orange” started as my eyelids were clamped open but unlike ‘Alex’ I coudn’t see. Just hear. I heard “Trocar please” and waited for sensation. Just pressure. A lot of pressure on my head, then ‘pop,’ the needle slid in. Painlessly. Another two and there were three tubes in my eye. One for a fibre with light, one for the microscope and one for instruments. I listened as he described the finer points of technique and called for instruments and the talking laser. No really, the laser announced every setting aloud (as a check).The surgeon spent a lot of time manipulating the retina causing visual hallucination and a lot of laser ‘spot-welding’ (burns that will firm scar tissue to keep the retina in place). Finally he tilted my head to blow out the jelly in my eye (vitreous humour) with gas. It ran down my cheek in a wet stream. After stitching (and a spot of cauterising by diathermy) I thanked him for “saving my sight”. He seemed dumbfounded by the acknowledgement. Wheeled into recovery, I just had to “posture” or keep still to a régime of right side 45m then face down for 12 hours (hard) then left side. I left with a large handful of drops, walked to the car with my pickup and lift and was delivered home to paracetomol.
The next day, I was examined. It looked ok. No bleeds, swelling etc. but the pressure was up. More drops. Subsequently, I have visited the eye-clinic frequently, one of the few places I feel relatively young. Progress is checked (its slow) next surgeries for the expected cataract complications are discussed and one Sunday I was called to have the left eye laser ‘spot-welded’ to prevent it peeling off too. Done from outside this time. The gas bubble has very slowly absorbed, the cataracts have very quickly gathered and I can’t see anything clearly from the right eye yet. But the retina is stuck, working and gives a full field of view. As a Christmas present, I expect cataract treatment, new glasses and a clear binocular view once more. I might even get to drive again.
So whats the point of this long indulgent thread?
THE NHS! Fast, free, skilled. I was blind and soon I will see. The cost? Enormous. Overall, by now easily the price of a detached house. To me? £0. We share the cost together. Surgery on a Sunday was catching up from Covid. 12 and 14 hour shifts are common. Every doctor that treated me was a person of colour, the accents of almost all of the eye-clinic staff are a cosmopolitan kalaidoscope of spoken English. WE MUST SAVE THE NHS FROM UNDERFUNDING, PRIVATISATION AND RACISM. You will need it.
Thank you to all. And thanks to my driver, Gill. I would have been in a dark hole without your help.