Under The Knife - Laser Eye Surgery - part 3

Catch up with 

Part 1 - The Importance of Vision

Part 2 - Making It Happen

I signed and initialled the various documents in the Patient Pack before turning up to the Optical Express branch on Shaftesbury Avenue a few minutes before my 1445 appointment. I had my father with me - the paperwork I'd signed had insisted I brought someone with me to 'help me get home' along with a pair of dark sunglasses as my eyes would apparently be sensitive/painful after the surgery and I would be very drowsy. He had generously volunteered to be my chaperone. 

After handing my documents to a nurse for verification, I found a comfortable seat and waited to be called up. As I was doing so, a man walked out of the clinical area wearing dark sunglasses. He was unaccompanied and stopped to exchange a few very cheerful and upbeat pleasantries with the nurse and then sprightly exited the building - still alone. I watched with confusion and after he'd gone, I asked the nurse if he'd had the surgery. She confirmed he had. I felt very reassured - this man had just been through it and come out on the other side in what was clearly a very buoyant mood and seemingly none the worse for wear. I wondered if my father had noticed, but I decided not to raise the issue as I felt a bit silly for having wasted his time and quietly continued to leaf through my documents.

Another man came out wearing dark sunglasses, this time with his parents, but again in a chirpy mood. I felt even sillier.

My name was called up about half an hour after my arrival. Only patients are allowed in the operating room so I walked in alone to find a very friendly and talkative nurse who asked me to leave my jacket on the side and lie down on the cushioned surgery table underneath a very large and bulky machine which I imagine is the laser. I leave everything on the side: phone, wallet, coins, keys - I want absolutely nothing on me that may upset a machine that's about to get up close and personal with my eyes!

The nurse is chatting away while explaining what he's doing - asking how I got there, sterilising the eye area, asking about my work, putting in some anaesthetic eye drops to numb the eye surface, talking about how good the surgeon is. If he was trying to help me relax he did a good job. Some time passes and he announces that the surgeon is here now and we'll commence. I wonder if the drops have done their work.

The surgeon gets straight into it. 

He warns he's applying suction - "hold very still - you'll feel pressure on your eye - don't blink until it goes dark and you can't see anything. Just relax."

I've read the procedure detail and know to expect all this but it's different when it's happening! "Just relax" while some machine pushes down on my eye and my vision goes dark?!?! Each eye is prepared in about fifteen seconds but so far it's definitely easier said than done.

The bulky machine swings to move directly over my right eye and I'm told to keep looking at the little flashing orange light directly in my line of vision. The next bit is the creation of the corneal flap. This is the actual surgical, slicing part of the procedure where the cornea is cut and folded back from the iris so the laser has the access it needs. This is where the surgeon earns his money and is a very delicate process.

He begins by saying something like "Ok Yusuf, I need you you to keep your eyes still and not to squeeze your eyes in this next part while I make the corneal flap. OK? No squeezing."

This part wasn't described in the notes. I murmur agreement but I'm thinking WTF? How do I even squeeze my eyes? I don't want to sound an idiot though so I resolve to just keep eyes very still and and stay very calm. He continues: "It'll be 15 seconds again for each eye then it'll be done. Just relax and keep looking at the light. You might see instruments moving over your eye - don't worry about them - just focus on the light."

And he begins. I do see an instrument moving over my eye. It's pointy but I keep my attention on the flashing orange light which has become a little bit of a friend. I hear "Yusuf don't squeeze". Dammit man, I don't know what you're talking about! I'm not squeezing! I resort to deep breathing exercises to help relax and distract me from what's happening. 

The instruments keep moving and suddenly the orange flashing light turns in an instant from sharp to an orange blur - similar to looking at a streetlamp in a thick fog. But it's still flashing and I keep looking at it. I calculate that the sudden blurriness means he must've folded back the corneal flap. "Don't squeeze, OK?". There's a bit more alarm in his voice now. And then he moves away. It was a very long 15 seconds but the eye is prepared. 

He moves to the other eye. It's the same procedure and having been through it once I'm feeling confident. We go along and it's the same thing except this time there's more alarm in his "Don't squeeze!" instructions. I learned later that I was actually squeezing quite a lot and almost spoiled things on the second eye. If I had done my last bit of squeezing a split second earlier we'd have had to do the flap all over again. I also learned that the squeezing he kept talking about was similar to when you squint at something! I can't help but feel it would've been useful to know before the surgery!

Now we've come to the laser - this part is all computer controlled. I'm still looking at the foggy flashing orange light when the surgeon warns I'll hear noises and possibly smell some burning. "Perfectly routine and nothing to worry about, just keep your body and your eye very still and it'll be another 15 seconds per eye." Easy for you to say - you're not about to smell your own burning eyes. But this is it. This is what I'm here for. I hold very, very, very still and exhale deeply. It begins.

It was over very quickly - one eye then the other in thirty seconds. I did hear the noises I was warned about but I'd heard them from the waiting area during the prior surgeries so wasn't alarmed. Thankfully, I also didn't smell any burning. All that was left was to replace the corneal flap which took a second for each eye and returned my vision to me, then to move the bulky machine away and finally to sit up. 

I looked around the room - the effect was instant and amazing. Having been staring intently at a foggy orange light for the last 5-10 minutes, everything I looked at was sharply defined and in clear focus. The surgeon led me to an examination room and checked close-up that everything was ok and as it should be and I was OK. No problems from my side, none from his side so we shook hands and I went for a post-op briefing with another nurse.

Eye protector

I was given a little bag with three different eyedrop bottles and an eye protector. She explained take the eye drops four times daily for a week and use the eye protector when I went to sleep also for a week. Absolutely no rubbing the eyes for a couple of days no matter how much you might want to, no water on the eyes for 24 hours, don't take the Underground for a few days (too dusty), come back for a check up tomorrow morning and various other instructions which were also detailed in the Patient Pack. Once that was done I was free to go. 

Eye drops

I felt really, really good. There was none of the pain or sensitivity that I'd been warned about in the reading material. I put on my sunglasses anyway, went to my father and about an hour after we'd arrived, we left the building and departed into the bright afternoon sunlight to catch a bus home. I took every opportunity to look at things in the distance and marvel at how astoundingly sharp and defined my vision now was and sat on the bus feeling, all in all, very good about myself and what I had just gone through.

It was about fifteen minutes after we'd left that the anaesthetic started to wear off and it became clear why they insist on having someone with you to help you home. 

TO BE CONTINUED.

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Previous article: Making it Happen - Laser Eye Surgery - part 2
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Making It Happen - Laser Eye Surgery - part 2

Catch up with Part 1 here

From here it should have been straightforward. Have the consultation, verify suitability, negotiate the price and then have the surgery. Nothing ever goes quite as it should though.

I had booked my no-obligation consultation for a Wednesday afternoon and ensured I had the last slot of the day at 3:50pm so I could get most of a full day's work in. On the day itself, I spent the morning and early afternoon making sure I'd covered my planned activities and it was all going smoothly until around 2pm when I received a call from Optical Express. The lady on the phone explained she was from my local branch, that they were running behind schedule and wouldn't be able to get to me before closing time. And would I mind moving the consultation to next week?

I wasn't overly impressed and said I'd be happy to come in later. She said that wouldn't work as the optometrist would have gone home. This left me even less impressed but I didn't really have much choice in the matter so agreed to delay by a week to the next Wednesday and mentally fumed at them for playing with my plans. This turned into actual fuming when I later received an email from Optical Express customer service asking why I hadn't turned up the consultation and if I wanted to re-book! Clearly they have some issues with coordinating their branches with their centralised (Scotland based) customer service team. 

I'd forgotten my anger by the next week though and upon finally going to my consultation, the company rep briefly explained the format: the whole process would take about 90 minutes, during which we'd run through various tests, which would be followed by an eye exam. I'd have chance to ask questions and afterward the decision to proceed or not would be totally up to me. Seemed fair to me.

Most of the consultation was actually with the optometrist who examined my eyes closely with various lights, gave me a proper eye test to verify my actual prescription and then together we watched a standard company video explaining the risks and benefits of eye surgery. The surgeon in the video talked of how confident he was in laser eye surgery - proof of which was that his wife and daughter had been through it. I made a comment about wanting to know if he was still married (maybe he didn't like his wife anymore). There were a number of risks and possible side effects and I would strongly advise anyone considering treatment to do their research into possible impacts and read the negative stories as well as the positive reviews. The USA FDA website put it very well - "You are probably NOT a good candidate for refractive surgery if you are not a risk taker". I

The optometrist explained the different treatment options available (entry level LASEK, middling LASIK and premium LASIK+iDesign) and that I was a suitable candidate for any of the three. Given that I was only planning on doing this once and that it was my own eyes, I was quite certain I wanted the best treatment possible with the shortest recovery time possible - eyes are important!

Having gone through all the tests, my optometrist typed the numbers into the computer which did its thing and she then quoted me the price the computer gave. From my previous research, I'd had an idea in my head of what I considered to be a fair price and it was well above my estimate. I asked why it was so different to the advertised prices and we briefly talked through the issue but it soon became clear that she wasn't the person I needed to negotiate with - it was the company rep who had the final say on the matter.

So I sat down with the rep and we discussed my expectations, what I'd been told, what the adverts said, the price others had paid and pretty much why I thought the price given was far too high. I claimed to be a reasonable man and accused them of being unreasonable. She was perfectly happy to negotiate and seemed to expect it so we talked for a little while and I raised the topic of various vouchers and promotions I'd come across online and talked about how I was also going to consult with other providers and eventually I managed to secure a healthy discount from the original price to a level I felt fair. 

Having agreed all the details, I booked the surgery for the next available Friday slot (which turned out to be in three weeks time) along with a pre-surgery appointment to meet my surgeon so I could get to know the person I'd be letting play with my eyes. I chose a Friday afternoon as the recovery period promised was only two days  - which would allow me to get away with taking only a half-day off from work and use the weekend to recuperate if necessary.

Before I left, I was given a folder holding information about what to expect before, during and after the operation along with a lengthy informed consent document which I would need to read and sign before any surgery could take place. This document went properly in-depth into the possible risks and requested my acknowledgement of all of them with my initials required after every paragraph to prove I'd read them. To me it felt like the document was there to make sure Optical Express were off the hook for as much as possible - which I guess is to be expected but wasn't particularly confidence-building!

Three weeks passed quickly and I went along to my pre-surgery appointment. Upon arrival my eyes were tested again to help double-check the numbers from my consultation and I was then introduced to my surgeon. It turned out he was an Indian doctor who had trained in Mumbai alongside a Dr Undre. No doubt some unknown and distant relation of mine but we had a pleasant chat about the city and surrounding areas which I'd last visited 10 years ago! I tried to recall as much as I could in an effort to bond with him so he'd feel greater accountability when doing my surgery. We spoke about numerous topics including his general opthalmic experience and his own motivations for leaving India and moving to the UK - an easier professional life. Chatting with the surgeon really did help to build trust and calm my thoughts and apprehensions about the upcoming surgery.

I left the clinic after an hour feeling very positive about the upcoming operation. The only thing left to do was wait four days and go under the knife.

TO BE CONTINUED.

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Previous article: The Importance of Vision - Laser Eye Surgery - part 1
Next article: Under the Knife - Laser Eye Surgery - part 3

The Importance of Vision - Laser Eye Surgery - part 1

I've been wearing glasses since I was 12 years old. It all started after I'd been representing Lancashire in a national table tennis tournament and, having been roundly beaten by some of my competitors and won only one match out of five, I blamed my losses on not being able to see the ball clearly - a distinct disadvantage in such a high-speed sport. In hindsight, it was a bit of a tenuous excuse and my mother sent me straight to the optician where it turned out that I actually was slightly short-sighted! Not enough to have realistically impacted my table tennis but enough to warrant glasses for occasional use. Thus began my life behind a window.

That life ended on Friday last week when I underwent laser eye surgery.

I'd expect that pretty much everyone who wears glasses has at least given laser eye surgery a passing thought. Having clear sight without needing corrective equipment will appeal to every single glasses-wearer. They may not like the procedure or the risks but the benefits will certainly appeal! Sight is the sense with which we quickly consume the largest volume of information about the world around us. The age of technology which we live in becomes very difficult to navigate without your eyes. Touchscreen phones are a prime example of a tool which becomes useless without sight but occupies an indispensable role in our lives. Those of you who don't need glasses are very, very blessed and fortunate and I hope you stay that way!

I'd ummed and ahhed about having the surgery for several years. One of the prerequisites of surgery is that your eyes need to be stable. Glasses-wearers will know that eyes tend to get weaker through the teen years and into the early twenties. In my own case, my prescription hadn't changed for several years and I hadn't needed to update my glasses. But still, it was a passive thought at the back of my mind and not something I'd seriously considered until one day I was discussing glasses with some work colleagues and it turned out one of them had had laser eye surgery to bring them from almost legally blind to not needing any correction. And then in short order I learned that a few more of my friends had also had it done and all spoke about it in glowing terms!

So I started reading up on the operation to get an understanding of what was involved, the different types, the risks, the benefits and the financial costs. The internet came into very useful - all the operating clinics have extensive information about all of the above and you can also find various forums and discussion boards where people have discussed their experiences with the surgery. Some people go abroad to have it done at significantly cheaper prices, some get vouchers and deals, others negotiate with the provider, some get cheaper treatment and yet others get put off by the whole thing and never have the surgery.

For myself, I decided that the actual surgery wasn't going to vary much between the different providers since my prescription was fairly low and the lasering needed would be minimal. Which made my three most important factors the price, the aftercare and location.

• Price - because as an elective surgery, there is no standard pricing so providers can charge what they like and no one likes being ripped off. 
• Aftercare - because the eyes are vital and delicate instruments so you want to make sure your provider will do a decent job during the recovery phase after the surgery.
• Location - because I'm lazy and didn't want to travel far so London based was perfect.

In the end, after months of research and investigation, my preferred choice ended up being Optical Express who ticked all three of my major requirements. They came with a personal recommendation for their aftercare from a friend, had a branch very close by to my workplace and had a reasonable range of pricing options. And from everything I read about them (including the negative views from disgruntled and unhappy former patients), they did seem a generally competent outfit.

So in early April I went onto the company website and after a quick chat with their online assistants, I booked a no-obligation initial consultation (to ascertain suitability and share information) scheduled for two weeks time.

TO BE CONTINUED.

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Next Article: Making it Happen - Laser Eye Surgery - part 2

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