The bump (oops, I mean hole) gets bigger

As of Friday, my Dr. told me to keep a close eye on my vision (nice pun, eh?) and update him if anything changed. Unfortunately, over the weekend, I was noticing increased bluriness, "bugs/floaters", and wavy walls. There was also increased pressure in the eye. I saw the Dr. Tuesday afternoon. After examining me, he was shocked to see the drastic changes in my eye over such a short period of time. What had happened is that apparently the pressure I felt in my eye was the complete detachment of the macular gel from my retina, which unfortunately has caused my macular hole to double in size. That is what caused the significant change in vision. The only treatment for this is to do a vitrectomy. Below is a more detailed description of the surgery...

Vitrectomy for Macular Hole
Detaching the vitreous gel from the retinal surface is an important part of macular hole surgery. In addition, there are frequently thin membranes on the retinal surface surrounding the hole, which are peeled in order to release traction on the retina and allow the hole to close. Perhaps the most important part of the surgery, however, is filling of the vitreous cavity with a bubble of gas. This gas bubble must press against the macular hole in order for the hole to close. Since the macula is located at the back of the eye, the eye should be looking downward in order for the bubble to float against it and exert the maximal amount of force. In order for this to occur, the patient must remain in a facedown position after the surgery. For most patients, 2 weeks of facedown positioning is recommended. The macular hole can be closed successfully in the vast majority of patients. This is usually accompanied by a significant improvement in vision and reduction of distortion. Most patients, however, will not recover all the vision that was lost, and will recognize some limitation.

As with any surgery, vitrectomy has risks. Cataract, retinal detachment, high intraocular pressure, bleeding in the eye, and infection are among the possible complications. Cataract is the most frequent complication of vitrectomy surgery. Many patients develop a significant cataract within the first few years after vitrectomy.

The general population has a success rate of 90% with this procedure, but with VHL their experience shows this may be closer to 50%. It's unclear why - some speculate that it is because there is so much more going on in the eye, as well as scar tissue from previous procedures.

As of now, I have ordered my post-surgical equipment (a massage-type chair and a face support to help me hold the recommended position). I will be seeing my internist tomorrow for hopefully some good drugs to take after this, as well as EKG, bloodwork, etc... Surgery is scheduled for Tuesday morning. I hope to be able to spend one night at the hospital, but unsure whether insurance is going to clear that. Now I need to get my house in order so that over the next few months when I can't see, I will able to find things (or direct others as to where to find things) for the kids. I am overwhelmed by the thought of this and am trying to figure out how I am going to spend the next few weeks of my life facing the floor with no vision (and two kids). Steve is taking off one week of work & we will play it by ear after that. For now I am planning to listen to books on tape, listen to the tv, and hopefully chat on the phone (will have to figure out how to make that work). Some friends have talked about organizing meals and visits. It's hard to know right now exactly what we will need, but am sure it will be very much appreciated. I will let you know what I need after I get home.

Please check back on the blog late Tuesday or Wednesday to see how things went... If anyone has any uplifting audio books they would like to recommend, I'd love it. Keep me in your prayers!

P.S. I just received a package from my college friend, DiTy! It was a iPod nano and iTune gift card. This will come in very handy. Any song recommendations or help setting it up would be appreciated.