Who would have thought ?  A difference between looking normal and seeing normal.

In the photo on the left, taken at a friend's wedding, it was my desire to look normal.  It didn't matter if I saw 2 of the photographer, related to a crossed-left eye which manifested as double-vision three months after --

my LASIK procedure performed by San Diego laser eye surgeon Doctor Michael Gordon in La Jolla California.

I believe Mr. Gordon annotated the condition as "diplopia" in my medical chart.

In the photo on the right, the left eye is patched, and the fusing of 2 disparate images by my brain is no longer a problem.  I see one image, which, I find, is frequently preferable to seeing 2 images.

As my corneal pain has exacerbated, I find that wearing sunglasses helps to "take the edge" off it.

It may not look normal, but, dressed as I am in the photo on the right, is the closest I can come to seeing normal - like I saw, with glasses (I was medium near-sighted with mild astigmatism), before the time of my LASIK surgery.

In fact, the 2 clinically useful medications that I take for corneal disease are Ultram, and Salagen.  Ultram is an anti-inflammatory, like Vioxx and Celebrex.

Salagen is a drug that was developed to stimulate salivary gland function in patients with diminished salivary gland function.  A side effect of the medication is that it stimulates tear production.  Which I need.

A description of my ocular condition ~
 

1.  A Letter I wrote to the FDA asking for help one year post-op, describing my symptoms at the time

2.  3 1/2 years post-op, this is a description of my symptoms.

These symptoms onset at the time of my LASIK surgery, and have become progressively worse since then.  My eyes were disease-free until the day of my LASIK surgery, at which time I was 40 years old.

*  Escalating, chronic pain in my left eye.  I now lay with my eyes closed about 6 hours a day because they hurt, and that is the only way I've found to make them feel better.  I am not referring to sleep.  I'm saying that, of the approximately 16 hours a day that I am awake, I spend approximately 6 hours of that time with my eyes closed, because it hurts to have them open.
*  Crossed left eye - causing me to see double when I look at anything more than 5 feet away.
*  Reading hurts my eyes so I stopped doing it ... I used to read 10 magazines an hour.
*  No more making stuff. I used to be able to make things with my hands.  Of course, this means being able to see up-close, without eye-strain.  As an ophthalmologist told me, "Yes, LASIK burns away your near-sighted vision.  Your surgeon should have told you."

I'm a design engineer.  I used to be a "hands-on" Design Engineer, intent on emulating the expertise of the most skilled engineers I have met, those who were most gifted in practice as well as theory.  This implied the ability to use expensive tools and resolve visual differences of a thousandth of an inch.  That is, I had eagle-eyed near-sighted vision.

Until August 14, 1998.  Now, my tools collect dust -- and they are currently being given away to the Salvation Army or moth-balled in a friend's backyard.  I do not have the "eye-time", evenings and weekends, to "make stuff" anymore, whether it be fancy box' for computers, or a Javascript Rollover.
*  Reduced Workout Time.   At the time of my LASIK Surgery, I worked out twice a day ... usually, a 2500 yard swim, followed by a 2 hour yoga class - with one day off a week.  As my corneal dis-ease has progressed, I have been forced to allocate less and less time for exercise, from which I once extracted a huge amount of enjoyment.

However, I find that it is much easier to cope with diseased and injured eyes if the rest of your body is in good shape.  I sometimes feel like the Richard Simmons of the situation.  I do urge ANYBODY who has experienced an injury or disease which limits their abilities, to consider finding an exercise or sport that does not pose a material risk to them -- and to do that exercise/ sport almost every day.

The bottom line is, if there are at least a few hours a day when I feel really good, and really relaxed, it is much easier for me to cope with the damage inflicted on my eyes, without my consent, by Doctor Michael Gordon.

*  Early Retirement.   Given the degradation in the condition of my eyes, Prudence says:  prepare for forced early retirement.  In fact, I've met another patient, an RK patient, whose eyes were over-corrected during RK surgery.  When presbyopia onset, she became unable to do her job, and she was forced to retire early.  She worked at San Diego State.  I spoke to her on the phone at her new low-cost home in the mountains.  She advised me to be prepared for the same fate.  Her surgeon was -- San DIego laser eye surgeon Doctor Michael Gordon ... the same Michael Gordon who has now added "laser skin peels" to his repertoire of products that, according to HIS website, can help you "look and feel your best."

I am doing the conventional things to obtain medical help.  However, I am finding that the medical community in the age of HMO's is geared towards patients that walk in with pink-eye, and walk out 15 minutes later with a prescription for eyedrops.  When a brand new patient walks in with a crossed left eye that manifested as double vision 3 months after bilateral LASIK, suddenly the situation is -- much different.  I only know of one patient who has undergone a post-LASIK strabismus surgery ... and I do monitor these things.

It's not a problem that can be solved in 15 minutes.  It requires consultation with gifted specialists - people I might have to trust to perforrm surgery on me, after having my trust shattered by a group of people that are a subset of the category, "LASIK Surgeon".

I had zero symptoms of corneal disease before my LASIK surgery.

I had a step function increase in corneal disease and vision problems, on the day of my LASIK surgery.

"The cornea after refractive surgery is not trouble-free" (1) -- I think the corneal surgery is a prime candidate, when trying to identify the source of my corneal disease.

The bottom line, is - I know there are thousands and thousands of kind, caring, compassionate, skilled ophthalmologists and optometrists out there.  The trick is getting their help.

Now, I went to see a Harvard-educated dry eye specialist at Scripps - the head ophthalmologist, in fact - Doctor Mitchell Friedlaender - about my dry eye.  I requested diagnostic procedures, to shed light on my eye problems.  All he had to say was that I have a GREAT LASIK surgeon.  Both Doctor Friedlaender and Doctor Gordon live and work in or near La Jolla, California.

That kind of "doctor", I don't need.

The kind of doctor I do need is one who will order a COMPREHENSIVE corneal confocal microscope exam.  I say COMPREHENSIVE because - I know one patient, with a huge amount of interface debris that was revealed in a subsequent corneal confocal exam, who went to see a Harvard-associated refractive surgeon in Boston.  He told her he saw nothing that would explain her pain.  The patient then went to another corneal confocal microscope specialist, and what was revealed was -- a huge amount of metallic lamellar interface debris.

I subsequently spoke to the product manager at the company that loaned the corneal confocal microscope to the Harvard-associated refractive surgeon in Boston.  That product manager told me that he received the microscope with no patient files.  That would mean one of 2 things:
1)  Harvard-associated refractive surgeon in Boston doesn't know metallic lamellar interface debris when he sees it.
2)  Harvard-associated refractive surgeon in Boston saw the metallic lamellar interface debris, and either didn't save the record of the exam to the hard drive.  Or, came back later and DELETED the file -- spoliated the record -- thereby sending the patient out into the night to live the rest of her life with constant pain in her eyes.

COMPREHENSIVE corneal confocal microscope exam means - no data is withheld.

I hope to improve my understanding of my condition in terms of diagnosis.

I need real medical help from a real doctor.  The old-fashioned kind, the kind who likes to solve problems to help people.

If I seem to have a sense of urgency, it's related to the fact that I know dozens of people with similar or more painful and disabling post-LASIK vision - people who need and deserve medical help.

It's difficult for me to read the posts of the patients in the medical forums listed on the home page without realizing that ...
1.  These people do need, and deserve, medical help, and ...
2.  Unfortunately - there are a lot of them.

Again --

Is there a Doctor in the House ?

Thank you.

Sincerely,

~ Roger ~

Roger Bratt

email address:
rodgerebratt@yahoo.com

NOTE: To email me, please remove the "d" from "rodger" in "rodgerebratt".

(1) Editorial
Dr. Leo J. Maguire
Mayo Clinic
American Journal of Ophthalmology
Volume 117, Number 3
March, 1994