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George's EyesWARNING: Some portions of this page are known to make some people queasy. Paragraphs with graphic descriptions are marked with a (*) George had eye surgery on January 26, 1999 at the Jules Stein Eye Institute within the UCLA Medical Center. The procedure performed was for general "Strabismus" to correct a form of Duane's Syndrome, a birth defect. The procedure was performed by Arthur L. Rosenbaum, M.D., Professor, Pediatric Ophthalmology and Strabismus Division, Department of Ophthalmology, UCLA.
August 28, 1998Went to see Dr. Rosenbaum for the first consultation appointment. I was referred by a local eye surgeon in San Luis Obispo. After the exam, he felt that I was a good candidate for Strabismus surgery and performed one last test to see if the two opposing muscles were too tight to allow the surgery to be successful. * To perform the test, he put anesthetic drops in my right eye, then took small forceps (very sharp pointed tweezers), grabbed the white of my right eye (stuck the points into the white of the eye), and wiggled the eye to see how much resistance there was. I passed the test, but almost passed out as my mind realized what he had just done. January 25, 1999I arrived at UCLA for the first of several appointments at about noon after a three and a half hour drive from Atascadero. A couple of friends accompanied me down so I would have someone to drive me home on the following Wednesday. The appointments were:
The following MRI's (Magnetic Resonance Imaging) were performed as part of a research project by Robert Clark, M.D.. There were 14 MRI's performed, each taking three and a half minutes and consisting of 17 slices through whatever that particular MRI was focused on. This took approximately an hour and a half. If you've never had an MRI, they're loud (lots of buzzing and clicking, they gave me ear plugs) and you have to hold still during the three and a half minutes. Since there were 14 of them, I was in the machine for the full hour and a half. During that time, I wore a mask with little LED targets that lit up for each scan and I had to stare at the lit target. Some of the images sent to me by Dr. Clarke are
During the tests performed today, they noticed that could turn my double vision on and off which made some of the tests more difficult. Most people with this problem wither see double all of the time or not at all. As a child, I used it for cheap entertainment so I could control it if I thought about it. January 26, 1999I went into the Eye Institute hospital at 8:30 AM on January 26, 1999 a little nervous since this would be my first surgery. I went into surgery at 10:30 AM and blinked looking at the ceiling to find myself in the recovery room. I was wheeled back to my room where they waited to make sure that I was stable and functional before releasing me from the out patient surgery. I went back to the UCLA guest house my friends and I were staying at and went to bed. I slept about 11 hours that night. January 27, 1999I saw Dr. Rosenbaum again for the first post operative appointment and he told me that he had ended up moving both the upper and lower muscle groups over toward the right side of my eye and that he felt they should be able to help the outer group pull against the inner group. He noticed an immediate improvement in that my head had already shifted from about a 15 degree offset to about a five degree offset. He was also impressed with the vertical movement I had maintained after the surgery. My friends drove me home that afternoon. At one of our stops, they debated on who should take the credit for the black eye that was developing. January 31, 1999Tried driving by myself for the first time during the day. I had to explain to several friends the black eye that I had. Several thought that a bar fight story would have been more exciting. It rained during the morning and when I came out of church the sun had come out. The glare off the road surface was a killer. Also driving in daylight makes me a little nauseous. I can only read for about 5-15 minutes at a time without getting a headache. As a result, I'm only going back to work when I can read for at least 30 minutes. February 2, 1999I got to take a shower today for the first time! The previous several days have been a pain not being able to wash my own hair. I went to a friends barber shop and had my hair washed in the mean time. Went to a Target today with a friend. The lights in the store gave me a headache. February 6, 1999Eleven days after the surgery and I went dancing for the first time. Not bad, I could even look over my right shoulder for the first time. February 8, 1999I returned to work today after being out for two weeks. The lights in the office are a little harsh, but I've found ways to get out of the office and perform other tasks that need to be done. I was drained by 3:00 PM that day. Follow UpAfter six weeks, I am to return to UCLA for an evaluation. If my right eye hasn't found a center position, that is its still off center, Dr. Rosenbaum would then inject a botulism toxin into the inner eye muscle group of the right eye to weaken it. * The injection will be performed while I'm awake with a local anesthetic. Considering what happened in August, I may not need an anesthetic, I may just go ahead and pass-out. A second set of MRI's will be performed at that time as part of the study that Dr. Clark is performing. March 11, 1999Today was the scheduled follow-up appointment. The drive to LA was a killer. It took an hour and five minutes to go the 15 miles from 101 to UCLA on I-405. I got to UCLA with minutes to spare and was taken to the Brain Mapping Institute for a second set of MRI's as part of the study that was being done. As soon as I have these decoded and turned into Web capable images, I'll post them here. (This time I was sent six complete MRI series of fourteen slices each!) I then went back to the surgeon's office for the post op examine. Since I would receive a small dose, if at all, I was one of the last patients he saw that day. After talking with Dr. Rosenbaum, we felt that I should have the injection. My right eye had gone from a 15 degree deflection to the left before the surgery to a little under five degrees just after to five degrees at six weeks. He felt that the injection would get my eye much closer to center. Since I had a bad reaction to the test he had performed in August, he sent me back out into the waiting room so he could take care of the rest of those waiting, saving me for the last. * Getting the injection was interesting to say the least! An electrode was placed on my forehead above the right eye's inner muscle group. Some type of probe was held by Dr. Rosenbaum over the area to receive the injection. A stead level of static was coming from a speaker behind me. The volume would increase when the needle made contact with the muscle tissue and then go silent when the toxin is injected. * A clamp was placed on my right eye's lids to hold them open (a small wire device which can be seen in a scene in the movie "A Clockwork Orange"). They then had me rotate my eyes to the right and he slid the needle along the surface of my eye under the tear duct. When the speaker indicated contact with the muscle, they had me rotate my eyes to the left so he could inject into a contracted muscle mass. Needless to say, my mind did not like this part at all, I started blinking my left eye and tried to hold still since he said that any movement could result in an injury to the eye. Once they toxin was injected, I had to slowly rotate my eye back to the right so the needle could be removed (that was the only thing I actually felt). Dr. Rosenbaum waited for about five minutes to make sure I looked like I was doing OK, then left. While his assistant was cleaning up for the afternoon, I continued to sit in the chair and relax. I felt I was doing pretty good and not going to have a problem. Five minutes after Dr. Rosenbaum left, the lights went dim and I felt cold and soaked with perspiration. I called out for the assistant who went and got one of the fellows who are training under the surgeons. He looked me over and said that I looked like I would be OK and tilted me back in the chair. Ten more minutes later I was able to get up and move around, although I did feel light-headed. The reaction is basically the minds way of shutting down to protect itself. A mild form of shock is what they described it as. I visited with a friend who worked at UCLA and ended up driving home a couple of hours later than I had originally intended to. I supposed to return for another follow-up in six to eight weeks. April 4, 1999Someone who I had not seen in a couple of weeks and who wasn't aware of the surgery asked me if I'd done something like change my hair style or something. She noticed something different, but couldn't put her finger on it. April 6, 1999During a periodontal appointment, I was placed in a chair and tilted back toward a bright ceiling light and my right eye upper muscle group had a slight spasm. It took a couple of minutes to get used to the lights while I waited for the periodontist. May 1999One night, I found a National Geographic issue that included 3D glasses and had two 3D photo articles. I looked at them and was amazed at the amount of depth I was able to see that I had never noticed before in 3D photos. I also tried a 3D View Master again, but it looked the same as before. June 4, 1999My next post op appointment has been scheduled for Jun 10 at 10:00 AM at UCLA. June 11, 1999Went down to UCLA for the second post op appointment. Traffic was a little lighter on I-405, so I made pretty good time. Got to the office about fifteen minutes early and grabbed a seat in the waiting room which was crowded by other waiting for Dr. Rosenbaum as well as the other doctors that share the examination area. When I saw Dr. Rosenbaum, he thought that I could use one more injection of the toxin to give me a little more movement to the right in my right eye. But before he gave me the injection, he wanted to have me get a binocular vision test. I went to the building next door and waited for that test since they were working with another patient. When I started the test, I was running late to get back to Dr. Rosenbaum who had a surgery scheduled for 11:30 AM. I returned to Dr. Rosenbaum's office at 11:55 AM and he had already left for the surgery. They started putting anesthetic drops in my eyes in anticipation of his return. Finally he got back at about 12:40 PM, but noted that a piece of equipment had been left back at the Operating Room which was required for my injection. While his receptionist went to retrieve it, we sat and talked about the differences between the two universities. * They put the eye-lid clamp on my right eye and proceeded in the same manner as the previous injection. It did feel a little different than before and this time I only got slightly light-headed for a couple of minutes. I think the secret to not passing out was to do it on an empty stomach. The time last August, I had just had breakfast a couple of hours earlier and in March I had just eaten lunch. Today, I hadn't eaten anything all day. As a result of the exam, he felt that I had the ability to see with binocular vision up to 10 degrees to the right. Prior to the surgery and shots I could only see binocular at 5 degrees to the left. With the second shot, he had hopes of getting up to 15 degrees to the right, which he felt is the most that anyone normally does anyway. He was surprised that my right eye hadn't drifted to the right for a short time a few days after the last injection. He also was surprised about what happened on April 6th in the periodontist's office, but didn't think it was a problem. After the shot was over, I ate lunch and drove back to Atascadero. Dr. Rosenbaum wants me back in another two months for another examination. June 12, 1999I went back to work the next day and experienced a slight amount of pain whenever I concentrated on my computer monitor. As a result I went home early and the problem disappeared that evening. June 1999Not much of a notable change since the last visit except that when I got new glasses I noticed that an object on the surface of my left eye which had been static since the age of 16 had quadrupled in size. Also noticed fatigue more often in the transposed muscles. September 30, 1999Went down for another visit on September 30. Dr. Rosenbaum suggested increasing the dosage because the reaction to the previous shot was minimal. I asked about the growth on my left eye and he indicated that it wasn't anything to do with the surgery and he recommended that I get it removed. As usual, the injection was very uncomfortable. October 1999I made an appointment with a local eye surgeon to look at the growth. They informed me that most growths can be removed in office on the appointment day. Since the last injection, I have noticed that I appear to see double more when looking to the left. January 2000Had another injection. Increasing the dosage. June 2000Upon measuring the shift to the left, Dr. Rosenbaum felt that the results justified no further injections. Future appointments will be with a eye surgeon in San Luis Obispo. If the right eye starts to drift back to the left again, additional visits to Dr. Rosenbaum may be required for further injections or a second form of surgery to weaken the inner muscle group. September 2004A recent visit to my regular eye doctor has resulted in no more follow up appointments with the eye surgeons. Last Updated: October 26, 2004George Westlund (gwestlun@calpoly.edu) |
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©2004 George Westlund |
