I can see clearly now…

I am incredibly fortunate to wake up each morning with perfect vision. Yet just a few months ago I couldn’t see anything clearly beyond my nose without the help of glasses or contact lenses. The transformation is, quite literally, life changing.

Towards the end of 2020, after years of prevaricating, I finally took the decision to ‘have my eyes done.’ In my case, this meant Lens Replacement Surgery as, due to the shape of my eye and my thin cornea, I was unsuitable for laser surgery.

My distance vision has been deteriorating since my early 20s (I am now 56) and I wore contact lenses constantly for years. But in recent years, my near (reading) vision worsened, and so began a series of experiments. First, varifocal glasses, then attempts to find a solution when it came to contact lenses. We settled on a long distance lens in once eye and a short distance lens in the other. This worked, but my vision near, far and in-between was never perfect.  And as I was getting increasingly dry eyes, I resorted to wearing glasses most of the time.

Then my mid-distance vision deteriorated which necessitated new glasses especially designed for using the computer. So for the past few years I have been pretty much fully dependent on glasses (several pairs). But because I only have to think about going for a jog to make my glasses steam up, I always had to switch to contact lenses for any sort of exercise – even walking the dogs!

Last summer (2020), I found myself in a situation where I felt vulnerable and extremely anxious because of my vision problems, having chosen to leave my glasses off and lenses out to go into deep sea water. This experience made me contemplate other situations I could find myself in when my glasses might fall off or get broken, and grabbing another pair wasn’t a straightforward option. Vanity and inconvenience were no longer my only reasons for doing whatever I could to restore my vision. Safety was also a factor.

As my prescription was -8.5 plus astigmatism in both eyes, I half expected the consultant to tell me I was too far gone for treatment. So my first visit was really to see if this treatment was even an option. After many different tests, the ophthalmologist said I was suitable, and that the consultant would decide whether I should have multifocal lens (which would allow distance and near vision in both eyes) or a monofocal lens (distance in one eye, reading in the other).

That first appointment was free. The next appointment with a consultant would cost £90. Still undecided, primarily due to nerves, I booked myself in, and at the consultation was told I should be suitable for multifocal lenses. I have tried multifocal contact lenses, and didn’t get on with them – but the consultant assured me these were different.

I was still uncertain. The many, many potential risks had been explained to me and they were terrifying. They included sight loss, reduced vision, infection, haemorrhage and, given the shape of my eyeball, retinal detachment. I was given the percentage risk of each scenario. In most cases this was minimal, but all the same, the risk was there! A friend who had the surgery done 10 years ago talked me through his ‘life changing’ experience, which was very encouraging – thanks Michael!

In the end I decided I had to go for it, the vision (excuse the pun) of how life might be after the surgery was compelling. I had my right eye done three weeks later, at the end of November 2020, and my left eye a week after that.

I am sharing my experience as I hope this might help someone else thinking about Lens Replacement Surgery. This is not a medical assessment of the procedure – anyone considering it will find information on the internet, and can then discuss their own circumstances with a consultant.

On the day of my first surgery I was in and out of the clinic in exactly one hour. As it was in the midst of the Covid-19 pandemic, additional precautions were in place (and had been through all my appointments) including wearing masks etc.

The previous day, I had had to insert drops every four hours, with more drops to dilate my pupil on the journey to the clinic. Once there, a nurse inserted lots more drops of different types. She took my blood pressure, and her pleasant, calm, manner was reassuring. I was taken to another room, where marks were made on my eyeballs by an ophthalmologist (with what seemed to be a black marker, though I am sure it was more specialised than that!)

Then it was across the room to the anaesthetist who clamped my eyelid back in order to numb my eyeball, as I would be awake for the surgery. She warned that I might feel a bit of discomfort, and for maybe 30 seconds or so I did feel a pressure at the back of my eye. It wasn’t painful, but it was a little odd.

From there it was straight into surgery. I had to lie down, remove my mask and glasses, and mini curtains were placed around my eye. Then a cold liquid washed around the eye – I could feel it on my face although my eye was completely numb. The only physical sensation I had was the surgeon’s fingers holding my forehead, presumably to stop me moving at a vital moment. No worries about that, I lay still as a stone throughout the procedure. There were some strange noises, a muted drill was a little alarming, but nothing frightening. Then the tape holding the mini curtains was whisked away, I was given a tablet and a glass of water, and led to the recovery room, where a nurse went through the course of eye drops I would have to follow for the next 28 days.

I balanced my glasses over the plastic eye shield which was taped over my right eye, and it was time for home. All over in just an hour.

My plans to sleep in a darkened room for the rest of the day were scuppered, as I had to put a drop from one of the three bottles I had been sent home with into my eye every hour. So I downloaded an Audible book, and that kept me entertained for the first day – and several after.

At 12 noon – two hours after surgery, I had to take the eye shield off and remove the tape that was holding my eyelid closed. I imagined my eyelid would pop open and – maybe – I could see! But the eyelid didn’t budge, indeed the eye remained almost closed, so it was with precision and a bit of contorting on my part that my husband managed to get a drop in. Through my other eye I could see that the eyeball looked a bit puffy, watery and bloodshot, but it wasn’t weeping and was still numb.

As each hour passed, and the shield came briefly off – my eye began to open. My skull was numb (a real numbskull) and there was no pain for several hours. Even then, it was just a scratchy, burning discomfort. At about 4pm I took a couple of Ibuprofen. I didn’t need any pain relief after that.

And I could see! Initially just light, then as the eye opened more, I could see clouds through the window – something I couldn’t have done before. Putting in a drop in the bathroom, I could see shapes and colour really distinctly (I never knew my curtains were that colour of plum!) When I looked at a painting on the wall, it was at a completely odd angle – and so was my daughter! This could have sent me into a panic, but I had been told it may happen, so it just gave us all a laugh, and an hour later the picture had righted itself!

By mid-afternoon, I could really see, although the eye shield had to stay in place all night in case I rubbed at my eye. So I just rested in a dark room, listened to my book. I rested all the next day and kept the eye shield on when lying down in case I dozed off. I briefly went to visit my dad, who expressed surprise that I looked ‘normal’ – he was thinking surgery would result in a black eye!

On day three I removed a lens from a spare pair of glasses with a view to using these to help me see through left eye (my clear vision in my right eye really emphasised just how bad my left was, and I thought this would allow me to see with both eyes). But the glasses just gave me double vision, and for the rest of that week I saw most things through my ‘new’ eye, and read my phone with my left eye, holding it an inch from my nose (a not-very-attractive look I have mastered over the years!). I could read the text with my right eye, but it was a bit of a strain. I experienced some halos with my new eye and flashing lights in the periphery of my vision, but nothing alarming.

I had hoped to return to work a couple of days after surgery, but because of the imbalance between the two eyes found looking at a computer impossible, so had the excuse to take more time off to recover.

Such a joy to see so clearly and the colours – those curtains, the orange of the leaves of the beech hedge, unimaginably vibrant, and my grey scarf which, it appears, is actually mauve!

A week after getting my right eye done, I was back for my left eye. This time I was less nervous, the right eye had gone so well. And I was so excited about the overall outcome. But things didn’t go so smoothly. There was a longer wait between each stage as the clinic seemed quite busy. However, a check on my right eye showed that I had better than 20:20 vision, and it was explained that the lens was set to read at computer distance, which is why reading the phone had been a bit of a strain. My left eye would be set to reading smaller print. All good.

Having been unnerved by the ‘pressure’ feeling during the administration of the anaesthetic first time round, my palms were sweating and my heart racing when I got to this stage, but actually, I felt it less and it was over in no time.

Back in theatre, the surgeon mentioned that my ‘lovely long eye’ could put me at increased risk of retinal detachment in 10 or 20 years, something he hadn’t said the week before, although I had been warned about it. Then the surgery began. At one point the surgeon commented that I may need a suture and that my cornea must be very thin. I was really hoping not to need a stitch, but knew it could happen and that it was not an issue – the friend who filled me in on his surgery had to have one. Still, I did feel anxious. Next, the surgeon remarked “This has caught.” I thought he meant the stitch hadn’t caught and I might need another. But I could hear someone leaving the room, and there was a tense wait (tense for me anyhow), during which time I could feel liquid being sprayed around my eye area. Had the lens had got caught or twisted as the surgeon was inserting it? Would it be stuck there forever, uncomfortable and useless, and me blind as a bat in that eye? I could do nothing but lie as still as possible. Huge relief when the surgeon announced that I didn’t need a suture after all.

Then it was all over. This time it took around 15 minutes rather than 10. Helping me sit up, the nurse explained that the lens had twisted on a tool before it had reached my eye and they had to go to the bank for a second one, so there was no cause for concern.  The discharge nurse went through the procedure with me, also without any indication of concern, and I was on my way home.

Two hours later, removing the shield, I could see that my left eye appeared very bloodshot, much more so than my right eye had done. But within a week, that had cleared up. Otherwise, recovery was similar to with my right eye. The anaesthetic took longer to wear off, and I didn’t experience any major discomfort afterwards. On day two I could see well, but felt the vision was a bit cloudy. 

Distance vision in this eye definitely took longer to settle than in eye one. But five days after the second surgery I felt safe to drive. And life began to return to normal.

I could see – 100 per cent. What a miracle!

I had been warned to expect halos, and I do see these at times, particularly in unnatural light (this is more of an issue with multifocal lens implant rather than monofocal) but it has not been an issue with night driving thankfully. The halos are much less frequent now.

Within three weeks of the second surgery, my distance vision was excellent and I could read a phone and book, and see the computer. I did feel I was straining a bit for the closer vision, and the computer distance, but resisted the temptation to wear reading glasses in order to train my brain to look through the correct eye – as I write this five months down the line I am finding this is happening more naturally, and I can honestly say I can read anything – including the small print on food packaging.

I had my second check-up a month after my second surgery. At that point the ophthalmologist detected that the distance vision in the left eye was not quite 20:20 – although my overall vision is perfect when using both eyes. It was suggested that this could continue to settle, but if the consultant was concerned, he may do a ‘little laser’ just to correct it. At my next check-up, at three months, both eyes were 20:20 – no laser required!

I have been an incredibly conscientious patient. As was advised, I didn’t wash my hair for a week after both surgeries, and then it was a case of sitting on a low chair with my head arched over the edge of the bath (very uncomfortable and requiring more contortions on my part!) wearing two eye shields, covered by my hands, just in case I got water into my eyes. I didn’t use the shower for the same reason, just bathed in a couple of inches of water!

I did not get gooey eyes, but did use the distilled water I was given to gently bathe them each day. I put my drops in religiously (several times a day for a month after each surgery). The gym was still open at the time, but I limited my activity to walking for an hour on the treadmill – no jogging, cross trainer, punchbag or weights! Once lockdown ends and the gyms reopen, I will be able to resume these activities without any problem (at least no problems relating to my eyes!).

For the first four months, I experienced uncomfortable dry eyes, particularly later in the day and after too much screen time. I work part-time and adapted my hours so my work is spread out over the whole week, rather than three full days, and that certainly helps. I raised the dry eye issue at my three-month check-up and was told I had a bit of inflammation in the eyes. I used steroid drops for the next three weeks, and now dry eye is fairly rare. If I feel a little uncomfortable, I use artificial tears.

I still get some halos, and flashing lights if there are bright lights in the periphery of my vision. I need good light to see to read.  But these things continue to improve, and I was told it could take up to six months for my new eyes to properly settle.

Are these small discomforts enough to make me regret having the surgery? Definitely not. I am embarrassed by how quickly I have come to take not having glasses for granted – I should be thankful for this miracle of sight every day. And I am. Overwhelmed really.

But occasionally, I still go to push my glasses up on my nose, or fumble around for them in the darkened bedroom!

Do I wish I had had this done years ago? Perhaps. But if I had had the surgery before my reading vision deteriorated, I would have probably only had monofocal lenses inserted, and would now be dependent on reading glasses. And, in all honestly, I could not have afforded it before. Each eye cost £3,200. That’s £6,400 in total. That’s a lot of money, and it is only thanks to gifts from dear family members who are no longer with us that I have been able to do it now. I could have put that money towards a new car – but the gift of sight – what a legacy and one which I will be forever grateful.

Update: June 21st 2022. It has been 19 months since I had my two eyes done – my vision is still perfect and I no longer have issues with dry eyes or discomfort. I did notice some shadowing in my left eye a couple of months ago, my local optician checked me out very quickly as I was concerned about detached retina, and said there was nothing sinister going on. I also went back to the clinic where the surgery was performed and after a very thorough examination learned that I was just seeing a friendly floater, one of a number which have been drifting around in my eyes for many years, but this was the first one to make himself known. He still pops up now and then, but would have done that regardless of the surgery, so it is no big deal.

And I should say that both the local Specsavers and the clinic took my concerns very seriously and neither charged me for the eye examinations.

Update: January 31st 2024. More than three years in and my eyes are still great! The floaters still make themselves known, by only occasionally and they really don’t affect my vision. I don’t suffer from dry eyes any longer. I only wear glasses for the computer and for reading a book, although I can read fine without them – I just like to magnify the print! The days of constantly switching glasses and contact lenses already seems a lifetime ago…

If you have any questions about my experience with Lens Replacement Therapy or the outcome, please feel free to leave a comment.

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