Sunday, April 13, 2014

Double Vision

The timeline is fuzzy. It's hard to remember when it all started. And because I've bounced around with doctors – can't remember their names, moved to a new state – getting clarity would be a lot of work. If not impossible. At some point in my adult-life I stated having trouble with double-vision. Strabismus is the medical name. While I can't remember when it started, I know I got it surgically fixed in 1999. And now it's back.

The last half of the 1990s were a tough time for me. A horrific bicycle accident – cut off by a minivan. Internal bleeding, collapsed lung, badly deconstructed shoulder, and huge head trauma. I would call it a concussion, but that just doesn't do it justice. I fully lost 18 hours – no recollection at all – while my brain was trying to descramble enough to encode memories. Just as well, I'm sure those were the worst hours of my life. Good ones to lose. And in the years-long recovery from the accident, my Tourette's-associated eye-tics began.

My tics were quick, straining, eye rolling movements. My eyes felt swollen in my head, or like they had air trapped behind them. The eye rolls were an attempt to relieve that pressure. Unaware that I had Tourette's Syndrome, I tried to get medical help. I can't remember how many Ophthalmologists I saw. At least two, probably three. I really only remember the last one. A highly regarded doctor in Bethesda, Md. He eventually learned to hate me. A patient who repeatedly came with a vague complaint. "My eyes ache." Multiple eye exams, tests, a biopsy, he even plugged my tear ducts in an attempt to make my eyes less dry. Nothing worked, I could hear his frustration when he talked to me.

Sometime during this period, the double vision started. Mostly at night, when I was tired, when my eyes were spent, used up from the day. Reading a book or watching a video, typically with a glass of wine. My brain would temporarily lose the ability to bring what each eye was seeing into one picture. I got two, one above the other, just a bit apart. Frustrating. My choices were to pack it in for the night or to cover one eye and continue. To my doctor, this was a relief. A measurable eye-ailment, something that can be fixed. This became the focus of the eye appointments. The vague achy-feeling was forgotten.

Double-vision or Strabismus is typically fixed one of two ways. Either by creating prism lenses in glasses that physically bend the image one is seeing into the direction that the eye now wants to face, or by surgery – essentially cutting and repairing the eye muscles so that the eyeball faces the correct way. I had both treatments. My Strabismus was progressive. The prisms in my glasses worked for a while, but 6 months later the double-vision was back. More prism, more time bought, but ultimately surgery was necessary.

And everything was fine for over a decade.

And then it started all over again. Split images, mostly at night. After a long day. Long car trips. Alcohol makes it worse (not several, one drink is all it takes). Lots of eye-appointments. Small prisms, larger prisms. I've been wearing my current prism prescription for over a year, and my vision has been great. No double-vision at all. A temporary cure. Somewhat out of mind.

And then I had a freak accident. Playing racquetball, my friend Fred elbowed me in the eye. He's a big dude. 6' 2'', 240, muscular. He's a farmer. Carries heavy crap around all the time. Me, I'm a little dude. 5'9", built like a runner. He actually launched me up into the air. When my glasses were fixed, when the swelling went down, when most of the black and blue drained away, my double-vision was back. Worse at night, but somewhat present all the time.

When I went for a second opinion the doctor verified what I already heard. Give it a month or two, but it probably isn't going away. More prisms, maybe, or more surgery, likely. And then he said something really interesting. He asked my why I had Strabismus in the first place. If anyone ever took any time to figure out what was causing it. And this, I contend is the problem with almost every doctor I've ever visited. Quick to treat the symptoms, but not much thought put into the cause. I get it. Looking for the cause takes more time. Research, data, trial and error. Nail the symptom and the problem is gone – at least for now. It's about what the insurance company will reimburse, which is not an hours-long discussions about lifestyle, diet, family history.

This doctor didn't spend any time trying to figure out why I had Strabismus either. At least he acknowledged it. "You're just here for a second opinion, my opinion is that you should wait a month and see a specialist if it doesn't go away."

So here I am, waiting it out. I've made the appointment already. It takes time to see a specialist. Another six weeks or so. Three full months since my racquetball game. Double-vision every evening, many afternoons, some mornings. Limited reading time. Difficulty getting stuff done at work. Going to bed early, cranky because I can't see. And wondering whether once fixed, it is just a matter of time before it all starts up again.

1 comment:

  1. Vision therapy, dude. Ophthalmologists have no idea about the neurology of vision... They artificially separate eyes and brain. Double vision is essentially a neurological symptom. Check out my blog: