Tuesday, June 21, 2016

Stick a Needle in My Eye

I saw the eye doctor today.  She's awesome.  So, let's talk about my eye for a while.  First, some vocabulary:
This is the nasolacrimal system. These are the eye parts we're dealing with
What you don't see in this picture is that the Lacrimal duct drains into the sinuses.  We already know that my sinuses are full of scarring.  My Lacrimal duct is too.  So what happens is all the stuff that would normal drain into my nose gets stuck in the Lacrimal sac.  I have this awesome party trick that no one ever wants to see: I can push on the corner of my eye (where the lacrimal sac hangs out) and a bunch of gross will ooze out in to my eye.  The resident who checked me out before the doc thought this was really interesting.

Almost all the gross that comes out of the lacrimal sac comes out of the upper canaliculus, which is unusual apparently.  The doctor was concerned that the lower canaliculus was also blocked, which would make things extra complicated.  To check this (squick warning) the doctor literally stuck a needle in the puncta and pushed it through to the lacrimal sac.  She also tried irrigating (the needle was at the end of a syringe of saline) the system - but it was pretty obvious that the lacrimal duct was completely blocked, and irrigating can actually make that inflammation worse.  She did irrigate my left eye, just to make sure everything was working. It is.

The good news is my canaliculus is not blocked.  The bad news was NEEDLES in my EYES!

By the way, having numb eyelids is a very strange feeling.

Also good news neither my vision nor my eye mobility has been effected.

So, I need surgery.  She's going to bypass the lacrimal duct altogether and just punch a hole in the side of the sac so it will drain directly into my sinuses.  She and Nose Doctor are going to do the surgeries together, so he will be able to make sure the scarring in my nose is cleared from the new opening.  Then she'll put in some silicon tubes (stents, really) that I'll get to keep in my eye for 12 weeks.  

In normal cases they would try to do all this by going into my nose and working out from there.  Unfortunately because my nose is so messed up, Eye Doctor is pretty sure that's going to be difficult.  So I will probably get a nice scar on my face.  She said that such scars usually heal really well.  I'm ok with a scar though.

Anyway, after having my eyes messed with for quite a long time (needles!), I got to go down the hall to the surgery coordinator.  As it turns out, Nose Doctor and Eye Doctor actually have very conflicting schedules.  They do, however, have a joint project/patient on July 26 already, so they both can have clear spot for my surgery as well that day.  Honestly, that's almost the worst time for me as far as what is going on at work and in life.  But I got the impression that I could either take that date or wait a very long time for them to both have an opening at the same time.  So I said yes.  

Hopefully Throat Doctor will be able to make it to the surgery party too.  I'll see next Wednesday. Maybe something will have gone spectacularly right for me, and my throat will be clear enough that he doesn't even need to get in there and dilate it.

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