PART (C) The Long & Tortuous Tunnel


Six months after the replacement of my left eye’s lens implant, the central vision of my left eye was still poor (VA 6/9) and was inferior to that of my right eye (VA 6/6). At regular follow-up checks, Dr Choong did not comment about the poor vision of my left eye and as the vision blurriness was not so severe and it did not significantly affect the activities of my daily life, I began to adapt to it.


But foremost in my mind was whether I could still pursue my hobby in scuba diving. Some of my diving buddies and I were booked to go to North Sulawesi to dive in Bunaken and Lembeh Strait in early May. And since I had completely recovered from the eye operation, I decided to undergo a diving test in N Sulawesi to see whether scuba diving would affect my new and the old lens implants. The eye specialist, Dr Choong fully supported my intention and suggested that I came to see him after I returned from my diving expedition.


I took it easy this time and was on a constant lookout for any problem associated with my vision. I did sixteen dives in six days; four in Bunaken and the rest in Lembeh Strait. I enjoyed all my dives, but because of the poor vision of my left eye I had a problem in seeing and photographing small critters in the muck.  It was also the first time that I used Nitrox air (air enriched with 32% oxygen) for all my dives in Lembeh Strait. The maximum depth I dove was not more than.30m. Though I did not feel any discomfort in both my eyes, I was a bit concerned about the polluted water in Lembeh Strait which could cause further damage to my left eye.

Two days after I returned home from N Sulawesi, I went to see Dr Choong. After some tests were done, Dr Choong told me that not only the vision of my left eye had deteriorated (VA exceeding 6/10) but also my retina had swollen! Though he could not tell me the exact cause/causes of my new problems, he was positive that neither the polluted water nor the Nitro air had anything to do with the new discovery of damage to my left eye.


I was left to ponder what to do next to the new-found malady of my left eye. When I was in communication with two divers, Dr Teh and Chris Chin, I came to know that they too had a slight blurry vision after they came back from N Sulawesi. But they fully recovered a few days later. I rested for another week and went back to see Dr Choong again to check the condition of both my eyes. The results of tests indicated that the vision of both my eyes was back to normal i.e. left VA6/9 and right VA6/6, but the “swell” of the retina in my left eye remained unchanged and no “swell” was seen in my right eye’s retina. This led me to believe that diving in polluted Lembeh Strait was not the cause of my “swollen” retina.


I started to enquire from friends whether they knew of any good eye doctor who specialized in retina. A few names were given and it was left to me to decide whom I should go for consultation.             


On the evening of 26th May, I sent my daughter, Mei, to UMSC to see a doctor to treat her injured knee. While waiting and loitering in the clinic, I noticed that there was a retina surgeon present. I took the opportunity to seek advice from her regarding my “swollen” retina. After registration and waited for more than half an hour I was ushered into the surgeon’s room. I briefly described to the surgeon the long story of my ailing left eye. She did a quick examination and told me to wait outside for the assistants to carry out further tests.


My eyes were dilated by a nurse and I waited and waited……More than half an hour later, my eyes were dilated again and I was left forlornly waiting and waiting. Another half an hour had elapsed and by then Mei had finished her consultation with her doctor and together we waited and waited. It was about 8pm and I began to feel cold and hungry. I told the nurse about it and she just ignored me. Fifteen minutes later, I was totally upset and I stood up and told the nurse quite sternly, “I am feeling cold and hungry and if the doctor does not want to see me now I am going home!” As I was about to leave, the nurse beckoned me and led me to another room where my eyes were examined by a machine operated by the surgeon’s assistant. An Optical Coherence Tomography (OCT) of each of my eyes was taken. The OCT showed clearly the damage to the retina of my left eye.


Soon after the OCT was taken, I was ushered to the surgeon’s room. The surgeon, looking at the OCT, told me that my left eye had “Epiretina Membrane”. Seeing that my face was blank, she wrote the two words at the bottom of the OCT image of my left eye and briefly told me that it was caused by my moving lens implant. She also told me that a simple surgery would be necessary to remove it but she would do it only in September! When questioned, she said it was not a serious disease and she was also busy for the next three months. I looked at her, baffled and dumb. After she had given me the appointment slip and the two OCT images, I left the room without saying a word.



                                                                          IOC IMAGES

I thought the ordeal of waiting was behind me when Mei and I left the clinic and went downstairs to the Casher Counter to settle the bill. There the waiting game started again. There were two cashers at the counter and once in a long while a name would be announced and he/she would go and settle the bill at the counter.  After waiting for more than fifteen minutes, I went up to the counter and told the cashers “I’m going home because I’m hungry. Please send the bill to my house and I’ll pay by cheque.” One of the cashers replied, “Wait, I’ll get the bill.”, and she started to go upstairs. I then shouted at her “I give you five minutes!” Soon she came back with the bill and I settled it and left UMSC, hopefully for good!                       

Though irked by the unnecessary waiting and curt treatment at UMSC, I was pleased that I now knew something about my “swollen” retina. I would get further information and details about “Epiretina Membrane” from the Internet.


Studying the OCT images of both my eyes and information I obtained from the Internet, I began to understand more about my eye problem.


“Epiretina Membrane” is the scar tissue that has formed on the macula, which is located in the centre of retina. The macula provides the sharp and central vision we need for reading and seeing fine details. The scar tissue formed in the macula will cause blurred and distorted central vision.


The main cause of my “Epiretina Membrane” was most likely due to severe trauma to my eye from the detachment of my lens implant in my left eye from early February to end of October 2008. And it might have got worse when the eye surgery was carried out in early November 2008 to replace the displaced lens implant. 


Though the new-found ailment of my left eye did not severely affect my daily activities like reading and driving, I would like to get rid of it soonest possible so that I could move on with my life freely and unhindered.


The contacts from my daughter, Mei and my friend, Dr Teh, advised that I consult Dr Wong of International Specialist Eye Centre (ISEC) regarding the latest discovery of my eye problem.  An appointment was made to see Dr Wong on 1st June.


After briefing Dr Wong about the long-drawn problem of my left eye and showing him the recent OCT images taken at UMSC, he did a quick examination and told me that the problem was not serious and could be resolved with a simple eye operation, a surgery called “Vitrectomy”, to remove the Epiretina Membrane. With local anesthesia and using the latest instruments, the surgery would take less than half an hour and I would not feel much pain or discomfort during or after the operation; but the cost would be about RM8,000. As I wanted to get over it the soonest possible I agreed to the cost and asked him how soon he could perform the surgery. He said he could do it any day within the next three days but after that he would be going on leave. As I had to go to Pagoh the next day (Tuesday) I told me him to carry out the operation on Wednesday. He agreed and told me to see the counselor to obtain more information regarding the operation. The surgery was fixed at 2.30pm on 3rd June and I was to be present half an hour earlier for the preliminaries.


At the appointed time I was at the operating floor. My eye was dilated and I was told to wait next to the operating room. I waited and waited and had no clue how long I had to wait for my turn. Off and on when the nurse came to dilate my eye, I would question her and her reply was “Just wait”! After I sat waiting impatiently for nearly two hours, I decided to walk off, go home and call it a day. Just then, a nurse came and put on a robe over my clothing and a cap over my head. About fifteen minutes later I was led into the operating room and asked to lie on the operating table. A nurse took my blood pressures and told me my pressure was over 140. I was shocked and I told her that my normal pressure was only about 120. She replied that I could be anxious about the operation. I immediately retorted, “Nonsense, my pressure went up because I was angry waiting for two hours!”  “Well” she replied, “You’ve got to wait for a good doctor!” I was speechless and I shut up to prevent my blood pressure from rocketing. According to her logic, it looked like for over one and a half years of seeking medical treatment for my dizzy and poor vision from about a dozen medical specialists in Malaysia and Singapore, I was unlucky to have met only two “good doctors”, one at UMSC and another at ISEC!   


Soon the surgeon came and administered an anesthetic to my left eye. A few minutes later, the surgery started. As my left eye had to remain open I could see what was going on inside my eye. I could discern the two tiny instruments, one tearing and the other removing the scar membrane on my retina. While the surgery was in progress, I heard the surgeon was talking but I could not quite comprehend the jargon. So I asked him “Are you talking to me?” “No, I’m talking to a friend.” he replied.  I was annoyed and told him “Please don’t talk until you’ve finished the operation.” He kept quiet and immediately after the surgery he left the operating room, leaving the rest to a couple of nurses to finish it off.





Vitrectomy surgery to removw

Epiretina Membrane

I returned home in the evening with a patch on my left eye, but with no medication. The next day I went to ISEC to have the patch removed. As Dr Wong was on leave, I was attended to by another doctor. A week later, I went for a follow-up check. Dr Wong was pleased that I had recovered well from the surgery and the VA for my left eye was nearly 6/6.


I only hope that this would be the end of the odyssey in finding a remedy for my minor vision problem. It took me nearly eighteen months and during this period, I saw a dozen medical specialists in Malaysia and Singapore (only two good ones, unfortunately) to finally end this most time-consuming and unpleasant episode!


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nakedeyeview.com.my 2008