This is a third in a series of posts on my odyssey with a dilated eye. I’ve tagged all the posts in the series here.
On a Sunday evening, I found myself with a dilated eye in my blind eye that freaked me out. By the next Friday, I had in hand a prescription for pilocarpine hydrochloride, a ray of hope that turned into a full-on catastrophe as the medicine left me with a bloodshot eye that hurt and a pupil that was not contracted. I stopped using the drug Sunday morning, but the symptoms continued, and even worsened, for the next five days, leading me to wonder if I had an infection or an adverse reaction or an allergic reaction.
I called the ophthalmologist’s office expression concern on Wednesday and Friday of that week. During the Wednesday call, I asked what to do and the nurse said the ophthalmologist wasn’t concerned. When I called Friday, I didn’t ask what to do — I told the nurse I needed to see someone. The nightmare scenario for me was spending the entire weekend with more of this pain and not knowing what to do about it.
I happened to be off work Friday, so when the nurse said she could get me into an optometrist at 11 am, I didn’t hesitate. My ophthalmologist, who is very good at what she does but also very busy, has a staff of optometrists who work with her as well as several other ophthalmologists and specialists in a prestigious hospital system in a metropolitan area. The optometrist I was scheduled to visit was a known quantity to me: he’s both smart and has good, practical bedside manner.
It was a weight off my shoulders to finally sit in that room, have him look my eye over carefully, and take notes. “Your right eye pressure is high,” he explained when he was done. He then gave me a number: 52.
I had absolutely no idea what that meant, but I assumed it was not good. (Later Googling would tell me that that was an understatement, as normal eye pressure is more like 12-22.) I asked if he thought the pilocarpine was the culprit, and he said he didn’t think it was. Rather, he said, the dilation was part of a process that was blocking off the release of fluid and pressure from my eye, and going off the pilocarpine may have inflamed the symptoms. He explained how some of the muscles in my eye had closed off the areas where pressure normally drains.
“Our next step,” he said, “is to treat it so you feel comfortable and don’t lose your eye.”
Now, the one thing I appreciate about the network of specialists at this hospital system — including my ophthalmologist and the optometrists — is how relatively conservative they are. I have a cataract in my right eye as well as a detached retina, and in both cases they have advised against surgery because the risks were far greater than the small benefit I would get. I respect that. Here, again, the optometrist emphasized that, while getting a prosthetic eye was a possibility, saving my existing eye was preferable if possible. “If it’s sick,” he added, “we want to treat it.”
“I’m going to speak to one of our other doctors,” he went on. “Someone who specializes in glaucoma and eye pressure. I want to get her take on what to do next.”
He stepped out and returned ten minutes later. “We’re going to put you on four eyedrops,” he explained. “One of them has two medicines, so you’ll actually be on five medications.”
“A cocktail of drugs,” I said.
“Yes. Three of the medications are designed to reduce pressure in your eye, one is a steroid, and one is an anti-inflammatory.”
“Do I need to wait for all of them before I start taking them?” I asked.
“No,” he said.
He also added that it was possible — although not certain — that the drugs might help loosen my pupil and help it contract.
I left the office feeling something I hadn’t felt in a week in a half — a sense that a professional had looked at my eye, figured out what was wrong, and had prescribe a solution. It was also helpful to know that my pain and redness wasn’t the result of allergies or bacteria or anything like that, but because of something more fundamental: that my bad eye was, for specific reasons, suffering from high pressure.
And, unlike the pilocarpine, I now had a prescription for, not the symptom, but the cause.