Myopic degeneration/lacquer crack

[wwhmustaine]

I was recently diagnosed with myopic degeneration in my right eye, and told that I have a lacquer crack in that eye. I am 40 years old, and as a practicing attorney, am obviously concerned that my condition will either worsen in my right eye, or also develop in my left eye, thus rendering me essentially disabled.  Is there any treatment, therapy or surgery available for my condition? If not, what are the best preventative measures to take to ensure the condition does not progress in my right eye or begin develop in my left eye?  Lastly, what is the likelihood that the condition in my right eye will worsen, or that it will also develop in my left eye?  In other words, is it likely that I won't notice any significant decline in my condition over the next few decades?

[KKinTX]

well, i went to my RS about what seemed like an increase in floaters and he said there was nothing.  no changes since i last saw him 4 years ago and that i didn't need to see him anymore unless something happened.  just see my regular eyeMD once a year.  

unfortunately 10 days ago something did happen.  i had leakage from a CNV that was near my lacquer crack.  the distorted area on an amsler is about the size of a penny or nickel.  he gave me a shot of avastin on thursday.  

really frustrated that there is such a lack of information.  my rs didn't talk to me very much but i heard what he was telling his assistant to write on my chart--peripapillary choroidal atrophy and i think retinal pigment epithelium atrophy.  the lacquer crack was discovered about 4 years ago when i noticed a very small blind spot in the se quadrant of my vision.  the new blind spot and distortion are in the nw quadrant of my vision.

also frustrated because i can't seem to find a doc that specializes in high myopes where i live here in TX

[KKinTX]

now you all have me scared.  I just generally trust the docs.  I don't seek out specialists.  I had a blind spot about 3 years and went to see the opthamologist who sent me to an RS.  I have always seen opthamologists.  I have worn glasses since age 4.  my eyes are OD -12 and OS -15.5 with astigmatism in both (+.75 and +1.25 respectively).  I wear gas perm lenses.  The RS found lacquer cracks in one eye but no cnv.  I haven't been back to the RS since that diagnosis.  Lately I've been seeing a lot more floaters than normal.  To the point that i have to wait for them to move so I can see sometimes.  thinking it might be time to go back to the RS...

[wwhmustaine]

It was a CNV.

I had an injection of Avastin yesterday (my second one, the first being 10 months ago), so hopefully this will rectify things.

Still 20/20, so they (we) hopefully caught it early enough to prevent any permanent damage.

[wwhmustaine]

Another setback.

Blind spot became more noticeable a few weeks ago, went to see RS on April 14, and since they didn't see anything (and I was still 20/20 or so), I was told they couldn't give me an injection of Avastin.

Since then, the distortions have increased even more, and I have an appt. tomorrow to see about getting that injection. My fear is that he'll refuse to do if he doesn't see a CNV, even though I know that things are getting worse.

Hard to know the cause and effect, but I'm starting to wish I didn't get the surgery with Dr. Ward in January. Everything was fine up until that point, and now this.

[wwhmustaine]

It's been a while, so here's the latest:

On January 6, I underwent surgery (posterior pole buckle) in San Jose, CA, performed by Dr. Brian Ward.  Dukey has posted his experience with the surgery in detail, so I won't retread that same ground, but I will say that I'm glad I did it.

I'm currently almost 4 weeks post-op. A day after the surgery, I was 20/50, a week later, I was 20/30, and at 3 weeks post-op, I was back to 20/20 (minus 2 letters, but I'm wearing contacts with an eleven year old prescription).

I still have double vision, though it seems to be improving gradually. Also, the eye is still pretty red, though again, this appears to be getting better.  No more pain, though, as that was gone within about a week or so.  You have a pretty bad black eye at first, and there is a lot of discharge, but that goes away after a few days.

Like dukey, I had the surgery on a Wednesday, and after follow ups on Thursday and Friday morning, I flew out Friday afternoon, and was back at work on Monday. I will say this, though: I probably shouldn't have driven until at least a week post-surgery, as the double vision was pretty bad until then. Also, you can't wear contacts for 2 weeks after the surgery, so that compounded the issue as well.  You're supposed to sleep and shower with a patch (or tape) as well, which isn't very convenient or comfortable. On top of that, you can't exercise for 2 weeks, so by the time I started running again (17 days post-surgery) I was somewhat out of shape, not to mention still feeling the effects of the operation.

As far as the procedure itself, I checked in at 5:30, surgery was at 7:30, and I was back at the hotel at 11:00. The rest of that day is a blur, though, as the Darvocet knocked me out and made me nauseous. I stopped taking it that day. I had almost no appetite for about 4 or 5 days after the surgery, which I think is the result of the anesthesia and meds.

Anyway, all in all, it was pretty much what I expected. Insurance covered the hospital charges ($51k +) and doctor's charges, though unbeknownst to me, it did NOT cover the anesthesiologist's charges, which were about $1,000, so I'll be coming out of pocket for those.

And while I'm glad to be doing well, I can't say I hope to ever need the other eye operated on.

[wwhmustaine]

One more update - I saw Dr. Ward yesterday. Turns out my right eye (the bad one) is 28.2 mm, whereas the left one is 27.3 mm. He said he "wasn't impressed" with the staphyloma in the right, and that it was "very shallow." He said my eye was oblong, not "torpedo-shaped," which apparently is a good thing. He recommended the procedure, but they're booked through Christmas, so I suspect I'll be arranging it for next year.

Both eyes still 20/20, no more bleeds.