One of the greatest marvels of the world is that every moment in the entire history of the universe right up until now happened in such a way that I am sitting here on the way to the ophthalmologist's office typing this, or that you are wherever you are right now reading this.
A Snapchat of my dilate eyes after my appointment
It was 2011 and I was a senior in high school. Just an average day, sitting in calculus wishing I was doing anything but finding the anti-derivative of whatever. I blinked a few times and something didn't feel right. I tried my best to ignore it, but it was just driving me crazy. At break I went into the bathroom and I saw some swelling around my left eye that was definitely not there a few hours before. Ignoring it I went about my day, finding it harder and harder to keep my left eye open. In the days before front facing cell phone cameras, I would pop over to the bathroom at some point during every class to look over my swollen eye, growing a little concerned that it wasn't getting any better and seemed to be getting worse. I went home that afternoon not stressing all that much. The next day though, I could not open up my eye at all. It was pretty clear that it was time we went to see someone.
That begs the question, who exactly do you go see when your eye is swollen? Ocular emergency is a thing, a fairly infrequent thing, but certain issues can actually be vision threatening and require immediate care. Even still, it felt kinda weird to go to the ER with a swollen eye. With my insurance you can't just go to an ophthalmologist without a referral, and I actually didn't have a primary doc I could even call, I was not 18 yet and my previous pediatrician had left the hospital so I was just sort of waiting until I was 18 to go see my parent's primary doc. So I had no one who could just give me a referral. Then my dad gets the brilliant idea to call John, a family friend who is an ophthalmologist in private practice. He does not take our insurance but he tells my dad to just bring me in.
Some numbing drops and an eyelid flip later he finds the culprit of the swelling, a little calcium deposit embedded in my eyelid. Basically a little rock. It is nothing insidious, it can happen to anyone. You have calcium in your body and sometimes excess calcium can form a deposit in your eyes, aggregates of calcium precipitate clump together in the form of an extremely annoying but nonthreatening rock in your eyelid. It was essentially scratching the surface of my eyelid, which is why my eye got so swollen so fast. Upon removing the rock from my eyelid, I instantly got better, I could independently open my eye again. He wrote me a script for some eye drops to take for a week as it healed. I thought that was it, but then he said something that really surprised me: I am seeing something worrying in the back of your eyes. I want to dilate them in a week, I think you might have glaucoma.
What? Glaucoma? Isn't that for old people?
See, this was before I had ever heard the word Parkinson's applied to me. This was my first old person's disease. I like to joke that I collect old person's diseases. I mean seriously who but me managed to get glaucoma and Parkinson's before I could legally vote?
So a week went by. I remember talking to my anatomy teacher about it (which I was taking on top of physics as an elective, I was a nerd then too!). He asked me, well yeah glaucoma would be rare in someone your age but its possible, have you had headaches behind your eyes?
I thought about it, and actually yes. I had been having headaches behind my eyes. But I didn't think much of it, probably just stress I presumed. Turns out it is an increased intra-ocular pressure (IOP) which causes this. Trying to push any worry out of my head, (which wasn't too hard given this was most definitely not my first time waiting on a medical test or test result) I went on with my week until my dilation day. I went back to John's office and they put the dilation drops in. 15 minutes later I had massive pupils and they did my first nerve fiber layer analysis. And there it was on paper. I definitely had glaucoma.
That diagnosis was a bit of a shock to the system but it was quickly followed by the good news. While it looked like I had moderate damage we could prevent further damage. I was started on a once daily eye drop called Lumigan, a medication to lower my eye pressure. Its kept me stable since 2011, the pressure headaches are gone, and my eyesight has been saved. Apparently I have a tiny little blind spot that I don't even notice, it was picked up on a field vision test. Your brain is really good at compensating for that, and I wouldn't even know it was there if they didn't specifically look for it.
Today's dilation was actually taking a picture of my optic nerve. The 'cupping' as its called is still there and pretty obvious when put next to a picture of what the back of your eye is supposed to look like, but it does not look worse than it did 5 years ago when they last took pictures in 2012.
In 5 months I am going back for another fiber analysis, we like to have that done once a year or so. But so far, so good, things have been stable and it looks like the treatments are working beautifully. As long as I keep up with it, I should not lose my peripheral vision. If my eye had not swollen up from a random embedded calcification, we would have never found my glaucoma. My ophthalmologist has told me that I would have noticed it somewhere between ages 30-40. Your brain is so good at compensating for blind spots that you wouldn't notice it until you had already lost 30-40% of your vision, and once nerve damage is done, you cannot undo it.
So a rock in my eye saved my vision. Call it what you want, but I cant help but believe that this was not so random after all.
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