[HN Gopher] I was terrified of an eyeball injection
       ___________________________________________________________________
        
       I was terrified of an eyeball injection
        
       Author : CTOSian
       Score  : 145 points
       Date   : 2021-11-04 08:06 UTC (14 hours ago)
        
 (HTM) web link (www.ctrl.blog)
 (TXT) w3m dump (www.ctrl.blog)
        
       | justasidenote2 wrote:
       | I've been Type 1 diabetic for 10 years. Even though my glucose
       | control is excellent over that period (A1C never >6.5%) I've
       | never been able to shake the latent fear that it's a matter of
       | time before I develop complications like retinopathy. What sucks
       | hard is that it's not _just_ determined by insulin and glucose.
       | Exercise, stress, activity level, protein/fat intake, illness,
       | and more can all cause massive variability in glucose levels and
       | insulin sensitivity. Therefore my most successful blanket
       | strategy for glucose control is keeping as consistent a routine
       | as possible: eating the same foods, doing the same activities -
       | at the same time, always exercising regularly, and avoiding
       | spontaneity.
       | 
       | While I've always had anxiety, it's only become worse over the
       | years given the fear of having issues in both day-to-day blood
       | sugar management and in being diagnosed with long term
       | complications. Living with T1D often feels like a case study in
       | applied stoicism.
        
         | JasonCannon wrote:
         | Do you follow the advice of Dr Richard Bernstein at all?
         | http://www.diabetes-book.com/
         | 
         | Dr Bernstein is a T1D diagnosed back in the '46. He followed
         | the typical diabetes advice and still developed complications
         | to his diabetes. He was an engineer and felt like the biggest
         | problem (at his time) was that diabetics couldn't tell what was
         | happening with their blood sugar so he started doing whatever
         | he could to gain access to a blood sugar monitor (rare and only
         | owned by doctors at the time) and once he got one he started
         | doing what engineers do, testing adjusting and tracking
         | results. He realized that complications from diabetes is
         | entirely caused by blood sugar, and that carbs are the largest
         | thing that affects blood sugar. A low carb high fat/protein
         | diet would have minimal effect on blood sugar levels. He tried
         | to advocate that everyone should follow this diet and also have
         | access to a blood sugar monitor. But the medical industry
         | wouldn't give him any mind, because he's an engineer not a
         | doctor. So this dude went out and became a doctor, and has
         | completely changed the lives of diabetics everywhere thanks to
         | his work.
         | 
         | Anyways, tangent about how awesome this guy is aside. He says
         | if you maintain an A1C of 5.5 you will not suffer the effects
         | of diabetes. The best way to do that, he recommends, is to eat
         | a low carb high fat diet in order to minimize spikes in blood
         | sugar and avoid needing to take excess insulin.
        
           | justasidenote2 wrote:
           | Yep, he's an inspiring guy and I've read his book. The fact
           | that he's lived well into his 80s with T1D gives me hope that
           | folks people can have a pretty good prognosis.
           | 
           | I also follow a low carb diet, which is how I've been able to
           | have good glucose control myself.
        
       | 1MachineElf wrote:
       | Reminds me of Issac Newton, who had the total opposite attitude
       | towards needles in his eye. He poked holes in his cornea as an
       | experiment.
       | 
       | This was discussed recently here on HN, but I couldn't find the
       | submission. Here's a link to another story about it:
       | https://jsaulburton.com/2014/07/27/isaac-newton-his-eye-and-...
        
         | alok-g wrote:
         | Oh my!
        
       | jcutrell wrote:
       | As someone who experiences medical anxiety regularly, this
       | reminds me of basically every dermatologist visit I've had.
       | 
       | The doctors who cut biopsies out of your skin don't seem realize
       | how much you'll think about there words when you leave. "How long
       | has that been there? That looks a little concerning. That seems
       | strange."
       | 
       | Doctors have to deal with patients of all kinds of mental
       | fortitude of course, but it wouldn't hurt to be clearer about
       | procedures, concerns, etc.
       | 
       | For example, tell me "I bias towards taking a biopsy if I have
       | even a little bit of doubt."
        
       | danepowell wrote:
       | > Surely other patients must have asked about [this traumatic
       | experience]? Or commented on it?
       | 
       | I find myself having this reaction all too frequently after
       | traumatic encounters with the healthcare system.
       | 
       | I honestly don't know the answer. Do other patients really not
       | communicate when they have a bad experience? Or do they
       | communicate and the system is simply incapable of listening or
       | reacting?
        
       | kgin wrote:
       | I'm curious why it seems they were seemingly conservative with
       | the anti-anxiety meds? A large enough benzo dose would turn this
       | from the worst day ever to a relaxing experience in just a few
       | minutes.
        
         | d2wa wrote:
         | Side effects like addiction and _feeling suicidal_ makes
         | doctors quite conservative.
        
       | efitz wrote:
       | I've had 4 cornea transplants and PRK (like LASIK but no flap).
       | Before I started I was very nervous and sensitive to anything
       | touching my eyes. Now it's like, whatever, do what you need to
       | do.
       | 
       | The anxiety is worse than the procedures, by far. I don't have
       | any helpful advice to give; I just toughed it out. The only bad
       | experience I ever had was during my second transplant. They
       | conduct transplants under conscious sedation plus local
       | anesthesia. The sedative puts you to sleep for a few minutes
       | while they nerve block the side of your face with Novocaine and
       | then they wake you up a little for the procedure. I found the
       | procedure profoundly disturbing psychologically even though I was
       | in no discomfort. They use a trephine (like a small razor sharp
       | cookie cutter) to remove your cornea; you're awake and can sorta
       | see it. It makes squishy noises. Your vision skews all over and
       | then goes really blurry and you realize that there's nothing but
       | gravity keeping the insides of your eye in. After that I always
       | asked the anesthesiologist to sedate me just to the point where I
       | was unconscious or at least not aware/lucid.
       | 
       | Most doctors are very caring people and used to addressing
       | anxiety. Maybe not surgeons so much, at least in my experience.
        
       | Lev1a wrote:
       | I had cataract surgery when I was 15/16 and since I was underage
       | I was fully knocked out for the procedure (thankfully) but what I
       | find to be a funny aspect about that whole thing is that wheeling
       | me in a bed (having already taken some kind of oral anesthetic in
       | tablet form) from the patient room to the operating room (down 4
       | floors, across, then up a few floors) took up essentially the
       | same amount of time as the actual procedure.
       | 
       | After the operations (first one eye, wait a month, then the other
       | eye) I had to wait six months to be fitted for glasses with
       | "progressive lenses" (having used store-bought reading glasses
       | inbetween) and I was done.
       | 
       | Over the ~10 years since then I've had to have my eyes lasered
       | two times because that pesky cataract tried to grow back
       | otherwise I just have a rather glare-sensitive pair of eyes[0]
       | with a fixed focus length (due to the artificial lenses) making
       | me both far- and near sighted[1] at the same time. Also the
       | glasses are expensive, to the tune of 180-200EUR per lens ie.
       | ~400EUR without the frame.
       | 
       | TL;DR: it sucks but it's better than the alternative, going blind
       | before or by 20 years old and having seen the difference [2] in
       | the month between my initial two cataract surgeries it's well
       | worth it.
       | 
       | [0]: outside on sunny days w/o sun glasses has me almost
       | constantly blinded if I look anywhere near the sun's direction or
       | any sun-reflecting surface (non-matte metal, glass, wet roads,
       | water surfaces from puddles to the sea or any sufficiently light-
       | colored surface, think paper or white walls etc.); ALSO
       | software/websites that don't have a dark color theme genuinely
       | become straining to my eyes within minutes if not seconds, so
       | take note software engineers and web-devs, dark themes are not
       | some hipster fad but a genuine accessibility feature
       | 
       | [1]: near-sighted from childhood astigmatism (extent: fine
       | details and separations between objects further than ~50-100m
       | become blurry), far-sightedness (extent: without glasses I can't
       | read normal documents nearer than my fully extended arm, visually
       | becoming just black fog/smudges on the white background) from the
       | IOLs (intraocular lenses), IIRC the IOLs were made to make me
       | more far-sighted with the idea that I would get more near-sighted
       | with age anyway to some extent cancelling each other out.
       | 
       | [2]: the not-yet-operated eye couldn't even see a large
       | smokestack ~2-3km away, there was just fog starting at around 1km
       | away, the operated eye could see them perfectly fine on the
       | horizon
        
       | univalent wrote:
       | I can sympathize. I had a seed fall into my eye while out on a
       | walk and it wouldn't come out. Had to to to the ophthalmologist.
       | She did local drops and took it out with forceps. It was
       | uncomfortable and scary but she did a great job at calming me
       | down and doing it quickly. I do think eye doctors have this kind
       | of thing down and folks needn't worry anymore.
        
         | PaulDavisThe1st wrote:
         | No doubt. But how does the learning process for this work and
         | what does it look like?
        
       | dirtyid wrote:
       | Did anyone else get mentally scarred by the Dali video of woman's
       | eye being slit by a razor. Accidentally saw it a few times on TV
       | when I was young, big reason I don't have cable anymore. Every
       | once in a while I still get get paranoid about accidentally
       | stumble across it in gif form. Fingers crossed we'll get ability
       | to filter out visuals like words someday.
        
       | jherdman wrote:
       | I'm very sympathetic to the author. I had to take a few breaks
       | reading this article. Eye damage, things coming close to my eyes,
       | or needles near my eyes are pure nightmare fuel as long as I can
       | remember. "Fire in the Sky"'s experiment scene really pushed this
       | over the edge for me as a child. I still get queasy thinking
       | about it.
        
       | s1artibartfast wrote:
       | This is a pretty common procedure that many are unaware of
       | because it largely affects the elderly.
       | 
       | Around 2.5 million ocular injections are performed a year in the
       | US and the busiest retina specialists perform as many as 50 per
       | day.[1]
       | 
       | As many as 11 million people in the United States have some form
       | of age-related macular degeneration. This number is expected to
       | double to nearly 22 million by 2050.
       | 
       | Many patients require periodic injections for the rest of their
       | lives
       | 
       | https://assets.bmctoday.net/retinatoday/pdfs/0520rt_AMD_MacC...
        
       | globular-toast wrote:
       | When I was a child I used to sometimes touch my eyeball with the
       | tip of a pencil. Everyone I've told this to is very freaked out
       | by it. For me it was a test of my own self control. Could I keep
       | my eye open? Could I be steady enough to not stab my eye? You
       | can't really see the pencil approaching in any detail. It's
       | really out of focus. The eyeball itself doesn't really feel much.
       | The key is not hitting your eyelashes because those are super
       | sensitive and will cause you to blink and withdraw immediately.
       | 
       | I think the touching the eyeball with a cotton swab thing would
       | work. It's not that scary once you've done it a few times. But
       | the thought of an injection does still scare me a bit.
        
         | elzbardico wrote:
         | > When I was a child I used to sometimes touch my eyeball with
         | the tip of a pencil
         | 
         | I really fear you.
        
         | pjerem wrote:
         | That's something you learn when wearing contact lenses. One
         | day, it'll move and hide under your eyelid. You'll try to get
         | it back without touching anything but anyway, in some seconds,
         | you'll quickly make it to a point where you don't even care
         | anymore touching your eyeball because you will immediately
         | notice that it's just waaaay less painful than this folded
         | plastic bastard.
        
           | ghostly_s wrote:
           | Yeah the white of the eye is really not that sensitive. The
           | lens is another story.
        
       | asciimov wrote:
       | I've been getting these eyeball injections this year. (1 eye,
       | every 6 or so weeks).
       | 
       | Bedside manner of the doctors and technicians is the most
       | important aspect of it. I have a Doc who wonderfully calm and
       | hires a pretty good staff.
       | 
       | One thing the writer doesn't mention is how long all this takes.
       | For me it's usually 2 hours of my time. I go in, get my eye
       | scanned, then dilation drops are applied, then I wait 45 minutes
       | for them to kick in. After that they, bring me back into a room
       | and start applying various things to my eye: antihistamine drops,
       | numbing agent, something to sterilize my eye, and an antibiotic
       | (I think). All the eye prep takes 20 minutes or so. Then the doc
       | steps in to do his thing, and that takes all of 5-10 minutes.
       | 
       | For those curious, you don't see the needle, you end up looking
       | toward the bridge of your nose and the doc comes from the
       | opposite direction. You don't see it inside your eyeball either.
       | You do see the fluid stream in and it dissipates quickly. If
       | there is a bubble in the solution you end up with one or a few
       | black dots floating around your vision, those dissipate in a day
       | or two. You don't feel anything other than a little pressure on
       | your eye. Afterward, you might have some eye pain. This depends
       | on how good of a stick it was and how your allergies are doing.
       | Sometimes you are relatively pain free afterward, but other times
       | it feels like your eye got walloped and your eye will be sore for
       | a few days.
        
       | Borrible wrote:
       | The obligatory reference to Bunuel's and Dali's 'Un Chien
       | Andalou' for the ommetaphobe:
       | 
       | https://www.dailymotion.com/video/x4cbwvf
       | 
       | https://en.m.wikipedia.org/wiki/Un_Chien_Andalou
       | 
       | https://en.m.wikipedia.org/wiki/Ommetaphobia
        
       | fredley wrote:
       | I have had a long-term phobia of needles. This is excacerbated by
       | the fact that I'm usually in some sort of stressful situation at
       | the point at which a needle is being put into me: be it a part of
       | a diagnosis with thoughts racing about outcomes, or worse in an
       | acute emergency.
       | 
       | I recently took positive action to try and dispel this fear with
       | a sort of exposure therapy: I started giving blood. It's a much
       | less stressful environment, that feels much more under control.
       | So far I haven't had any issues at all, which is a surprise to
       | me. It hurts a bit when the needle goes in, but my heart does not
       | race, nor do I get a massive hit of adrenaline. I'm on my third
       | donation, and next time I need to have a needle inserted for
       | something else, I hope I'm a lot less troubled by it.
        
       | nickthemagicman wrote:
       | I couldn't even finish reading the article, the prospect sounded
       | so horrifying.
       | 
       | This author is a king.
        
         | fernandotakai wrote:
         | same. i can't even wear contacts -- i tried but it felt soooo
         | bad!
         | 
         | my wife, on the other hand, is a fucking champ when it comes to
         | anything eye related. she has keratoconus[0] and not only she
         | has to do a ton of eye exams every year, but she has to wear
         | rigid contact lenses whenever she's awake.
         | 
         | [0]https://en.wikipedia.org/wiki/Keratoconus
        
           | pjerem wrote:
           | I'm probably not the first person to say it to you but the
           | "fear" to put contact lenses fades very quickly. Maybe not
           | the very first time, but from the second or the third time,
           | you'll stop to think about it for ever.
           | 
           | > it felt soooo bad!
           | 
           | It shouldn't. You are not even supposed to feel them, in
           | fact, some people fall asleep with them even if they know
           | they shouldn't. If you suffered, even if it was your first
           | try, it's probably due to presence of dust between your lens
           | and your eye, and I agree that this is super painful. But
           | that's not the normal sensation, and that's not an issue as
           | long as you remove the lens and retry after some cleaning.
        
             | frosted-flakes wrote:
             | A bigger problem for me is getting them out. At least the
             | dailies I've tried recently (various types). I had a pair
             | of monthlies 10 years ago and I don't remember it being a
             | big problem then.
        
         | davidw wrote:
         | I started looking through the comments here and... NOPE, I do
         | not need this information in my life right now.
        
         | selimthegrim wrote:
         | Going in for a retinal exam (in Metairie) today, I took heart
         | from the author.
        
       | tnjm wrote:
       | I wonder if some people cope better with knowing less. If the
       | procedure for removing the stitches from my eyeball had been
       | explained in advance, I'd still have them now.
       | 
       | Going in, I'd imagined the best possible outcome. This, of
       | course, didn't bear much relationship to what followed.
       | 
       | No doubt some people would have steeled themselves first given
       | more information. (And perhaps been more stoic!)
        
         | kenjackson wrote:
         | What happened? I'm intrigued and slightly queasy.
        
       | draven wrote:
       | I have a lot of sympathy for the author. I've been thinking about
       | getting LASIK (or SMILE as it seems to be gaining popularity in
       | France) since friend got it and says it's life-changing, and
       | since I've started considering it I sometimes have nightmares
       | about the procedure.
       | 
       | I already had some minor surgery with local anesthesic and I
       | didn't have any anxiety, but there's something about having
       | something done to the _eyes_ while _fully awake_ that I find
       | frightening.
        
         | DoingIsLearning wrote:
         | Make sure you understand the clinical outcomes and potential
         | side-effects.
         | 
         | When a cornea flap is cut, you are cutting a lot of innervation
         | to the cornea surface, this for many people means fairly
         | persistent dry-eyes. In addition the scaring of the cornea in
         | the incision flap rim, can also create visual artefacts like
         | Halos, more visible during nightime as your pupil expands and
         | may catch some of the visual distortion of the scar tissue.
         | 
         | I am describing from experience so your mileage may vary. At
         | the end of the day I would probably still go ahead with the
         | surgery but I genuinely feel that it was not thoroughly
         | explained to me, ahead of the surgery, what all the potential
         | side-effects could be.
        
           | at_a_remove wrote:
           | I was talking to my eye doc while he was performing surgery
           | on my eyelids, just sort of chit-chatting. So I was curious,
           | my eyesight is pretty good -- but for how long? -- and I
           | asked, "What do you think of LASIK?"
           | 
           | Now, this guy has a dry sense of humor so he said, "You may
           | notice that I'm wearing glasses ..."
           | 
           | And I guess that was all of the input I needed.
        
             | l33tman wrote:
             | A lot of people are perfectly comfortable with wearing
             | glasses. All surgical procedures carry some non-zero risk
             | and you have to weight the risk benefit ratio which is
             | different for all patients.
        
             | loceng wrote:
             | There are photos floating around of the doctors attending
             | LASIK conferences, where 50%+ of doctors are wearing
             | glasses.
        
           | smnrchrds wrote:
           | NYT had a good article about this:                 <quote>
           | 
           | His eyes are so dry and sore that he puts drops in every
           | half-hour; sometimes they burn "like when you're chopping
           | onions." His night vision is so poor that going out after
           | dark is treacherous.
           | 
           | But Mr. Ramirez says that as far as his surgeon is concerned,
           | he is a success story.
           | 
           | "My vision is considered 20/20, because I see the A's, B's
           | and C's all the way down the chart," said Mr. Ramirez. "But I
           | see three A's, three B's, three C's."
           | </quote>
           | 
           | https://www.nytimes.com/2018/06/11/well/lasik-
           | complications-...
        
           | draven wrote:
           | As I understand it SMILE implies a smaller cut (3mm) with
           | less nerve damage.
           | 
           | Thanks for the heads-up, I'll make sure I'm OK with the
           | potential side effects if I go forward with it.
        
             | loceng wrote:
             | Look up central sensitization and hyperalgesia, a side
             | effect LASIK only recently admitted to, and to which LASIK
             | caused me and has made my life hell - and why I know about
             | Jessica Starr, the Facebook support group, and the stromal
             | stem cell research - all things I had to find on my own as
             | the industry is protecting itself, indoctrinated and with
             | no real interest in helping those they harm except for
             | billing you to treat the purposefully mislabeled "dry eye
             | syndrome" - where research not done by LASIK shows up to
             | 40% of people have permanent problems after.
        
           | Traubenfuchs wrote:
           | I am suffering from moderate dry eye now and was suffering
           | from severe dry eye in the past.
           | 
           | I once had a day at work where the pain was so bad I thought:
           | This is it. I can't keep on working, I will lose my job and
           | live on disability from now on.
           | 
           | After some conversations with healthy people, I learned that
           | many can not even imagine dry eye pain. One sentence stuck
           | out: ,,I didn't know eyes could hurt."
           | 
           | What I wanna say is: Don't risk it. Lasik can ruin your life.
        
             | loceng wrote:
             | Indeed, the idea of "informed consent" is complete non-
             | sense because the layperson will have no way to understand
             | what the potential consequences entail - and personally I
             | was lied to multiple times by LASIK before getting the
             | procedure done.
        
               | Traubenfuchs wrote:
               | I am bound to my glasses I loath but at least can barely
               | stand to wear contacts to go out once a week due to my
               | diligent eye treatments.
               | 
               | I would love to do lasik! But any potential worsening of
               | my dry eyes is not worth it. I would still sacrifice my
               | whole fortune to have healthy eyes again. (to be clear: I
               | did not have lasik, but I probably suffer from permanent
               | isotretinoin damage)
        
               | DantesKite wrote:
               | I developed severe dry eyes, light sensitivity, halos,
               | and migraines as a result of corticosteroids.
               | 
               | But I was able to reverse a majority of it and continue
               | to do after learning Tribulus upregulates androgen
               | receptors in the brain, which seems to control the
               | aqueous liquid in our eyes.
               | 
               | I'm not sure what Vitamin A does to the body. From a
               | cursory glance, it seems to affect skin androgen
               | receptors, which would explain why it affected your eyes
               | but if it has a similar affect, you might want to
               | consider Tribulus.
               | 
               | Start off with a low dosage. Say 1 pill daily for a week,
               | then taper off. On and off for a few months.
        
               | Traubenfuchs wrote:
               | To be more precise, androgens (especially DHT) suppress
               | inflammation in the meibomian glands.
               | 
               | I strongly recommend dissolving an oral pill of
               | hyaluronic acid twice daily -do not swallow the pill
               | whole, it won't dissolve and you will shit a tiny
               | gelatine egg.
               | 
               | Besides that eye heating masks and lid-hygiene (e.g.
               | blephacura) do wonders.
               | 
               | As for AR expression, I believe L-Carnitin should also
               | improve it. Creatine should increase DHT.
               | 
               | But I am afraid to haphazardly increase my androgens or
               | receptor expression because of my AGA.
        
         | ghostly_s wrote:
         | I am curious what is "life-changing" in anything but the most
         | quotidian sense about no longer having to wear contacts or
         | glasses?
        
         | [deleted]
        
         | hrydgard wrote:
         | Consider ICL instead of LASIK if it's an alternative for the
         | level of vision you have. Super happy, and the procedure was
         | really no big deal.
        
         | wccrawford wrote:
         | I had ICL and then Lasik as part of the same planned procedure,
         | and I had the same thoughts beforehand. The doctors actually
         | made it sound worse than it is.
         | 
         | For ICL, they'd say things like, "You'll feel a little pinch"
         | before they did something, and I _barely_ noticed that anything
         | was happening.
         | 
         | For Lasik, it was _nothing_. The most uncomfortable part of the
         | procedure was while they were prepping me, and even that wasn
         | 't anything worth talking about unless you have some phobia.
         | 
         | It's been a few years now and I barely remember anything about
         | the procedure beyond the room layouts and remembering thinking
         | it went much easier than I expected.
        
           | buu700 wrote:
           | I had an ICL procedure as well, about seven years ago. I
           | can't say I had anywhere near OP's level of anxiety about it
           | beforehand, but I was concerned about potential
           | pain/discomfort and my ability to keep my eyes still enough
           | to not ruin the procedure and blind myself.
           | 
           | Unfortunately I have no memory of the procedure itself, so I
           | can't comment on any discomfort or lack thereof. I don't
           | _think_ I was ever told I 'd be put under general anesthesia,
           | so it seemed a bit odd at the time to walk in and out with no
           | memory of in-between. Does anyone know if this is a common
           | side effect (or intentional effect) of drugs commonly used
           | during ICL implantation surgery?
        
         | param wrote:
         | I was always iffy about LASIK and got it done to appease my
         | wife & I can tell you it was way simpler than I was imagining.
         | 
         | I can't even put contact lenses in my eye myself, but getting
         | operated was a breeze. I have been glasses free for 8 yrs now -
         | its great!
        
           | Buttons840 wrote:
           | How old are you, if I may ask?
           | 
           | I'm very nearsighted (I can't see distant objects clearly
           | without glasses), and I know people's ability to see close
           | objects or read diminishes with age. My plan has been to
           | remain nearsighted in hopes I can always read without
           | glasses. Many people have their far sight improve as they
           | approach 40 or 50.
        
         | loceng wrote:
         | Listen to the nightmares - it's your subconscious trying to get
         | a message/warning through to you.
         | 
         | There's a Facebook group called LASIK Complications Support
         | Group that has 3-4 people joining it daily desperate for help
         | from the pain they're left with. LASIK as an industrial complex
         | has done well to suppress the problems. In 2011 one of the FDA
         | expert advisors who voted to approve LASIK wrote a public
         | letter to FDA asking them to immediately recall LASIK, as he
         | said there was data they were ignoring that they shouldn't have
         | been ignoring, and that it should never have been approved.
         | 
         | A story of suicide post LASIK (actually specifically she did
         | "SMILE") of a news reporter Jessica Starr - many articles on
         | her, but here's two: https://www.ctvnews.ca/w5/families-deal-
         | with-repercussions-a... + https://www.fox2detroit.com/news/in-
         | her-own-words-jessica-st...:
         | 
         | ""She looked at me and she said, 'Dan [her husband], it's like
         | my eyes and my brain aren't communicating like they used to. I
         | can't process like I used to. I'm not visualizing things like I
         | used to,'" Dan said.'
         | 
         | My hypothesis is that the more creative and sensitive a person
         | is (therefore less redundancy in neural networks) the more
         | fragile and detrimental damage/injury caused by LASIK.
         | 
         | The cornea is the most sensitive tissue in the body with
         | 300-600 times the density of pain receptors than your skin, and
         | LASIK lies - your cornea doesn't/can't heal on its own.
         | 
         | At least wait until the stromal stem cell treatment available
         | clinically. Human clinical trials in India were fast tracked
         | under compassionate grounds, the original research on animal
         | models from University of Pittsburgh, that were highly
         | successful healing/regenerating deep/severe scarring and
         | chemical burns. It'll likely take anywhere from 2-5 years, with
         | the pandemic delaying things, for it to be available in
         | India/US with FDA approval.
        
         | foobarian wrote:
         | My problem with LASIK is the rare issues. It looks like it
         | works fantastically when it works, but it seems to also cause
         | fantastic problems when something goes wrong. Given my high
         | negative prescription I just can't bring myself to do it.
        
           | DantesKite wrote:
           | Excellent thinking.
           | 
           | I've read enough horror stories to know it's not worth the
           | risk, especially when my optometrist told me my vision would
           | worsen anyways in 10 years.
        
             | glxxyz wrote:
             | I had LASIK almost 20 years ago and for me it's been
             | wonderful. My vision settled down to a small (about -0.5)
             | prescription which hasn't changed since then. Legally I can
             | drive without glasses but I basically only wear them for
             | driving and the cinema. Multiple optometrists in the years
             | since have told me that I have no corneal flattening, no
             | scarring, and I've had no dryness.
             | 
             | Relevant to the OP it was quite a procedure to experience.
             | I was a little concerned before but it was quite
             | interesting to watch the corneal flat be cut open (with no
             | feeling at all) and peeled back, then see the little laser
             | flashes accompanied by (weirdly) a smell of burned hair.
             | When they dropped the flap back down my vision was
             | instantly corrected, although initially a bit cloudy.
        
             | deepspace wrote:
             | Yes, even if I could overcome my phobia of things touching
             | my eye and bring myself to have LASIK done, I would never
             | do it, for the simple reason that my prescription keeps
             | changing year by year.
             | 
             | The glasses I was prescribed a few years ago are almost
             | useless today, so I cannot help thinking that LASIK would
             | just correct my vision at a point in time, and then a
             | couple of years later it would be back to glasses. Not
             | worth the risks in the slightest.
        
               | glxxyz wrote:
               | Yes a stable prescription is one of the recommendations,
               | mine had been unchanged for about 10 years before LASIK,
               | and hasn't changed in the 18 or so years since then.
               | 
               | I'm not big on the idea of touching my eye but the
               | numbing drops are amazing- after I'd had a couple of
               | eyeball pressure tests I got used to the odd sensation of
               | things touching my eyes without me flinching.
        
       | cosmojg wrote:
       | > We briefly discussed my anxiety, but his immediate solution was
       | the anti-anxiety drug. I made it clear that I was worried about
       | the procedure and wanted to know more details about it. He didn't
       | want to explain the procedure beyond "we'll inject medication
       | that will help preserve your vision", and he avoided answering
       | repeated questions. Maybe he tried to shield me from the details
       | and not confirm my worst fears.
       | 
       | Based on stories I've heard from emotionally immature doctor
       | friends and my own experience being a little more confrontational
       | with my doctors, he most likely didn't know the answers to your
       | questions and was too proud to say, "I don't know."
       | 
       | It seems many forget that, at the end of the day, doctors are
       | people, too, with just as many flaws and emotions as the rest of
       | us. It's unfortunate that this affects quality of care, but it's
       | a fact of life in every industry.
       | 
       | The best thing you can do for yourself in such a situation is to
       | prepare yourself before appointments and remember the humanity of
       | doctors during appointments. If your doctor is being dodgy about
       | answering questions, let them know that it's okay if they don't
       | know and that you won't think anything less of them for it. If
       | it's an urgent matter, suggest looking it up together so that
       | your doctor can provide context for whatever research you manage
       | to find.
       | 
       | A doctor is like a contractor you've hired to inspect and
       | maintain your body. As with any contractor, if you want them to
       | do a good job, you have to work with them, as a team.
        
         | s1artibartfast wrote:
         | Alternatively, if you think your contractor is unfamiliar or
         | underprepared for a job - find one you like!
        
         | cjbprime wrote:
         | Perhaps worth mentioning that medical malpractice lawsuits are
         | a devastating possibility for doctors (because of license
         | suspension), especially in the US, and so they may have
         | sensible reasons to specifically avoid the phrases "I don't
         | know" or "I'm sorry" even if they're empathetic people.
        
       | nightfly wrote:
       | https://www.youtube.com/watch?v=XAjQQG_uT_E
        
       | AceJohnny2 wrote:
       | There was an interesting observation that practitioners optimize
       | for themselves, not the patients[1]. When you're seeing dozens of
       | patients a day, each of them reacting differently, it's hard to
       | empathize fully with, and adapt to, each of them. The one you can
       | optimize for, as the practitioner, is yourself.
       | 
       | [1] Dan Ariely, in the intro of his must-read book "Predictably
       | Irrational"
        
       | UI_at_80x24 wrote:
       | I've had 2 cornea replacements. In 5-10 years I'll need them
       | replaced again, (and repeat until I die or go blind).
       | 
       | I was freaking out for 6 months about the entire operation. The
       | more research that I did, didn't help. Even support groups that
       | had gone through it didn't help. I was terrified.
       | 
       | The first eye: I took Xanax before the procedure, and they gave
       | me something to calm me down. I was partially aware of life for
       | 10 minutes after I was almost home.
       | 
       | The second eye: I didn't take Xanax, and partway through the
       | procedure I woke up enough to be able to feel them working in my
       | eye. I was calm and not bothered by it. It felt more like a
       | tugging and pulling (like how your foot associates your shoe-
       | laces being tied); but I was calm. The doctor told me to stop
       | moving my eye. They must have given me something more, because I
       | don't remember anything else.
       | 
       | It's an out-patient procedure.
       | 
       | If you are in a similar position and have ANY questions, I'll
       | talk to you about it.
       | 
       | There will be a hundred people who say: "If I can do it, anybody
       | can!" I don't want to be dismissive about your feelings. I was in
       | horrible shape before the procedure.
       | 
       | But I will be honest with you and talk about it if you want.
        
       | mam4 wrote:
       | Try watching a cataract operation on YT without being OMGOMGOMG
        
       | lurquer wrote:
       | Makes me shudder...
       | 
       | I had some systemic inflammation behind my retina that would
       | flare up every year or two, causing my retina to warp and make
       | everything look like a fun-house mirror. (At least with the good
       | eye closed... with both open, the brain sorts it all out and
       | provides a good image...)
       | 
       | To reduce the swelling, I needed steroids shots towards the BACK
       | of the eyeball! Speculum goes in, then the doc puts his thumb on
       | the eyeball and rotates it so that I'm looking into my own brain
       | (it seemed) and injects something... aargh!
       | 
       | Didn't help they he was 76, had shaky hands, and would say things
       | like "now don't move or you'll go blind... haha."
       | 
       | Not all that painful, though... the anesthetic drops numb
       | everything. But, the most disturbing medical experience I've had.
       | 
       | (Of course, I'm a guy... I doubt it's as disturbing as squeezing
       | a baby out of a small orifice in your groin, so there's that...)
        
       | RHSeeger wrote:
       | I have double vision because of previous eye surgery, and the end
       | result is going to be a surgery where they
       | 
       | 1. Put me under
       | 
       | 2. Disconnect the muscles from the back of the eye sockets and
       | reconnect them temporarily in a better location
       | 
       | 3. Wake me up and make sure the locations are correct
       | 
       | 4. Push the eyes to the side and reach in with a tool to
       | permanently attach the muscles
       | 
       | The doctor was telling me the last part and I was staring at her
       | like she was insane; "wait.. while I'm awake?!?". My plan is to
       | just schedule a psychological appointment for later the same day.
        
         | coryrc wrote:
         | Play Tetris after!
         | 
         | https://pubmed.ncbi.nlm.nih.gov/32293830/
        
         | s1artibartfast wrote:
         | Strabismus Surgery?
        
           | Zababa wrote:
           | There's a surgery for strabismus? I've always heard that it
           | was basically untreatable outside of wearing glasses.
        
             | rootusrootus wrote:
             | Indeed there is! I had it in the mid 80s when I was a
             | child. They put me completely under. My understanding is
             | that today it's not uncommon to do it under a local
             | anesthetic so they can test the correctness of the
             | alignment in real time.
        
             | s1artibartfast wrote:
             | (obligatory not a doctor, not your doctor)
             | 
             | Apparently yes:
             | 
             | https://eyewiki.aao.org/Strabismus_Surgery,_Horizontal
        
             | snuxoll wrote:
             | Had it when I was a child! Twice, even! (18mo and 10yr
             | old). Mine was so bad my left eye basically hung out in the
             | corner - so incredibly thankful for the awesome pediatric
             | ophthalmologist I had looking back on how much different my
             | vision could have turned out (it's still far from perfect,
             | my left eye is mostly used for periphery, but it's much
             | better than the alternatives).
        
               | Zababa wrote:
               | I've had it since birth I think, on my right eye, and
               | while my left eye vision is great, I have trouble reading
               | even very big text with my right eye. I'm a bit mad that
               | I've never heard about this surgery until now.
        
               | snuxoll wrote:
               | I'd be a bit mad myself in that case, any board certified
               | ophthalmologist should be well aware of the use of
               | surgery as a treatment for strabismus; especially ones
               | specialized in pediatric ophthalmology since it's better
               | to take care of it at a young age while there's higher
               | neuroplasticity (so a higher chance of the brain properly
               | adapting to the corrected vision).
        
               | Zababa wrote:
               | Maybe it's less of a thing in France, or it was at the
               | time (early 2000)? You're right about neuroplasticity,
               | even if I get it fixed now I don't know if my brain would
               | adapt to it.
        
         | snuxoll wrote:
         | > The doctor was telling me the last part and I was staring at
         | her like she was insane; "wait.. while I'm awake?!?
         | 
         | Holy hell, NOPE. I'm very glad I was under the whole time when
         | I had my strabismus surgeries as a child, because I'm pretty
         | sure I would be psychologically scarred for life.
        
         | david422 wrote:
         | Technology today is both amazing and terrifying all at the same
         | time.
        
       | Tronno wrote:
       | This reminds me of a fun internet rabbithole. Feeling a little
       | too comfortable? Need a little spice in your life? Why not watch
       | some... surgery videos?
       | 
       | In the wake of having multiple surgeries myself, I became
       | interested in watching procedures like the one in the article
       | actually being performed. For example:
       | https://www.youtube.com/watch?v=DQfRKTKmq80 (warning: may be
       | disturbing).
       | 
       | I don't consider myself squeamish, but just try finishing a video
       | of, say, knee-replacement surgery. Imagine carpentry, with
       | someone's _living bone_. Yikes.
       | 
       | Massive respect for the people who successfully do this every day
       | without being completely overwhelmed by the complexity, the high
       | stakes, and, especially, the cringe-inducing gore.
        
         | saulpw wrote:
         | Surgeons and CEOs have a higher rate of psychopathology than
         | the population at large.
        
       | inetsee wrote:
       | I have diabetes. My glucose control at home is fairly good
       | because almost everything I eat has a nutrition label, and I can
       | calculate somewhat accurately exactly how much insulin I need to
       | take. When I travel, eating in restaurants regularly, I have to
       | make wild ass guesses as to how much carbohydrate I'm consuming.
       | On a recent trip I had some health issues, including a
       | significant spike in my glucose readings. My A1C went from 6.9 to
       | 8.4 and I had noticeable vision problems. I went to my
       | ophthalmologist and he told me that I had serious retinal bleeds,
       | and I would need injections in both my eyes. It was serious
       | enough that he gave me the first injection in one eye that day,
       | and the second injection in the other eye the next day. My
       | ophthalmologist is very good and I trust him implicitly. The
       | procedure involved antibiotic drops in my eyes, anesthetic drops,
       | and betadine on my eyelids before the injections. The needles
       | used were very small gauge (they looked like 32 gauge). I didn't
       | feel any pain; just a slight feeling of pressure.
       | 
       | If you have a good ophthalmologist, nowadays there is little
       | reason to fear getting injections in your eyes.
        
         | JasonCannon wrote:
         | T1D also, with not great control. I've had about a dozen
         | injections over the last two years. A couple laser treatments
         | and a full on surgery. The laser treatments are uncomfortable
         | mostly because of the time it takes. The injections don't hurt
         | at all and I barely notice them, but the little clamps they put
         | on your eye lid to keep them open makes me uncomfortable as
         | shit. Easily the worst part of the entire experience.
        
           | inetsee wrote:
           | My opthalmologist doesn't use clamps; he uses his fingers to
           | keep my eyelids from blinking. The injection only takes a few
           | seconds to complete. I suppose it depends on your doctor's
           | training. I've been fortunate that my opthalmologists have
           | all been very good.
        
         | samstave wrote:
         | >>My A1C went from 6.9 to 8.4
         | 
         | Whats good vs. bad?
        
           | valenceelectron wrote:
           | Higher is worse. There may be different ,,schools" of thought
           | or opinions but according to my doctor 7.5 is a threshold you
           | should not cross (type 1).
        
           | inetsee wrote:
           | The [A1C] goal for most people with diabetes is 7% or less.
           | [1]
           | 
           | [1] https://www.cdc.gov/diabetes/managing/managing-blood-
           | sugar/a...
        
       | wing-_-nuts wrote:
       | My mother accidentally put mosquito repellant in my eyes as a
       | child (my father had put it in an eye dropper to carry hunting
       | and didn't label the bottle)
       | 
       | To this day _anything_ that messes with my eyes freaks me out.
       | That little puffer thing at the eye doctor? That thing is my
       | nemesis. I won 't wear contacts. Lasik is out of the question
       | because on top of this phobia I also have CP and I get super
       | spastic when stressed.
       | 
       | Having to get monthly injections in my eyeball would be pure
       | nightmare fuel for me. I'm not sure which I'd fear more, that, or
       | going blind.
        
         | deepspace wrote:
         | Oh god, the puffer. Pure torture.
         | 
         | I tried contacts many years ago, and after two months of
         | struggling, it still took me over an hour every day to get them
         | in, so I gave up on that.
         | 
         | I still remember the day I first heard about Radial Keratotomy
         | in the 70s. I could not imagine how anybody could consciously
         | allow a scalpel anywhere near their eyeball.
         | 
         | Even today with LASIK/PRK, the whole idea of voluntary eye
         | surgery is just a total nope for me.
        
         | rootusrootus wrote:
         | I sympathize, that must be terrible. Your story reminds me of
         | something my wife did a long time ago. She wanted to put
         | sunscreen on our baby daughter's face, and she had the bright
         | idea to blow in her face so she'd close her eyes, and then
         | quickly spritz with the spray.
         | 
         | That worked out exactly like you are probably thinking.
         | Fortunately there doesn't seem to be a resulting phobia, 11
         | years on.
        
       | danpalmer wrote:
       | As someone who isn't far off this level with regular injections
       | in regular places, I have a lot of sympathy for the author. Based
       | on my past experience I'd expect it to take me a couple of years
       | to get to the point of being able to do this, and I have no real
       | anxiety about my eyes.
       | 
       | Well done to the author for not giving up.
        
       | user_7832 wrote:
       | Well I was nervous after reading the title. Reading the article
       | as a diabetic-of-fifteen-years with suboptimal glucose/health
       | management made me positively queasy. I'm taking this as the sign
       | that I need to get my shit together, and I recommend anyone else
       | who's also procrastinating like me to take this opportunity.
        
       | iamjdg wrote:
       | Not to brag, but to brag, this is nothing. I've had a gas bubble
       | injected into my eye to repair a detached retina (pneumatic
       | retinopexy).
       | 
       | https://www.google.ca/amp/s/www.hopkinsmedicine.org/health/w...
        
         | morelisp wrote:
         | Things people I know have had in their eyes I didn't know could
         | be in eyes:
         | 
         | - The aforementioned gas bubble
         | 
         | - The same but an oil bubble, when you need the pressure to
         | remain there for longer (and a second surgery to remove it)
         | 
         | - A _1mm bypass stent_ to reduce intra-ocular pressure
        
           | garren wrote:
           | The bypass stent is interesting. Was that relatively recent?
           | I heard of ALT and SLT, both laser therapies as I understand
           | it, for iop conditions. I'm wondering about the effectiveness
           | of laser therapy versus a stent.
        
             | Asooka wrote:
             | I actually have IOP problems and have discussed these
             | treatments with my dr. The answer is really it depends. In
             | my case, the problem is that the little channels which
             | drain the fluid are too small and get clogged by debris
             | from my flaky retina (so it's two problems coming together
             | to make one big problem). I could get a laser treatment to
             | burn and widen those channels, but it generally lasts for a
             | year or two and then you have to do it again. The high
             | powered laser additionally can burn your retina as it
             | diffuses through the vitreous. A stent doesn't have those
             | problems, but it does come with some chance of
             | complications. For now I'm managing just fine with
             | eyedrops. It's annoying to have to put them in every day,
             | but they definitely work. One side effect is that my iris
             | might turn brown after some more months, sadly.
        
             | morelisp wrote:
             | Several years ago. Germany is extremely strong in
             | ophthalmologic surgery - I've heard something like 3 of the
             | top 10 eye clinics in the world are here in Berlin, though
             | I doubt such broad measurements are really meaningful - and
             | I think several MIGS devices were approved here a few years
             | before elsewhere in the world.
             | 
             | I think laser therapies were avoided in this case because
             | the patient was young.
        
             | [deleted]
        
         | zwieback wrote:
         | Awesome - here's an instructional video:
         | https://www.aao.org/clinical-video/pneumatic-retinopexy-rhem...
        
       | Tokyolunch wrote:
       | I can relate to this story a bit.
       | 
       | I had an Avastin injection in my eye 10ish years ago in my mid
       | 20s. It turned out that I had a central retinal vein occlusion
       | which caused me to suddenly lose vision in one of my eyes. There
       | was lots of hemorrhaging and swelling of macula which made me
       | lose vision.
       | 
       | One of the suggested ways to treat some of the swelling was by
       | injecting Avastin into my eyes. The ophthalmologist said that
       | there weren't really anything else to do at that point besides to
       | let the eye naturally heal so I did take the chance to take the
       | shot.
       | 
       | I experienced all of that anxiety that the author wrote about as
       | just the thought of a needle injection into the eye is truly
       | gruesome. But what everyone else on here have said is correct in
       | that, they put all this stuff on you, antibiotic drops,
       | anesthetic drops, and betadine and then they have you look up in
       | the upper right hand or upper left hand corner as they inject
       | into the white of your eye.
       | 
       | I remember this being the excruciating part as once the needle
       | goes in, you shouldn't move your eye at all and keep it in that
       | position or risk blindness (as the ophthalmologist put it). What
       | was seconds seemed like minutes. Due to all the anesthesia, you
       | feel no pain but you do feel this discomfort of pressure as the
       | needle gets inserted into the eye.
       | 
       | Thankfully, I only required just one injection but I knew a lot
       | of other elderly with macular degeneration and such who needed
       | these injections regularly in order to not lose vision. The whole
       | process was pretty professional but I don't know if I would want
       | to go through that all again but I know that if it was between
       | that or lose my vision, I think most people would decide to get
       | the injections.
        
       | scop wrote:
       | I had to have my tonsil biopsied a few years back. With my mouth
       | agape and a six-inch needle down my throat, my ENT quipped:
       | 
       | > I did this once, I learned a lot.
       | 
       | Surprisingly that was the most comforting thing I could hear. To
       | know that the ENT had enough confidence and presence-of-mind in
       | his procedure to crack a joke told me I was in good hands, even
       | if those hands were holding a six-inch needle down my throat.
        
       | stevebmark wrote:
       | Many of us will face eye injections as we age and develop macular
       | degeneration, where eye injections are currently the best
       | treatment to slow and stop age based macular degeneration.
       | 
       | Type two diabetes can be reversed with diet, maybe those facing
       | this procedure will get more motivation to try stricter dietary
       | interventions.
        
         | RHSeeger wrote:
         | Type two diabetes MAY be able to be reversed with diet,
         | depending on the person. That being said, the article didn't
         | indicate if the author was type 1 or type 2 (or both).
        
           | d2wa wrote:
           | The author is a type 1.
        
       | gdebel wrote:
       | (Ophthalmologist): To any future HN reader scared by those
       | intraocular injections: don't fear them. I'm on my way to the
       | operating room and going to perform cataract surgery under
       | topical (=eyedrops only) anesthesia, as I always do, and as most
       | surgeons today do. Patients won't feel anything except water
       | slightly flowing on the eye surface. The surgical knife is 2.2mm
       | wide : the 25 Gauge needle is 0.260mm wide. Anesthetic eyedrop
       | work amazingly. Patients can actually feel the eye speculum (pro
       | tip: open wide both eyes++, it will be less disturbing) and the
       | itchy feeling of Betadine, and the touch of the needle : that's
       | usually all.
       | 
       | Don't postpone eye injections because of fear: if it is
       | indicated, there is usually some degree of emergency.
        
         | dirtyid wrote:
         | This is reassuring but does not remotely allievate my
         | irrational fear of eye based trauma.
        
         | jmnicolas wrote:
         | Counter point: a few years ago my mother had a botched cataract
         | surgery, she now sees worse than before.
         | 
         | Don't act like you don't take a chance on every medical
         | procedure. Most of the times it's OK, but sometimes it's not.
         | Then what?
        
         | edgyquant wrote:
         | You might be right but I'm too much of a wuss to put eye drops
         | in without flinching, let alone a needle
        
           | spicybright wrote:
           | Tip: If you tilt your head back and squirt it in the corner
           | of your eye (near your nose), it'll flow into your eye
           | perfectly every time.
        
         | cortesoft wrote:
         | You can't tell me not to fear it. I have a HUGE eye phobia; I
         | can't even open my eyes under water. It doesn't matter what
         | anyone says, it isn't a rational thing.
        
           | fossuser wrote:
           | Pre-surgery benzodiazepines might fix that and are given to
           | particularly anxious patients - I was terrified going into a
           | surgery and was given those, ten minutes later there was
           | total relief. I can easily understand the addiction risk (and
           | haven't had them since), but for acute anxiety it was wild
           | how much of a relief it was.
           | 
           | I went from nervous with fairly intense physical symptoms to
           | being totally chill.
        
           | rblatz wrote:
           | This is so bizarre to me, to be an adult and just unable to
           | control your own body? I guess I'm lucky to not have this
           | issue, but man it's so foreign to me that you can't even open
           | your eyes under water.
        
             | cortesoft wrote:
             | I think you might be overestimating what I mean by "can't"
             | open my eyes under water. I think the 'touching a hot
             | stove' metaphor is a good one. It feels like that to me.
        
             | randcraw wrote:
             | Phobias are very common. Almost everyone has one, like fear
             | of heights or being trapped in a small space. The fear is
             | not rational, and the phobic is well aware of that, but
             | simply knowing it's irrational doesn't help rid you of it.
             | 
             | https://en.wikipedia.org/wiki/List_of_phobias
        
             | burnished wrote:
             | Would you also not struggle to touch a hot stove? I think
             | it is a similar feeling. Genuine question too - I've got a
             | friend who is comedically brave and doesn't experience pain
             | the way that other people do who might express a similar
             | idea. He just already knows that its unusual and not the
             | default.
        
               | rblatz wrote:
               | That's an interesting idea. I think I'd be able to touch
               | it, I know I'd dislike it immensely though.
               | 
               | But this question helped me clarify my thoughts around
               | this more. It's the distinction between rational fear vs
               | irrational fear. Assuming clean water the fear of opening
               | your eyes underwater is irrational, it's not going to
               | hurt you or do any long term damage. The example from the
               | story about getting an injection on your eye is maybe
               | someplace in between, needle in the eye is much more
               | invasive, but also deemed medically necessary where the
               | risk of not doing it is greater than the risk of doing
               | it.
               | 
               | Not having the ability to override your own emotions in
               | cases where they are irrational is interesting to me.
               | It's like giving agency to an "external other" that you
               | have no control over.
        
               | cortesoft wrote:
               | If I absolutely needed to open my eyes under water for an
               | important reason, I likely could. That is just not a
               | common situation and I haven't encountered it.
               | 
               | I don't think not opening my eyes under water is THAT
               | irrational, really. My reason for keeping my eyes closed
               | (my fear and not liking the feeling of water touching my
               | eyes) is greater than my need to open my eyes under water
               | (which has been no real reason so far).
        
               | doliveira wrote:
               | I seriously doubt you can rationally override your own
               | emotions at any situation. And you should doubt that too,
               | it can make you biased to think you're being rational
               | without noticing you're not.
        
               | rblatz wrote:
               | It seems like you are stretching my words here.
        
           | anon9001 wrote:
           | The trick is to take the entire day off of work, take xanax,
           | and do the motions without panicking.
           | 
           | The feeling you're describing is literally panic from an
           | anxiety disorder. If it it's interfering with your adult
           | responsibilities (like going to the doctor), that's the right
           | time to use medication to get through it.
        
             | cortesoft wrote:
             | My toddler recently scratched my cornea with a finger, and
             | while I was completely traumatized, I was able to go to the
             | doctor and allow them to treat me. The phobia is not quite
             | debilitating, just strong.
        
           | bobobob420 wrote:
           | Yeah if you are afraid to open your eyes underwater there is
           | no way your letting a needle come near your eye when you are
           | conscious and can see it. I have never heard of this eye
           | phobia very interesting
        
             | ignoramous wrote:
             | I don't open my eyes either but mostly in swimming pools
             | full of chlorine. Didn't know it was a phobia, because all
             | I'm trying to do is avoid annoying eye irritation.
        
           | hinkley wrote:
           | Talking about eye surgery is like nails on a chalkboard to
           | me. I don't want to talk about yours, let alone think about
           | mine.
           | 
           | I have joked with my friends and family about giving them a
           | limited power of attorney that in the case of eye or
           | testicular surgery they can dose me with tranquilizers or
           | anti anxiety meds without my knowledge and deliver me to the
           | surgeon, having not told me that my surgery is today.
           | 
           | They're not sure if I'm kidding, and neither am I.
        
             | randcraw wrote:
             | Have you tried watching videos of surgeries to see if you
             | can acclimatize your fear? Starting with something trivial
             | like a skin suture or mole removal might be tolerable.
             | Exposure therapy is an established way to gradually
             | inoculate yourself against a fear that seems inescapably
             | overwhelming.
        
               | ignoramous wrote:
               | > _Have you tried watching videos of surgeries to see if
               | you can acclimatize your fear?_
               | 
               | If you're anxious enough already, then: Don't. Ever. Do.
               | This. Videos don't help, at all. And your brain is
               | constantly thinking about ways things might have gone
               | wrong, while simultaneously looking (no pun) for comments
               | from people explaining how exactly things went wrong for
               | them!
        
           | scruple wrote:
           | I'm the same way. I even have a hard time with drops despite
           | using them regularly for years. I understand perfectly well
           | that it's completely irrational yet I have not found a way to
           | gain control over it.
        
           | s1artibartfast wrote:
           | >You can't tell me not to fear it.
           | 
           | They didn't. They said don't postpone your treatment and
           | suffer irreversible vision loss, due to fear.
        
             | jamincan wrote:
             | >To any future HN reader scared by those intraocular
             | injections: don't fear them.
        
               | s1artibartfast wrote:
               | Missed that, thanks.
        
         | joshlemer wrote:
         | What happens if a patient accidentally looks left or right
         | during the surgery? I would be afraid of
         | subconsciously/accidentally looking one way or an other during
         | the surgery, but would that not cause a catastrophe?
        
           | randcraw wrote:
           | The needle they use is short and does not extend very far
           | inside the eyeball. (No, you can't see the needle.) If the
           | eye jerks while the needle is inserted, it won't move far.
           | Eyeball tissue is thick and strong and the presence of the
           | needle will limit the eye's motion to only about 2-3 mm,
           | doing no damage. The needle enters the side of the eyeball,
           | peripheral to the sensory part of the retina.
           | 
           | An eye flinch is exactly what happened to me when I got my
           | latest injection of VEGF-inhibitor to counteract macular
           | degeneration due to 20+ years of diabetes. It was no big
           | thing, just a little disconcerting.
        
           | iKnowKungFoo wrote:
           | I've had multiple eye surgeries. Prep includes putting
           | lidocaine jelly over the eye, which will immobilize your eye
           | from movement during the procedure.
        
             | aeternum wrote:
             | This is also my greatest fear. The lidocaine isn't much
             | consolation as it seems like it could easily wear off or
             | they don't get the dose right and you move you eye.. the
             | stuff of nightmares.
        
             | saruken wrote:
             | Thank you for this. That's the primary thing I wanted to
             | know from this post too.
             | 
             | Although I will say having my eyes immobilized also sounds
             | scary. And I feel like I would constantly be "checking"
             | that I still can't move them.
        
               | ignoramous wrote:
               | Don't stress-test stuff in prod.
        
             | hodgesrm wrote:
             | Same here. I've had surgeries for cataracts and detached
             | retina (2 of each). Eye surgery has outstanding outcomes
             | and involves virtually no physical discomfort.
             | 
             | I'm profoundly grateful for modern medical technology, as I
             | would otherwise likely be blind in both eyes.
        
           | sedatk wrote:
           | We call those happy little accidents.
        
         | Taylor_OD wrote:
         | Good lord just reading your description made me feel very
         | uncomfortable.
        
         | mcguire wrote:
         | One of our friends has been having monthly eye injections for
         | macular degeneration for a couple years. At this point, I'm
         | more freaked out than she is.
         | 
         | Better than the alternative.
        
         | notJim wrote:
         | No offense to you, but this attitude is exactly the problem
         | here. I _know_ it 's not rational to be very concerned about
         | this, but I also know that the entire duration of that
         | procedure, I will be thinking "KNIFE. IN. EYE." In the world I
         | normally inhabit, knives should not ever be in eyes, so this is
         | an incredibly stressful thought, stressful enough that I might
         | do something crazy like MOVE WHILE A KNIFE IS IN MY EYE. This
         | thought is even more stressful.
         | 
         | The best advice for me personally is probably to breath deeply
         | and try to relax.
        
           | lotsofpulp wrote:
           | I like their attitude, gives me more confidence that they
           | know what they are doing since they can explain it.
        
           | xattt wrote:
           | Anything can be dissected (pun intended) to the point of
           | disgust.
           | 
           | Milk? That's just cow blood that goes through one weird sweat
           | gland. Honey? That's bee vomit.
        
             | ignoramous wrote:
             | Thanks. I hate you.
        
           | lisper wrote:
           | This. I have an extremely strong blink reflex which I cannot
           | overcome. The one time they tried to put contact lenses in my
           | eye it took them 15 minutes to get them in and another half
           | an hour to get them back out. It was one of the most
           | stressful experiences I have ever had. It was over 30 years
           | ago and it still makes me shudder to think about it. There is
           | no way that I can possibly rational-ize my way out of that
           | stress and convince myself that injections or surgery would
           | not be ten times worse.
        
             | Jxl180 wrote:
             | Blink reflex doesn't really matter. If it's anything like
             | my Lasik surgery, they insert devices (like Clockwork
             | orange) to make it impossible to blink -- who wouldn't have
             | the urge to blink when something is approaching their eye?
             | It's an involuntary reflex for self preservation. They also
             | put a ring in my eye that made it impossible for me to move
             | my eye whatsoever regardless of my urge to look away.
        
               | lisper wrote:
               | Yeah, I get that. The issue is not that it wouldn't work,
               | the issue is that I think it would be more traumatic for
               | me then a normal person, and I base that assessment on
               | the fact that putting contacts in is more traumatic for
               | me than a normal person (like "extremely traumatic" vs
               | "something so non-traumatic that they voluntarily do it
               | to themselves on a regular basis").
        
           | ses1984 wrote:
           | Sometimes they also give you something for anxiety, like
           | valium.
        
             | Avshalom wrote:
             | To be fair the topical anesthetic is cocaine.
        
         | sdenton4 wrote:
         | My fun fun eye surgery was to remove a stye that had hardened
         | into a chalazion. This didn't involve any actual needle/scalpel
         | work on the eye itself, but did require flipping my eyelid
         | inside-out and cutting into the back with a scalpel. The local
         | anaesthetic worked great. A side effect of the eyelid-flip (I
         | think) was that my eye rolled into a position that wasn't
         | seeing anything.
         | 
         | Overall, it was kinda like going to the dentist, but I could
         | keep chatting with the doctor through the whole thing. The
         | ability to keep communicating was great for keeping things
         | chill. (However, one must be careful not to laugh while there's
         | a scalpel near one's eye.)
        
           | metabagel wrote:
           | I used to experience blepharitis and occasional sties, but of
           | all things what cleared everything up was tea tree shampoo
           | and face wash with tea tree oil.
           | 
           | https://www.healthline.com/health/eyelash-mites
           | 
           | Keep any tea tree oil product well away from the eyelashes.
           | It's not actually necessary to treat it there, and you'll
           | regret it if you get any of the product in your eyes.
        
             | sdenton4 wrote:
             | Mine was caused by doing stressful grad school things,
             | keeping ridiculously bad sleep schedules, and staring at a
             | too-bright monitor for dozens of hours per day. These added
             | up to rubbing my eyes a lot, which led directly to styes.
             | 
             | After reducing my monitor brightness, the problem went
             | away.
        
           | ignoramous wrote:
           | Had that one myself. Looks way scarier in the videos:
           | https://www.youtube-nocookie.com/embed/phWKZTsy2dg In
           | reality, it is a not a big deal at all.
        
         | closetohome wrote:
         | Thanks, I'd never really thought about eye surgery before and
         | now am deathly afraid of literally every aspect of it.
        
         | axegon_ wrote:
         | Thanks for this! Mind you, as much as I understand the
         | importance and need of such procedures, that doesn't make me
         | any less terrified. I've had all sorts of absurd injuries over
         | the years all over my body and I am in no ways frightened or
         | disguised of any bodily fluids. That said, I am terrified of
         | the idea of such a procedure. Same with dental work - I abhor
         | the feeling of anything being done to my teeth. Getting a
         | wisdom tooth pulled out was arguably the most terrifying thing
         | I've ever experienced. A needle going into my eyeball wouldn't
         | feel any less terrifying.
        
         | olegious wrote:
         | As someone that had cataract surgery on both eyes in my early
         | 30s, I just want to thank your profession for what you do.
         | 
         | The experience was entirely painless, tooth cleaning at the
         | dentist is more uncomfortable.
        
         | mahathu wrote:
         | I fully believe your professional assertion that eyeball
         | injections won't hurt but this is probably the worst thing I
         | ever read on HN.
        
           | bigfudge wrote:
           | I had one of these and while it was awful to think about, the
           | sensation was actually minimal. I wouldn't hesitate in
           | future...
        
         | s1artibartfast wrote:
         | A couple questions:
         | 
         | How are you using the surgical knife in your intravitreal
         | injection procedure?
         | 
         | Any thoughts on how often patients can see the needle? I always
         | thought it was out of the visual axis, but some reports in this
         | thread mention seeing it !?
        
           | randcraw wrote:
           | I've had eye injections three times now and never saw the
           | needle. I can't imagine you you could, since the eye can't
           | focus on the needle since it's _inside_ the lens which is
           | necessary to focus what you see outside the eye onto the
           | retina. I don 't see how the fovea could receive a focused
           | image of the needle without help from the lens.
        
         | coffeefuel wrote:
         | I was born with cataracts and had the natural lenses in my eyes
         | removed when I was days old. Fast forward to 2018 and I had
         | intraocular lens implants (I believe it's called) under general
         | anaesthetic. Went fine for the most part, however I had to go
         | to A&E because the pressure in one of my eyes was ~65. The
         | cause was blood leaking into the back of one of my eyes (if I
         | remember correctly), and they had to use the drops you
         | mentioned. At the time I was a bit concerned with what they
         | were going to do, but obviously was willing to have whatever
         | done to get back to normal.
         | 
         | I'm still impressed by how well those drops worked. And, yeah.
         | All I could see was red (blood), and all I felt was just a
         | prick of something sharp. Was done within probably 10-15
         | minutes.
        
         | 4ad wrote:
         | Jesus Christ, you have managed to make it worse than I thought
         | it would be (and I expected it to be very bad). This is the
         | stuff of nightmares, I would never do this while I was
         | conscious. Hell, it would be better if there was pain.
        
         | [deleted]
        
         | wjamesg wrote:
         | I had a detached retina a couple years ago and it was super
         | scary experience. I am back at 20/20 with some wonderful work
         | by my doctors (and some intraocular injections, for sure),
         | although I am terrified of it happening again with permanent
         | vision loss
        
       | rob74 wrote:
       | I personally hope I will never need an eyeball injection. Then
       | again, there are people who volunteer to having their eyes not
       | only immobilized and then poked and prodded repeatedly, but also
       | bombarded with laser beams, to be able to see better:
       | https://en.wikipedia.org/wiki/LASIK#Operative_procedure - I have
       | a lot of respect for anyone who is brave enough to go through
       | this...
        
       | BasilPH wrote:
       | A close relative needed cortisone to manage an eye infection post
       | eye surgery. The insurance stopped paying for the cortisone drops
       | after a while, the only thing they would pay for were injections.
       | The procedure consisted of a large syringe that was used to
       | inject a literal pellet that would float around in the eye and
       | slowly give off cortisone over multiple weeks. My relative said
       | they could sometimes see the pellet float through their eye as it
       | intercepted light on its way to the optical nerve. It manifested
       | as a circular shadow in their field of vision. They called it
       | their "satellite".
       | 
       | The thing that struck me the most, is that a human eye seems to
       | be pretty puncture tolerant before it starts to leak. Also, the
       | insurance's decision is hard to understand: The injections cost
       | $2k compared to a couple hundred for the eye drops. And once the
       | pellet is in, you can't get it out to reduce the dosage.
        
       | MadameBanaan wrote:
       | I had 3 shots of Avastin to fix a neovascularization in my retina
       | [1] around the end of 2010.
       | 
       | I have to say, it's not a very pleasant treatment. I vividly
       | remember the image of the needle inside my eyeball and the liquid
       | squeezing in (Avastin has a refractive index slightly different
       | than the vitreos). But at least now I have a cool icebreaker when
       | I get my flu shot every now and then :D
       | 
       | [1] - https://pubmed.ncbi.nlm.nih.gov/17011951/
        
         | el_benhameen wrote:
         | Yikes! I had a similar experience with cataract surgery. I was
         | conked out for the initial portion, but I regained a state of
         | half-consciousness about halfway through. I was drugged up
         | enough that I could sit calmly while listening to the surgical
         | team and watching them stick stuff in my eye, but it's
         | unnerving to remember it.
        
       | fitzroy wrote:
       | I had a laser iridotomy a few weeks ago for "narrow angles".
       | Other than feeling like you're in a staring contest with Locutus
       | of Borg, it was quick and painless.
        
       | wheybags wrote:
       | Is there no way they can do this while you're unconscious?
        
         | JacobDotVI wrote:
         | Many patients need these injections regularly (every 4-6 weeks
         | on some treatment protocols). My understanding is that it's not
         | safe to give some general anesthesia that often for as long as
         | patients need these treatments (years).
        
         | PaulDavisThe1st wrote:
         | It may be possible (I don't know), but anesthesia comes with
         | its own risks, and one has to balance that against what seems
         | like an otherwise very low risk procedure.
        
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