Upon hearing his comment, what I feared most had stricken down my spine. It was inevitable finally. What has to come, has come. I had to accept the reality. My mood swung 180 degrees.

We rushed home to have a quick lunch, called my mom to ask her to help MIL to take care of the three dinos at home. It was a public holiday tomorrow, so we had to rush to make it to the clinic before the clinic closes in the evening. LA drove and I guided her into KL and to the clinic at Mid Valley Mega Mall.

It was about 1:30 P.M. when we arrived at the clinic. The VR specialist confirmed the detachment area which was holding up by previous and fresh laser retinopexy scars. He strongly recommended vitrectomy to repair the detached retina. The story goes this way:

Last evening, we were told by the doctor in Melaka that everything was stable and the tear was held up by the laser and there was no detachment. But this VR specialist told me the other story. There was a big detachment area and fresh laser mark surrounding that detachment area. One question: Why did the doctor in Melaka give me more laser?

Obviously, (in my opinion) the doctor in Melaka had denied us the truth. I am damn f@$&#*? sure that he did not mention about any detachment in progress at all and what LA and I heard was that “Everything is stable but I just need (and feel better) to put more laser surrounding the blood vessel.”

So, I could wait to see if the laser marks would hold or the detachment would progress slowly until it would need a repair. I made the decision on the spot to be vitrectomized based on several reasons:

• if the detachment has been progressive, it will eventually need a repair.
• the longer I wait, the lower chance I have to have a better recovery because the longer the retina is detached, the retina cells will die and I will loose partial vision.
• since I am already consulting a VR specialist and he can immediate vitrectomize my eye, why wait until Monday or so? It is a long weekend and God knows what will happen during the weekend.

So the decision was made. The doctor immediately picked up his phone and arranged for a vitrectomy procedure. The vitrectomy is done as out-patient procedure with local anesthetic. The entire procedure takes only about 30 minutes and I can go home after that.

The doctor took me to another room to take some photos of my retina. Here are some snapshots of my retina. The first photo was taken in March this year at an optometrist shop. The “X” roughly marks where the tear and detachment area is.

Taken in March this year at an optometrist shop

The photo appears to be cloudy due to the blood and debris in the vitreous humor

The white dots are fresh laser marks surrounding the detachment area (U shape)

After the photography session, they sent me to consult a surgery consultant. At her office, she explained to us what the procedure is and what I shall do after the procedure. I have to sit, sleep, stand and walk with my head facing down so that the air bubble in my eye will push against my retina. Not so bad though, I thought. At least better than the previous one (on my right eye) which I had to sleep only on my left all the time. While she explained to me, my nervousness struck me and sent me a great chill. I was shivering with very obvious tremor.

We went for quick lunch at Gardens and went back to the operation floor. I felt warmer with a sweater which LA brought along. It was 3 P.M. Not long after we arrived at the operation floor, the nurses got me ready into surgical gown. Very soon, a nurse came out from an operating theater and called me in. Why so soon? We were told that my procedure would be around 4 P.M.!

I went into the operating theater and was told to lay down on the operating bed. Then the nurse put on a blanket on my body to keep me warm. Not long after, the door opened and my doctor entered. He gave me a warm greeting and ditto. We started some conversation while he and his surgical team were preparing.

The doctor instilled two drops of anesthetic into my left eye. After a minute, he returned to give me a local anesthetic injection. He pulled down my lower eye lid and poke the needle into my eye. Ouch! He told me to breathe in and out for him while he performed the injection slowly. When it was done, he applied a gauze and pressed on my eye. After a while, a nurse took over. I began to feel numb on my left eye. Later, a nurse wrapped my face with an adhesive film and then cover the other eye of mine with a cloth.

After a while, the doctor came back and started to cut a hole on the film to expose my left eye. I could hear the sound of the instrument knocking on the table and some noises from some equipment. While the doctor was operating on my eye, we chatted. He is from a small town called Jasin in Melaka. He has two daughters. And the gas he is going to inject into my eye is Sulphur Hexa-fluoride (SF6) and it will only last for 2 weeks instead of 4 weeks for C3F8.

I did not feel any pain except some pressures during the surgery. With our conversation, the surgery was over very quickly. It seemed like only 5 to 10 minutes having a chat with a friend. The experience was much better than the cataract surgery I had in 2007. My body wasn’t tensed this time. Perhaps, I am more prepared after the two surgeries previously.

If you are curious about what the doctor did to me, click here. It is the same procedure without the scleral buckle thing.

After the surgery, we went over to Borders at Gardens to browse some books. We left for home afterward and arrived around 8 P.M.

We went home happily and had a good relieve. LA and I had been in and out of the clinic for almost three weeks since I had PVD (Posterior Vitreous Detachment) and retina tear on May 18. I guessed, at least for this moment, nothing to worry about.

I had my cataract surgery on June 19, 2007. Read here. I also posted a video of a cataract surgery here. The surgery removed my natural lens which had been clouded by the penta-fluoro carbon (C3F8) gas in the retina repair surgery. A new artificial lens was inserted to replace my natural lens. The only consolation reward I could think of was that my short-sightedness was reduced by half, as my doctor told me.

During the phacoemulsification procedure, the lens is removed but not the posterior lens capsule. It has to be left there to hold the new artificial lens. Not all lens cells can be completely removed. Some are left behind. Sometimes, the lens cells grow across the new lens. It is more likely to grow back if you are younger. Sometimes this happens in a few months after the cataract surgery, sometimes years. This is not a re-growth of cataract. It is the thickening of the back of the lens capsule. It is called the posterior lens capsular opacification. The picture shows the posterior capsular opacification on retroillumination.

Frequency-doubled Nd:YAG (neodymium-doped yttrium aluminium garnet; Nd:Y3Al5O12) laser with a wave length of 532nm is used to make a “hole” in part of the capsule to allow light to pass through the lens directly. This procedure is called YAG laser capsulotomy. The doctor aims the laser exactly onto the posterior lens capsule and fires very short pulses of laser to blast off the part of the capsule and make a small circle shaped area. This leaves some of the capsule intact to hold the lens. The very small part of the lens capsule which is cut away falls harmlessly inside the eye.

The laser capsulotomy is very quick and not painful at all. I only heard some clicking noise as the laser was working. My vision on my right eye became clear again immediately after the procedure. The only discomfort I had was when my doctor attached a contact lens onto my eye.

The reason to lay on my left is to allow the air bubble in my right eye ball to push my retinal onto the wall of upper right corner of my eye ball.

I had both procedures called pneumatic retinopexy and scleral buckle.

I waited at YC house for LA and the kids to arrive. They arrived around 1900. We had quick dinner and shower and off we went to the Hospital. By that time, the horse shoe shape had covered more than quarter of the lower left corner of my vision.

I was admitted to the Hospital around 2015 and waited until 2100 for Dr. Lim to examine my eye. His presentation had reassured our decision that he was the right doctor despite of good comments from YC’s friends. He took half hour to explain in great details about my condition and my surgery procedures. He advised me to sleep on my right side. This might help to prevent or slow down the retinal from further detachment. The detachment was on the upper right of my right eye. I could have think of that. Our eye sees things in opposite sides. Bottom to the top. Left to the right. I was too worry to think about this basic science I learned from my high school. What an idiot am I?

The nurse wheeled me back to my ward. LA settled down with me and I kissed and said good night to LA, Dmitry and YC. They told me not to worry and rest well and they would be here in the morning.

I felt calm and I guessed I had accepted the faith. I slept on my right through out the whole night.

I quickly made a call to my doctor’s clinic and get the earliest appointment at 0930. We rushed down town and arrived at the clinic at 0925 but we waited until 1230 to see the doctor!

The nurse dilated my right eye and after a while the doctor examined my eye. He confirmed I had retinal detachment. He referred me to Dr. Lim, a vitreoretinal specialist in Kuala Lumpur and arranged with him for an urgent surgery.

After paying the doctor, we made our way home and we began to called our relatives and family to inform them about my condition and urgency for an op. We arrived home by 1330. The house stirred into actions. Phones started to ring.

IS (my brother-in-law) was here in Melaka and we asked him to help. He sent me and my mother-in-law together with Dominik to YC’s (another brother-in-law) home in PJ. LA would and the other 2 kids would be in the other car and they pushed off later. LA needed time to pack for the kids.

On the way out, I suddenly noticed some dark floaters with smeared tailed. I began to worry. This seemed like some kind of hemorrhaging in the eye ball. After my children health examination, I quickly check the Internet and began to worry. I still had no clue what had happened to my eye.

I immediately called up an eye specialist in town and scheduled an urgent appointment. When I was at the clinic at 1430, and waited for almost half hour, the doctor finally examined my eye. He could not see much until he dilated my eyes. Again, it took another half hour to dilate my eye.

The doctor confirmed that I was having retinal tear and the tear was running across one of the blood vessel. He suggested to perform Laser 532 surgery.

Laser 532 is a green doubled frequency YAG laser with 532 nm wavelength. It is used to seal off retinal tear by creating a scar to prevent further progression.

The laser was very bright and I could hardly open both eye (my left eye was closed due to the reflex of the right eye). The doctor had to increased the power of the laser so that it could penetrate the blood clog. When he did that, I felt pain at each pulses of the laser firing. He could not stand the complaining of my pain and he stopped the surgery and scheduled for the next appointment on next coming Monday.

Because my eye was dilated, I could not drive. I called LA to arrange with my cousin BS give her a lift to the clinic. She drove me home.

When reached home, I immediately Googled “retinal tear”. OMG! This was serious. My fear began to set in after reading about retinal tear and retinal detachment and the surgery procedures to repair the retinal.