This might be a little long, but I felt I needed to explain what has been happening with me in the past 6 months or so...
If you had asked me what I thought of the idea of having a cancerous tumor inside my eye, I'd probably have said that it sounds like the scariest thing I could have happen to me. In reality, it probably is one of the worst ways to get cancer... why? because it can evade detection until it is too late, and as I've read up on Ocular Melanoma, it tends to be extremely aggressive once it metastasizes. It's a "Primary Cancer" - that is, it isn't caused by other cancer in the body. Detection seems to be the main key to recovering from this sort of cancer, with treatment ranging from my own radiation therapy to removal of the eye.
In August of 2010, I went to the eye doctor for the first time in 8 years, looking to get a better prescription. During the exam, the optometrist discovered an issue with my retina, and pointed out that I had lost some of my peripheral vision in my right eye. I had "noticed" this, but I hadn't really "acknowledged" the issue since the blind spot was in my vision to the upper left of the right eye (toward the center of my brow). They took images of the spot they saw on the back of my optic nerve, and referred me to a retinal specialist. A week later, I got the bad news from the retinal specialist - the spot was a lump. They referred me to University of Michigan's Kellogg Eye Center in Ann Arbor. The retinal specialist asked if I saw any flashes, and of course, once I went to bed that night, I saw them... or at least I finally paid attention to them. "Glints" throbbing along the area of my vision where the blind spot was, i.e. at the edge of the lump over my optic nerve. Ugh... this was going to drive me nuts, between the things I ignored before, and now noticed, and the very scary thought that I might have a cancerous tumor in my eye.
My visit to the Kellog Eye center in early September brought the awful reality of the situation to full light: it was cancer. Four hours of poking and prodding... including an ultrasound that was performed directly on the surface of my eyeball. The ultrasound was not the worst thing I'd have to endure; and in retrospect, was not nearly as bad as I had envisioned. They applied numbing drops to my eye, and most of the time the probe was at the inside corner of my eye. The buzzing sound the probe made was reminiscent of a dentists drill, but logically, I knew there would be no harm done to my eye. Really, it was that thought that got me through - nothing they did to my eye would cause it any real harm. All I had to do was endure the brief periods where they needed to do something directly to my eye.
Very quickly, they scheduled radiation therapy, and before I could actually have the operation done, I also needed to get a full cancer screening to insure the cancer had not spread. A full cancer screening meant a doctor's physical, chest x-rays, liver function test, and an ultrasound or CAT scan of my abdomen. Cleared of obvious signs of the cancer spreading, I was ready for my operation. I also met with the radiologist who was preparing the radioactive plaque for implantation… I asked him if the radiation would cause other problems, given that it was essentially right next to my brain, and was assured it would not be an issue. The Ocular Oncologists had already informed me that the radiation would, however, impact my vision, since it would also kill a significant part of the “good” optic nerve.
The plan was pretty straightforward... I would go in Monday, and the doctors would implant a radioactive plaque (chip, if you prefer the term) containing a specific amount of material, directly onto my eye beneath the tumor. Some muscle would be cut and the chip was sewn into place... I was put under general anesthesia for the treatment, so I awoke with gauze taped over my eye and a “shield” in place (this was a large radiation shield, which covered about a quarter of my face). I would keep the shield over my eye, and the gauze, until the radioactive chip was removed on Friday afternoon. I was not allowed to be in the company of anybody for more than 20 or so minutes at a time, and I’d have to sleep alone to minimize exposure to others. I had painkillers to help with the dull throbbing pain from the implant, but for the most part, I felt better than I had in some time. The glints gave way to a strange sparkling that branched out around the edges of my blind spot. The strain on my left eye was bad… it was very difficult to work without taking many breaks.
On Friday, I was ready to get the radioactive chip removed. After the operation Monday, I was prepared to have them put me under, but that was when they informed me they were putting me under “MAPS” – not general anesthesia. I would “not care about it and forget about it” but I would be conscious for the operation… yikes. My anxiety level rose as they wheeled me to the operating room, but that was the last thing I remembered. As it turned out, I had pain issues, and they put me under general during the operation. Removal of the plaque was followed up by laser therapy, and I awoke about 4 hours later, the familiar gauze taped over my right eye, but thankfully, no radiation shield. I was informed I would have a follow up in a month or so to examine the eye, and that I would have two more laser therapy sessions – one in 4 months and another in 8 months. I would use Atropine drops daily in my eyes, and apply antibiotic ointment 3 times a day to the eye (by “scooping” it into my lower eyelid)
When I finally removed the gauze, I found that my vision was, well, just plain terrible in my right eye. Double-vision, and obvious weakness in muscle control, made things like driving very difficult, particularly night time driving. It took several weeks before I felt as though my vision had recovered well enough to attempt driving. Even so, eyeblinks were enough to throw my right eye “off” and skew my vision sometimes.
One of the things I noticed after the operation, when putting in the eyedrops, was a large “lava lamp-like” black blob that descended on my vision when I tilted my head back. In the course of the operation, some blood, apparently, had gotten into my eye, and I was seeing the remnants of the blood as my vitreous humor rolled around. When I figured out what this was, it didn’t bother me as much. Blood take a LONG time to absorb back into your system inside the eye. It would eventually shrink to nothing.
By the time I had my follow up exam, the right eye was still very blurry, but my overall vision wasn’t too bad (the left eye provided detail, the right eye helped with depth perception). The exam provided some positive news – the biopsy came back negative for metastasization of the tumor, and also, it was a “Type A” Colloidal Melanoma, apparently the less malignant form of the cancer. All signs pointed to a good recovery and that the cancer had not spread. The tumor was shrinking as expected, and my vision would continue to become less blurry, particularly after I stopped using the Atropine drops used to keep the eye dilated. I continued to use the ointment, as needed. Besides another ultrasound on the eyeball, I also had one scary moment when the doctor proceeded to take out a pair of tweezers and tug at a stitch that still remained on my eye!! This was more disconcerting than painful, and the doctor quickly responded by having more numbing drops put in to easy my discomfort.
By mid-November, I made an interesting discovery when out shopping with my son… though my right eye’s vision was still a bit blurry, I could see 3D (as in 3D TV) just fine. When I had been informed that I’d probably lose most of the vision in my right eye, over the next several years, I made a vow to get a new plasma HDTV with 3D capability to replace our old 720p Rear-Projection CRT TV. I had already put aside money for the purchase, so upon learning that my eyesight was good enough to enjoy 3D TV, we went ahead and purchased a Samsung 58” Plasma with the 3D extras (Shrek 3D kit with 2 glasses and a Blu-Ray player).
Now it is mid-February, and after 2 attempts, I finally got my “4 month” laser therapy done. My original appointment was on January 19, but I opted to reschedule the actual therapy until February 2nd, because the examination took too much out of me. Unfortunately, February 2nd was the day of our big storm, and I had to reschedule again (this time for the 16th).
After all the rest of it, the laser therapy caused me a bit of anxiety… the doctor had informed me that it would be painful, so I was unsure what to expect. As it turned out, the painful part turned out to be the injections they had to give me directly under my eye, performed like the dentist does in the gums. It felt worse because thee ae a lot of nerves there, and, well, it’s my eye… the squirting noises from the syringe didn’t help matters, but once they were done, my eye became immobilized and eventually, my eyelid drooped down as well. At that point, the doctor took out some sort of “lens” device, flopped open my eyelid with his thumb, and placed the lens on my eye. The eyelid dropped over the lens (there was some sort of lip around it to keep the eyelid from closing in front of it). The procedure at that point was pain-free and quick – about 10~15 minutes, with the doctor moving around his light to observe the tumor as he aimed the laser at it and burned the edges of the tumor. As he depressed the foot pedal, a tone emitted with the activation of the laser (no other sign the laser was doing anything, for me at least) and he called out different strength levels to the assistant. No pain during the therapy itself or afterward. When he was done, he pulled the device (which “plopped” out from the eyelid that was closed around it), put gauze on the eye, and I was ready to go.
My eye was frustratingly immobile until I went to sleep that night. Eyestrain was bad again, but it was only a few hours. When I awoke the next morning, I could tell my eyelids could open behind the gauze, so I removed it and beyond the blurriness, I at least had some vision in my right eye.
That was a few days ago, and my right eye is still slightly blurry, but I can read text, at least. No pain from the therapy at all.
At this point, I have one more follow up in 4 months and everything looks good for full recovery.
I’d like to add that the doctors at the University of Michigan are great, particularly Dr. Demirci. I hope my story can help others who may have to go through the same procedure… it may be daunting, but it can be endured. Please make sure you get regular eye exams, and when you something amiss, take notice! Had I not had my exam when I did, I’d probably be terminal and counting the days. I was very fortunate to also have a path of treatment that, while uncomfortable at times, was far easier than people that must undergo chemotherapy or actually have surgery to remove cancers.
One last thing before I sign off on this story for now… remember when the doctors told me the radiation would only affect my eye? I’m not too sure about that. I was looking through some digital photos we took with one of our cameras, from 2005 – and a strange cat appears in one of them, in our house (we currently have 4 cats). While my family remembers “Tigger” I do not. Not one single memory of this cat, which according to my wife, had heart problems and we eventually had to put him to sleep after several trips to the vet. How I could forget this cat is beyond me… it’s like the memory was plucked clean out of my head! My suspicion is that the radiation somehow took out a key neuron linking my memory of this cat. I have come across nothing else in my experience that might be “missing” from my memory… no technical knowledge, family members, friends… I can account for quite a bit of memory through my life, trips I’ve taken, for both vacation and work, cars I owned, etc… but this cat, “Tigger” still eludes me today. Small price to pay, I guess, for escaping death.
UPDATE: A couple of months ago I underwent my final laser therapy, and the doctor let me know that the tumor continues to shrink. Basically, it's going as good as can be expected, though I'll have to make regular checkups and cancer screenings for the rest of my life. The eyesight in my right eye is getting a little "wonky" - a little blurriness in tiny, random spots that become noticable when I close my left eye; this is due to the radiation treatment, and was expected.