Health Care in CZ (A detailed account of how to get your eye jelly sucked out in the Czech Republic)

Warning: This is long and tedious. It’s probably only interesting to people thinking about having a lens replacement. Or perhaps it’s best not to know… Sorry there are no pictures. 

I HATE GLASSES

I started wearing glasses full-time about 25 years ago, and I’ve been plotting to get rid of them ever since. For about five years in Australia, I wore contacts, but when I moved to Hong Kong, I found that they just didn’t work as well. I’m far-sighted, which means I had to have one contact for close distance and one for far. Your brain works it out and you can see both close and far, but after a few years, my brain said, ‘Nup.’ Additionally, the humidity in Hong Kong meant I’d have to wear dailies: too much trouble. I’d looked into laser surgery a few times, but it was a much better  option for short-sighted people than long-sighted, so I put it off.

A few days after I arrived in Prague, my fairly new glasses broke. It seemed like a simple thing to fix, but I couldn’t find anyone to do it, and I couldn’t find a service centre for the company online. My glasses are expensive. They’re multi-focals (which is the most expensive aspect), and these were transitional, darkening in sunlight. I bought high quality lenses that wouldn’t scratch, and because I hate glasses so much, I bought frames I rather liked, and which were expensive. They were worth over $1000 USD in Hong Kong. So I had to wear my old glasses and look like Velma on Scooby Doo.  After a couple of months, I decided to look into laser correction again. This was my first experience going to the doctor here. In one of my Facebook groups, people recommended a particular laser clinic, and when I called the doctors’ centre recommended by my school, they recommended the same place. I called them.

THE CONSULTATION

It took about a month to get an appointment. The initial consultation would take three to four hours, and cost 1500 koruna ($60USD). I challenge you to find any kind of medical process that lasts three to four hours, in any developed country, for less than that. I guess that in countries with a great public health system, you could do it, but this is generally an elective surgery, so I’m not sure how many countries would cover it for free.

It was a very efficient, large practice. Sign here. Wait there. Come into this room and have air puffed into your eyes. Wait there. Come into this other room and look at the balloon. Wait there. Come into… you get the idea. Not many of the people spoke much English, but it didn’t seem to matter. You can have air puffed into your eyes in any language.

Finally, after about three hours of lights, balloons, charts, and dilating drops, I saw the specialist. Her English was good and she was very professional. I wasn’t thrilled with her recommendation though, at first. At a certain age (around 40), everyone develops presbyopia: the crystalization of your eye lens. It becomes inflexible, and that’s when a lot of people start needed reading glasses. Because I had presbyopia and was long-sighted, she said that laser would not be the best option for me. I’d still need to wear glasses for reading.

I THINK I’LL DESTROY A PAIR OF PERFECTLY GOOD ORGANS

Instead, she suggested, let’s destroy your natural lenses and insert two artificial ones. Well, I wasn’t immediately convinced. It just wasn’t that appealing. Then she told me that because my long and close diopters were positive (my glasses prescription is +) I was in the most satisfied group of people who had the procedure. She said that if I got trifocal lenses, I would never need glasses again. I would also never get cataracts.

Hard decision. What to do? I emailed my family’s Facebook group and a very close relative said she had had her lenses replaced because of cataracts, and it was fast and easy, and she was thrilled with the results.

I decided to go for it.

Then the doctor told me that I had a little pigmentation on my retina, and I’d need to come back for some more testing to make sure the pigmentation was not on all nine layers of the retina. Of course I had a little panic and wanted to know WHAT THE HECK pigmentation was doing on my retina, and  were there …. sinister… complications? She said it wasn’t really a big deal. We made the appointment for the next morning.

ONE MEAN GUY AMONG MILLIONS

The next day was really my first experience of a Czech speaker being mean to me because I couldn’t speak Czech. It went like this:

I wait in the waiting area. Someone calls my name. I go into one of the small rooms.

He: A lot of Czech. A lot. Most Czech people, especially in a situation like this, use gestures. He looks at his computer screen instead of at me and just keeps talking.

There is a machine in front of a single chair. Safe to make an assumption, I guess.

Me: Promiňte (sorry). Nerozumim. (I don’t understand) Anglicky. (English)

He: Keeps talking to me in Czech.

Me: I guess you want me to sit down.

I do and rest my chin in the obvious place.

He: Keeps talking in Czech, not really to me, I guess, since he knows I don’t understand.

I can tell he’s irritated. He’s starting to sound cranky. He keeps talking.

Me: (without moving chin) I’m not stupid; I just don’t speak Czech.

He: (in perfect, slightly accented English) Why not? It’s an easy language to learn.

Me: (without moving chin) It’s a beautiful language, but it takes a while to learn.

He seems to be becoming a more agitated. The only word I can pick out in his tirade is ‘americký’. 

Me: Australian.

He keeps going on in Czech until it’s over.

Before you judge the whole country on this guy, see if you can imagine something similar in your country. I’m quite sure you can.

I went to the doctor afterwards and she gave me the good news. My retina pigmentation wasn’t a problem. We set a date. She explained that my vision wouldn’t be 100% immediately (spoiler – I’m writing this on my laptop (on ‘Actual Size’) without glasses!) and she showed me some pictures of a problem that might occur temporarily afterwards: haloing—a glow around bright lights at night. I decided that I could deal with it. We made the appointment. This was a bit tricky. They do one eye and then the other the following week, and the practice only does the procedures in the morning. I had to take two days off school, after only barely starting there. Tricky. I made the appointment.

THE NAKED FACTS

Prior to the procedure, I needed a battery of tests: blood, EKG, urine. I decided that this would be a good opportunity to have a mole that had been worrying me checked out. The GP testing was very easy. She spoke English and was efficient and kind. The dermatologist was great too, but there was one thing that really surprised me.

Normally in Australia or Hong Kong, if you have to be examined, the doctor asks you to go behind the curtain, undress, and cover yourself with a sheet. Not so here. She told me to take off all my clothes. All of them. The mole was on my upper arm, but she wanted to check everywhere. Everywhere. There was no curtain and no sheet. But there WERE windows. A lot of them. I undressed quickly and all my moles were okay. My blood pressure (never high before) was super high though when I went downstairs to the GP. Stressful!

THE BIG BLIND DAY

On the Wednesday morning of my procedure, I was asked to wear no make up, and to take a change of clean clothes. I asked if this was really necessary, since it was only supposed to take fifteen minutes. They said the operating room was a sterile environment. I was SO glad I took a change of clothes. The room where you waited for the procedure had half a dozen people dressed in hospital gowns, gaping at the back. One woman clearly had not brought a change of clothes, and had to walk around a room full of men and women with her undies poking out. Well, I guess most of them had cataracts and couldn’t see well anyway, but was glad I was clad.

No one in the pre-op waiting room spoke English, but ‘allergy’ is basically the same in English and Czech, with the Czech ‘g’ sounding like the hard ‘g’ in ‘go’. The nurse gave me drops about every twenty minutes for a couple of hours, and then I put on my shoe covers and went into the operating room. At this point I noticed that every doctor I’d seen in Prague—the GP, the dermatologist, Hugo’s immunization doctor, the eye specialist, and now the surgeon— was female.  She spoke English! Comforting!

She told me that if I felt any pain, I should tell her. No need to worry about that, Doctor!

The procedure was … strange. The nurse put a blue cloth (slightly transparent—woven paper, I think) over my whole face and then peeled back an opening over my eye, trimming the cloth with scissors so that my whole eye was exposed. The cloth had sticky bits, I guess, and she gently taped back my eyelids. I didn’t feel any of this. Maybe they’d already put anaesthetic in. I was told to stare at a very bright light quite close to me. It was like looking straight into the sun. They swished anaesthetic in my eye a few times. Couldn’t feel it. I couldn’t really see anything except the light. I saw instruments approaching. I knew that they were going to make a tiny hole in the white of my eye and insert a cannula through which they would remove the old lens and insert the new one. DO NOT LOOK THIS UP ON YOUTUBE. YOU WILL REGRET IT.

Everything was fine until the surgeon said, ‘I’m going to destroy your lens now.” I had a teensy panic. It hit me that I was destroying a perfectly good eye—in effect, making myself blind. What if it didn’t work? What if the surgeon was drunk? What if the power went out? What if the surgeon slipped? Like, on a banana peel? I had to do some serious self-talk.

I heard a slight whirr which, honestly, was rather disturbing and then everything became much darker and blurrier. Then I started to see an amazing light show. It was mesmerising. Suddenly, there was a lot of talk and the surgeon then said, “I’m sorry. There’s a defect in the lens. I need to take it out and insert another one.”

This meant that I had the same operation twice in one session. There wasn’t really any pain involved. Actually, I did say ‘Ow’ once because I could feel a little pressure on my eyeball, and I’m a big believer in preventative pain relief… It was painless overall, but unsettling. I had this sense that my eye was looking in odd directions, and afterwards, I had a headache and I felt motion-sick, as if I’d been cross-eyed for too long. I can’t put a number on how long is not ‘too long’.

The big disappointment was that night, when I removed the bandage to use the antibiotic eye drops. I could barely see out my eye. It was as if I was looking through a blanket.

The next morning, it was no better. At my 24-hour visit, the eye specialist told me three things:

  1. This was the first time in the clinic’s experience that a lens was defective.
  2. I had a severe oedema in my eye and it could take a while to go down.
  3. The surgeon had applied medication to stop my pupil dilating in order to stabilize my eye.

I couldn’t see because of the oedema and the medication. The specialist told me that I needed to be able to see for the other eye to be operated on in five days time.

I basically had one eye for several days. It wasn’t fun. I ended up covering the newly operated eye with my hand for a couple of days, as I could see better with just one eye when I needed to look at something small. It was pretty awful. It wasn’t a lot better until Sunday, when I could see an improvement.

On Monday morning, the day I was supposed to have the second eye done, I knew that my vision in the first eye had improved. I hoped it was enough. I just wanted it all to be over and done with. When I got to the clinic, my eye was tested, and it turned out that while they expected I might have 60-65% visual acuity, I had 90%. The oedema was still high around the edges, but it had reduced a bit right behind the pupil – the exact place I needed it to reduce so I could see. The doctor said I could do the second eye.

EYEBALL NUMBER 2: LET’S DO IT

It was so stress-free! Once again, I enjoyed the craziest light show. I had no pain or motion sickness afterwards because it was over so fast (the way it is for 99.999% of people), and when I took the bandage off that night, I could already see better out the second eye than the first.

The most interesting thing about the whole process is the halo effect I experience at night. It’s amazing, but would be rather inconvenient if it were permanent. At night, artificial lights have rings of light around them, the same colour as the light, in concentric circles. They’re large enough that if I see a car coming, the rings around the two headlights meet in the middle. All lights look a bit like Van Gogh’s Starry Night. It’s pretty spectacular. It’s Christmas everywhere. Last night, I got to see fireworks, and each glittery bloom had the bright rings around it. It’s amazing. I wish everyone could see it, just to see how gloriously wrong your brain can be. My favorite experience of the halo effect, though, is the moon. Wow. It’s got this lilac glow around it. Stunning. I feel as if I am an artist, constructing beauty. Unfortunately, I absolutely could not drive under these conditions. Fortunately, at this particular point in my life, it’s all subway.

It is now 11 days since the second operation, and my vision is pretty good. It’s not perfect, but I can leave my laptop on ‘actual size’ almost all the time. I had my one week visit yesterday, and the specialist said that everyone was going well.

I said: It’s still a bit blurry and my eyes get tired. She said: Normal. Give it a month. Your brain is going to take a while to adapt to a very abrupt change.

I said: The rings around lights are insanely gorgeous but very distracting. She said: Give it two to three months. And don’t lift anything heavy. Keep putting all these drops in your eyes and come back in six weeks.

That’s it.

I don’t wear glasses any more.

 

 

 


		
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