16 ms·

I was terrified of an eyeball injection

170 points by CTOSian 5y ago

dirtyid 5y ago
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.
danpalmer 5y ago
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.
nickthemagicman 5y ago
I couldn't even finish reading the article, the prospect sounded so horrifying. This author is a king.
- selimthegrim 5y ago
  Going in for a retinal exam (in Metairie) today, I took heart from the author.
  - nickthemagicman 5y ago
    Stay strong soldier! Hope everything turns out alright. If you get the dilation your eye's will look like you are possessed by a ghost, for the rest of the day, and you might scare children ;).
    - selimthegrim 5y ago
      It was fine they just told me to get the sleep apnea and blood pressure under control (ie lose weight fatass)
- fernandotakai 5y ago
  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 https://en.wikipedia.org/wiki/Keratoconus
  - pjerem 5y ago
    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 5y ago
      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 5y ago
  I started looking through the comments here and... NOPE, I do not need this information in my life right now.
tnjm 5y ago
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 5y ago
  What happened? I’m intrigued and slightly queasy.
- arp242 5y ago
  This is one of those things that probably depends on the person, as well as the exact procedure. For some, "as little details as possible" is probably the right approach, for others "as many details as possible". For most of us? Probably somewhere in-between. One of the advantages of giving details is that it builds a bit of a trust relationship with the doctor.
draven 5y ago
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.
- wccrawford 5y ago
  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 5y ago
    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 5y ago
  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!
nightfly 5y ago
https://www.youtube.com/watch?v=XAjQQG_uT_E https://www.youtube.com/watch?v=XAjQQG_uT_E
inetsee 5y ago
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.
- samstave 5y ago
  >>My A1C went from 6.9 to 8.4 Whats good vs. bad?
  - valenceelectron 5y ago
    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 5y ago
    The [A1C] goal for most people with diabetes is 7% or less. [1] [1] https://www.cdc.gov/diabetes/managing/managing-blood-sugar/a1c.html https://www.cdc.gov/diabetes/managing/managing-blood-sugar/a...
- JasonCannon 5y ago
  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.
iamjdg 5y ago
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/wellness-and-prevention/pneumatic-retinopexy%3famp=true https://www.google.ca/amp/s/www.hopkinsmedicine.org/health/w...
- zwieback 5y ago
  Awesome - here's an instructional video: https://www.aao.org/clinical-video/pneumatic-retinopexy-rhematogenous-retinal-detachm https://www.aao.org/clinical-video/pneumatic-retinopexy-rhem...
- morelisp 5y ago
  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 5y ago
    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.
    - deleted 5y ago
      [deleted]
    - morelisp 5y ago
      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.
stevebmark 5y ago
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 5y ago
  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 5y ago
    The author is a type 1.
rob74 5y ago
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 https://en.wikipedia.org/wiki/LASIK#Operative_procedure - I have a lot of respect for anyone who is brave enough to go through this...
wheybags 5y ago
Is there no way they can do this while you're unconscious?
- PaulDavisThe1st 5y ago
  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.
- JacobDotVI 5y ago
  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).
univalent 5y ago
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 5y ago
  No doubt. But how does the learning process for this work and what does it look like?
globular-toast 5y ago
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.
- pjerem 5y ago
  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 5y ago
    Yeah the white of the eye is really not that sensitive. The lens is another story.
- elzbardico 5y ago
  > When I was a child I used to sometimes touch my eyeball with the tip of a pencil I really fear you.
MadameBanaan 5y ago
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/ https://pubmed.ncbi.nlm.nih.gov/17011951/
- el_benhameen 5y ago
  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.
mam4 5y ago
Try watching a cataract operation on YT without being OMGOMGOMG
RHSeeger 5y ago
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.
- david422 5y ago
  Technology today is both amazing and terrifying all at the same time.
- s1artibartfast 5y ago
  Strabismus Surgery?
  - Zababa 5y ago
    There's a surgery for strabismus? I've always heard that it was basically untreatable outside of wearing glasses.
    - s1artibartfast 5y ago
      (obligatory not a doctor, not your doctor) Apparently yes: https://eyewiki.aao.org/Strabismus_Surgery,_Horizontal https://eyewiki.aao.org/Strabismus_Surgery,_Horizontal
    - snuxoll 5y ago
      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).
wing-_-nuts 5y ago
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.
- rootusrootus 5y ago
  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.
- deepspace 5y ago
  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.
gdebel 5y ago
(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.
- jmnicolas 5y ago
  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?
- s1artibartfast 5y ago
  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 5y ago
    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 5y ago
  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.
justasidenote2 5y ago
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 5y ago
  Do you follow the advice of Dr Richard Bernstein at all? http://www.diabetes-book.com/ 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.
  - 5y ago
s1artibartfast 5y ago
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_MacCumber.pdf https://assets.bmctoday.net/retinatoday/pdfs/0520rt_AMD_MacC...
asciimov 5y ago
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.
cosmojg 5y ago
> 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 5y ago
  Alternatively, if you think your contractor is unfamiliar or underprepared for a job - find one you like!
- cjbprime 5y ago
  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.
scop 5y ago
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.
fitzroy 5y ago
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.
danepowell 5y ago
> 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 5y ago
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 5y ago
  Side effects like addiction and _feeling suicidal_ makes doctors quite conservative.
  - kgin 5y ago
    I just mean a one-time dose for a procedure, not an ongoing prescription.
user_7832 5y ago
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.
Tronno 5y ago
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 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 5y ago
  Surgeons and CEOs have a higher rate of psychopathology than the population at large.
1MachineElf 5y ago
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-his-bodkin/ https://jsaulburton.com/2014/07/27/isaac-newton-his-eye-and-...
- alok-g 5y ago
  Oh my!
jcutrell 5y ago
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.”
lurquer 5y ago
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...)
Tokyolunch 5y ago
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.
BasilPH 5y ago
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.
efitz 5y ago
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.
AceJohnny2 5y ago
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"
jherdman 5y ago
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.
Lev1a 5y ago
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 180-200€ per lens ie. ~400€ 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
Borrible 5y ago
The obligatory reference to Bunuel's and Dali's 'Un Chien Andalou' for the ommetaphobe: https://www.dailymotion.com/video/x4cbwvf https://www.dailymotion.com/video/x4cbwvf https://en.m.wikipedia.org/wiki/Un_Chien_Andalou https://en.m.wikipedia.org/wiki/Un_Chien_Andalou https://en.m.wikipedia.org/wiki/Ommetaphobia https://en.m.wikipedia.org/wiki/Ommetaphobia
fredley 5y ago
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.
UI_at_80x24 5y ago
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.
srvmshr 5y ago
I have choroiditis. It has formed patches of dead zones in my retina, maybe due to a faulty gene. I have to get steroid injections to my eyeball (intra-focal administration) whenever there is a significant flareup. That bring said, I was apprehensive the first time. But you have to trust the doctor and his skills. The injection itself doesn't hurt. There are no pain receptors in that zone. Only a faint prick when the needle pierces the sclera (the white outer skin of the eyeball). In my case, the doctor explained me before what I had to expect. A sort of cost-benefit analysis: "Bear your anxiety for a few seconds and the disease gets under control". It helps to understand what is at stake. Also, knowing the physiology of the process eases the nerves. If I know there is no nerve ending to feel the pain, I know I will be more relaxed. Protip: I keep my fist clenched to my belt & gaze fixed to a spot to prevent any accidental movement.

170 points by CTOSian 5y ago

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.

danpalmer 5y ago

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.

nickthemagicman 5y ago

I couldn't even finish reading the article, the prospect sounded so horrifying. This author is a king.

selimthegrim 5y ago
Going in for a retinal exam (in Metairie) today, I took heart from the author.
- nickthemagicman 5y ago
  Stay strong soldier! Hope everything turns out alright. If you get the dilation your eye's will look like you are possessed by a ghost, for the rest of the day, and you might scare children ;).
  - selimthegrim 5y ago
    It was fine they just told me to get the sleep apnea and blood pressure under control (ie lose weight fatass)
fernandotakai 5y ago
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 https://en.wikipedia.org/wiki/Keratoconus
- pjerem 5y ago
  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 5y ago
    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 5y ago
I started looking through the comments here and... NOPE, I do not need this information in my life right now.

tnjm 5y ago

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 5y ago
What happened? I’m intrigued and slightly queasy.
arp242 5y ago
This is one of those things that probably depends on the person, as well as the exact procedure. For some, "as little details as possible" is probably the right approach, for others "as many details as possible". For most of us? Probably somewhere in-between. One of the advantages of giving details is that it builds a bit of a trust relationship with the doctor.

draven 5y ago

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.

wccrawford 5y ago
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 5y ago
  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 5y ago
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!

nightfly 5y ago

https://www.youtube.com/watch?v=XAjQQG_uT_E https://www.youtube.com/watch?v=XAjQQG_uT_E

inetsee 5y ago

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.

samstave 5y ago
>>My A1C went from 6.9 to 8.4 Whats good vs. bad?
- valenceelectron 5y ago
  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 5y ago
  The [A1C] goal for most people with diabetes is 7% or less. [1] [1] https://www.cdc.gov/diabetes/managing/managing-blood-sugar/a1c.html https://www.cdc.gov/diabetes/managing/managing-blood-sugar/a...
JasonCannon 5y ago
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.

iamjdg 5y ago

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/wellness-and-prevention/pneumatic-retinopexy%3famp=true https://www.google.ca/amp/s/www.hopkinsmedicine.org/health/w...

zwieback 5y ago
Awesome - here's an instructional video: https://www.aao.org/clinical-video/pneumatic-retinopexy-rhematogenous-retinal-detachm https://www.aao.org/clinical-video/pneumatic-retinopexy-rhem...
morelisp 5y ago
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 5y ago
  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.
  - deleted 5y ago
    [deleted]
  - morelisp 5y ago
    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.

stevebmark 5y ago

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 5y ago
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 5y ago
  The author is a type 1.

rob74 5y ago

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 https://en.wikipedia.org/wiki/LASIK#Operative_procedure - I have a lot of respect for anyone who is brave enough to go through this...

wheybags 5y ago

Is there no way they can do this while you're unconscious?

PaulDavisThe1st 5y ago
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.
JacobDotVI 5y ago
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).

univalent 5y ago

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 5y ago
No doubt. But how does the learning process for this work and what does it look like?

globular-toast 5y ago

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.

pjerem 5y ago
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 5y ago
  Yeah the white of the eye is really not that sensitive. The lens is another story.
elzbardico 5y ago
> When I was a child I used to sometimes touch my eyeball with the tip of a pencil I really fear you.

MadameBanaan 5y ago

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/ https://pubmed.ncbi.nlm.nih.gov/17011951/

el_benhameen 5y ago
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.

mam4 5y ago

Try watching a cataract operation on YT without being OMGOMGOMG

RHSeeger 5y ago

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.

david422 5y ago
Technology today is both amazing and terrifying all at the same time.
s1artibartfast 5y ago
Strabismus Surgery?
- Zababa 5y ago
  There's a surgery for strabismus? I've always heard that it was basically untreatable outside of wearing glasses.
  - s1artibartfast 5y ago
    (obligatory not a doctor, not your doctor) Apparently yes: https://eyewiki.aao.org/Strabismus_Surgery,_Horizontal https://eyewiki.aao.org/Strabismus_Surgery,_Horizontal
  - snuxoll 5y ago
    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).

wing-_-nuts 5y ago

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.

rootusrootus 5y ago
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.
deepspace 5y ago
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.

gdebel 5y ago

(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.

jmnicolas 5y ago
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?
s1artibartfast 5y ago
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 5y ago
  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 5y ago
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.

justasidenote2 5y ago

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 5y ago
Do you follow the advice of Dr Richard Bernstein at all? http://www.diabetes-book.com/ 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.
- 5y ago

s1artibartfast 5y ago

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_MacCumber.pdf https://assets.bmctoday.net/retinatoday/pdfs/0520rt_AMD_MacC...

asciimov 5y ago

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.

cosmojg 5y ago

> 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 5y ago
Alternatively, if you think your contractor is unfamiliar or underprepared for a job - find one you like!
cjbprime 5y ago
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.

scop 5y ago

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.

fitzroy 5y ago

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.

danepowell 5y ago

> 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 5y ago

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 5y ago
Side effects like addiction and _feeling suicidal_ makes doctors quite conservative.
- kgin 5y ago
  I just mean a one-time dose for a procedure, not an ongoing prescription.

user_7832 5y ago

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.

Tronno 5y ago

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 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 5y ago
Surgeons and CEOs have a higher rate of psychopathology than the population at large.

1MachineElf 5y ago

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-his-bodkin/ https://jsaulburton.com/2014/07/27/isaac-newton-his-eye-and-...

alok-g 5y ago
Oh my!

jcutrell 5y ago

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.”

lurquer 5y ago

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...)

Tokyolunch 5y ago

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.

BasilPH 5y ago

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.

efitz 5y ago

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.

AceJohnny2 5y ago

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"

jherdman 5y ago

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.

Lev1a 5y ago

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 180-200€ per lens ie. ~400€ 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

Borrible 5y ago

The obligatory reference to Bunuel's and Dali's 'Un Chien Andalou' for the ommetaphobe: https://www.dailymotion.com/video/x4cbwvf https://www.dailymotion.com/video/x4cbwvf https://en.m.wikipedia.org/wiki/Un_Chien_Andalou https://en.m.wikipedia.org/wiki/Un_Chien_Andalou https://en.m.wikipedia.org/wiki/Ommetaphobia https://en.m.wikipedia.org/wiki/Ommetaphobia

fredley 5y ago

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.

UI_at_80x24 5y ago

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.

srvmshr 5y ago

I have choroiditis. It has formed patches of dead zones in my retina, maybe due to a faulty gene. I have to get steroid injections to my eyeball (intra-focal administration) whenever there is a significant flareup. That bring said, I was apprehensive the first time. But you have to trust the doctor and his skills. The injection itself doesn't hurt. There are no pain receptors in that zone. Only a faint prick when the needle pierces the sclera (the white outer skin of the eyeball). In my case, the doctor explained me before what I had to expect. A sort of cost-benefit analysis: "Bear your anxiety for a few seconds and the disease gets under control". It helps to understand what is at stake. Also, knowing the physiology of the process eases the nerves. If I know there is no nerve ending to feel the pain, I know I will be more relaxed. Protip: I keep my fist clenched to my belt & gaze fixed to a spot to prevent any accidental movement.