Essay: Macular Holes Kiab

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Macular Holes Case Study

Kiab has a family history of myopia from both parents. At 10, she already suffered from the refraction error and astigmatism. The conditions might or might not have been aggravated by her work at a computer laboratory for at least four hours a day for two years. In those two years, she at first noticed that her right eye was blurring. She also experienced extreme vertigo after long hours of computer work and reading. She attributed the blurring to her long use of the computer and reading. She thought that all she needed were corrective eye glasses and contact lenses. Developing macular holes was completely out of her mind. She did not even know what it was. Yet the disease had then already developed and would change her life.

When she had vision check-up, she was not expecting anything unusual. She only suspected that her myopia had gone worse and that new eye glasses would take care of it. She told the ophthalmologist about her many hours of computer use and reading, expecting these as the sole cause of her deteriorating vision. But something happened not too long ago, which told her that her expectation was wrong. She saw gas bubbles on top of her right eye, which blocked what she was looking at if she did not look downward. Deep fright ran up and down her spine and made her head spin. What could those gas bubbles be? She never saw them before!

Her doctor ran the same tests on her eyes as before. When he found that her right eye pressure was quite high, he told her that additional examinations had to be done. He used an ophthalmolcope to explore the condition more deeply. He discovered few small tears, indicative of retinal detachment. He told her that these small tears or breaks can turn into macular holes. And the chances are high that macular holes could further lead to blindness. What was worse, he added, was that the development of a macular hole in one eye tends to duplicate itself in the other eye within the person's lifetime.

She was in a state of shock. The condition was totally strange and unknown to her and just as frightening. The very thought of holes in her eye caused her deep panic. She felt very light and numb while walking out of the doctors' clinic. She wanted to ask more questions but no word came out of her mouth. She was frozen and speechless with dread. She did not know where she was leading to and what to do next.

Before she left the clinic, the doctor tried to somewhat console her. He told her that her symptoms were still in their early stages and medications might be able to resolve or arrest the progress of the holes. He then prescribed the use of eye drops and said he would monitor her condition. He also told her, however, that if the eye drops would not seal the holes, surgery would have to be performed. She had to have regular check-ups every two weeks for observation.

At this point, Kiab was praying and hoping that her left eye would not be affected and that the holes on her right eye would seal by themselves. But her hopes were crushed when she discovered holes appearing on her left eye three months later. The doctor's last option to operate on both eye had to be taken and performed immediately. When she approached the school ophthalmologist, she was told to look for another since the school had no resources to perform the surgery.

That was another blow to Kiab. She needed to find the money for the surgery and she did not have any. She just had to stop seeing a doctor and getting treatment altogether. For two consecutive months, she was in distress. Her vision on both eyes continued to deteriorate. Everything she saw was blurring more and more and looked bent. In one desperate move, she decided to consult once more with the ophthalmologist for surgery.

During the consultation, the doctor told her that her high myopia could have caused the macular holes to develop. He also told her resign from her job, which required working too long before a computer, which emits much radiation. Moreover, he strongly advised her to drop all lab courses until her condition could resolve.

The doctor also thoroughly instructed her on macular holes and about vitrectomy, which he would perform on her. Vitrectomy, he said, is a surgical procedure, which removes a vitreous substance in the eye and replaces it with a bubble. While listening, Kiab had many questions, which she could not help asking. "Will surgery make me completely blind?" Kiab asked, trembling. The doctor smiled and assured her that it will not. Instead, it will cure her disease. But there is no guarantee that new holes will not develop. Despite the assurance, Kiab remained very anxious about the outcome of the surgery.

The doctor emphasized that, after several weeks, the pressure of the gas bubble will close the holes. But because the gas rises and the macula is at the back of the eye, Kiab will have to lie face down after the surgery. The doctor consoled and assured her about the effectiveness of vitrectomy. "The visual acuity of most patients who undergo vitrectomy improves. It usually takes 6 months to a year for maximum resolution to occur."

Kiab's anxieties piled up and pounded on her. It seemed all like a very bad dream. She would have to lose her job. She had to raise the high cost of surgery and, at best, could only pay in installment. Despite her misfortunes, she hoped that things would get better for her. She might just land another job without the same health risk and be able to support herself again. But these had yet to happen. Right now, she must worry about the result of the surgery on both her eyes and the possibility of more holes developing in the future. She could only hope that she could overcome all these trials and everything would work to her advantage.

The day of the surgery finally came. The nurse brought her to the operating room and made her lie on the operation room bed. The operating room assistant applied some anesthesia on her eyes and covered her entire face with a light blue cloth, exposing only her eyes. When the anesthesia began to work, Kiab could see very little light. But her hearing became stronger as if to compensate for her poor vision. And the sounds intensified her nervousness. She became even more scared of everything. At this point, she had absolutely on control over any part of her body, nothing over her life. The nurses were conversing aloud but she could not make out what they were talking about or saying. She just felt she was sweating and her body temperature falling. When the doctor entered the operating room to begin the procedure, the noisy nurses stopped talking. Everything came to a chilly hush. Minutes later, Kiab could hear only the shrill of the laser and humming and biting machine sounds. She felt more dead than alive. Soon, all sounds were silenced and the doctor announced that the surgery had been completed successfully.

The nurse drove Kiab to the recovery room. Her thought on the way to the recovery room consisted of the doctor's repeated assurance about the effectiveness of the procedure in the majority of patients who underwent it. It was very highly possible that her case would be just as successful. It was an unparalleled experience for Kiab to be subjected to a strange and new procedure. The anxiety remained despite all assurance of its effectiveness and the expertise of… [END OF PREVIEW]

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Macular Holes Kiab.  (2014, January 29).  Retrieved June 24, 2019, from https://www.essaytown.com/subjects/paper/macular-holes-case-study-kiab/6426345

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"Macular Holes Kiab."  Essaytown.com.  January 29, 2014.  Accessed June 24, 2019.
https://www.essaytown.com/subjects/paper/macular-holes-case-study-kiab/6426345.