Eye Injury Recurrence

Perhaps regular readers of Juan Or and Mommy's blog may have noticed of Mommy's 'disappearance' from the blogging scene one more time shortly after the recent 'disappearance' during the last week of April till the 1st week of May. This time, Mommy's 'disappearance' was not due to work stress, instead Mommy went on medical leave for the first 4 days of the week followed by a day of annual leave. So Mommy was literally unconnected throughout the week.


So what caused Mommy to have to take medical leave? Actually Mommy had a recurring eye injury that was inflicted about a year ago (you can read about what happened here and here). In short, about a year ago, Juan Or, who was 12+ months old that time, had held a back-scratcher stick and hit Mommy's right eye, so causing Mommy's cornea to be scratched, but luckily the injury was only at the outermost layer of the cornea. The wound healed, but recurred. And when it recurred, Mommy didn't know it recurred because about 2 weeks approaching the day when Mommy really had to visit the eye specialist, Mommy noticed that whenever Mommy opened the eye after long hours of sleeping, Mommy experienced dryness in that eye. But after having blinked plus keeping the eye closed for some time, the dry sensation disappeared throughout the day, so Mommy didn't give much thought to it. Then on last Saturday, the climax of the dry eye incident came when Mommy couldn't even open the right eye after long hours of sleeping and it even felt painful (or rather a very irritating sensation!) to keep the eye open! However, the irritating sensation fluctuates (ranging from less irritating to very, very irritating) throughout the day and felt very much like there was foreign particle stuck in the eye.

That Saturday night itself, after coming back from teaching piano, Mommy called up Tun Hussein Onn Eye Hospital to see whether they are opened on Sundays. The staff explained that there will be no eye specialists available on Sundays (or is it weekends? Can't remember!) and that only medical officers will be on duty. However, the hospital can call up for an eye specialist to come immediately if it is really an emergency case (and Mommy thinks probably the hospital fee will be super high too for that matter!). So on Sunday, Mommy beared with the eye discomfort to wait for Monday.

On Monday, Papa fetched Juan Or and Mommy to his parents' house very early in the morning so that father-in-law can take Mommy to the eye hospital (Mommy can hardly open the eyes at all so cannot drive!). Mommy was assigned to the same eye doctor that treated Mommy last time, Dr. George Thomas. After checking Mommy's eye with the eye-checking machine, he found that the epithelium layer of the old injury spot on the cornea had broken down. So Mommy asked him how the layer can break down by itself to which Dr. George said Mommy could have rubbed the eye too hard. This time, Dr. George instructed the nurse to put an antibiotic eyedrop and then an eye patch (which was never done in the previous treatment) to prevent Mommy's eyes from opening so that the recovery process is faster. Dr. George said that Mommy could only open the eye patch 24 hours later and thereafter apply the antibiotic eyedrop (Tobrex) once in every 2 hours and artificial tears once every hour (except during sleeping time). He also put Mommy on 4 days medical leave and required Mommy to come to see him again for follow-up on the 4th day. The medical bill that day was RM120 (RM45 for consultation, RM5 for registration, RM5 for service and RM65 for medication).

What and how does it feel like to have the eye patch on? Well, it was really no fun as Mommy realized that having the eye patch on is just as inconvenient as having other parts of your body plastered although it was just the eye and not the limb. Mommy felt handicapped throughout the 'patchy' period and surprisingly, Mommy felt drowsy and sleepy most of the time even though oral medication was not prescribed at all. It was also a feeling of inactiveness plus clumsiness, probably because of the 'handicap psychology' lurking in Mommy's head. There were certain times throughout the day when the patched eye felt an irritating sensation (though not in so much a degree as before treatment) but Mommy cannot do anything yet because it was not yet time to remove the patch. Another thing about having the eye patch on was that the eating process became tremendously inefficient as the mouth cannot even open big enough (due to the surrounding tapes that fasten the patch in place) to scoop in dinner spoon! Little bits and pieces of rice kept spilling out as Mommy ate food. Even the appetite went rock bottom!

As the days went by, the eye improved a little. There was no more irrritating sensation but vision on that eye was blurred and both of Mommy's eyes could not withstand normal sunlight. Luckily by the 4th day (when it was time to go for follow-up consultation), Mommy was able to drive again though Mommy had to have the sunglasses on to minimize the glare but still Mommy's eyes had to blink quite often when in normal sunlight.

From the follow-up consultation, after checking Mommy's eyes, Dr. George concluded that Mommy's eye showed good progress although it has not healed completely. Nevertheless, there was already a layer or so of cells covering the main injury spot though there were still small spots here and there that looked raw. Now Dr. George recommends that Mommy only have to apply the antibiotic eyedrop twice a day and the artificial tears once in every 4 hours till the supply finishes. The doctor also explained that recurrence of an old eye injury is bound to happen within 2 to 3 years and after that period, things are likely to go back to normal subjected to the new cells sticking firmly and well on the wounded spot in the first place. The medical fee for the follow-up was RM55 (RM45 for consultation, RM5 for registration and RM5 for service).


Mommy also called up Mommy's insurance agent (Prudential) to see whether the medical fee is claimable or not to which he said that claims for recurrence of an old injury is only limited to one year from the time when the injury claim started and that no subsequent medical report is needed to back up the claim. Only the receipt, credit card receipt (if paid using credit card) and a photocopy of the medical chit is needed to make the claim.

So from now on, Mommy dare not rub the right eye anymore no matter how itchy it is. By the way, Dr. George also mentioned that Mommy can still rub the unaffected eye because there was no weakness in the cornea in the first place. As of this time of writing, vision in that eye is not as blur now though the image is still not as sharp as the other eye. Mommy no longer wants this kind of thing to happen again, if possible - it's really no fun to experience it.

Follow Up of Eye Treatment at Tun Hussein Onn National Eye Hospital

Remember how Juan Or hit the back-scratcher stick onto Mommy's right eye? Well, the eye did not get any better one day after the visit to the general practitioner (GP). The eye still had an irritating sensation whenever Mommy blinked the eye. And both eyes can hardly keep open even in normal lighting.

So on Friday late afternoon (29th May 2009), Father-in-law drove Mommy to see the same GP again to get a referral letter to go see an eye specialist in Hospital Universiti Kebangsaan Malaysia (HUKM). However, upon reaching there, the clinic assistant told Mommy that the doctor went out to eat and will be back by 4 pm. So, ok, Mommy thought, might as well go by Pediasure for Juan Or first before heading back to the clinic. So after buying, Mommy reached the clinic again at 4.15 pm and still the GP was not in. So Mommy decided to go back home and perhaps try again tonight.

However, upon reaching home, Sister-in-law mentioned that specialist clinics in HUKM are closed from 5 pm and during weekends, thus leaving Mommy with no choice but to go for a private hospital - and that is Tun Hussein Onn National Eye Hospital at Lorong Utara B, Petaling Jaya (PJ). So Father-in-law offered to tke Mommy there on the motorbike, if Mommy is brave enough to pillion ride, considering that the PJ should be jammed since it was near 5 pm already. Immediately, Mommy took the offer and hopped on the motorbike and reached the hospital in just 15-20 minutes' time - pretty fast since we were travelling mostly on the motorbike lane.

At the clinic, there was not many people, so Mommy's turn came quite quickly after registration. First a nurse took Mommy into an eyesight-checking room. The nurse put a piece of lens in front of the hurt right eye and pointed to alphabets in different rows and Mommy had to read them out. Then she shifted the lens to the left eye (the good eye) and did the same thing. After that Mommy was directed to go into the consultation room where a young Indian eye doctor attended to Mommy. Using some eye-checking machine, he found that apparently Mommy's cornea was scratched, but luckily the scratch was at the outermost layer. Had the scratch been on the third layer, then that would be problematic. He said that scratch on the outermost layer of the cornea will heal by itself. He even taught Mommy how to see the scratch: the scratch will appear as a dark green lump on the cornea. After that, the young eye doctor referred Mommy to a more senior eye doctor - one Dr. George Thomas - an elderly Indian doctor. So Mommy went into Dr. George's room and using the same machine, he checked Mommy's eyes again - probably to confirm the diagnosis done by the young doctor. Dr. George prescribed an eye drop for Mommy to put once in every 4 hours and arranged for a follow-up appointment on 1st June 2009 (Monday). The bill came up to RM79 which consisted of RM10 for registration, RM50 for consultation, RM14 for medicine and RM5 for services. Mommy considers this RM79 bill as 'not bad' because Mommy has a colleague who went to this same hospital for scratched cornea (as a result of contact lenses) with a bill of RM129! And hers was attended only by a young doctor and no referral was made to see a more senior eye doctor!

On Saturday, Mommy's right eye felt better in which there was no irritating sensation when blinking the eye. However, the eyes still cannot stand normal lighting intensity. By Sunday, Mommy's right eye felt a lot better, can stand normal lighting already and the swelling has decreased tremendously.

Today, Mommy went for the follow-up apointment and saw Dr. George Thomas again. After checking Mommy's eye with the eye machine, he said that Mommy's cornea has healed but it is not stable yet. So Mommy asked what he meant by 'not stable'. Dr. George explained that the outermost layer of the cornea is 5 cell-layers thick. So Mommy's cornea wound now is maybe 2 cell-layers thick. Then Dr. George prescribed Mommy to continue applying the eye drop prescribed that day and also to apply artificial tear drops once in every 3 hours. So Mommy left the hospital with a bill of RM86 which consisted of RM5 for registration, RM40 for consultation, RM36 for medicine and RM5 for services.

(The eye drop, Tobrex, on the left which was prescribed on Friday, and on the right is the artificial tears' vials which actually came in a much bigger packaging. Mommy took out a few vials at a time for the convenience of carrying them around.)

How is the service like in Tun Hussein Onn Eye Hospital? Well, Mommy would say it's very good - the nurses were very helpful, the administrative staff was also very helpful (one admin lady even helped Mommy to find Mommy's water bottle which Mommy left in one of the consultation rooms!). The parking is free (Yes, it had better be free because Mommy is paying RM5 for the services!) except for one elderly Chinese man manning the main pharmacy counter - he looked and sounded grumpy! Even Mommy's colleague did not have good experience with that Chinese man at the pharmacy counter!

By the way, Mommy decided to claim the hospital fee (RM79 + RM86) from Mommy's insurance (Prudential) considering that Mommy's employer impose a RM100 limit per month for medical expenses on a use-or-lose basis (but subjected to approval if you seek treatment from specialist). And Mommy's insurance agent has already confirmed that such minor accident is fully claimable! As for the GP's fee (RM35), Mommy will claim from the employer because it doesn't require any prior approval.

Don't Ever Play with Something that Resembles a Stick!

Don’t ever let your baby or toddler play with anything that resembles a stick. Even if your baby didn’t end up injuring himself/herself, your baby may end up injuring others or even yourself. That’s what Mommy learnt the hard way. And having a hurt eye is really no fun at all. So don’t risk it. It all began like this.

That evening, Mommy played with Juan Or after bringing him back from the babysitter’s house. What was the game? It was a game of hitting the wind chime. The wind chime was hung high up on the beam of the ceiling. And Mommy knows that Juan Or loves to hear the sound of the wind chime. A fretful Juan Or can easily be pacified by merely hearing the sound of the wind chime. So Mommy used a back-scratcher stick to hit the windchime. After demonstrating how it was done, Mommy gave Juan Or the back-scratcher stick for Juan Or to hit the wind chime. Mommy thought this was good practice for Juan Or to improve his hand-eye coordination. First few hits were not accurate, so Mommy held Juan Or’s hand to hit directly on the wind chime. After that, Juan Or tried himself and finally he hit the target. Then Juan Or started waving the back-scratcher stick wildly and the next thing Mommy knew was that the stick entered from the top corner of the gap between Mommy’s spectacles and right eye and it hit right onto Mommy’s eye!

(The back-scratcher stick and the wind chime.)

Mommy quickly snatched the stick from Juan Or, put him down and inspected the eye. No blood shot eye. Image was still clear. But blinking the eye caused a sensation like that of having something stuck in the eye. This sensation went on the whole night through. Mommy’s right eyelid swelled and became teary and watery and a bit red too. Mommy’s right nostril became blocked and runny as well because of the tears that flowed into the nose. Mommy just can’t help closing the right eye because keeping it open would require Mommy to blink the eye which results in the irritating sensation. And yet keeping one eye open and one eye close is tiring. So what other better thing to do than to just go to sleep and hope the swelling subsides the next day. Anyway, by then, Juan Or was already asleep, so Mommy went to sleep too.

(Oww.....can't help closing the eyes!)

The next day, however, the condition did not improve. Mommy decided not to go to work because Mommy could hardly keep the eyes open, let alone to drive to work. So Father-in-law drove Mommy to visit the doctor. After telling the doctor what happened, the doctor checked Mommy’s right eye. Using the torchlight, the doctor instructed Mommy to look up, look down, look left and then look right. Finally, the doctor said, “Your cornea is not scratched.” The moment Mommy heard this, Mommy felt relieved. “But your eyelid is. I’ll give you an eyedrop to apply once in every 4 hours, and some medicine for the swelling and pain. The eyedrop is the antibiotic to prevent infection. If the pain doesn’t go away by tomorrow evening, then come back to me again for checking and I’ll refer you to an ophthalmologist.”

After paying for the medical fee (RM35), Father-in-law and Mommy left the clinic. Back at home, Mommy applied the eyedrop and slept a lot – because the eyes felt better to be closed. Mommy can’t do much reading. Even at this time that Mommy is typing this posting, Mommy’s right eye has to close and from time to time, Mommy has to close both eyes to rest. Mommy’s right eye is wet all the time now because tears just flow uncontrollably. Mommy hopes things will be better by tomorrow.