Tag Archives: floaters

PHPV: my perfect deformity

I’ve been meaning to write this post for months—since September of last year, really. I’m only getting to it now because I’ve had some horror dentist experiences in the past few weeks (there is nothing wrong with my teeth, I might add, other than one front tooth was busted in my youth and poorly fixed. I do mean to get around to fixing that, but it’s just not a top priority). But because I’m all too quick to rant about our (american) health care system, I’m going to start by relating a few good experiences.

Last fall I noticed floaters in my vision. I only have sight, for the most part, in my right eye because of a birth defect called persistent hyperplastic primary vitreous (PHPV) in my left. It’s fairly rare. It happens in utero, beginning around the third month. The eye forms with a gel that turns into vitreous as it develops. With this condition, for some unknown reason, the hyaloid artery does not recede and the gel instead keeps growing and becomes scarred. My doctor explained that it hardens into a stalk, which causes all sorts of structural problems. A few include the stalk pulling on the retina, elevated eye pressure, a smaller size (microphthalmia) and orientation of the affected eye, band keratopathy (calcium deposits on the cornea), cataracts, and extreme light sensitivity, though the scarring prevents enough light from getting to the back of the retina. Because the eye is so malformed, there isn’t much that can be done for it other than to protect the vision of the good eye.

I saw a lot of ophthalmologists in my childhood, and wore a patch for awhile in hopes of strengthening my left eye. It didn’t work. Now, I can see a bit in the left eye, but it’s mostly peripheral vision on the far left. Because of the calcium deposits on the right side of the left eye (which appear to be on the left side of the eye on the right in the photo), I see more out of the left side. The right is just fuzzy. My brain has trained itself to see the periphery with this eye. If I focus hard and try to get full vision with both eyes, I see double, as the left eye is tilted up a bit, as you can see in the picture.

I adored my childhood ophthalmologist, or my adolescent ophthalmologist I should say (Dr. Todd Woodruff MD), who looks quite a bit like David Letterman. I was transferred to him when I was about 11 to be treated for elevated eye pressure, which was occasionally called glaucoma. I was always the only patient in the office under 70, as it’s not a young person’s condition. Regardless, he was much more patient with me than the pediatric ophthalmologist I’d suffered for my first decade of life. After a horror experience with an eye doctor in Oakland during my college years who told me I needed surgery because of a detached retina (I didn’t), and suggested cosmetic work to make my eyes look more alike (it’s fairly risky to even wear a contact lens when one has vision in only one eye), I didn’t trust anyone else with my eyes for a long time. Though inconvenient, I would try to make appointments with Woody, as we called him, when I visited my mother.

This got a bit tiresome scheduling wise, especially as my insurance didn’t cover him. And when my mother started visiting me, I stopped going to the eye doctor. Bad. So, in September, when I started seeing floaters, and coincidentally read in an unrelated blog that it can signal retinal detachment and potential blindness if untreated, I logged on my health insurer’s website to find an ophthalmologist I might trust. Oh dear.

This is getting a bit long. I’ve not even gotten to my point. Even so, I’m going to continue tomorrow.

other posts on phpv:
my perfect deformity
my perfect deformity, part ii
PHPV: the eye, vision, and how I see