Unexpected challenge…Tom is having surgery in Nelspruit today…

Shortly after Di and Peter left Marloth Park on September 6, Tom told me he was having trouble with his left eye. He described seeing what looked like a crescent- or saucer-shaped shadow. Naturally, I was immediately concerned, but Tom insisted he wasn’t seeing flashing lights or experiencing any of the other symptoms he associated with a retinal detachment. He was convinced we should continue with our planned visa run to Madagascar. If we didn’t leave as planned on the 7th, we’d become undesirables with severe consequences.

Even though we went ahead with our trip, I wasn’t comfortable simply waiting to see what happened. Before we left, we made an urgent appointment with a highly rated ophthalmologist in Nelspruit for the day we returned. The doctor’s schedule was almost completely booked, but his office staff somehow managed to arrange an appointment for us only two hours after our plane landed in Nelspruit yesterday morning.

Everything fell into place. Our Monday flight from Madagascar to Johannesburg went as planned, as did our flight from Johannesburg to Nelspruit on Tuesday. We picked up the rental car at the airport and arrived for the appointment with plenty of time to spare.

The moment we walked into the huge, modern facility, we both felt we’d made the right choice. Several ophthalmologists practice in the complex, with a sophisticated hospital on the premises as well. We chose Dr. Dean van der Westhuizen, the owner and head ophthalmologist, because of his extensive experience with retinal repairs.

Of course, we had no way of knowing exactly what was wrong with Tom. We’re certainly not experts when it comes to eyes, although Tom’s family has a long history of blindness and eye disease, including retinal detachments, and he is quite familiar with potential issues.

We wanted the best medical care we could find, and everything about the facility and staff was reassuring. Tom underwent more than an hour of tests before we were finally taken into a treatment room to meet with Dr. Dean. He pulled up various images and test results on multiple screens and carefully explained what they showed.

Unfortunately, the news wasn’t what we’d hoped to hear.

Tom didn’t have a partial retinal tear, which was what we’d been hoping for. He had a full retinal detachment.

Hearing those words was frightening, especially after we’d spent the previous week in another country, wondering what was happening with his eye. In hindsight, I’m incredibly grateful that Tom’s symptoms weren’t worse and that we had already arranged to see a retinal specialist immediately upon our return.

Dr. Dean explained that Tom needs immediate surgery to repair the detached retina, and that surgery is scheduled for today at 3:00 pm.

Tom will be having a procedure called a vitrectomy. In simple terms, the surgeon removes the vitreous gel, the jelly-like substance that fills much of the inside of the eye. Removing it allows the surgeon to access the retina and, importantly, eliminates the pulling forces that can contribute to the retina remaining detached.

During the procedure, the surgeon will make several tiny openings in the white portion of the eye, called the sclera. The surgeon then inserts very small instruments to remove the vitreous gel. The surgeon can drain any fluid trapped behind the detached retina and use a laser or freezing treatment to seal retinal tears or damaged areas.

As part of the same surgery, Dr. Dean will also remove the cataract in Tom’s left eye. At some point later, Tom will need cataract surgery in his right eye as well, so this surgery will address two issues in his left eye at once.

The final step involves placing a temporary substance inside the eye, such as a sterile gas bubble or, in some circumstances, silicone oil. This acts like an internal support, pressing the retina against the back wall of the eye while it heals.

It all sounds rather remarkable when you think about it. Someone will be working inside Tom’s eye using instruments so tiny that I can hardly comprehend it, attempting to restore something as delicate as his retina.

Needless to say, we’re nervous about today.

But we’re also grateful. Grateful that Tom finally spoke up when he noticed something wasn’t right. Grateful that we didn’t simply ignore the problem while we were in Madagascar. Grateful we found an ophthalmologist in Nelspruit with extensive retinal experience. And perhaps most of all, grateful that the flights worked out perfectly and we were able to get Tom into the doctor’s office almost immediately after returning to South Africa and… getting our new 90-day visa.

Now, all we can do is trust Dr. Dean and his team and hope for the best possible outcome.

Our plans for getting back to our ordinary life in Marloth Park will have to wait a little longer. For now, the only thing that matters is getting Tom through surgery and beginning the healing process.

We certainly didn’t expect our return from Madagascar to turn into this.

But then again, after almost 14 years of world travel, we’ve learned that life doesn’t always follow the itinerary.

What the Procedure Involves

Photo from ten years ago today, September 16, 2016: