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Thread ID: 142269	2016-05-30 23:20:00	Top Gear , new season, new presenters	1101 (13337)	PC World Chat

Post ID	Timestamp	Content	User
1421208	2016-06-17 00:52:00	Gee Joe, thinking of you and hope it works out OK Ken	kenj (9738)
1421209	2016-06-17 05:21:00	Tnx, Ken. I had an appouintment touday at The VA in Helena, and althouugh the eye was nout being addressed at this time, I gout goud neuws that my kidneys, proustrate and bladder are all goud. So goud things still happen I guuess. At the same time, I knouw that Paul's right thouugh. This eye-thing is nout a trivial thing. I'll have tou balance the need tou see with the need tou live I guess. I'll fire uup my (leftouver) Windouws machine and scan a full colour pix ouf that retina four youse guys to see. I'm still kindy iffy on uosing that scanner and printer on Puppy and Mint. It's confousing.	SurferJoe46 (51)
1421210	2016-06-17 07:37:00	If you like, I could post the interior picture of the nevus showing the scar tissue. Let me know .... as I would like grossing out all my inverted buddies in Upsidedown Land. I hope I'm spelling Nevus correctly....the spellclucker doesn't like it any which way I attempt to spell it! Bleedin' hell Joe, you sure know how to get your share of eye problems. Unfortunately it's often the case that some people get all the dramas, while others get none. I do a fair bit of piggyback work, so I can appreciate the significance of the underlying issues there, but all those other surgeries as well... I am left with some doubt now though. In the light of all that intervention the eye has had a lot of observation, and a lot of potential for anomalous scar tissues to confuse things. You said the naevus / nevus was stable, so it's been there a while, and they've seen fit up to now to leave it be... so what has changed to trigger a reconsideration of the management? A naevus is generally harmless, and common, but like a skin mole, they also can turn bad, so they're not entirely to be ignored. I don't have the level of expertise to judge your image (but would love to see it, just don't expect any advice from me upon seeing it) I do wonder if the presence of the buckle might be leading to a chance of misinterpretting the area. One other consideration is your age and health. Posts in the past have lead me to believe that you may expect to be in your last few years of life (sorry if I'm wrong to assume this). If (for other reasons) you have a genuine expectation of being dead in less than 5-8 years, then maybe it is best just to leave it be. Keep the eye, or continue to monitor until a more certain opinion is achieved. If leaving it may risk it killing you in 4 years, but removing it may not mean you live much longer anyway, then ultimately you've not really gained much. You've lost some ocular function, gained stresses and disfigurement, but not really extended your outlook for survival. Death is the final punctuation to all our lives, with when and how being the only uncertainties in that regard. It's a tricky one, and does indeed involve an evaluation of your entire bodily health, family needs and expectations, and not just a consideration of vision or survival alone. Try to dodge an invasive cancer death just to suffer a cardiac death instead? And if it is indeed a melanoma, there's always the chance it already has seeded to other areas, as yet unknown. So it's all about odds, estimations and best guesses. Impair your quality of life (function) on the chance of extending your life. Lose one way to hope to gain another way. It's a whole different equation if there's other significant health/life issues in the mix. Best of luck getting better guidance on the whole thing. Your opinion, your specialist opinion, and your immediate families opinion (and situation, eg dependant family members needing your care or support) may all be relevant factors in the choices you ultimately settle on. Will the remaining eye be adequate to allow you to drive? Will you have to move elsewhere if you can't drive?	Paul.Cov (425)
1421211	2016-06-18 16:29:00	OK - for all you ghouls out there and for the seriously interested ones, here's the link in my Picassa3 Web Album to see it. picasaweb.google.com ...and here on the newest iteration of Google Photos too...... goo.gl This site (vBulletin.com (https://www.vbulletin.com/)) seems to think my photo format is illegal or illogical and I cannot put the actual photo here ----- which is prolly a good thing if you open this whilst swilling ---- but there you go, one or both of those two links should work for youse guys.	SurferJoe46 (51)
1421212	2016-06-18 22:43:00	Thanks for the image Joe. Being adjacent to the optic nerve it's in an easy to spot position, so once again I do have to wonder how long it has been there, whether it's been quietly noted and 'observed' (but possibly not discussed) by previous examiners. Many nevi look a very faint grey when viewed directly with an ophthalmoscope, and it's not unusual for retinal cameras to add contrast to highlight these things, so when viewed directly it's possible that its colour is a lot less apparent, to the extent that it might not even be recognised as any different from the surrounding tissues. Without being familiar with the characteristics of the gear taking the image I'm not able to guess at its thickness or true colour, but growth (area and thickness) are the obvious things to watch out for. Other surface and edge changes can also act as a guide. There are no 'windows' through it, and I can't see lipofuscin, although at the scale I'm getting I wouldn't expect to see any. The border seems fairly distinct and regular, it's about 2, maybe 2.5 times the with of the optic disc (it's common to express their size in relation to the diameter of the disc (DD), so I'd label it as 2 to 2.5DD in size. Without knowing more about its history, and surface features, depth, symptoms, etc, I could pass it off as a simple, benign naevus. If I remember rightly you moved home a while back. Would your previous eye care folk have any images / records of the area? For the others in the forum (who seem to be unaware of this hijack and are likely ignoring a Top Gear thread), all the black and white drama to the left of the image is old scar tissue from the earlier retinal detachment and repair. It looks more dramatic, but the point of concern is the round dark bit adjacent to the white round bit (the optic nerve). Your macula and optic nerve look good! But again, I'd normally work off a closer view before passing judgement. My earlier query of whether the buckle was causing ambiguity is now proven as nonsense. This is nowhere near the buckle or the scarred areas. Thanks Joe. I'm actually a little less concerned now that I've seen the image, but again I need to stress that I'm not an expert, and I don't have all the info, and you should still let those expensive specialists be your guide.	Paul.Cov (425)
1421213	2016-06-19 06:32:00	I've been led to agree with your assessment of the situation by most of the experts . I hear that it's 2 . 5 something-or-other diameters, thickness is also 2 . 5 something or others in thickness and it returns a distinct color around 50% of the edge that all the retina specialists don't like much, but doesn't seem to be growing in reflective area - whatever that means . I'm not in favor of the needle biopsy as I am concerned about 'tracking' possible aspiration of dangerous cells into the vitreous upon retraction of the needle itself . That there are a myriad of blood vessels in the same area make me nervous about inter ocular hemorrhage and possible more dis-attachment of the retina . This idea of checking for 'aggressive DNA' in the nevus is new to me too . Question: There are no 'windows' through it, and I can't see lipofuscin, although at the scale I'm getting I wouldn't expect to see any . . . . how might there be lipid deposits in the retina? Thank-you very much for a long distance consult, as it is the same conversation I've had with two other retina specialists . I really appreciate you on your response and information . It's nice to have friends even though they have to cling precariously to the earth in Upsidedown Land . :)	SurferJoe46 (51)
1421214	2016-06-20 08:40:00	So ep3 even worse if the brief was find new presenters who can drive but have zero personality BBC you did it. I have been a Top Gear fan since it started in the 70's but no more it's a disaster	gary67 (56)
1421215	2016-06-20 20:36:00	Question: . . . how might there be lipid deposits in the retina? Hi Joe, I don't think I can properly answer that . There's a bunch of lipid / fat based flaws that build up in the retina, drusen being the very common ones . The actual mechanism or chemistry of it is probably still just a topic of speculation . Sometimes it's just described as 'metabolic byproducts' or 'cellular waste', and in these cases is largely benign, although is also suspected to do physical and oxidative damage at a cellular level, leading to macular degeneration (when these things happen at the macula - these things are not much concern outside of the macula) . To use what we're told regarding overall fat levels, a healthy retina contains fat . Stressed parts of the retina leak fat (and show an excess amount in the retinal layers), dead sections (like the ret det scars) lack fat . We have a newish device, called an Optos Daytona which actually measures the levels of fat indirectly (flash light at fat, fat will glow for a while, capture the 'after-glow', and you have a fat map) that can highlight unwell areas long before issues show under visible light . This is called Fundus Auto Fluorescence (FAF or AF), and you may have had something along these lines done already . FAF images are monochromatic, like an old black and white . Healthy areas are an even grey, stressed areas white, dead areas black . The optic nerve is the exception, showing less fluorescence, and appears darker, but this is normal .	Paul.Cov (425)
1421216	2016-06-21 04:24:00	Very interesting about all of the new things that are now available for diagnosis of the eyes . Imagine the same technology being available fifty years ago and where the eye science would be today . You've explained it all so succinctly that now I feel like I have a degree in opthamology . I'm very happy to hear your concurring opinion . It gives me a better understanding of the problem I have and what my options are .	SurferJoe46 (51)
1421217	2016-06-21 05:08:00	So ep3 even worse if the brief was find new presenters who can drive but have zero personality BBC you did it. I have been a Top Gear fan since it started in the 70's but no more it's a disaster Perhaps Jay Lenos Garage might interest you. Can't complain lack of personality there. :) And its all about cars, modern, classics & even steamers . He's a car collector from way back. His latest TV show :season2 , is now on his youtube page www.youtube.com	1101 (13337)
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