Heading into eye surgery, the patient is understandably nervous.

While he won’t feel a thing – and may even have a snooze during the procedure – he will technically be conscious.

Still, he’s given a sedative to calm his nerves in the operating room at Surrey Memorial Hospital (SMH).

Once the patient is wheeled into the sterile environment, the doctor warns him he’ll feel a pinch as he injects a local anesthetic around his eye. A red ink arrow on the man’s forehead points to the affected eye. The eyelid, surrounding cheek, forehead and half of his nose are swabbed with disinfecting iodine. Then his entire upper body, including his head, are draped with plastic and a blue sheet.

All but his right eye.

It’s being held wide open with stainless steel clamps, exposing the burst blood vessels in the white of the 78-year-old’s eye.

• • •

The procedure isn’t one most people can stomach watching. Eyeballs, for some reason, tend to make folks cringe.

Not Dr. Hugh “Chip” Parsons, however. He’s been doing this for two decades.

His first surgery on this particular day is one he performs regularly: a “right posterior vitrectomy and endolaser.” It’s a process that involves removing pooling blood and cauterizing blood vessels on the retina – the tissue lining the inner surface of the eye.

“This gentleman lost his vision within a week or so,” says Dr. Parsons, director of retina services at SMH. “He was going through life fairly well until now.”

• • •

The specialist removes his shoes so he can manipulate the numerous pedals at his feet and pulls his stool closer to the head of the man’s bed. Peering through a large, double-lens microscope, he begins by making miniscule incisions and inserting tiny tube-like ports into each side of the eyeball.

No wider than a very thin straw, these will be the openings through which he’ll work.

Everyone in the room dons protective orange-lensed glasses while a laser is used to zap the bleeding areas and stop the excess vessels from growing back.

The entire operation, which takes less than half an hour, is visible on two video screens in the OR. But while the instruments the doctor uses appear standard size, they are actually very small, crafted especially for the microscopic work necessary inside the delicate eye. A pair of tweezer-like tools, for example, have pinching tips as fine as light bulb filaments.

• • •

Because the tools are so incredibly minute, no stitches are required, making the patient’s recovery that much more comfortable. The man’s eye is patched with gauze and tape and he’s allowed to return home in a half an hour.

“Rest quietly tonight though,” warns Parsons. “No mowing the lawn or anything like that.”

Ironically, “Hungry Eyes” is playing quietly on the iPod nearby as the patient is wheeled out and the operating room is prepared for the next surgery.

• • •

Like many of Dr. Parsons’ patients, the first of the day was diabetic. Between 30 and 40 per cent of his patients are.

The second patient in the surgery queue is a fellow in his 30s who’s had the disease since he was a child, and the third is also a diabetic man.

Diabetes affects the blood vessels – including those in the kidneys, feet and eyes – meaning specialists such as Parsons are often called upon to help repair and preserve eyesight.

Often, he can use a laser in his office or a drug injection to treat patients – all steps that are taken, if possible, prior to recommending surgery.

Still, about 10 per cent of diabetics will eventually go blind regardless of medical intervention.

• • •

The patients that aren’t diabetic include those like the fourth patient of the morning.

She has what are called “floaters” that are obscuring the vision in her left eye. To her, it may appear as though dots or webs are moving in front of her eye, but what’s actually happening is small pieces of debris are drifting in the eye’s vitreous fluid. In this case, it’s because her retina has partially separated.

Meanwhile, Dr. Parsons receives a call that an emergency detached retina case is on its way from Maple Ridge. It’s a call he’ll typically receive a couple of times a day. If not dealt with promptly, vision is seriously threatened.

“A tear can happen very quickly,” he explains. “Most are spontaneous, some are a result of trauma. “Usually, someone will go to bed at night and wakes up with no vision in one eye.”

Retinal surgery:

• SMH houses the Fraser Health

region’s retinal program, serving Surrey, White Rock, Langley, Delta and beyond.

• More than 1,300 retinal surgery cases at SMH annually.

• Diabetic retinopathy and age-related macular degeneration are

the two most common threats to the retina.

SMH eye care:

• There are nine eye care physicians at SMH – four retinal specialists, four general ophthalmologists with specialties in cataract, cornea, or glaucoma, and one pediatric ophthalmologist.

• The eye care program transferred to Surrey from New Westminster when St. Mary’s Hospital closed in 2004.

Click here to view index of other stories in the Leader's Surrey in Focus: Health special edition.