Wednesday, September 12, 2012

My Left Eye

A true story

by Dieter

My first clue was the fact that regardless of what eyewear I used, I was seeing halos around lights at night.  Since I was often doing monovision in contact lenses, it was particularly annoying.  The reason for that was simple.  My dominant eye, the one corrected for distance, could read signs and generally see well in daylight.  But at night, my vision was obscured by a haze especially from oncoming headlights when driving.  My other eye saw a blurred image anyway because it was corrected by less than one-half of the full prescription in order to see moderate distances for reading and computer use.  At my next eye exam, I found out why.  But first my optometrist gave me the ‘bad’ news.

“I know this comes as a surprise at your age, but your prescription has crept up,” he stated, “I need to raise one eye by -.25 and the other by -.50.”

“Is that why I’m seeing halos at night?” I asked.

“We’ll talk about that in a minute,” he replied.  “I just want to make sure you’re OK with an increase because we may have to make an adjustment for the monovision, too.”

I sat quietly waiting for more information and assured him that I wasn’t bothered by an increase.  Secretly, I was a bit excited.  Finally, I asked.

“So, what is my real problem?

“A cataract is forming in your left eye,” the optometrist divulged.

My heart sunk.  How could I possibly be developing a cataract at only age fifty-one?  He reassured me that everything would be fine.  Cataracts develop slowly, usually over a period of many years, so I would have lots of time to consider options.  He explained that a modern lensectomy is a simple procedure done in an outpatient surgery center.  The result of a lens replacement is much more successful than it once had been in the past.  There are even possibilities available today such as “bifocal” lenses and built-in monovision.  Also, the surgery could be done when the problem becomes too much to tolerate since insurance companies no longer require the cataract to become ‘ripe’.  Believe me, that term was the doctor’s; not mine.  Current thinking is that a cataract will never get better so there is no purpose in waiting for it to get worse.

I was worried by one thing the optometrist told me.  Cataracts come in pairs.  He wanted me to be prepared for the other eye to develop the same problem.  He updated my prescription and gave me new contacts with the plan being that we wanted to optimize my vision.  I got new lenses in my glasses as well since I needed the slight increase in strength.  Within a short time, however, I quit wearing contacts altogether.  Glasses, with a corrected distance prescription for each eye, were the only way I could see well enough to be comfortable for most activities especially at night.

One morning eight months later, I noticed that there was some sort of murky object on my left eye.  It wouldn’t wipe away and as I tried to compensate, my eye began to feel dry and irritated.  No amount of eye drops or saline solution helped.  Eventually, I realized that the object didn’t move and was actually inside my eye.  When I awoke the next day, my vision in that eye was completely incomprehensible.  I was essentially blind in one eye.  It could discern nothing more than light.  The massive obscurity had seemingly developed in a time span of two days.

I called my optometrist’s office and spoke with the receptionist.  She was unwilling to forward my call to the doctor because he was quite busy.  When asked about my concerns, I told her what had happened. 

She asked, “Does it look like you’re looking through waxed paper?”

“Yeah, that is exactly what it is like!” I exclaimed.

“You have a cataract.” She stated.

Having confirmation from a highly trained optical professional, I was relieved that it all seemed somewhat normal at least.  Since the process of correcting a cataract was a surgical procedure, I had to work through my medical insurance provider.  I called their hotline to find out what to do next.  I was told to see my basic care provider to get a referral.  So, I called my MD’s office.  Since I hadn’t had a physical in several years, he wanted to see me in person.  His receptionist said she had an appointment available the following week.  I scheduled it.

A week later, as a nurse checked my temperature, pulse, blood pressure, and weight, the MD looked at my chart.

Then he looked into my eye with some kind of an instrument.

“Boy, it’s really clouded over!” he exclaimed.

Essentially, that was all he could offer.  He gave me the formal referral, helped me choose an ophthalmologist at a large practice, and then scheduled an appointment for me for about a week later.

By this point, my eye had been ‘clouded over’ for almost two weeks.  I had limited depth perception and had a huge blind spot which was virtually anything to the left side of my nose.  Adding to all of this was the fact that I worked in a city about seventy-five miles from home.  I had to drive nearly three hours a day to commute to work.  Seeing anything in the left rear-view mirror was almost impossible.  But worst of all, I still had not seen or talked to anyone that had any real knowledge of the subject.

At the very least, I was quite worried.  Was it nothing more than a ripened cataract?  Why had it matured in only eight months?  Should I expect the same thing to happen to my right eye?  For my own peace of mind, I really needed some answers.

A week later at the ophthalmology office, an assistant took me into a room to do a refraction, which of course was charged to my insurance company after I paid my co-payment.  My right eye needed the usual -3.25 prescription.  My left eye could see only waxed paper.  Well . . . . . duh.  I’m not sure what I expected, but I’m especially not sure what they expected.  Maybe they thought I was faking it.

Eventually, a surprisingly young doctor arrived and began an examination.  We discussed the situation and he confirmed that it was a ripened cataract.  He reassured me that my right eye was completely clear and free of any signs of the same.  At least that was a relief.  He took measurements for about thirty minutes to try to determine the size and shape of my left eye.  We discussed options but quickly settled on surgery as the only real solution.  I asked who would actually perform the surgery and again was surprised when he said he would do it.  Like I said, he seemed so young.  However, since the cataract was completely clouded over, he wanted a confirmation of his measurements.  He contacted an eye clinic with an ultrasound machine for that purpose and scheduled an immediate appointment.  The doctor also wanted a second opinion of his findings.

After driving a mile or two down the street, I began waiting in another room.  That was rather fascinating because there were people with extreme visual problems in there.  I saw some very exotic eyewear in that waiting area.  I also overheard several unique conversations about visual irregularities.  If I hadn’t been so concerned about my own problems, I would have enjoyed hanging out there for a while.

Eventually, I met with another ophthalmologist that was a specialist of some kind.  He took me into a room to get the ultrasound readings.  In our discussions, this doctor began to question my visual history.  He seemed very interested when he found that I had had an affliction known as ‘iritis’.  This had begun when I was in college and had recurred probably about eight times but always in my left eye.  I remembered this fact vividly because the first time it happened; one corny college professor asked me, “If it’s in your left eye why isn’t it called ‘eye-left-es’ as opposed to ‘eye-right-es’?”  Without going into a lot of detail, iritis is like an extreme case of conjunctivitis or “pink eye”.  It is much more severe and impedes the ability of the iris to open and close the pupil.  This makes focus nearly impossible and causes considerable pain from light sensitivity necessitating the use of dark glasses.

Anyway, this doctor pointed out that the medications used for iritis are known to cause . . . . . drum roll, please . . . . . cataracts!  For nearly thirty years, I had been prescribed and used medicine that was known to encourage the development of cataracts and nobody bothered to tell me.  Here’s a big ‘shout out’ to the medical community.  Thanks!!  As the second doctor completed the forms to go back to the first doctor, he added that this was the likely cause and that he agreed with the diagnosis.  He also attached the measurements taken during the ultrasound procedure.  The good thing was that I, at least, had a reasonable explanation for why I had a cataract at a fairly young age and knew that it would not likely be repeated in my other eye for the same reason.  I returned to the first ophthalmologist and we set a date for surgery in three weeks.  Those were the longest three weeks.  Have I explained how difficult it was to see and drive to work with only one eye?

The only thing difficult about the day of surgery was that I had been told not to eat or drink after 10:00 p.m. the previous night.  Unfortunately, my procedure was scheduled last in the afternoon.  In fact, I didn’t have to be at the surgery center until 11:30 a.m.  Needless to say, by that time I was starved and parched.  And, naturally, the surgeries were running late.  All afternoon, I watched television and talked with my wife trying to do anything to keep my mind off of food and water.

Finally, I was rolled into the operating room where I was introduced to the anesthesiologist and surgical nurse.  Thank god, they were older than my doctor.  They would make sure he did everything correctly.  Suddenly, there was a commotion amongst the group about the bed upon which I had been placed.  Apparently it was supposed to have a triangulated or pointed end in order to give the surgeon better access to a patient’s head.  They squabbled briefly and wanted to know the name of the nurse that had done the prep.  I felt bad for her because she had been very comforting throughout the long afternoon.  But, my doctor finally demanded that I be placed on a correct surgical bed.  I remember vividly the scene of him standing there with his hands of his hips, refusing to budge, and completely in charge of the situation.  That’s when I knew that, despite his looks, he was no kid and he was going to do everything possible in the best interest of me.  I was in good hands.

The surgery was a vague dream.  I was not completely asleep but I was not coherent, either.  I remember seeing the people in the room floating about and having conversations . . . . . and little else.  I had no recollection of what they were doing or saying.  What actually happened is that a small slit was made in the side of my eye and the damaged lens was sucked out.  The artificial lens was folded into a tiny roll and pushed through the slit where it unrolled and popped into place.  The slit was so small, that no sutures were necessary.  When I awoke, an aide was cleaning the room.  She spoke to me as I slowly gained my wits.  I soon discovered a patch bandaged over my eye.  Once fully alert the aide gave me instructions for the night and sent me home.  It was 5:30 p.m. and the surgery center was nearly emptied of people.  In fact, a man was running a vacuum in the hallway when I left the recovery room.  It had been a long day.  My wife walked me to the car and drove me across town to home where I ate and drank with vigor.  Desperately, I had almost made her stop at MacDonald’s on the way.

By 9:30 the next morning, I was back in another office near my house (my doctor had three throughout the city).  The bandage was removed and the doctor examined my eye with his light for a bit and seemed pleased.  He asked what I could see on the eye chart.  With my left eye, I read the 20/20 line with ease.  My right eye still couldn’t see the big “E” but, then, it hadn’t been able to do that since sometime before I was age seventeen.  Of course, the doctor declared my surgery a success.  He suggested I try getting along without any corrective lenses to see if that was comfortable then return in two weeks.  Though it wasn’t exactly the plan, I now had permanent monovision with a -3.25 difference.  My dominant eye could see nearly perfectly while my other eye could read and see the smallest of detail.  I had to hand it to the doc.  He got the ‘prescription’ as correct as you could expect.  Though, I was a bit shocked when I saw myself in a mirror in the waiting room as I left.  I looked like I had been in a fight.  The white of my eye was completely blood red and I had a ‘black eye’ bruise across the left side of my face.  For the next several days, whenever someone seemed to take notice, I would simply tell them, “You should see what I did to the other guy!”

Without doubt my eye and face were a bit sore and sensitive.  But it didn’t feel any worse than after any good bump to your head.  Wearing sunglasses, neither I nor anyone else could tell the difference.  Leaving the doctor’s office, my wife suggested that we travel to an office of the Department of Motor Vehicles.  Since we were both off from work, she wanted to renew the license plates for our cars.   We had not received the proper forms by mail so renewing the plates in person would be necessary to avoid late fees.  As she drove, I began to wonder if I could pass the eye test.  When we arrived, I asked the clerk what was required and she told me that you must to be able to see 20/40 with one eye.  I read the 20/20 line with my left eye and the corrective lenses requirement was removed from my license.  It seemed amazing that I could see so well with that ‘blood-filled’ eye.  The surgery had been performed only eighteen hours previously.

It took about a year to get totally comfortable with my ‘new and improved’ vision, though.  The discrepancy between my eyes is fairly severe.  Initially it seemed like it was difficult to see well at any distance.  My eyes constantly struggled and felt strained and exhausted.  At one point, I wished that the doctor had replaced the lens with one without correction.  Then I could have worn glasses or contacts like I always did.  That option had never been suggested but I have since read of people that have done that.  In fact, I read the statements of one lady on Eyescene that said her surgery had purposely left her at -5.00 in both eyes because she did a lot of close work in a laboratory. 

I am contented doing most activities without correction now.  Apparently, it just took some time to relearn how to see well.  As I stated previously, I have built-in monovision that allows me to view objects in the distance almost perfectly yet see the tiniest of objects up close.  I struggle only with mid-distances at about 18 to 36 inches.  My nearsighted eye can’t see that far without help and my ‘bionic’ eye can’t see that close especially with a non-flexible fixed lens that has no accommodation.  The one thing that concerns me is when something has to be done to the other eye.  I now know that everyone will get cataracts if they live long enough.  I fear that someday I will be forced to deal with an age-related problem in my right eye.  I’m pretty sure that my choice would be to be left with monovision when uncorrected.  One thing I know from experience is that a replacement lens like mine is rigid.  I see how my natural lens still adjusts a little, at least.  The artificial lens compensates for nothing.  Of course, technology marches on so it is unpredictable as to what may be available at any time in the future.  I just hope it is a long time before my right eye has issues.  Fortunately, it never had any bouts with iritis.

There are two exceptions when I do use some kind of eyewear:

(1)When driving, I usually wear glasses.  Mine have a -3.25, +.25 lens for my right eye and a Plano, +.50 lens for my left eye.  I have a small amount of astigmatism in both eyes but it causes few problems.  At times I simply wear a -3.25 contact in my right eye.  Being fully corrected for distance at night eliminates the fuzzy lights that would otherwise obscure clear vision.  I find that especially useful when I’m in dark and unfamiliar territory.  It also avoids an uncorrected view when an object blocks the view of the good eye.  This happens sometimes when catching a glimpse into the rearview mirror with only the myopic eye.

(2) I wear a single -1.25 contact lens on my right eye at my job since I work around computer screens all day.  Occasionally, I wear a -3.25 lens and use reading glasses.  That’s usually in situations where I want my best vision when driving to and from work.  There are also times when I prefer to use ‘computer glasses’ that have correction to allow both eyes to see at 18 to 36 inches.

Being an OO, I miss wearing glasses most of the time.  It had been a long time since seeing bared-eyed was an option for anything besides reading.  There are times I feel vulnerable without glasses.  I had forgotten the protection they provide from the wind when riding a bike, scooter, or motorbike; or from tree branches when mowing the lawn; or from debris when using a weed-eater, grinding wheel, or drill press.  For protection, I now have to consciously remind myself to get sunglasses or safety glasses when embarking into those activities.

No, I’m not complaining.  I’m sure there are millions of people that would trade their situations with me.  Some of you know what it is like to deal with eyes with lenses that have become inflexible.  The rest of you will find out soon enough.  I guess I’m pretty lucky to be my age and be able to do most everything without glasses.  But if I could just find a job without computers . . . . .

1 comment:

  1. Very goog story, and a sort of encouragement, as I shall have cataract OPs in both eyes, starting in 3 weeks from now.

    I come from RE +4,25sph/-2,50cyl 90deg and LE +4,00/-1,75 95deg with a reading-add of +2,00. But I have decided for a monovision-nearwork-lens for a working distance of 31 centimeters equivalent to a +3,25 on both eyes, with myope correction glasses of -3,25, then astigmatism correction in the glasses.
    If I am allowed to wear contacts, I'll do GOC from time to time with an additional +8,00 up to -12,00 correction approx.

    I pray and hope, everything will turn out well ....