Tuesday, October 16, 2012

Enamored With Myopia

by Specs4ever
The church was packed. Dad had been in business in this town for 50 years, and even though he had retired 5 years ago at age 75, the townspeople and those from the surrounding countryside had packed the church out of respect. Everywhere I looked I could see the reflections glinting off the faces off the plano fronted lenses of the glasses most of the crowd wore. Oh sure, there were a few plus lenses in some of the glasses out there, but most of the crowd wore reasonably strong minus lenses. And of the 20% or so of the crowd that wasn't wearing glasses, almost all of them wore contact lenses. Dad had been very successful.

The service was over and the pallbearers wheeled the casket out to the waiting hearse. My sister and her family rode in one of the limousines, and my wife and kids and I rode in the other as we followed the hearse to the graveyard, where Dad’s body would be laid to rest beside Mother. I laughed inwardly as I remembered Mom’s funeral 2 years ago. Dad had been insistent that Jim, the funeral director should leave Mom’s glasses on her face, and her wedding ring on her hand and Jim had been just as insistent that he always removed glasses, and jewelry. But Dad won out, as I knew he would. And now Dad was being buried with his wedding ring on his finger and a spare pair of Mom’s glasses in his inner suit pocket. He just knew that he would meet up with Mother again in heaven, and he wanted to have a spare pair of glasses for her in case she had broken her own. Theirs had been the greatest love story I had ever heard.
Dad had enlisted in the Army in late 1943 when he was 18. He had been sent to England, where he was fortunate enough to join the medical corps. Dad had been assigned to the ophthalmolic division and had worked under some very good eye doctors. They looked after the servicemen who had suffered damages to their eyes in the fighting in Europe.
One evening when dad was on duty there had been an air raid. After the all clear signal had sounded they returned to work, but a short while later an air raid warden came to the hospital escorting a young lady who appeared to be almost blind. Dad was assigned to examine this young ladies eyes to ensure that they had not been damaged during the bombing, and the air raid warden went back to his post. Dad was able to ascertain that this young lady was just extremely shortsighted, and her glasses had been knocked off and trampled on while she was in the shelter. He was able to use the instruments, and he arrived at a prescription of –25D for her right eye, and –24D for her left, with no astigmatism. At this point dad assumed the role of protector for this very shortsighted pretty young English girl, and it was not hard for dad to convince her to wait until he had finished his shift so he could guide her home.
Later that evening he lead the young lady to the address that she gave for the home she lived in with her parents. When they arrived at the address, there was a burned out shell of a house, and Molly’s parents were nowhere to be found. So my father took Molly to a hotel, and checked her into a room. Molly didn’t want my father to leave her, as she could see virtually nothing without her glasses so he stayed in the room with her for the night.
The following day dad took Molly to her optician’s who ordered her a new pair of glasses. Unfortunately the new glasses would take at least a week before they were ready. Even if Molly could see without glasses, she had nowhere to go, nor did she have any money. So dad took Molly back to his boarding house with him, and made arrangements with the landlady to rent Molly a room, which my father was going to pay for.
Over the next few days dad spent a lot of his spare time with Molly. Finally Molly’s new glasses were ready, and dad paid for them with money he had put aside to go traveling around England on his time off.
Once Molly had her new glasses she began to search for her parents, but unfortunately they had been killed when the house had been bombed. Molly was an only child, and her parents had left her their estate, which amounted to whatever she could get for the land where the house had been, and a few pounds in the bank. It was at this point that dad asked Molly to marry him, and she accepted, even though they had only known each other for a couple of weeks.
When the war ended, dad really didn’t want to return to the USA without Molly, and although the state department made it fairly easy for servicemen to bring their brides back with them, it was still going to take some time before Molly was going to be allowed to go to the USA. So dad stayed on in England until 1946, working with the eye surgeons, and helping with the vision needs of the wounded American and British soldiers. Once Molly was allowed to return with dad to the USA, dad made the arrangements to return. Major Bradley, a surgeon who dad had worked with talked dad into enrolling in the school where he was teaching, so dad took his GI money, and enrolled to become an ophthalmologist. Dad went to school for 2 more years, and became an ophthalmologist.
I don’t know why dad picked this little town in the northern mid-west to move to. I can only speculate that he figured that with the long cold winters, and nothing more to do than read by the light of coal oil lamps in the evenings, the people in this area were more likely to have vision problems than city people would have. I suppose he was correct.
When my father and mother moved to the town I am pretty sure that there were only a handful of high myopes in the area. I know that Earl, the man who sold insurance had worn very strong glasses forever according to the stories I heard from other kids as I was growing up. By the time I was old enough to require insurance for my first car Earl’s glasses were so thick that they almost looked like myodiscs, and they were dished in on both sides. Jimmy Stewart, who owned the Chevron station, was married to Donna, who probably wore glasses with a prescription of at least –12D. And Ina, the lady who worked at the smoke shop and billiard parlor wore pretty thick glasses. Out in the surrounding country was a lake where everyone went to go fishing. At the lake there was a boat rental, and bait shop. The man who owned the store, Pete, was married to a miserable sourpuss of a high myope, whose glasses were always sliding down her nose. And their son, a child who was mildly afflicted with Downs Syndrome, also wore very thick glasses.
Over the past few years I have come to suspect that my father was a fan of myopia. He did not wear glasses himself until he was around 50 years old, and then they were only reading glasses. They never developed into full time wear glasses. But there were a lot of things in his life that just didn’t add up, unless he was a man totally enamored with the love of myopia.
The first clue was of him falling for and marrying our mother Molly. Molly was an extremely myopic lady at the age of 17, and her myopic progression continued throughout the first few years of their marriage before it stabilized in the early 1960’s with a prescription of OD –32.00D, and OS –31.50D. Then I suppose the next clue was that my father studied to become an ophthalmologist, but instead of doing eye surgery he moved to a small town in a farming community and practiced as an optometrist. And, as I mentioned, this community was in an area where the winters were long, and cold.
My father was busy prescribing glasses to the people in this community long before my sister and I were born. He had a policy that he carried through with right up until the day he retired, and to me this was the third clue. If any patient felt they were not seeing as well as they had when they first got their glasses, within the first 3 months dad would do another eye examination, and supply new lenses free of charge. If the patient felt their vision had become blurry at anytime during the 12 months following an examination, the reexamination was free, and the new lenses were half off. So, essentially my dad would do a free examination at least every year, and be paid for an exam every second year. I thought he would have made a lot more money if he had cut out these free exams, but he explained to me before he died that his mark up on lenses was more than enough to cover the half off price, and the pair that was paid for every second year was very profitable. Under the guise of being concerned for the vision of the people in the community, my father had actually been getting the people to come in and get new, stronger prescriptions more frequently, and his guarantee cut to the heart of the thrifty people in the area, bringing them in more frequently. But, I honestly believe that my dad had never increased a prescription, and that all the increases that were prescribed were actual increases.
My sister was born first in 1958; 12 years after mom and dad were married. I came along as a child of the 60’s, born in April 1960. If the vision care that the members of the community received was second to none, the vision care that my sister and I received was the elite of eye care. When my sister was discovered to require glasses at age 4, dad examined her eyes every 3 months. By the time I was 5, I was also found to be nearsighted. And, over the years there were not too many examinations during my sister and my growing years that did not result in an increase to our prescription of at least –0.25D. By the time we graduated from high school my sister and I were wearing prescriptions that were right around –20D.
There were a lot of other children that my sister and I went to school with that seemed to experience similar myopic progressions. One nice thing about this was that there were so many other kids who wore strong glasses that there was no teasing about 4 eyes, or coke bottles or anything else. And, every once in a while, there would be a classmate who seemingly had developed runaway myopia. I suppose this would be my 4th clue. I was a year ahead of Sally in school, but since we were in a school that had 2 grades to every teacher, I was in the same room as Sally every second year. Of course, when we went off to high school we were no longer together, but since Sally lived close to our house I found myself walking Sally home from school frequently. I thought my sister and I were getting stronger glasses pretty frequently, but by the time Sally graduated from grade 8 she was wearing myodiscs. And, during high school her progression continued, although at a slower pace. Since I also sat in the front of the classroom during the years Sally was in my room, I often observed Sally, with her nose buried in her schoolbooks. And I knew that Sally would read anything she could get her hands on. Now, Sally was definitely a pretty young lady, but when I was in high school, I remember my father suggesting more than once that I might like to go out with Sally. And when Sally and I did go out together, and we decided to get married, my father seemed extremely pleased. Thinking back on this he was far too pleased about the idea of me marrying a lady with extremely poor eyesight for a normal father.
After Sally and I were married dad wanted me to go to school to be an optometrist, and take over his practice. But I didn’t want this, so I chose to go to school to become an optician. I also apprenticed as a lens maker, and when Sally and I returned to our town dad helped me set up an optical shop. Now he no longer sold glasses, but he still honored his guarantee for the free eye examinations, and if he had to prescribe new lenses during the first 3 months he paid for the new lenses out of his own pocket. But, as a dutiful son, whenever this happened I remade the patient’s lenses for him at my cost, so it really didn’t cost him much. And there were only a few kids that this happened with, so it became a game with us to see if we could spot the kids who were going to be very high myopes from the rapid increases of their myopia.
Sally and I settled back into town as if we had never left. I would not let her look for a full time job that was suitable for her to do because of her severe myopia. So, she did help out as a receptionist at my father’s practice a couple of days a week, and she looked after the accounting at my optical store. Even with the best possible correction and the latest lens technology dad and I were never able to get her BCVA much over 20/70. Her prescription was now stronger than my mother’s, at –35.00D for her right eye, and –34.00D for her left eye. My in laws couldn’t understand how it was that their daughter had such poor vision, as neither of them wore glasses except for reading.
Sally really wanted to have children. I had managed to prevent this for a few years, but as Sally approached 30 she told me that if I couldn’t impregnate her she wanted to have in vetro fertilization. With this statement I knew she was serious. I confessed to her that I had been holding back, because I had read that very nearsighted women sometimes had large increases in their myopia, and I didn’t want her to go blind. But Sally felt that she wanted to take the chance, so we went ahead and brought 2 lovely little girls into the world. Our 2 daughters were born within 18 months of each other, and they seemed perfect in every aspect. And Sally had been one of the fortunate ones. She had not had any increase in her prescription during the pregnancies.
The longer I was in this town the more I realized that every generation was creating more and more myopes. The kids that my dad had first prescribed glasses for were now myopic grandparents, and their grandchildren were, in most cases, quite myopic. I loved fitting people with their new glasses, but it was sort of strange to have a classmate from school come into my store, accompanying their son, or their daughter, and have me fit the child with a new pair of glasses.
Sometimes I really enjoyed my job more than I should have. I loved to have 2 young girls come in, around 2 years apart in age for new glasses or new lenses. The best part was when the youngest girl required a stronger prescription than the older child did, although it wasn’t quite as much fun for me when my 2 girls ended up at this point. My youngest daughter, at age 7, required –1.50D more than her older sister’s –5.00D prescription. But, it hadn’t surprised me when my 2 girls had to get their first pair of glasses. After all, with Sally and I both having strong prescriptions we expected the girls to need glasses.
My sister Joan had left town after high school. She had headed to California with a real jerk of a boyfriend. She still remained in contact with us, and we were pleased when she finally left her husband. Fortunately they hadn’t had any children. I had spoken to Joan about her eyesight the last time she called and I was amazed that we both still had very similar prescriptions. Our myopia had not increased any more after we left high school and we were both still around –20.00D. She had a new boyfriend, and dad was thrilled, as Joan was going out with an optometrist.
Dad and mom were even happier later that summer when Joan and her boyfriend came to visit them. It appeared that Joan and Robert were quite serious about each other, and a wedding was in the near future. Dad spoke with Robert for hours. He was trying to convince Robert to bring Joan back to town and take over his practice. However, Robert didn’t quite seem ready to do this. He had a thriving practice somewhere in a place called the Coachella Valley. Joan had been living and working in that area, and had gone to Robert for her annual eye examination. Robert had confessed to her that he liked ladies who were so confident of themselves that they didn’t try to hide the fact that they wore strong glasses by always wearing contact lenses. So they started to date, and they eventually fell in love.
The main reason that Robert had not wanted to leave the area where he grew up was that both his parents were getting on in years, and he was an only son. Joan and Robert had 2 children in fairly quick succession, which was good, because this allowed Robert’s parents to be with their grandchildren for a few years. Finally Robert’s parents passed away, and now our parents were in declining health, so Robert agreed that he would come back with Joan and take over dad’s business. Mother lived for 3 more years after this, and now we were burying dad.
When Robert first came to work with dad he was amazed to see that such a large percentage of the population in the area was myopic. He immediately realized, after seeing dad’s records, and finding out about dad’s policies, how a lot of this myopia had been created.
“You realize Gary that I can’t keep this up.” Robert said to me.
“Keep what up?” I asked, playing stupid.
“I know that your Dad has, whether planned, or inadvertently with his policies, created a level of myopia in this area that matches the levels found in South East Asia. In this area myopia in children below the age of 21 is around 70%.” Robert replied.
“I know we have a lot of myopic people in the region, but I hadn’t realized that it was so high. And why do you seem to think that Dad’s policies increased these levels?” I asked.
“I know that the minute a child was brought to your Dad complaining that he or she was unable to see the chalkboard at school your Dad prescribed minus lenses for this child. Now I’m not saying that the refraction that your Dad preformed was not correct, and I am not saying that the child didn’t require the minus lenses. But what I am saying is that by just throwing a pair of minus lenses at the child your Dad started this child on a long upward staircase of myopia progression. Some children can’t have this progression stopped. But other children, with the use of vision training can have their myopia arrested, or even eliminated at this point.” Robert replied.
“Your kids are both myopic and are wearing glasses now. And Katie’s are extremely strong for her age. Why didn’t you stop or slow her progression down?” I asked.
“It’s not that simple Gary. You just made a new pair of glasses for Katie. She is probably one of the only children of her age that you have made progressive lenses for. When I first discovered that Katie had become quite nearsighted I tried every trick I knew of. First I under prescribed for her, because no child of 6 requires perfect 20/20 vision. Her first prescription was OD –3.75 x –1.50 x 160 and OS –4.00 x –2.00 x 20, and this was –1D less than what she really needed. In less than 2 years she had increased to OD –6.75 x –1.75 x 163 and OS –7.50 x –1.75 x 24. I could not bear to see her scrunch up her eyes to see everything, so I prescribed her full prescription with a +2.00D add for bifocals. Within a year she had increased to OD –8.75 x –1.75 x 160 and OS –9.50 x –2.00 x 20. I gave her the full distance correction and I increased her bifocal to +2.50. It was only 6 months later that I had to increase her prescription significantly again. Now she needed OD –9.75 x –1.25 x 165 and OS –10.50 x –2.00 x 20. I couldn’t increase her bifocals because for a straight bifocal +2.50D is about the maximum. There is a loss of intermediate vision, and the child will look through the upper, stronger portion of the lens to see anything more than about a foot away. So this time I went to a +3.00D progressive add. But this didn’t seem to help, as within another 6 months her prescription increased again to OD –10.50 x –2.00 x 170 and OS –11.75 x –2.00 x 10. Then she went for 2 years without really needing an increase. But, now, as you realize since you made her last pair of glasses a few months ago, at age 13 Katie requires a prescription of OD -12.00 x –2.50 x 170 and OS –13.25 x –2.00 x 10.” Robert told me.
“So what is the answer, and why has Katie’s prescription climbed so much if you have used every trick you know of to slow her progression down?” I asked.
“I have no answer. And I have tried every trick I know of. Katie developed her first bit of myopia very rapidly. She was a little nearsighted when I examined her about 6 months before I had to prescribe her the first pair of glasses. But her myopia was so benign that I didn’t think it necessary to get her glasses then. I showed her how to read with her book at a proper distance, and I got her a pair of reading glasses with a prescription of +1.50D. I instructed her to look away from her reading material frequently, and I kept a pretty close eye on her to make sure she was following my instructions. In an amazingly short period of time she became very myopic, even following all my instructions. So I could no longer deny her glasses, and her prescription has climbed very rapidly as she grew taller.” Robert replied.
“So do you think this is hereditary? Mom was very nearsighted, and I suspect she passed this gene on to Joan and I.” I said.
“Well, what is worse is that my mother was also an extremely high myope. She was around –17D in both eyes, with a little bit of cylinder, and my father was myopic with a lot of cylinder. He was –4.50D with about the same amount of cylinder in both eyes. So, yes, I am sure there is a genetic component involved here.” Robert told me.
“But you have good eyes. Why are you not myopic? And why is Curtis not a high myope?” I asked.
“I am as mystified with this as you are. And you are wrong. For his age of 14, Curtis has plenty of myopia. He is almost a –6D myope now, and I suspect that his next exam will put him into the high myope category.” Robert said in reply.
“So what do you plan to do?” I asked.
“I will do what I have to do to protect my license and make sure I am not sued. If a parent brings a child in to me, and I discover after a careful refraction that the child has a very low myopic prescription I will carefully advise the parent and the child of the dangers of starting the child wearing minus lenses. If the parent or the child still want to be prescribed minus glasses I will do so, and I will definitely include a notation in my file that the parent and the child were advised that a regime of alternate vision improvement techniques should be tried before glasses are worn. And I will also suggest to the parent and the child that the child should not wear the glasses except when needing good distance vision.” Robert replied.
“So will this reduce my clientele?” I asked.
“I doubt it. Most of the children will decide that since most of their friends wear glasses they will want to wear theirs as well. And, once a low myope gets used to having clear vision again I think you will find that theses same kids will continue wearing their glasses all the time. And, really, very few of these children will ever go much higher than –10D. The ones that do were likely destined to be high myopes anyway.” Robert replied.
“And, since so many of the parents, and grandparents are myopic the children will not see anything wrong with the wearing of glasses.” I added.
“That is true. In this area you have a very high number of myopes, but you have a very low percentage of contact lens wearers. So the wearing of glasses seems very normal.” Robert added.
“So, at least my optical business should remain fairly stable as far as my income goes. Do you think that Joan and I are as nearsighted as we are because Dad made sure we had examinations, and new lenses if necessary so very frequently?” I asked.
“It is a possibility. However I suspect that you both inherited your myopia from your mother, and you would likely have become quite myopic anyway. Lets face it, if you are a –15D myope you are as dependant on your glasses as a –20D myope is. And I doubt that there would have been any more difference than –5D in either of your eventual prescriptions.” Robert replied.
“That makes me feel better. What are your projections for my girls?” I asked.
“Don’t put me on the spot Gary. This is something that no one can really tell. But, taking into account their age, and the prescriptions they are now wearing I would suggest that they might both reach –25.00D. Neither of them have enough astigmatism to make cylinder correction necessary; so they should both have fairly good acuity. Katie is the one I worry about. She could easily reach into the –30’s, and hopefully her astigmatism doesn’t get any higher.” Robert told me.
Over the next 5 years I discovered that Robert’s predictions were fairly close. A number of kids were brought to me by their parents with a prescription written by Robert for –0.50D or –0.75D that had a notation on it that the glasses were not recommended for full time wear. The kids wanted glasses anyway, and I suspect that most of them wore them full time, because I saw them back in a few months for lenses that were at least double in power.
Joan had gotten her optician’s license, and she went into partnership with me. I didn’t mind having my income reduced, because I wanted more time to spend with Sally and my children, who were now of university age. And I was fortunate enough to be able to spend a little more time with Mom before she died. After her death I visited with Dad as often as I could.
One of the benefits I really enjoyed was having more time to spend with Sally. As she grew older she became even more beautiful. We began to spend a lot of time hiking in the hills and forests around the town. And, since Sally had never been able to drive because of her strong prescription, I frequently joined her on a bicycle ride around town. I was amazed at how well she was able to see through her strong double myodiscs. And, when the bike ride was over we would go home, put on our shower glasses, and shower together. Often this would result in a little playing around, and once we were out of the shower we would towel each other dry, clean each other’s glasses, and often fall into bed for an extended period of lovemaking. I really liked making love to Sally when she was wearing her old larger frame sized thick plastic lensed double myodiscs that she wore for having a shower.
Finally Dad passed on, and here we were heading for the graveyard, where the man who was enamored with myopia would soon be buried. He would have been very proud to see the turnout, with the sunlight glancing off all the plano fronts of the glasses worn by the mourners. He had been very successful businessman, and had created many myopes during his lifetime.
July 2007

1 comment:

  1. Anonymous10:49 pm

    I have always loved the stories & morphs.