On seeing, and the sighted.
One year ago, I had the first surgery.
It was little more than a preventative measure. There hadnāt been any damage done yet, but if left unchanged, the health of my eyes would have slowly, irreversibly degraded over time. Itās a procedure thatās done all the time. There were very few risks, and if it worked as intended, my long-term health would be in far better shape.
It was a no-brainer: Go under the knife, take a few weeks to recoup, make a couple of minor lifestyle changes and remain healthy for decades.
On Feb. 23, 2015, the doctor first operated on my right eye.
On Feb. 24, 2016, a different doctor operated on that same eye, one week after he operated on the left.
On Feb. 25 I woke up and saw the world as it was meant to be seen for maybe the first time.
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The thing about seeing is you donāt think about it until you canāt.
At least I didnāt.
Itās breathing, itās a heartbeat ā itās automatic... until you canāt.
You read and navigate through your world without a momentās thought. You take in all the signs, screens, faces and places you come across, your brain automatically processing the million million colors created by a billion billion waves of light in a fraction of a fraction of a second. You know red, blue and green. You might even know cyan, magenta, yellow and black. They just occur. They just appear ā until they donāt.
Seeing is impossibly simple. Itās synapses and waves of light and infinite infinitesimal reactions occurring constantly, incessantly and effortlessly ā well, usually effortlessly. It just happens. Itās just a process.
Until it isnāt.
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Iāve learned a lot about the anatomy of the human eye in the last three-plus years.
Theyāre really fascinating little organs.
Light passes through the cornea and the pupil, the lens focuses that light into an upside-down image on the retina at the back of the eye, and then that image is sent through the optic nerve to the brain where a million more things happen.
You know... in layman's terms.
The thing Iāve learned most about the eye, though, is that there are so many things in that process that can go wrong.
If your eye isnāt the right shape, the light doesnāt pass correctly through the cornea and isnāt focused correctly by the lens. If your iris is inflamed, your pupil wonāt contract or dilate as itās supposed to, and things may appear darker or brighter than they truly are. If your lenses are clouded ā better known as cataracts ā your vision can be seriously impaired. If the vitreous ā the fluid inside the eye ā is inflamed, youāll see floaters or haze clouding your sight, or if the pressure of that fluid is too high inside your eye, your optic nerve may be damaged ā better known as glaucoma ā which can cause losses in your peripheral vision. If your retina is damaged, well ... Thatās just generally bad.
Most of us will experience at least one of those problems in our lifetime, most likely glaucoma or cataracts in our later years.
In the last three-plus years, Iāve had a crack at each at least once.
The eye is an incredible, delicate, intricate little organ.
It can also be a real pain in the ass.
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The health of my eyes has slowly been deteriorating for more than three years.
At first, it showed itself as single spot in my vision. Then, redness and swelling. Later, thereād be haziness or floaters in my vision, only occasionally rendering an eye all but useless. Everything was relatively minor and easily treated with steroid injections (which, with the benefit of experience and hindsight, is not as terrifying as it sounds).
But, after several months of treating the same symptoms the same way, the side effects of those treatments began manifesting itself in other, more destructive ways.
My intraocular (inside the eye) pressure skyrocketed, putting me at risk of glaucoma.
A steady regimen of drops (four to six a day) was put in place to keep the pressure at bay, with mixed results. My doctors and I experimented with different combinations of different prescriptions and nothing got us the results we wanted.
So, surgery it was.
On Feb. 23, 2015, the doctor installed a device behind my eye with a tube designed to drain excess fluid from inside the eye to the outside.
Iād no longer be able to wear contacts. Iād have to limit my strenuous activity for six to eight weeks during the healing process. But if all went according to plan, the risk of damage being done to my optic nerve would be exponentially decreased.
Like I said, a no-brainer.
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Iāve thought about seeing a lot the last couple of years.
It started slowly at first.
Iād always had poor vision. Iāve worn glasses or contacts since I was in second grade. Then one day there was a new blur in my sight. I came up with so many theories.
āMaybe itās allergies.ā
āMaybe itās a stray dust particle.ā
āMaybe itās a lack of sleep or simply a bad contact.ā
The first few hours were annoying. I tried rubbing it out. I tried washing it out. I blinked purposefully, hoping to clear out whatever irritant had inconvenienced me. Eventually I resigned myself to sleeping it off.
āItāll be better tomorrow.ā
But itās still there on tomorrows two, three and so on. Some days were better, most were the same. You try eye drops. You try wearing your glasses instead of your contacts. And after a month or two pass, you start to be a little less annoyed and that inconvenience becomes a sort of ānew normalā.
Is it annoying? Sure. But a reason to panic? Of course not. Youāve dealt with worse. For all you know, it could still get better. For all you know, it could be this new brand of contacts. For all you know, it could be nothing.
Then you notice you canāt see your golf ball after youāve hit it anymore.
You stop drawing and reading because itās more work than itās worth.
Your back and neck hurt after a night of work at the computer because youāve been sitting so close and leaning forward to get even closer.
You run a stoplight because you couldnāt see it until it was too late to stop.
You might not have noticed much, at first.
But at some point, itās all you notice.
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I came to Austin only a few months after my first surgery, and my first priority ā after, you know, unpacking ā was to find a new doctor so that I could continue the necessary treatments.
I found a doctor I liked. He treated me kindly, he answered my stupid questions as if they were the most insightful heād ever heard. He told me the game plan for treatment at every step along the way.
In the months after my surgery, Iād started to develop cataracts ā common following a procedure like mine combined with the continued steroid exposure.
Step one: Clear up those cataracts in both eyes. Step two: Glaucoma surgery on the left eye to match the right. Step three: Never see an eye doctor again (hopefully).
Two days before the first scheduled cataract surgery, the clinic called to inform me that, while my doctor was covered by my insurance, the facility at which he performed his operations was not. So I needed to either pay for the procedure in full or wait for my doctor to get admitting privileges to a different facility.
By the time we got to this point, my vision had decreased substantially ā close to 20/50 in both eyes, with my glasses ā but by no means were these surgeries urgent. I could drive without issue. I could work without issue. I could wait.
This was in November.
I was on the phone with the clinic approximately once a week thereafter, urging them to get the credentialing done, asking what more I could do, trying to move things along.
By mid-December, things had started to really regress.
I went to the DMV to get my Texas driverās license. To get a driverās license, you must be able to see at no worse than 20/70. When I stepped up to the testing monitor, I was stumped.
āUm, so, just these eight-letter rows?ā I asked, seeing two clusters of four blurry figures in front of me.
āThereās 12,ā the man behind the counter grumbled.
Right. 12. Thatās close.
Looking through the viewfinder, it struck me what was happening: My right eye was picking up the letters to the left, and I was seeing the letters in the middle OK, but my left eye was blind to the letters to the far right.
I was in more trouble than I had thought.
I stammered my way through a guess.
āNot quite. Are your glasses for close up or for distance? Do you need new glasses?ā
āYes,ā I squirmed, knowing Iād gotten stronger lenses only a week prior.
āThe third line down?ā I asked, hopeful that heād correct me, that Iād be able to read the larger line above, the one I could almost vaguely make out most of the shapes.
āMmhm.ā
Pressing my forehead as far forward as the viewfinder allowed and pressing my glasses as close to my face as the bridge of my nose allowed, I knew that if I didnāt pass this test, Iād almost certainly leave not only without my Texas driverās license, but without any license at all.
The longest 30 seconds of my life passed as I squinted and half-heartedly guessed based on little more than the blurry shapes that appeared in front of me.
The man let out a gravely sigh as he begrudgingly signed off on my test and began printing my new license.
āClose enough.ā
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It wasnāt just the letters of vision tests that were lost to me.
Street signs were just green rectangles. My cell phone was just a glowing blur. Restaurant menus were all but worthless scraps of paper in my hands.
It was harder to read books or magazines without putting the words inches from my eyes ā and by āinches,ā I mean two or three ā and so for the last several months, I didnāt even bother. Iād click links to stories or posts that looked interesting, but after craning my neck to get close enough to my monitor to decipher the words for a couple of paragraphs, Iād inevitably give up and move on.
Faces didnāt look quite right and eyes didnāt sparkle the same. If the sun was shining just right ā or, later on, at all ā faces disappeared altogether, becoming little more than shadows in front of a bright white glow. The features on the faces I knew became a little harder to distinguish. The features on the faces of strangers went completely unnoticed, making them unrecognizable upon a second meeting.
Even the places and faces I saw every day started to fade into blurs.
The only driving I was comfortable doing was short distances at night, or routes with which I was intimately familiar.
Parts of my life had slipped away entirely, little by little, at an almost unnoticeable pace, until my vision had almost left me completely.
I know in the grand scheme how lucky I was. There are millions of people who canāt see, have never been able to see and will never be able to see. Fortunately, there was never really much risk that Iād join that group.
But I also intended to do everything in my power to ensure I never did.
After months of waiting ā far, far too long, again with the benefit of hindsight ā I found a new doctor and made a new plan.
I was getting my eyes back.
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Last week, I was finally able to have the surgery that promised to restore my vision to a level Iām not sure itās ever been ā with corrective lenses or not.
The procedure is done thousands of times a year, and it is incredibly simple: The doctor cuts away the cornea, removes the cloudy, cataract-covered lens and replaces it with an artificial, vision-correcting lens.
The patient (in this case, me) is awake the whole time, sedated only by a single Valium to keep them calm ā it may come as a surprise, but some people have trouble remaining calm when seeing a surgical knife closing in on their eye ā and what I estimate to be a liter of numbing drops. On the table, you have to only remember to breathe, which, speaking from experience, isnāt as easy as it sounds, considering whatās going on inside your skull.
I was in and out of the operating room in 15 minutes.
Once the procedure is done, thereās minimal recovery. Most people return to work and normal activity the next day.
If you canāt afford the $5,000-per eye laser surgery and premium artificial lenses (which normal human people such as myself cannot and insurers, naturally, do not cover), you can choose between one of three mono-focal implants, correcting your vision to near 20/20 for either distance (the most common choice, good for driving and watching TV), mid-range (computer work) or near (reading) vision.
Three weeks after surgery, when the eye is fully healed, Iāll get a new glasses prescription, and all I need are reading glasses to get by in the interim.
Thereās the added bonus that Iāll also never get cataracts again.
Iāll be fine wearing reading glasses, I think.
Itās a small price to pay for the ability to see at near 20/20 without glasses or contacts for what might actually be the first time in my life.
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When the doctor had made my cornea whole again, patted me on the shoulder and said āWeāre all done,ā I wanted off the operating table as quickly as possible.
A nurse stood me up and gingerly maneuvered me to a wheelchair, wary of the affect the Valium would have on my motor function.
She then wheeled me to a small waiting room where she checked my blood pressure and made sure I was up to speed on my post-operative instructions.
I didnāt have my glasses ā they were in a leather case along with fresh tape for my clear plastic eye shield, instructions on who to call if I experienced pain or changes in my vision, and coupons for artificial tears ā and I was just minutes out from an operation on only one of my eyes, but all I could do was look around.
I could read nameplates on doors and the name of the restaurant on the takeout menu on the nurseās desk. I could pick out individual leaves on the tree outside the window. And the next thing I knew, I was giggling to myself, almost uncontrollably, giddy about every little detail I could finally see again.
I couldnāt wait to get back there and get the right eye done just the same.
And I havenāt wiped the smile from my face since.
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I hadnāt realized everything I wasnāt seeing until I could see it again.
Grass and leaves dance in the wind.
Paint on cars glistens in the sun.
My co-workers have gray in their beards and lines on their faces.
My fiance has perfect freckles and the most beautiful blemishes on her skin. And I can finally see the color of her eyes again.
There was so much Iād missed.
On Feb. 25, I woke up seeing it all again for the first time.
