I Once Was Blind

Well, not BLIND, exactly … but my eyesight has always been an issue, thanks to extreme myopia (nearsightedness) inherited from my parents. When I was a teen I wore thick, “coke-bottle-bottom” glasses which made me look like quite a nerd (before it was cool to be a nerd!). When I met this beautiful girl I was interested in, named Darlene, I committed to DOING SOMETHING about my nerdiness and went out and got contact lenses. Not the “soft” and comfy kind many people wear today, but hard lenses. (My eyes were actually too myopic for soft lenses.)

Hard contact lenses were a pain to get used to, but I gritted my teeth and did it, for the sake of getting rid of the thick glasses. After several weeks of discomfort, I got used to them, and wore them for the next 47 years.

In middle age my myopia more or less stabilized so my prescription didn’t change much. But that all changed about 13 months ago. Things were getting fuzzy and I noticed that as a professional driver and deliveryperson I could no longer see road signs or house numbers like I used to, particularly in dim light. So I went to my eye doctor, got examined, and a new set of contact lenses.

They were worse.

I went back, got examined again, and got some slightly improved but nowhere where my vision had been just a year earlier. This happened twice more.

Finally I asked my eye doctor, “Do you think this could possibly be cataracts?” Several years earlier we had talked about cataracts. That conversation basically went, “Pretty much everyone gets them as they age. You’ve had mild, slow-growing cataracts for nearly a decade now. At some point you’ll need cataract surgery, no doubt, but I don’t think you need it yet.”

So, this time I asked him, “Do you think it’s time to consider cataract surgery?” He shrugged and said, “Perhaps. They don’t look too bad to me, but you may be the best judge.” He prescribed new glasses, and those were even worse than the contact lenses, so I made an appointment with a cataract surgeon. He examined me and said, “Oh boy. Yes, your cataracts are moderately bad. And combined with your severe myopia, no wonder you’re having problems seeing. I would certainly recommend surgery, I think it will make a significant difference for you.”

And so I did that. It was a long process. First I had to go without my contact lenses for quite a period of time, so my eyes could revert to their “natural” shape. Apparently hard contact lenses influence the shape of your eyes. Cataract surgery removes your cloudy, natural lens with a clear artificial lens. But they have to triangulate the correct prescripton for that artificial lens. And then there are decisions to be made about your visual goals. Do you want to focus clearly on close-up objects, enabling you to read or work on the computer without corrective lenses? Or do you prefer clear distance vision, or somewhere in-between? If you have astigmatism, do you want to try and correct that through using a laser to reshape the cornea? Or do you prefer to go old-school and remove the cataracts without the assistance of lasers? Etc.

A compromise between near- and far-vision wasn’t available to me due to my myopia, so I opted for laser surgery that would give me ideal distance vision while providing the best chance of correcting my moderate astigmatism. Health insurance didn’t cover this “above and beyond” process and so I ended up paying a good deal of the cost out-of-pocket.

The Surgery

This morning I had the first of two surgeries, this one on my left eye. As with any surgery, I was required to fast before the procedure. Once in pre-op, I met with an anesthetist nurse who gave me the anesthesia options. For this surgery a series of numbing eye-drops is always used, and as most people do I opted for some additional medication (Valium) to help keep me relaxed. It’s amazing how the notion of someone cutting into your eyeball creates conscious or subconscious anxiety!

The surgery was further complicated by the fact that I have Type 2 Diabetes. I wasn’t allowed to take my normal medication before the surgery, and my blood sugar and other vitals were closely monitored.

The Valium (a single pill) basically had the same effect on me as drinking a few glasses of wine, relaxing you and making you feel like you want to take a nap. When my turn came, I was placed on a guerney and wheeled into the OR.

Once there, I quickly connected with my eye surgeon, Dr. Nicholson. I asked if he minded if I asked questions about the procedure as he was doing it, and he seemed happy to comply. He basically talked me through what was happening with every step of the 15 or 20 minute process. And it was fascinating.

First he placed a cup-like device around my left eye which held my eyelids open (after taping my right eye shut). I wondered how they might immobilize any eye movements, but other than the Valium and him telling me to keep my gaze straight ahead there really was no attempt I was aware of to do this.

After positioning my head carefully, he lowered the laser surgical device down onto my eye. He told me they would make two 3-millimeter decisions on the junction between the sclera, the white part of my eye, and the cornea. Through these incisions were inserted the tools that would do the work inside my pupil.

Surprisingly, much of the time I could see (sort of) what was going on. At times there was a sense of pressure and slight discomfort, but never any real pain. There were a lot of bright lights. Often it looked like I was being enveloped by a kind of kaleidoscope. It was really quite fascinating.

He described the lens as being like an “M&M” that was encased by a clear sheath. He made an incision in that sheith and proceeded to cut the lens itself into quadrants. In a best-case scenario, they could simply remove each quadrant, one at a time. I could hear a computerized voice proclaiming each time a quadrant had been removed.

But in my case, Dr. Nicholson said the center of my lens was unusually dense. Because of this he needed to do some additional work chopping up or freeing each quadrant of the lens before it could be evacuated.

After the final quadrant was gone, he explained there was an “onion-skin” like structure that lined the inside of that lens sheath, and he used lasers to dissolve this and remove it. At times there was a sound similar to a dentist’s drill, but fortunately not as intense.

Before long this tissue had been removed and the procedure was almost done. What remained was for the artificial lens to be inserted through one of the incisions. He said the lens was smaller than my contact lens, maybe 3 mm or so, but was inserted in a rolled-up shape. Once inside my lens sheath, it needed to be unrolled and tamped into place, with the assistance of some sort of tool that did this in a tap-tap-tap fashion.

During the entire process there was a light fluid spray of some sort that bathed my eye to keep it moist. I asked how the incisions would be closed, and he said they were made at an oblique angle so that the natural pressure inside my eyeball would hold the incisions shut until they healed.

Dr. Nicholson said the procedure had gone well and he was hopeful for a good result. I was soon wheeled back into a recovery area after additional eyedrops were applied. These created quite a burning sensation and my eye ached, but it was not severe.

Post-op instructions were given, a clear plastic eye-guard installed, and I was soon able to stand up on my own two feet. My wife (and driver) Darlene met me there and listened to the post-op instructions, but I was fully aware and able to ask questions. They then released me to go home.

They warned me that now that my cataract was gone on that side, the light would seem exceedingly brighter, and indeed it did. Darlene had a pair of sunglasses I was able to put on top of the eyeguard, which helped me on the way home.

The drive home was the most uncomfortable part. The eye ached and burned somewhat, and felt as if I had a contact lens misplaced on the surface of my eye. Once I got home, I took two Ibuprofen, added one of the eyedrops they had supplied, had some lunch and then settled down for a nap. I don’t think I’ve slept that hard in a long time. When I woke up I felt much better, and haven’t needed Ibuprofen since then, though I have to keep applying the eye drops 4x per day for a week.

Tomorrow morning I go back for them to check my post-op progress. But I suspect I will receive a clean bill of health. While bruising and redness/irritation was a stated possibility, so far my eye itself looks nearly normal.

And the cool thing is that I saw immediate progress. They warned I would be quite blurry for a few weeks, but even so my new artificial lens proved itself able to see more clearly than my old contacts ever did. I am hopeful for 20/20 distance vision soon, even though I know I will need to wear glasses for reading and up-close computer work.

My main goal in writing this post is to help anyone else who needs cataract surgery to have an idea what to expect, but I also am mindful of some spiritual applications to my situation. In 2 Corinthians 4:4, the Apostle Paul says,

“In their case the god of this world has blinded the minds of the unbelievers, to keep them from seeing the light of the gospel of the glory of Christ, who is the image of God.”

Blindness can be a very subtle process. Now that I have one eye fixed and one eye still containing a cataract, it’s fascinating for me to compare the view between the two. I hadn’t realized how dim, colorless and yellowish the entire world had become as a result of my cataracts. If I look at scenery now with my bad eye, then compare it to my brand-new good eye, the result is astounding. The truth is, you really can be blind (or close to it … somewhere on the spectrum) without fully realizing your situation. If all you know is the world that you see, you can be fooled by the slow fade into thinking you are seeing reality.

I’m thankful for living in a day and age when technology and modern medicine can dramatically improve and extend our senses. Like the man healed by Christ in John 9:25, I can now proclaim, “One thing I do know: I once was blind, and now I can see.”

2 thoughts on “I Once Was Blind

  1. Good Job on this post Larry! Like your doctor said, pretty much everyone will get cataracts as they age. It is good to know what to expect, when the time for surgery comes.

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  2. Just an update following my second surgery yesterday, on my right eye. It was far more challenging, and also more interesting.

    Darlene and I navigated icy weather to the surgery center in Tacoma for my 7:30 a.m. appointment. I was told during pre-op that the laser process my surgeon had used for the left eye wasn’t working properly so they were going to do it manually. They offered to double my Valium dose, but I declined, as 5mg had seemed like plenty the first time.

    As the procedure started, I asked the surgeon if the problem with the laser was software-oriented, and he said it was. But he told me he could basically do the same thing manually.

    Which he proceeded to do, in a surgery which only lasted about 15 minutes. But it seemed like a really l-o-o-o-o-n-g 15 minutes! Parts of it were quite uncomfortable, and at the end I told Darlene I felt like I had been hit in the eye by a sledgehammer and was battling some nausea from the experience.

    I took a couple of ibuprofen right away, and the bad feelings subsided to a dull roar. I had quite a migraine most of the day yesterday, but woke up today feeling quite a bit better.

    I don’t think the right eye will end up as sharp and clear as the left (where I now have better than 20/20 vision), but when they measured it this morning they said it was 20/25 so that’s not too bad.

    Now that the discomfort is gone and I no longer have to wear the eyepatch during the day, I definitely feel blessed by good distance vision. Though I have to wear different powers of reading glasses for close-up, computer and dashboard work.

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