the way i see it

Close up of an eye with mature cataract © Clare Gilbert, International Centre for Eye Health via by Community Eye Health via flicker and used under a Creative Commons license

My eyes are super-sensitive, as I discovered fifty years ago when, walking on a gusty day on an unfamiliar city street, a piece of grit flew into my eye. I was in instant agony: blinking, holding the eyelid, eye watering and conscious of time changing. Seconds became nanoseconds of excruciation. I looked around with the good eye for help. In one of the most fortuitous coincidences of my life I was passing an optician’s shop. I opened the door, stood on the threshold blinking, eye streaming uncontrollably. The optician guided me to a chair. His chosen instrument, the corner of an envelope, seemed amateurish as he said “We’ll have that out in a moment.” He held up my lid, said “I can see it.” I flinched each time the envelope neared my eye and it took several attempts to remove the grit, to my immediate, heartfelt, lifetime relief.

“I can see why it was so painful,” he said. “It’s as big as a rock.” Then he showed me the almost invisible black mote and smiled. Who knew that such a tiny speck could wreak such havoc? He didn’t even charge me. He could not know that fifty years later I would still feel residual gratitude. He’s dead by now and doubtless in heaven.

Now I’m looking forward to cataract surgery. “Anticipating” would be more accurate. Years ago an ophthalmologist who told me I had incipient cataracts, couldn’t tell how long they would take to develop. Dread has been in the back of my mind for a decade and now it’s only four days away.

I cross all my bridges before I come to them. My parents who admonished me for that as a child are long gone, but I’m still doing it. I google “cataract operation” and watch a surgeon with microscope on YouTube, insert an ultrasonic instrument, vibrate the existing lens at 40,000 pulses and extract the resultant gunge by suction (described as “aspiration of the cataract cortex”). Then he or she inserts another instrument, implanting a folded acrylic intraocular lens which expands inside and restores one’s vision. I frown at the mirror; my pupil is miniscule. How will they wield those fine tools in such a tiny area? The incisions are self-healing. I’m relieved to know that they only sometimes need to stitch the eye afterwards.

Leaflets supplied by my eye surgeon describe the risks and benefits of surgery. “As with any operation, complications such as minor irritations and scratchiness can occur, or more major ones such as glaucoma, swelling of the retina, clouding of the cornea or even complete loss of the eye. Fortunately the risks are very small….you need to decide whether or not the advantages outweigh the small risks.” I weigh improved vision against a glass eye and unaccountably decide to go ahead. Recalling the saint who relieved my agony, I know that “irritations and scratchiness” are huge. I mention to the surgeon my sensitive eyes which might cause him problems and he says with equanimity, “We can render the eye incapable of moving if necessary.” Great. Now I picture my head immobilized in a vice, ocular muscles paralyzed by killer drops.

Research informs me there’s “approximately 99% or greater chance of having much improved vision.” The last time I was told I had a 99% chance (of successful contraception with an IUD), I conceived twins within weeks.

When the ophthalmologist advised the cataracts’ removal last November I swiftly replied “Not yet, I can still see quite well,” adding mentally, “With any luck I might die before next summer,” but in the event I didn’t. For years I’ve gone out at night only with reluctance or with a driver. I’ve reached the stage where I see cartwheel-size blue auras around street lights in darkness. Driving home dazzled recently, at 25 mph even where the speed limit was 45, I arrived shaking, needing a stiff gin and tonic. I need these operations for others’ sake as well as my own: left eye first and the right two weeks later.

Friends, with whom I’ve discussed cataract surgery, reassure me it’s “a piece of cake” that only takes ten minutes. But one is conscious throughout. I envisage the surgeon coming at me with a scalpel, appreciating friends’ encouragement but at the back of my retina is the knowledge that one can lose an eye if infection sets in.

In preparation for the eye drops for antibiotics and inflammatory pain starting tomorrow (D-Day minus 3), I’ve prepared a chart to record the eye drop schedule, four times a day. All I can do now is drop my shoulders and wait.

The Operation:

My daughter in law accompanies me to the hospital as driving is impossible after dilating eye drops, blurred vision and dark glasses. I lie on a trolley while blood pressure is checked and forms are completed. “Would you take this Valium tablet?” asks the nurse. “Absolutely,” I say, “it’s the only thing I’ve been looking forward to.” I’m left for half an hour to relax. To calm my nerves I disassociate from my surroundings, imagining a young woman on horseback, galloping as one, on tundra with infinite grace. It’s a scene I watched yesterday in the amazing “Human” documentaries just released on YouTube. (Don’t miss them.) Several more drops are applied to my eye including local anesthetic.

The Valium lulls me into blissful relaxation, having the same effect as when I was wheeled to theater over forty years ago to give birth to breech twins, so I know it’s good stuff. Reflecting that the world would be a safer place if Kim il Jong and Assad were prescribed tranquilizers, Humphrey Bogart’s comment “The whole world is two drinks under par,” comes to mind. I relax into the experience. Then I walk to the operating theater which is full of lights and elaborate equipment (not an envelope corner in sight). I resolve to lie entirely still and submissive. I see two bright lights above the left eye which is held open with curved metal edges like a pair of eyelash curlers. (The right eye is covered, sight obscured, and I’m allowed to blink that one.) The surgeon reassures me as each part of the operation is completed. He makes a tiny cut in the cornea in addition to the lens pocket, to adjust astigmatism. When the contents of the existing lens are removed I can see nothing but grey light. The new lens is inserted. Nothing hurts. (The eye is frequently washed, like one’s mouth at the dentist’s.) After fifteen minutes the surgeon tells me it’s over and removes the cover. My blood pressure has risen but that’s to be expected. Vision is blurred.

Immediately I walk to be interviewed by the post-operative nurse, with instructions and more forms to sign. The next day I’ll have a check-up at the surgeon’s clinic. It’s astonishing how minimally invasive the process is. I notice that the hospital wall is Eau de Nil in the left eye and sludge green in the right.

I stay with family for 24 hours, standard practice. That afternoon, lying on my grandson’s bed, I sleep for two hours and when I awake, notice with the new eye the pretty sky-blue curtains in his room. With my old eye they look dull blue behind a beige film. I’m astonished how much my eyes have deteriorated with age, and delighted by the vibrant blues and whites I now see. Vision is still blurred until the next day, but the vivid hues are an immediate sight for sore eyes. I can focus better too.

Four times a day for up to six weeks I must put three kinds of drops in my eyes, for swelling and pain, and an anti-biotic. That’s a chore, but small price to pay for the reward. “There is no pain,” I tell my grandson Jake (9) and he asks me if the drops hurt? I say “Only the ones for pain sting,” and we both fall about laughing.

Five days after the operation I’m delighted with my ability to see more clearly, and this time I’m really looking forward to surgery in ten days to rejuvenate the other eye.

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Image Credit: Close up of an eye with mature cataract © Clare Gilbert, International Centre for Eye Health (license) via by Community Eye Health via flicker and used under a Creative Commons license.
Eileen Dight

Eileen Dight

Eileen Dight is a retired British specialist on trading in Spain, now resident in Ireland. Spanish- and French- speaking, graduate (at 46) of International Politics and History; former editor, interpreter and fundraiser. Her five sons and twelve grandchildren live in four different Time zones around the world. She has lived in England, Wales, Spain, France and Virginia, North America for 11 years. In 2012 she self-published her memoir Plate Spinner and Only Joking, 200 pages of collected jokes categorized for easy reference, as well as What’s On My Mind, her first 50 essays published in Like The Dew. All available on Amazon.com.