The Eye Man Cometh

“Better than a poke in the eye with a sharp stick…”

         This week I’ll pay a man to stick a sharp knife in my only functional eye.  He’ll destroy the lens through which I’ve watched my life for 68 years and leave an oddly-shaped bit of clear plastic in its place.  He’ll do all this under topical anesthesia while I’m wide awake.  He’ll make only a tiny incision, much smaller than the lens that he’ll insert, which will start out as a tightly-rolled cylinder and unroll once it’s in the eye.

         This lens, I expect, will restore my once-dependable distance vision.  I could once see so farsightedly, even without glasses, that I was the go-to guy for visual ID questions.  When we travelled, I could usually read the road signs before anybody else in the car.          

         Now, especially in the past year, my ability to resolve detail at a distance has deteriorated alarmingly.  I can’t see small boats on the horizon, I can’t see the whale spouts when Jan points them out, and I can’t read many street signs until I’m abreast of them.

         When we visited Sacramento in October, I drove downtown by myself early in the morning to meet with my men’s group.  Looking for “P” street, I found that I suddenly could not read any of the single-letter signs against the sunrise-bright sky.  I groped my way to the meeting, guessing at familiar sights, feeling for the first time in my life visually impaired.

         In Las Vegas in November, I had the same experience of being unable to read freeway signs against a bright sky unless I already knew what they said.  I found I was leaning heavily on Jan as a sign-reader.

         Driving at night has become incrementally more difficult, and I have difficulty seeing the road in the glare of some oncoming headlights.  When we go to dance lessons, even the brilliant green of the multiple traffic lights at our turnoff from Kuhio Highway seems blinding, forcing me to shade my eyes so I can see where to turn.

         Roadside objects emerge surprisingly from the scenery.  Walkers and cyclists appear on bright days where there was only a shady berm seconds before.  Dark cars with their lights off suddenly appear on empty pavement at dusk and dawn.  People who think they can be seen just have no idea how invisible they are to somebody with even a little visual difficulty.

         My appointment with my ophthalmologist in December revealed that things were actually as bad as they seemed.  It was not likely, his optometrist told me, that I’d be able to pass eye exam for a Hawaii Driver’s License now.  Lord, how the mighty have fallen…

         So it’s time to have the cararact extracted.  I’m on the edge of being significantly impaired, of being unable to read well, of being unable to drive, and of being unable to practice medicine. (“I’ll be putting a breathing tube in your windpipe, ma’am.  I can’t actually see it that well any more, but I’ve done it lots of times and could pretty much do it in my sleep.  Pretty much…”)

         I’ve taken care of lots of patients having this operation, and have watched this surgeon do dozens of these without a hitch.  In fact, I’ve admired his technique from the first time I sat in his room, everybody silent, all the details just so…  And now it’ll be my details that will be just so.

         For a long time I feared having this procedure, back in the days when retrobulbar block with a needle behind the eyeball was the standard method of regional anesthesia for the procedure.  I knew the block usually went well, but with only one eye that works, I wasn’t eager to risk any complication at all from such an injection.

         And now, most surgeons do this operation with topical anesthesia.  Even though we still make a big deal out of it, which it is, surgically, the patient’s experience is more pleasant by far than the average visit to the dentist. Jan reminds me that people don’t even know about eye pain unless they’ve had lids and eyebrows tattooed, a procedure that seems increasingly common here.

         So I’m not nervous.  I’m eager.  Tomorrow I’ll undertake my three-day regimen of eyelash cleaning and cleansing eyedrops, and Thursday I’ll have more to tell.