Thursday, February 12, 2015

Truth in Advertising


The Eyes Have It

Last November 5th I made the most  harrowing drive of my life, three hours to and then back from Hartford at night after a light rain on a four-lane highway heavily utilized by tractor trailers. It was then that I fully realized just how bad my vision had become as I drove through a visual chaos worthy of the “trip” sequence in “2001: a Space Odyssey.” My hands were more than just a little sweaty and I had cramps in them the next day from my death-grip on the steering wheel.

As do so many people of Age, I had developed cataracts. The biojelly lenses in my eyes had accumulated pigmentation and biological junk that reduced the light trying to reach my retina. The world had become darker, light sources generated distracting halos, and the minor details of everyday life such as facial features and printed text were becoming indistinct even with my “Coke-bottle” glasses. It was time to turn to the miracles of biotechnology.

Uncomfortably, this involves cutting opening your eye with sharp pointy instruments. However, I had numerous testimonies from family and friends as to how miraculous the procedure was and how significantly it had benefited their sensory lives. My ophthalmological surgeon told me that she could not promise that I would not need glasses other than reading lenses, but if I did it would be a light prescription. She also said that while I could be rendered unconscious for the procedure, anything other than local numbing of the eye was not really necessary for the operation which would only take about twenty minutes. The risks were described as extremely low.

As a curious fellow, I watched a video of the operation on Youtube that was vaguely disturbing but then all surgery is a nasty business from a non-technical perspective. The procedure shown did last for twenty minutes. Time to bite the bullet.

Typically when bilateral ocular surgery is to be performed each eye is done several weeks apart, but the surgeon wanted to do my procedures one week apart to avoid perceptual/cognitive conflict. I went under the knife for the first one yesterday. In truth, it was no worse than sitting for a dental extraction except for the incessant eye drops for several days before, a dozen in the hours just prior, and on-going for several weeks following the operation. I am no damn good putting drops into my own eyes! Plus, the drops just before the surgery to numb my eyes and dilate the pupils stung. Following is the sequence in the cataract-removal procedure:
  • Anaesthetic - The eye is numbed with either a subtenon injection around the eye or using simple eye drops.
  • Corneal incision - Two cuts are made through the clear cornea to allow insertion of instruments into the eye.
  • Capsulorhexis - A needle or small pair of forceps is used to create a circular hole in the capsule in which the lens sits.
  • Phacoemulsification - A handheld probe is used to break up and emulsify the lens into liquid using the energy of ultrasound waves. The resulting 'emulsion' is sucked away.
  • Irrigation and aspiration - The cortex, which is the soft outer layer of the cataract, is aspirated or sucked away. Fluid removed is continually replaced with a saline solution to prevent collapse of the structure of the anterior chamber (the front part of the eye).
  • Lens insertion - A plastic, foldable lens is inserted into the capsular bag that formerly contained the natural lens. Some surgeons also inject an antibiotic into the eye to reduce the risk of infection. The final step is to inject salt water into the corneal wounds to cause the area to swell and seal the incision.
A shield that looked like part of the costume of a Bug-Eyed Monster was placed over my eye for the ride home. I could then take it off then wear it again for my first night’s sleep. The nurse said that I would probably notice a general increase in brightness and enhancement of colors. Oh, how I do love truth in advertising! Although my vision will be blurry for several days, the ambient light is brighter, and I realize that I’d gradually forgotten just how brilliantly colorful our world is! And, oh frabjous day, I can see text on prints, posters, and street signs beginning to come into focus! I am actually eager to get my second eye done so that my stereoscopic vision can synchronize.

I look forward to walking the dog in the rain without my glasses being spattered by droplets; to going swimming and not losing sight of the shore. I may need lenses for my most distant vision (and as noted, for reading), but I won’t need them for preparing a meal or finding my way around the house. I am pleased.

Now if only my hips weren’t aching so that I wonder if they’re the next replacement to be needed…


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