Friday, January 24, 2014

A Turd In the Punchbowl: The Human Eye With Cataracts by Peter Reum

For the last six years, my vision has gotten progressively more and more impaired due to the rapid advance of cataracts in both of my eyes. Unlike many visual impairments, cataracts insidiously sneak up on you and gradually blur your vision and eventually make your world an artificially dark world, even on a sunny day.  For several years, I did not realize that my  vision was headed southbound, and that my confidence in my own perceptions was being impacted by my vision's deterioration.

Something began to look wrong when I could not read a computer screen at a normal distance, even with glasses.  I found myself creeping closer and closer to the words on the screen, and thought it was due to my corrective lens prescription. I have always trusted my glasses, as they are a part of me, a tool I have used with 20/500 vision since I found I could not see the blackboard in first grade over 50 years ago. In the Disability Rights Movement, we have worked hard to help the general public to see that a wheelchair does not confine a person with quadriplegia, it gives that person freedom to move anywhere they desire, as long as the world is accessible.The Deaf Culture has fought hard to preserve American Sign Language, even though the cochlear implant has made aural correction possible for many people who are deaf.

So, what happens when a person with a disability has the chance to be "cured?" Would a person with paraplegia accept technology or medical intervention that would eliminate fully that mobility impairment? Would a "little person" be willing to accept medical intervention if they could effectively be of  "average height?" That was the question that was posed to me in my 2012 Annual Eye Exam when my opthamologist told me that I would gradually go blind, if I did not accept corneal implant surgery, I was caught flatfooted, as I did not know much about cataracts, at least until he told me that I had a moderate to severe case, and that I could see if I went through with the surgery.

In a sense, the human eye is a ball of liquid, nearly round, with light entering the eye through the pupil, then being focused by the cornea or lens, thereby projecting the image to the retina at the back of the eye, which then travels to the brain's visual cortex. The lens of the eye, due to several factors, including aging, will become gradually clouded, and changes from being clear at birth to opaque in later life, thereby creating a feeling of uneasiness and uncertainty of visual perceptions over time.

With the gradual darkening of the eye's lens comes blurred vision, and an inability to read subtle elements of facial expression and nonverbal communication through body language. Other domains of life are also impacted... I have not driven at night for several years, and my vision has deteriorated to the degree that I cannot read street signs during the brightest part of day.

Into this situation came the possibility of replacing my eyes' lenses with corneal implants. I had been approached with the idea during my 2012 eye exam, and had chickened out that year. In 2013, my opthamologist again advanced the idea, and I accepted his recommendation to have corneal implant surgery. We scheduled the surgery after a review of my health, and I looked forward to the surgery

On last Wednesday, I enter the Billings Clinic Outpatient Surgery Building, and with some mild temerity awaited my first eye to be changed forever. As an aside, I will say that I have been very nearsighted since birth, and have never had the experience of seeing the way ordinary sighted people see....until now. The operation was preceded by some very thorough preparation by the delightful Billings Clinic Staff, and each of them did their utmost to make me comfortable and feeling safe. Having spent the last year reading about corneal implants, I felt that the surgery was a wonderful experience, if a bit anticlimactic.

The operating opthamologist and the anesthesiologist came by and told me what to expect, and then did exactly what they said that they would do. I was under sedation but awake, and remember the surgery as an experience of lights hovering over me like a fleet of UFO lights. The time in the recovery room went by quickly, and they covered my eye with a taped patch, with my orders being not to touch it. I had no feeling in the eye, at least nothing felt painful. The next day, I went to the Billings Clinic Opthamological Department, and met with the operating doctor, who removed the patch.

What I saw in that eye was completely unprecedented and utterly fantastic. My vision measured 20/20 in the eye, and all that I have experienced since has been mind blowing but wonderful. Imagine walking without  a limp if your were born with a bad leg, or whatever metaphor works for you,  The interesting dichotomy that is my vision, is that I still have a cataract in my other eye for a few more days, and it is a contrast bordering on mind fornication....one eye functioning perfectly, the other dark, hazy, blurred, and shadowy.

Next Wednesday, for the first time in my life, I will see as others see, and it cannot come too soon. My sincere thanks to Billings Clinic, the Outpatient Surgery Staff, and Doctors Bell and Schmidt for their amazing work. Your work literally helps the almost blind see.