Waking up one morning in 1975 I saw my roommate’s dog Casey,
an Irish Setter, sitting against my bedroom wall.
“Casey. Good
morning. Come here girl.”
I made that smooching kissing kind of sound we make to call
dogs to us. She didn’t move.
I was in the smallest bedroom of a country house I shared
with two other guys. I was there
temporarily. Well, we all were there
temporarily as it turned out but I was the most temporary of the three. I planned to leave in the spring for South
America, a plan I carried out.
In my little bedroom was a twin bed mattress and box spring,
a wooden barrel, some books on the floor, and a backpack with very few clothes
on top of it in the corner. I was
covered by a sleeping bag.
“Casey, don’t be silly. Come here.”
I stretched out my arm and wiggled my fingers, promising to
scratch her behind her ears which she liked so much. She was about three feet beyond my
outstretched hand. Still she didn’t
move. I pushed out from under the
sleeping bag, closing the gap between us and touched her.
When my fingers touched her I realized it wasn’t Casey but
my brown wool sweater. I had mistaken my
sweater for a dog, and was reminded how bad my vision was without
correction. It’s sobering, but you learn
to live with it.
I first got glasses, for myopia, in 1960 when I was in third
grade. When I left the eye clinic in
Bloomington wearing them I looked down the street and said to my Mom
“I can see every leaf on those trees.”
I loved wearing glasses.
I never took them off. As I got
older my glasses got thicker. I got
contact lenses in 1968 because my coach thought contact lenses would improve my
peripheral vision. He was right. With them I could see if the base runner leading
off first was leaning towards second when I pitched. When basketball season came I became more
aware of the whole court. I experienced
little discomfort, and wore those contacts as much as I possibly could, which
was probably a mistake.
My vision became more of a problem in 1972. After spring finals at ISU I went to my eye
doctor because I thought I had scratches on my contact lenses. My vision was annoyingly blurry, both near
and far, as if I was looking through something.
I cleaned the contacts, the old hard kind, little pieces of blue
plastic, several times but could see nothing on them. Turned out it wasn’t my contacts but my
eyes. I was looking through scars on my
corneas, like stretch marks. My corneas
had become cone shaped. I had developed an
eye disease called kerataconus. When corneas lose their uniform curve and shape
they not only scar but they distort your vision. There’s no getting around that.
I was fit with special contacts that held back the cone but
at the same time irritated my eyes more.
I learned to live with that. As
the years went on with the help of excellent eye doctors I made use of every
new technology available. I was fitted
with gas permeable contact lenses which allowed more oxygen onto the surface of
my eye and lengthened my wearing time.
But my eyes continued to change.
I flunked the vision portion of my driver’s test in 1990 and
went to my trusted eye doctor for a more extensive exam. He passed me, allowing me to drive, but only
after exacting a promise that I would visit an ophthalmologist who specialized
in cornea transplants. Turned out I was
a prime candidate for such surgery.
My corneas were replaced a year apart in 1990 and 1991. After each surgery I snapped that eye’s hard
contact between my fingers, the little bastards that caused me so much
discomfort, and vowed to never wear contacts again. The transplants gave me not only a clear
surface to look through but reduced my astigmatism as well. After it was all done my new glasses, rather
than being coke bottle thick, resembled those of a normal person. I thought the transplants would eliminate my
eye disease. But I was wrong.
It crept back.
Astigmatism became the problem.
While my corneas remained clear something about my eye caused them to
again lose their shape. My prescription
crept up again, and not uniformly in each eye.
My eyes became very different one from another. The eye doctors worked so hard to help me
see.
I would attempt to explain to my eye doctor, now the son of
the man who insisted I see the surgeon, what it was like to see through my
eyes, so he could understand what was happening.
“Don’t try,” he said.
“Vision is a hard thing to put into words, especially the vision of
people with kerataconus. Looking through
non uniform corneas, each eye different from the other, and each patient’s eyes
different from the next, causes unique individual distortion. It’s distorted in an infinite number of ways. Your brain can accommodate many of those
differences. But convincing me what it
looks like for you is not really helpful to me.
It’s interesting, but not important.
My job is to produce vision for you as good as possible given your eyes,
and when I can no longer do that get to someone who can make your eyes better.”
He gave me a prism in one lens after I complained that my
eyes watered at night while reading. Even
with it I reported that occasionally the vision of one eye or another suddenly wildly
diverged, the print on one side of a sentence jumping way higher than the other
side making it impossible to read.
“That is your brain taking a break. The difference is too great and your eyes go
out of focus temporarily. Your brain
can’t hold it together any longer.”
If I stood in front of a wide banner with print trying to
read it across, one side of the banner, usually the left, would be clear while
the right side blurred out. I found it
better to close the right eye and move my head to scan the entire width with
the left.
Occasionally things that I knew were concentric, say targets
with equally spaced rings, the kind you shoot arrows at, would not be so. On one side the rings would scrunch
together. On the other side they would
bow out. But the worst part of living with
so much astigmatism, which requires such a strong prescription, is the lack of
depth perception. There was a time
before I flunked the driver’s test that I desperately relied on “stop ahead”
signs. Without them I would slam on my
brakes at a rapidly approaching stop sign believing I had plenty of time. No one has told me this but I think
corrective prescriptions with high minus make everything appear smaller, yet in
relative proportion. It allows you to
see the world more clearly, but not as it really is.
A few years ago my young cutting edge optometrist introduced
me to an innovation called Synergize (brand name) contacts.
It’s a gas
permeable lens surrounded by a soft contact skirt. That skirt allows your eye to push the lens
out to the curve it needs while the rigid lens stays in place over your
pupil. They fit tightly so extended
wearing time is not recommended. With
them I saw amazingly well. But as time
went on I could wear them less and less.
And when I took the contacts out and used my glasses they didn’t
function well because of something called corneal molding. Even when that subsided glasses could not
replicate the vision afforded by those advanced contacts. Finally I had to abandon the contacts because
blood vessels began to grow onto the iris in an attempt to bring needed oxygen to
the surface of the cornea. When that happened I was once again referred to a young and
respected ophthalmologist.
Beginning this summer he performed a series of procedures to
both eyes, incisions which relaxed my cornea and allowed it to take a more
normal shape. He risked cutting into my
transplanted cornea, a risk not all professionals of his kind will do. He was relaxed and confident. I like him a lot. I think his confidence comes from not only
his skill and experience but because he has the best equipment available, all
the latest technology, and a team of people around him who supply him with very
accurate information and take no shortcuts.
I felt immediately comfortable in his office, believing I had arrived at
a good place.
This past week he concluded his work, performing two
cataract removals and replacing my God given lenses with corrected Alcon Toric
lenses. Each of those lenses has six
diopters of correction for my astigmatism.
That puts correction inside my eye, in the small lens in front of my
retina, rather than on or directly in front of my cornea. It’s an outpatient procedure done while you
are awake. For the second eye I turned
down the pre op offer of Valium so I could pay better attention to what was
going on. I was at the Center for
Minimally Invasive Surgery in Mokena, a nice unassuming place by a warehouse
off Route 80. My doctor asked where I
wanted the surgery done. I replied that
I wanted to be where he most liked to be.
Totally his call. He picked CMIC.
In preparation I needed only to strip to the waist before putting
on the funky gown. I even kept my shoes
on. They put little booties over them. A
nurse writes something on my forehead above the eye I’m having done, most
likely “Cut this one!” and puts both dilating and numbing drops in that
eye. Another asks me to look straight
ahead and puts a dot on my eyeball for the doctor to use as a reference when
placing the Toric lens.
“Is that a Sharpie?”
She smiled. “I don’t
know. Sort of. It’s a felt tip marker of some kind. Special
though you know.”
Bianca, a nursing student, was my transporter each time,
wheeling me from the staging area to the hallway outside the operating
room. She wrapped a warm blanket around
me while I waited. I was operated on
early last Saturday so we talked about the snowstorm and snow removal as we
waited. I was lucky to have made it to
Mokena from Ottawa. Bianca and her
family lived in a nearby unincorporated area notoriously bad at plowing
snow. She felt lucky to be there too.
Inside the operating room they tilted my head so the eye
being worked on was properly positioned and clamped into something of a soft
vice before forcing my eye open with a speculum. Before I was clamped in I looked at the
equipment instruments, big overhead lights, and a giant machine on a massive
arm that looked like a movie camera. On
the side of it was the word “Leica.”
“Hey,” I said to no one in particular. “It’s a Leica.”
“You familiar with the microscope industry?” A nurse asked.
“Not at all. But
Leica used to make very good cameras.
Professionals used their stuff. I
hadn’t heard of them in years.”
While travelling in the 70’s with a Minolta I would run into world travelers with money carrying Leicas.
They were proud on the verge of snobby about them.
“Well that is a spanking new digital Leica microscope that
makes all this work possible.”
“Good to know they’re still around.”
My doctor came in and shook my hand. He looked different. We were both wearing hair nets for one thing,
and he sported orange crocs on his feet.
He asked the nurse to put the music on.
It was mindless pop. He sang
along to “You Shook Me All Night Long” by AC-DC as he got ready to work.
“Doc, how about telling me what you’re doing as it goes
along today? I didn’t take the Valium.”
“I’d be glad to. Let
me get this instrument in position.
We’re about ready to go.”
He put an extremely bright light directly above my fully
dilated eye. Inside the brightness were
three rectangular brighter lights. It
was so bright everything seemed to be turning red. Nothing I could do about it. Above me the doctor pulled the camera into
position and looked through two eyepieces.
“I have a great view of the interior of your eye thanks to
this machine. Your eye is fully dilated
and I can see your lens very clearly.”
“OK, I’m making a 2 millimeter incision on the side of your
eye, and inserting my probe through that incision. Your lens has a diameter of about 6
millimeters. First I dissect it, then I apply radio waves that break up those large pieces into bits small enough to
be sucked out by the probe. It’s called
phacoemulsification.”
I felt nothing.
"This is going well.
Now I’m beginning to clean this out.
I’m vacuuming out your old lens in a sort of sac it rests in while
leaving the snug place it fit into intact.
I’ll insert the new lens in that same place and in time it will incorporate
itself into that same place. The eye
will grow around it somewhat.”
As he did this a sound like a video game came from my right
side. Bloops and bings of various length
and tones burbled along.
“What’s that funny noise?”
“The machine gives me some audio feedback on material
entering and going through the probe. Along with what I’m seeing it helps me
know when I’ve gotten all the loose material.”
“OK. I’m done with
that part. Now I’m putting your new lens
into my probe. I’ll put it near the site
and then release it. When I do it
unrolls and takes shape. It has a diameter of about 6 mm like your natural lens with arms of another 7 mm that are used to hold it in place . So in total its 13 mm.”
“And you get that thing all rolled up into a cylinder that
fits through a 2 mm incision?”
“Yep.”
“That sounds like magic.”
“I know it sounds like magic but it is actually wonderful
material and great science.”
“I forget about great science sometimes.”
“It’s easy to do that.
But in my work I see firsthand what a difference it makes.”
“OK your new lens in nicely situated. Now I’m going to rotate it to the proper
axis.”
“Is this where the dot on my eyeball comes in?”
“Yeah. Not high tech
at all but very effective.”
“OK. One more look
around. Like leaving a hotel room and
making sure you didn’t forget something.
OK we’re done. That went well Mr.
McClure. I think you’ll have a good
result.”
“Do you glue the incision shut?” I knew I didn't have a stitch the previous time.
“None needed. It’s so
small. It should close and heal nicely
on its own.”
“So that’s it?”
“Well, your careful compliance with the follow up regimen of drops is
important. But other than that I’ll see you tomorrow, and in a week, and then
my job is done. You do know to call me
if you have any kind of emergency at all, right?”
“Yes. What would that emergency be?”
“Anything you think is a problem is an emergency. Call if you have any concern but
especially in the event of pain. You
should experience little if any pain.
Perhaps some discomfort for a while after the numbing drops wear off, like a speck
of something in your eye, but nothing serious.
Just call if you have a worry. See you tomorrow in my office.”
And with that he was gone, off to take care of the next
person in the hall. Bianca wheeled me
out, gave me coffee and snacks. Another
nurse went over discharge instructions, and before you knew it I was back on
Route 80 headed home. I was there just
over an hour.
That was a week ago today.
I’m writing this now with no glasses, no correction at all. I’ve been driving in town. On Thanksgiving I drove the Buick to pick up
my son at the train station in Joliet. Hell I used to drive to Springfield and Chicago with corrected vision much worse than this. I’m
pretty confident I could pass the test at the Driver’s License place right
now. I think I’ll need a slight
correction in the end, but it’s evident that I am seeing better than I have
seen since before I was nine, and maybe ever.
I’m amazed.
Given that I will need these eyes for only twenty more years,
give or take five or so, this could be my last big fix. (Knock wood.) Even if my eyes deteriorate and my prescription
changes I’m starting at such a good place I may never need the kind of correction
I needed just four months ago.
And so this Thanksgiving I am glad to be living in these
times when such technology is available.
I’m thankful for these caring doctors:
Dr. Tim
Ortiz, Optometrist - Ortiz Eye and Hearing Center
Dr. David
Lubeck, Ophthamologist - Arbor Eye Care
And I’m thankful for the staff that support these doctors. Like many who lead or
have led organizations, they may in the end be only as good as their staff. Those two doctors are surrounded by good
people.
And while I’m at it let me express my thanks to the Alcon
company, and Leica, and all the producers of the equipment and materials that
go into these amazing new technologies and procedures that have been developed. I can and do criticize our health system for
many things: high costs and profits, lack of access, and other shortcomings, but when
I realize all it has done to enhance my life and the lives of others it shuts me up
some.
So yes I’m thankful for the insurance company and the structure
they work within. I had fallen into a
gap between my wife’s teachers insurance and Medicare. She qualified for Medicare while I did not,
and I was no longer eligible to ride along on her policy. So I took out a Blue Cross/Blue Shield policy
to get me by. Thanks to Obamacare it
covered all my preexisting conditions.
This deal cost me some, but given the outcome that cost is ridiculously
low. How do you put a value on clear sight
really?
At this time last year I was on a solo road trip to Florida
via two lane roads through Kentucky, Tennessee, and Alabama. This year, to celebrate these new eyes, I’m
going to take a similar trip, in a new used Buick with a gas gauge that works,
going further east before heading south.
I hope to catch West Virginia, North Carolina, all of Georgia, and
central Florida. The Blue Ridge
Mountains are out there somewhere as are the Appalachians. I’ll leave January 4th and blog
along the way, reporting on what I see. If
you are familiar at all with that route and have suggestions for places to visit
by all means let me know.
Trust me, I am very grateful to be able to make such a trip
again.