The Experience of Cataract Surgery

EyeDiagram

Steve Campbell February/March, 2016

You may never have thought about surgery on your eyes, and with any luck you may never have to experience this problem.  Or, you may be facing this problem and wonder about what to expect.  It sounds very serious and, with any imagination at all you can come up with some really scary possibilities.

Well, you can stop worrying after you read about my surgery.

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I vaguely remember – from my very early years – my Great Uncle Ben, who wore what we called “coke bottle bottom” glasses and was legally blind.  He came in to our house one time (yes, somebody drove him there) and he tried to hang his hat on the corner of the mirror on the wall.  I reckon he made out a vague figure of some old man trying to hang a hat there and when in Rome…

I don’t know what Ben’s ailment was, but I doubt it was cataracts, since surgery has been possible for that, actually for centuries.  I mention him because I, too was losing my vision – and at a younger age (60) than Ben.  In my case, it was cataracts.  I looked up this definition:

“Normally, the lens in the eyes are clear or transparent. However, a cataract is an abnormal clouding or opacity of the eye’s crystalline lens. The opacity can lead to a decrease in vision and possibly blindness.

Cataracts are thought to develop as a result of age-related degenerative alterations to the proteins in the lens. Smoking, diabetes and steroid use may also be contributing factors to the development of cataracts.” (1)

It started when I noticed that my eyeglass prescription was quickly becoming inadequate.  In fact, I could now see better without my glasses.  However, the stars at night were now all “doubles” and all oriented the same way.  That orientation changed when I tilted my head.  A natural reaction to double vision – closing one eye – did nothing to change this.  This is called an astigmatism and I thought that was the only problem.  I even tried the Driver’s eye test, and to my surprise, my left eye could not read, nor even tell that the numbers existed.  With the right eye and with both eyes I could clearly read.  At no point did I notice any “clouding”.

I made a visit to the eye doctor and he found that my vision had changed dramatically, especially on the left.  He also diagnosed cataracts developing in both eyes.  My father had cataracts when he was my age so, I was not surprised.  Worried yes, but not surprised.    While I had been a smoker, I quit in 1994, when my father was permanently on oxygen with chronic obstructive pulmonary syndrome, due directly to 50+ years of smoking.  Oddly, I still smoke in my dreams, but that is another story.  So, I don’t know if smoking did it, or just age, but the eye-doc referred me to a surgeon, who evaluated the left eye and scheduled surgery.

Choices

There are several ways to do this and it will be your decision how your vision changes.

First, you can opt, as I did, to have a fixed-focus lens implanted. This will give you 20/20 vision at a distance, but you will still need reading glasses.

You can have one lens set for distance and one for reading.  That will let you read without glasses, but require glasses for driving.

You can have a “multi-focal” lenses implanted, eliminating any need for corrective lenses, altogether.

I did not choose the multi-focal option.  I asked how the eye “selected” which focus to use.  As I understand it, the brain picks which focus to use.  Think of a screen on a window.  You can focus on the view out the window or the screen itself.  I am afraid it was not very convincing.  I can only afford to do this once.  I did know some people with fixed-focus lenses and they seemed quite happy with them.  The multi-focus option also costs more.

As for the near/far combination option, I figured that if I need glasses for driving, they would be prescription.  And, I would need a spare pair and sunglasses.  However, if I need glasses for reading, I can buy them at most dollar stores or get a six-pack at Sam’s for cheap.

Pre-Op

As I pointed out to the pre-op crew, everything you do in this place would make your mom yell at you!  Do I put on pajamas?  No, they just cover my street clothes with a hospital gown.  Take off my shoes to go to bed?  No, they just cover those with a couple of shower caps.  The eye is rendered numb by some eye -drops that (rather inappropriately) sting like the Dickens!  After that they roll me off to keep my eye open while they poke it with sharp things.  Mom wouldn’t like that, either.

Surgery

The surgery sounds scary at first.  They will break up my natural lens and suck it out with a small tube.  The artificial lens will then be inserted through the same incision where it will expand and anchor itself in the “pouch” where the natural lens had been.  When you add in the fact that I will be conscious and that eye will be open –  I don’t know about you – but that scared the “willies” out of me!

You may doubt me, but it is not as bad as it sounds.  The anesthesiologist served up an I.V. dose of something that made me think, “Shoot, this ain’t so scary!”.  They stain the natural lens with some dye, so all I “saw” was some shifting colors.  Once the implant lens is in place, the improvement is startlingly, impressively obvious.

The colors are suddenly brighter and more vivid.  The implant even allows a bit of the ultraviolet light that a natural lens would block.  During World War two the British used cataract patients to pass secret messages in light that was invisible to everyone else. I did some research on this and could only find a Car Talk puzzler that mentions this phenomenon. (2) I can tell you, though, that I heard this from an Astronomy professor back in the 70’s.  Also, it is mentioned somewhere in Isaac  Azimov’s vast body of work and an Astronomer named Walter Scott Houston used his new “super-vision” to observe stars that “normal” people could not see. (3)

Comparing the “good” eye to the “bad” one was something I could not stop doing.  The “clouding” of the still-cataract affected eye was now “blindingly” obvious.  The walls in the recovery room were a light brown through the right eye or pure white through left.  The Moon is dirty brown (right) or bright silvery color (left).  The gas flame on the stove is a pale, grayish blue (right) or a deep, rich blue (left).

You will need someone to drive you home.  The eye will feel “scratchy” and inflamed for a few days and you may notice the edge of the lens in your peripheral vision.  Bright lights cause some headaches and I wore dark glasses (kindly provided in my hospital “swag bag”) for weeks afterward.

They told me that once I had the worst eye fixed, I would notice how bad the other really was.  I did and it got worse, so we did the right eye about two months later.  It is a different and very distinctly visible world, now.  I really did not know what I was missing. This is one thing that has really made me quite happy in the last few months, which have tried my soul otherwise.

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