In which I get the blues (a tale of miracle surgery)

I have a good excuse for not writing for a while: eye surgery in the new year, which made reading or writing of any kind difficult. Only now am I starting to get back to my old literary self.

I have worn glasses since about age six. My myopia had grown progressively worse over the decades until I settled at about -11 diopter with an astigmatism of about 3.5. Standard laser surgery was out of bounds, as my deeply distorted corneas didn’t have enough width to sculpt away. Soft lenses became unworkable, and then toric lenses in their turn, leaving gas-permeable hard lenses the only contact option. Finding these increasingly uncomfortable, I eventually surrendered to specs.

In my forties, I started losing my near vision too. I remember the precise moment I realized this: I was riding the New York subway, got a bit lost and realized I was physically unable to read the network map in my hand. Thus began the era of carting around three different eyeglass cases in my handbag, and shoving my glasses up onto my head to read my iPhone with one eye a few millimeters from the screen.

To make matters worse, for the past few years no optician has been able to give me a spectacles prescription that made far vision even remotely sharp. I finally went to Moorfield’s Eye Hospital to find out why.

The answer: early-onset cataracts.

I wasn’t actually unhappy to hear this. It was good to have a diagnosis at last, especially one with such a safe and reliable surgical method of treatment. Before this, I’d even been toying with the idea of treating myself to more intensive surgery. So this seemed like a good excuse to jump in feet first.

As is traditional, I underwent treatment one eye at a time. For approximately a minute, the surgeon blasted the cornea of my right eye with an impressive piece of kit known as a femtosecond laser. This was primarily to allow surgical access, but the computer had been programmed to bestow a bonus partial reduction in astigmatism. (“You’re a tough case,” the surgeon told me cheerfully. “I spent an entire evening with your scans.”)

Next, as my veins were flooded with opiates and sedation by a breezy anesthetist who looked like a rock star, and “Comfortably Numb” blasted into the theatre (I still don’t know if this was a joke), my natural lens was sonicated to bits and sucked away, and a brand-new perfectly powered artificial lens was deployed, probably as specialist as one of the eyepieces on our fancy microscopes back in the lab. It was all over in 20 minutes, efficient and painless.

The world of our senses is a neuronal construct, a fudge factor the brain cobbles together to keep us alert and safe. It’s not something most of us probably think about very often, if at all, until we encounter a drastic change. As I was wheeled into recovery, the difference was stark. I couldn’t see much out of the right eye yet, but everything was suddenly pure and silvery blue, bathed in an ethereal full-moon glow. In contrast, my knackered old left lens showed a dingy-yellow world that I didn’t much like the look of.

Which one was real? I had no idea, and I still don’t. The ageing lens does increasingly facilitate the yellow wavelength, but is the newborn lens crystal clear? Does my son see the same white-hot light that my right eye was seeing now, or is it a super-human enhancement courtesy of a lens that is clearer than any biological material could ever achieve? I can’t think of any objective way to measure this, as my experience can’t be coherently compared with anyone else’s.

But more revelations awaited. My surgery was in the evening, and it wasn’t until the next day that I properly appreciated the difference. A large number of things were newly blue, an effect that intensified when my second lens was swapped. Black looked dark navy, and some shades of blue were now full-on purple – including, it seemed, half of my wardrobe. Sunsets and sunrises featured lush, jaw-droppingly beautiful shades of violet and lavender; flames contained an iridescent core of indigo that I’d never seen before and is impossible to describe now.

Having done some reading, I now know that I’m lucky. Some color changes are more drastic, and can be quite distressing to patients (and life-changing, if their profession relies on color distinction, such as interior decorators). And while the blue shift turns out to be common, it sometimes comes at the expense of other shades, washing out greenery into a dull grey for example, and draining existence of beauty.

More than a month on, I still wander around in a daze, half befuddled and frustrated by my poor far and close vision, and half admiring the world’s transformation. My acuity improves week on week but I have a long way to go. It can take six months for the brain to adjust to the new input, and I have a hefty residual burden of astigmatism which may be correctable with more lasering, or toric lenses if not. Meanwhile, the temporary difference in acuity between my two eyes has led to a new problem: double vision in the distance, especially when I’m tired or have been using reading glasses (which are still essential for most close-up tasks beyond reading). I now have a grand total of four eyeglass cases in my bag – two different powers of readers for very close work and screens, unpowered lenses with a rather obtrusive prism in one eye to correct the double vision when I can’t bear it any more, and sunglasses for those rare bright days when the white light becomes overwhelming.

Yes, I’m partially disabled now, worse than before for a few months: things like working from a cookbook or assembling something from instructions have become so troublesome that my brain keeps urging me to avoid them. But equally, I feel I’ve been blessed with an astonishing miracle. I can see, without glasses, for the first time in my conscious life.

A world without glasses – I never thought I’d see the day.

About Jennifer Rohn

Scientist, novelist, rock chick
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