Cataract surgery: it's what I had. And yes, my world, my seeing it for the first time, really, in a long time, has been right out of Genesis. My right eye was done on the fourteenth of December and the left on the Thursday right before Christmas--on the day of the winter solstice, as it turned out. This was less an Annie Sullivan and Helen Keller at the well kind of moment than it was an Ebenezer Scrooge at the end of A Christmas Carol scene. Being happily whiplashed into the seeing world, now able to see distance (where "distance" means anything more that a few feet away without any kind of lenses) easily has made me into a character in my first grade reader, Fun with Dick and Jane: Look, look. See Sandy look.
"I can see you," I said to my brother.
Before the surgery, without lenses of any kind, I had maybe a four inch vision range. My eyes used to be -14 or so but correctable to 20/20 with hard contacts and reading glasses. (I started with pink cat eye glasses for reading only in elementary school and things slowly progressed from there.) Vision changes as we age and I have had cataracts for some time, or so I was told. But late this summer my very slow growing cataracts were finally declared "ripe" which meant they were bad enough that health insurance would pay for the necessary surgery. This judgement meant that my sense that my driving at night was unsafe was not irrational at all. I was vindicated!
As I write this, I have 20/25 vision in my right eye. (New York state requires that drivers have only one eye--and this vision--to drive without corrective lenses.) My left eye is still healing but is well on its way to catching up with the right eye (almost). I can see laugh lines, bigger smiles. I can see farther (the snow on the top of the neighbor's Christmas wreath on their front door), and in general things look much closer and brighter. I can stand in my dark kitchen at night and see shapes and details, including my black cat Swishy. (I can see much better where the light hits her fur.) And the photos I have taken overseas over the decades? They look brighter and are going on the walls as soon as I can get them enlarged and framed.
I have a lot to look at.
Mostly because I can.
Yes, this is all very trippy.
During the week between the surgery on my right eye and on my left eye--Cyclops week which was not as bad as I imagined it would be--I could see the difference not just in vision but in color: through the eye with the cataract, yellows were more grey-yellow, dull, and whites were, well, dirty. (Think of an old biology book with the body part overlays. Think of Mary Hartmann's "waxy build up" on her floors.) Nothing was as clear and bright as things were through the new lens in my right eye.
Now with two new lenses: so this is what the world looks like. Wow.
I can now see dust and cobwebs. There is a curious architecture to the cobwebs when I put on my drugstore reading glasses to peer at them. I think of them as having been made by one of my own little Charlottes (the most benign characterization I can think of for the critters who, I assume, like Charlotte, have now moved to that Great Cobweb in the Sky). But although I can see cobwebs, I don't have to manically take them down right now. In this annual time of endings and beginnings, the cobwebs are old news. I will get to them. Newer news: the color I tried out on the living room to make an accent wall last summer now looks dingy and blah; I have already picked up paint chips and a test pot of a bright coral to replace it, a color rich and celebratory. I don't know how long it has been since I saw motes of dust in the sun coming in the front windows. And why is there schmutz at the bottom of the refrigerator door?
Vision restored.
I can see snowflakes. On the way to New Hampshire I could read billboards with a glance: "Gift wrap a torso" and "Give them a squat" for a company selling athletic clothing. "Breakdown lane open for traffic." "The shortest distance between two people is a story." Christmas lights were brighter. I turned on the television for the first time in a long time. Yes, I could see it. (And then I turned it off.) I may not be able to see detail as calico Moonbeam comes in for a nose touch (without my wearing reading glasses, that is), but her caramel, white and black colors are vivid.
The new lenses that replace my corneas are less than a quarter of an inch in diameter. Unlike glasses, they don't fog up. They don't require soaking or cleaning solutions although I will be putting in eye drops several times a day until my eyes are completely healed. I will not lose them down the drain as I am washing them. Although I no longer have to take my contacts or glasses off before I go to sleep--a nice fuzzy departure to the day--I do have to wear eye patches at night for a few more weeks to protect my eyes. Just in case.
And the surgeries were paid for by health insurance except for a total of $600 for better-than-basic lenses for my -14 eyes. (Abbot -1 in the right eye, -1.5 in the left. The lenses have barcodes for identification.) I agreed to the surgery in August although the soonest it could be scheduled was December.
It turns out cornea surgery is one of the most common procedures in the world, and I had about three months between the decision and the procedures to consult Dr. Google: half of Americans have cataracts by the time they are eighty. NOVA has a two minute video under "Gross Science" called "Ancient Cataract." Monet had cataracts. Mary Cassatt and James Joyce had successful cataract surgery. Less successful was the surgery on JS Bach (he went blind and died four months later). Early treatment included basically pushing the cornea into the vitreous part of the eye ("couching"); doing this got the cloudy lens out of the field of vision but didn't do much else. The first artificial intraocular lens in the US was in 1951, and phacoemulsification (breaking up the lens and taking it out) started circa 1967. Howard Ridley, a British ophthalmologist, noticed during World War II that shattered windshield fragments in the eyes of fighter pilots did not always lead to infection. Still, old timey US cataract surgery involved incisions, stitches and time in bed with your head between sandbags. (My dissertation director sat through my defense a few days after cataract surgery and with a felt eye patch under his glasses. At the time, he was much younger than I am now. He did once tell me that in general the more ways you have to see things, the better off you are.) Why is it called "cataract"? Because it was thought--correctly--to be opaque, like a waterfall.
I had no big incision, just drugs that made me happily loopy, a slightly scratchy eye for a couple days, and no pain. The surgeon's work itself took maybe ten minutes per eye. I have started for the moment to shut up about the medical-industrial complex, but I can still rant about the prices Big Pharma charges. When I thanked the ophthalmologist who did the surgery, he was modest, marveling with me at the move from -14 to 20/25 but also giving most of the credit to the technology: "It's amazing what you can do these days."
Recently in the New York Times Jane Brody discussed cataract surgery changing peoples' lives. Certainly I am not going to start running marathons, but I am looking forward to getting back into the pool in a few months after the risk of infection passes. I do find myself eating better, more vegetables: I mean, carrots, as in "Have you ever seen a rabbit wearing glasses?"
And there is still the matter of depth perception. I am still learning how far away the coffee cup is. How quickly or slowly I need to downshift to stop at the stoplight. If the walls and trees and people all seem significantly closer, they also seem more brilliant, vibrant, alive--even if they are inanimate. And these days it seems ungrateful to close my eyes on a world I can finally see. I look around just to see what I can see. In the supermarket the lights seemed to have been brightened just because I had arrived. Fruits and vegetables were beautiful.
My naps are shorter and fewer. I've always been a slow driver, and I have to be careful not to slow down even more because I am looking around.
Cataract surgery is one of the best things I have ever done.
I didn't realize that the second eye was scheduled on the winter solstice until the day of the surgery. This is the season of light, after all, and I am pretty sure I have been staring and gawking even more than I know. I have not been hopping around the room singing "Raindrops on roses and whiskers on kittens" but I am taking less for granted than I used to: Colors. Size. Close and far. Detail. Angle. Light. Dark.
I don't want to say "The world is charged with the grandeur of God" as Gerard Manley Hopkins wrote, but maybe something secular along those lines. Richard Wilbur wrote, "Love calls us to the things of this world," but these days the things of this world call me to the world.
I can see.
Not that any promises come with my new improved vision. We can all be hit by a bus tomorrow. But I marvel at the world: so this is what it is like to wake up every morning and see the world without lenses and wetting solutions, without fog. I had forgotten.
Christmas lights are crisp and sharp. "Have yourself a merry little Christmas, " the song goes. "From now on our troubles will be far away." "Through the years we'll always be together" is followed by the most chilling words of any Christmas song, after all: "If the Fates allow."
I can see stop signs from afar. Faces. Comparatively speaking, the world seems nearby. And the shadows, both early in the morning and in the late afternoon, are more vivid and dramatic than they were, say, on December 13, the day before the first surgery.
Although I can't see around corners to see what comes next, I can now see colors and shapes, lights and darks and seemingly infinite shades. My ophthalmologist assures me the world as I see it now has always been here--I just haven't been able to see it for a while.
I'll settle for that.
A new year, a new world.
Copyright Sandra Engel
January 2018
