Saturday, March 22, 2014

No Rain to be Gone, but I CAN See Clearly

I played Little League when I was a kid.  Just one season.  I wasn’t ver good.  I could field, but I was an atrocious hitter.  I went the the entire season without getting a single hit.  The closest I got to getting on base was once, after swinging and missing on a strike three pitch, the catcher dropped the ball.  I didn’t realize he’d dropped it until a couple moments later and started to run to first, but he caught me and tagged me out.  
It was few months after the end of the baseball season a teacher at school noticed me squinting at the blackboard from the first row and suggested that I be taken to an eye doctor.  
Eventually, in High School, it was determined that I had an eye condition called keratoconus.  The most common thing my eye doctors have told me over the years is that my cornea, the clear part of the eye that sits over the lens, is shaped like a football.  The way I describe it to people is to imagine a circus tent, with poles supporting the curving shape of the tent overhead.  The poles in my eyes, along the edges of the cornea, are broken and sagging, causing the middle section to stand out like a cone.  
What this has meant for me has been a new pair of glasses every year.  My prescription can change wildly from year to year as my cornea changes shape.  I also have a degree of far-sightedness but my keratoconus is so bad that it turns it into near-sightedness.  I tried contact lenses in the past, both hard and soft, but fell out of using them.  The hard lenses cut the surface of my particularly soft cornea, and the soft lenses conformed to my cornea’s misshape and did little to help me. 
Years passed.  I found my current eye doctor through the insurance I had at work at the time.  He took special care to monitor and track the changes in my cornea’s shape and state of my keratoconus.  In December he told me that my keratoconus was progressing to the point where he was losing the ability to correct it with eyeglasses.  
Huh.  Ok.  I remember thinking to myself, after hearing him say that, “And...  So...  How long before I can’t see well enough to drive to work?”  
My eye doctor has been giving me the names of specialists who treat keratoconus that I’ve been going to see.  They’ve talked to me about the different treatment options that are now available.  
One of them is something called “Intacts.”  As the name suggests, they are something like contacts that are inserted into one’s eyes.  Little rings of special plastic material that support the edges of the cornea to keep them from sagging.  A brace for my sagging tent poles.  
Another treatment is call “cross-linking.”  This is where they grow new support material within the cornea by bathing the eye with riboflavin, vitamin B2, and dousing the eye with ultraviolet light.  
When I was told about cross-linking, I thought back to the scene in the movie, Star Trek: The Wrath of Khan, when Bones brings Kirk his birthday gift, a pair of reading glasses.  
“For most patients of your age, I usually prescribe Retlax Five.”
“But I’m allergic to Retlax.”  
“Exactly.  Happy Birthday.” 
I wish they had invented Retlax already.   
The problem with these treatments as they apply to me is timing.  Which is another way of saying that at my age, they only have a fifty-fifty chance of working and, in the case of cross-linking, is not covered by insurance because it is so experimental.  
One of the specialists, though, is a Dr. Silver in Sherman Oaks.  He makes contact lenses for people with keratoconus.  “I don’t even know how to use the equipment he has,” my regular doctor told me when giving him my name.  
Going to see Dr. Silver, I was skeptical.  I had tried contacts before.  The soft lenses were no better than glasses because they would conform to the shape of my distorted eye.  The hard lenses did better, but I had trouble working with them.  But I wanted a chance to correct my vision and even though I knew it was going to be very expensive and most of it not covered by insurance, I went.
We’re talking about one’s sight.  When it’s something like that, you go.  
Dr. Silver mapped my eyes with his high tech equipment, he explained what he was going to do.  It was going to take about three months to fit me with the right type of lenses.  I was going to keep coming back, every two weeks, until they got it right.  The lenses would cost about a thousand dollars.  Five hundred for the visit and the measuring.  Another five hundred for the lenses themselves, two-fifty each.  
I took a deep breath and nodded.  I think I might have said, “Ok.”  
“Let’s try something...”   Dr. Silver probably sensed my hesitation inducing skepticism.  He left the office and came back a few minutes later with what he called a “test lens.”  It was not powered, it had none of my prescription added to it.  He wanted to put it into my left eye and give it a try.  
I’d worn contacts before.  I remembered the procedure.  He put it in for me.  He congratulated me on taking it so well.  He told me to keep my eyes closed for a minute or so and then open them.  He’d be back a few minutes after that.  
I did as instructed.  I think I even counted to a hundred and twenty to make it an official two minutes.  Then I opened my eyes.  
When I was a young kid, after that disastrous first and only Little League season, and first fitted with glasses, my mom asked me, “Are you crying?”  
“No, no...”  The eye doctor answered for me.  “That can happen when you get your first pair of glasses.  The eyes can water because of the extra light they are taking in.”  
The doctor was covering for me.  I WAS crying.  I was crying because I could SEE!  I could see the pictures on his wall.  I could read the lettering on his diploma.  The world had transformed itself into a muddy, soup of objects bleeding into one another, which I thought how everyone perceived it, into crisp and clean, individualized things!  For for the first, I saw my mom as she actually looked, not some blurred version from an impressionist’s dream. 
When I opened my left eye in Dr. Silver’s office, I remembered that moment.  Because, for the first time since then, I could see clearly from that eye.  I could read the chart on the wall across the room.  The bottom-fucking-line!  It was incredible.  
The doctor explained, when I asked him how this lens made me see so much more clearly than other contacts I had tried, he said that his lenses are cut on a 3D lathe that etch these tiny structures into the inside surface that allow them to match with the sagging parts of my eye, compensating for the distortion.  The hard lens will help push my eye back into a more normal shape.  Eventually I will have to get a new prescription for my eyeglasses, to wear when I take my contacts out, because the shape of my eye will change.  
I tell people about this and they say things like, “Wow...”  or “That’s incredible...” or “You look weird without your glasses.  I don’t like it.”
Well, get used to it.  That’s what I’m trying to do.  I’m aware of them all the time.  My vision is twisted around.  I can see better with my left eye now than I can with my right, I FEEL that when I turn around to look at something.  And, while I’m getting adjusted to my contacts, my reading vision is worse.  Dr. Silver tells me it should adjust itself by the time we’re done fitting me with my final set, but if it doesn’t, then he can tweak the contacts to make one of them stronger for reading vision and the other for far vision.  My brain will combine the images as needed.  Until then, I’ve purchased a set of non-prescription reading glasses to wear while I’m doing things like writing this blog entry.  
I’m told I have to be patient.  It will take a while.  But, as the nurse commented when I popped the lens in and out as part of my training, “You’re strongly motivated for this, huh?”  
Yes, I am.  Whenever I feel my eyes getting tired, or irritated by having something there my brain wants me to pluck out, I close my right eye, take off the reading glasses, and look out and SEE.  That motivates me to stick with.  
Wow...  This apartment REALLY does need straightening up.  Hadn’t noticed before...


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