Cataract Conniptions*

Dear George,

Just about everybody gets cataracts if they live long enough.  About 60% of people develop cataracts by their mid-70’s, and over 90% have them by age 85.  Dr. Winters, my opthalmologist, had been watching my eyes for a while and recommended cataract surgery on my left eye three years ago.  I thought the operation was remarkable, both technologically and because of its dramatic results.  Within a day or two the world became brighter, clear, and sharper.  In addition, the surgeon put in a special lens to correct my  astigmatism, and lines, e.g., telephone poles, doorway frames, etc., which had previously been wavy and undulating, became perfectly straight.  Needless to say, I was thrilled.  At the time Dr. Winters said that the cataract was smaller in my right eye, so there was no hurry and I should simply should tell him when I was ready.

Five or six months ago I started having trouble reading because of my uncorrected right eye.  As Dr. Winters was to explain, the cataract had become more intrusive, and, while my surgically improved left eye had been dominant previously, now my brain was getting mixed signals, with deleterious effects.  He referred me to Dr. Konstanz, the surgeon associated with his practice.  Dr. Konstanz did a pre-op assessment and explained that cataract surgery is successful about 85% of the time, but, as with all surgery, there is risk.  He also noted, as Dr. Winters had told me over the years, that my right eye had a puckered retina which could affect my vision after surgery.   I told him I was so happy with my previous results that I was very eager.  The receptionist scheduled me for a  Wednesday appointment.

Katja came along because I wouldn’t be able to drive home myself.  The whole process was like a well-oiled assembly line.  A nurse took my blood pressure and asked me a bevy of medical questions; a technician tested my eyes; the surgical nurse put an IV in the back of my hand; the anaesthesiologist introduced himself; another nurse hooked me up to the drugs (a painkiller and Versed, a sedative).  Everybody asked which eye I was having done, and the last person marked it with a black X.  Along the way, the various nurses addressed me as Dear, Sweetie, Honey, and Sweetheart.  This seemed odd but it gave me a feeling that I was truly cared for.  I was also excited to get the sedative through my IV because I was sure would make it an even more enjoyable occasion.  Then things went blank for a while.  I don’t remember Dr. Konstanz coming in, but I do remember him busy at work on my eye.  He talked about each step along the way, and I could hear the noisy grinding sounds of his instrument cutting the cataract out of the interior of my eye.  It went on for quite a while but everything was so relaxing and pleasant it didn’t bother me.  Visually, it was like a light show, with a kaleidescope of flashing red, yellow, green, and blue amorphous shapes.  Katja came in afterwards, and Dr. Konstanz said all had gone well. Katja and I went out for brunch at the First Watch to celebrate.

Dr. Winters called me at the end of the day to see how everything had gone.  He’s always called me after every appointment.  A friend says that he wants to go on a date with me, but I think he’s just unusually concerned and attentive.  I quoted Dr. Konstanz’s statement that all had gone well.  Dr. Winters said he would be out of town the next day so I would meet with his partner Dr. Greech for my 24-hour follow-up.  By the next morning it was clear to me my vision was doing poorly.  My visual field was brighter, but, when I tried to read anything, the line of print was wiggly and had a big bump in the middle which moved along the line as my eye moved.  It made reading a struggle.  Moreover, my “good” left eye was no longer dominant; my squiggly surgeried eye had taken charge.  I went in for my appointment with Dr. Greech, and, though he looked my eye over carefully, he didn’t seem very interested in discussing the problems I was having.  Since I wasn’t really his patient, I think he preferred to hand me back to Dr. Winters.  I asked Dr. Greech about going to my line dancing class in five days, and he said he suggests to his own patients that they wait two or three weeks before exerting themselves. That depressed me still further.  Back home I hoped Dr. Winters would give me a phone call, even though he was out of town, but, for the first time in history, I didn't hear from him.

My eye was less blurry after two days, but the distortion problem hadn't gotten any better.  I was having just as much trouble reading as I’d had before the surgery.  Every once in a while my good left eye would seem to become dominant and the line of print would straighten out, but that would be a momentary state of affairs.  After a week I went back for an appointment with the surgeon, Dr. Konstanz.  I explained the problem I was having with reading, and he said, “Oh nuts,” shaking his head.  He explained that it was caused by the pucker in my right eye, but that it was still too early to know how it would wind up since my retina was inflamed and my brain would be making further adjustments in coming weeks.  It would be a month before we really knew how my eye would be doing.  That gave me a ray of hope.  Like Dr. Greech, he didn’t seem to want to talk about it too much.  I asked Dr. Konstanz about going to my line dancing class that night, and, much to my surprise, he said that was fine.  I could also resume lifting weights at the fitness center and boosting heavy sheepdogs into our SUV.  All that made me feel better.

I got nervous during the more strenuous numbers in my line dancing class because I kept remember Dr. Greech’s recommendation to be cautious, but it turned out o.k.  Jack, the instructor, said he was going to put together a line dancing group to do an exhibition at a Cincinnati Reds game.  Because I’m one of only two men in the class, he looked at me and said I needed to volunteer for this.  The group would get together to practice and get special training from a choreographer in order to develop a more polished performance style than we normally do in class.  Jack said we might also perform at Octoberfest and at “endless other opportunities.”  While this fed into my social and performance anxieties, it also seemed like an excellent chance to advance my newfound career as a line dancer.  One’s vision isn’t that crucial for line dancing, though, of course, you want to see well enough to be able to dance in a straight line.

The next day something interesting happened. I worked for five hours at my office, writing on the computer, reading articles on the Internet, consulting a textbook, etc.  There wasn’t a single moment when I was aware of any visual problems at all.  They hadn’t gotten any better, but I was engrossed in what I was doing and simply forget to pay any attention to them.  I just went ahead and worked away.  That bodes well.  I’ve decided I can train my brain to make my undistorted right eye dominant by saying “Good!  Good!” to myself every time that a line of print looks straight.  If that doesn’t work, I’ll try giving myself an M&M each time.  Surely I can manuever my own brain to behave the way I want.  Three weeks till my doctor checkup.  I’m going to get it all together by then. 

Love,

Dave

*Pseudonyms used in this story

G-mail Comments

-Phyllis S-S (4-8):  -Dear Dave,   "Endless other opportunities"  - will I be asking for your autograph?  Will you be featured in People magazine?  I hope the eye continues to improve…  Phyllis