Posts Tagged 'Cataract surgery'

Drops and Pokes

If my eyes were formerly feeling lonely, I have now moderated that condition by letting a horde of strangers in white coats peer into them, flood them with all manner of drops, and poke them as though one were testing the ripeness of an avocado.

In previous episodes, I chronicled the events that precipitated these invasive activities and eventually concluded with my optometrist, Dr. Brockman, announcing that I was now “ripe”, a euphemism that conveyed his conclusion that I was primed for cataract surgery.

Live long enough and you too will experience at least one, and probably two, such surgeries.

In addition to cataracts, I am keeping glaucoma at bay. Once a rampant blindness provocateur, it’s controllable with multiple medications dropped into the eyes one or more times a day. Untreated, glaucoma will damage the optic nerve leading to loss of vision. The malady is precipitated by abnormally high pressure in the eye, called ocular hypertension, that inflates your eyeball like a balloon and squeezes the life out of your optic nerve.

Squeezing drops into my eyes is a hit or miss activity that normally results in much of the liquid dripping down my cheek. I have tried different approaches including tilting my head way back to where it almost touches my butt, experimenting with the distance between the dropper and my eye, and soliciting Jackie’s assistance. Employing Nurse Jackie is the most reliable method, but she often is preoccupied; lately she is focused on watching all 356 episodes of Grey’s Anatomy.

Theories abound as to the causes of glaucoma. Some folks recommend avoiding headstands; however, I have learned that eye pressure is independent of blood pressure. Other soothsayers blame bananas, coffee, and banging your head against the wall (my mother did a lot of that and did not suffer from glaucoma.)

Most eye practitioners put the entire blame on our parents for passing on the dreaded ballooning gene. Thank goodness for that; at least I can continue standing on my head.

Easily discernable symptoms of glaucoma are generally absent. Eye pressure is measured with numbing drops placed onto the eye, and then a tap or two on your eyeball transmits a pressure reading to the observer. I consider myself an expert in evaluating the skills of those who tap on my eyeballs, having been subjected to the process by optometrists, ophthalmologists and retina specialists.

Almost anyone in the doctor’s office, from a board-certified physician (whatever that is) to the newly hired receptionist is apparently authorized to attack your eyeball with a vengeance. Additionally, I have found that occupational status has little to do with the efficiency and comfort attendant to the process. The receptionist in my ophthalmologist’s office gave me the best balloon job I’ve ever had.

Completing the trifecta of eye afflictions is macular degeneration. Like cataracts and glaucoma, the disease runs rampant through my family. My earliest recollection of it begins with my father’s mother who, like my parents, was a Lithuanian refugee. Skinny, just short of five feet, and wearing a sheitel (head covering used by orthodox Jewish women), she moved like a specter through her kitchen, never uttering a sound. Perhaps I was too young to remember but I’d swear she was a mute. Her eyes glistened in a way that made her appear sightless. All in all, I was too frightened of her to ask.

Macular degeneration results in severely blurred or a complete loss of vision in the center of the field of vision. Peripheral vision remains, so that you can spot someone creeping up on you (unless glaucoma is part of the daily double.) Seeing faces, driving, eating and other daily activities are featured challenges in most Mission Impossible movies.

My father, Morris, had macular degeneration. One of my embedded memories is of him sitting sideways on a folding chair in front of the TV, watching a White Sox game out of the corner of his right eye. Glaucoma complicated the process of defining the images and required that the players on the TV screen move very slowly so he could tell what was going on. Baseball easily filled this requirement; watching the Bulls or the Blackhawks was out of the question.

Irv, my brother, suffered from all the aforementioned maladies and, like Mr. Magoo, tended to bump into stationary objects. As I have begun to do, he walked very tentatively in darkened areas, sticking his toe out well ahead of the rest of his body to feel for objects that might be on a collision course.

My cataract surgery was relatively uneventful except for the complete loss of vision in my left eye. My hysteria abated over the next 48 hours as my AWOL sight gradually returned. However, lack of significant improvement in my visual acuity over the next week or two resulted in a follow-up trip to the surgeon. Further drops, pokes and machine games resulted in a highly sophisticated diagnosis of “Looks good to me.” And a referral to a retina specialist.

The retina maven resided in the largest office of the three specialties (who knew that the retina could be so important). I dutifully filled out several reams of forms that asked for everything but my preferred coitus position. I was then interviewed by a young lady who seemed on the verge of asking that question, but I was put at ease when she only asked for my bank account and social security numbers.

The anticipated drops and pokes were accompanied by the largest array of eye testing devices I had seen in any office. One of the devices looked much like the evil storm trooper featured in a Star Wars movie. A human sized, white rectangular device, I half expected Darth Vader’s breathy voice to emerge from it.

My face was squashed into the front of the trooper and my head positioned in ways that were not intended by our Creator. The technician, obviously dissatisfied with my eyelid, lifted and jerked it in order to get really good photos, ones that would no doubt be one day found on a list of Facebook Favorites.

Finished with the activities that were intended to offend my eyes, I was escorted to a nice room that could, in a pinch, be called a home away from home. Several impressive computer screens lined the shelf in front of me displaying the photos taken by the storm trooper.

The door opened slowly and I half-expected to see Darth Vader. Instead, I met the Marx brothers. The first, using his given name, introduced himself as Damien the ophthalmologist and leader of the band. The second, Susan, was apparently the only one who could make the computer screens come to life. The third, who reminded me of my grandmother who could not speak, was introduced as Roberta, the medical student. It almost seemed like an episode of Grey’s Anatomy, without the blood.

Damien was a slap-happy sort who seemed to enjoy giving me bad news. He did, however, display good judgment by starting with the good news. He gleefully announced that my being 81 put me in the pediatric section of his practice; most of his other clients had survived the sinking of the Titanic.

He went on. “You’ve got a lot of macular degeneration. Not enough to be concerned about…yet. And there’s a bunch of other stuff that you won’t understand so I’ll not get into it. Go home, eat olive oil, nuts, fish, and the other things that Italians like…but maybe not so much pasta and watch how much wine you slug down. And maybe take those pills you’ve been taking for the last two years; they’re probably good for you. Ok, we’re done. Come back in six or eight months. Oh, and happy almost birthday.”

I split the difference with the receptionist and made an appointment seven months later. I exited the building with dilated pupils the size of basketballs. Jackie drove up and I plopped down in the passenger seat. “How’d it go?” she asked.

“Not bad, same old drops and pokes. But at least I met the Marx brothers.”

The Eyes Have It

I had cataract surgery on my right eye a few years ago. It was a relatively uncomplicated procedure that didn’t hurt, wasn’t life threatening and, I think, improved my vision.

Cataracts have been around since ancient times, ever since humans began to live longer than their prehistoric ancestors. It’s a disease that afflicts at least half the population by the age of 80. If you have good genes and live to 95, one hundred percent of you will be victims.

Cataract disease causes the lens of the eye to cloud over; eventually you will think you’re in a London fog. If you’ve never been to London, think of driving your car down Highway 99 in the Central Valley through a Tule fog, same thing.

Factors, in addition to aging, that affect the formation of a cataract include diabetes, smoking, obesity, high blood pressure and, sadly, unbridled alcohol consumption. Injuries, like having your spouse fist you out, can also speed the formation of a cataract.

The outpatient procedure is pretty straight forward; under a local anesthetic, the ophthalmologist surgically removes the clouded lens and replaces it with a nice plastic one from Ben Franklin. The best thing about the procedure is that you can watch the doctor stick you in the eye while a glorious light show is playing in your brain. Anxiety reducing Valium pills are an added treat.

Cataract replacement, like LASIK surgery, can also improve your vision and eliminate the need for glasses. I am often reminded of the late comedian, Dick Shawn, who self-billed himself as The Second Greatest Entertainer in the Whole Wide World. His old standup comedy routine included the following prediction, “Ya know, pretty soon you won’t need glasses; they’ll just grind your eyeballs.” I thought he was just being funny, but maybe not.

Eye problems run amok in my family. Glaucoma and macular degeneration are like visiting relatives who don’t know when to go home. Accordingly, I visit my optometrist, Doctor Brockman, every three months to see what else we need to do to protect me from their onslaught. He often delivers a line that would have fit quite nicely into Dick Shawn’s routine, “My job is to keep your eyes working until you die.”

My latest visit to Doctor B included the compulsory reading of the ubiquitous eye chart. I always wear my glasses when reading the chart since we long ago determined that trying without them is a waste of time. Recognizing the inanity of it, I also gave up trying to memorize the lines on the chart; now I only do that when I visit the DMV.

Doctor B has prepared me for the eventual need for cataract surgery.  It was no surprise when I couldn’t find the eye chart, much less read it, that he said, “It’s time.”

Given a choice of ophthalmologists and noting the surprising absence of any Jewish names, I lofted a dart at the presumed location of the eye chart and selected Doctor Shabatien. I guessed that he or his ancestors probably came from the Middle East near Israel, a hotbed of Jewish doctors. Close enough.

Doctor S was very busy and, as I was in no hurry to have my eye sliced, booked an appointment for an evaluation four weeks out. I figured I could just use my right eye in the interim, enlarge the Netflix movie captions, ask Jackie to read the small print on my meds, and have her to guide me through the darkness of the hallway leading to my bed…a place of refuge where eyes are superfluous.

The day of my evaluation came and we scurried to Doctor S’s in Ventura, arriving 20 minutes early. Jackie and I share the same annoying habit of arriving everywhere ahead of time. I’ve tried being late to no avail; the best I’ve ever done is 12 minutes ahead of schedule. I often arrive a day early just to avoid the traffic.

I was promptly escorted to one of Doctor S’s exam rooms. His assistant, Rita, was pleasant and efficient. She began with the dreaded eye chart; I became ecstatic when I actually saw it on the wall in front of me. Reading it was another kettle of fish; I might as well have been blind, a condition that I might have acquired on the elevator to Doctor B’s office.

Rita tried to coax enough vision from either of my eyes to avoid declaring the operation a failure and labeling me as untreatable. Squinting and silent prayer eventually produced enough vision that allowed me to identify two of the four characters on the fourth line of the chart. Rita congratulated me on my perseverance and gave me a cookie.

Other tests were performed; I had no idea why nor how I scored. It seems that Rita was capable enough to perform the tests but was not permitted to discuss the results. As this prohibition was hopefully not life threatening, I did not press it and lamely decided to wait for Doctor S to arrive and give me the bad news.

Rita applied eye dilating drops and then left me to pursue other adventures. I sat in the rigid exam chair designed by Barcalounger rejects and visualized what the world would look like when I ventured outdoors. With pupils as big as Ford F-250 hubcaps, light is unimpeded, and you feel like you have Superman’s x-ray vision.

Time passed and Rita returned. “I’m really sorry but the doctor is going to be late. He went to his Lancaster office by mistake. He’s on his way here, maybe an hour and a half. Would you like to stay, come back later or maybe reschedule for another day?”

I thought about the other times I’d waited for doctors. But never because they went to the wrong office. I thought about his honesty in saying that he just screwed up. No emergency, no my dog ate my schedule, no traffic was a bitch. So, I decided to stick around and think of him as just being a little tardy. And I got a free cup of coffee.


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