[Part I, which dealt with my iridotomies about fifteen or so years ago, can be found here.]
When I left off my story in Part I, about fifteen or so years ago, I’d recently had two iridotomies. The one in the left eye was unusually large and let in extra light, although I got fairly used to it over time. But every now and then I’ve sometimes had eye technicians or eye doctors exclaim on seeing it, “Wow, that’s an incredibly large iridotomy!”
Then about seven years ago I was told I had the faint beginnings of cataracts in both eyes. It wasn’t a problem yet, except that when I looked at the moon at night the image was somewhat doubled. Same with glowing numbers in the dark, such as on my clock-radio. Nothing much to get excited or disturbed about, though.
Then a little later, one day when I’d been to the eye doctor for my annual checkup and come home, I looked in the mirror with my eyes dilated and saw an odd thing about the pupil in my left eye: about a quarter of the pupil’s circumference hadn’t dilated along with the rest. My left pupil looked like someone had taken a noticeable bite out of the circle.
How odd, I thought. That had never happened before. But the eye doctor, who must have seen it, hadn’t mentioned it to me as a cause for concern, so I pretty much forgot about it.
Then one day about four years ago I was in a store dressing room trying on some clothes and suddenly I saw something that looked like a lightning bolt in the outer periphery of my right eye. It kept happening, particularly when I turned my head to the right, and I quickly realized I might be having an eye emergency called a retinal detachment.
My regular eye doctor had retired two years earlier and I hadn’t been to an eye doctor for those two years, but I called the office and they set me up with someone else who had impeccable academic credentials. She saw me pronto, that day, and assured me that it wasn’t a retinal detachment I was experiencing but merely something called a posterior vitreous detachment, quite common in older people and usually innocuous except for an increase in floaters and those lightening flashes for a while.
While there I was asked to read the eye chart before my eyes were dilated. With my right eye I could see as well as ever, which was pretty darn well. But when I closed my right eye and looked with only my left eye, I discovered that I could barely read the top letter on the eye chart. Everything below that first line looked like Chinese characters, and very blurry ones at that.
I was so shocked that I almost fell over. My mouth went dry and my hands went cold. What on earth had happened to me? And I was almost as shocked and upset that I hadn’t even noticed it until that moment; apparently the vision in my right eye had grown almost totally dominant over the left. I managed to tell the eye doctor that in the last two years my left eye had apparently gone from almost 20/20 vision to being almost unable to read the eye chart, and I hadn’t even realized it. Why had that happened? How had that happened? When had that happened?
The doctor didn’t seem to know and what’s more she didn’t seem to care. I asked whether it could have been from my cataract, but she was adamant that my cataract wasn’t bad enough to account for it. Then I asked her another question: what about that area of my pupil that didn’t dilate along with the rest of the pupil? What was that all about? No one had ever explained it.
“Oh, you just have some scar tissue there,” she answered. This was profoundly disturbing to me as well. Scar tissue? How on earth did I get scar tissue? “You must have had some inflammation at some point in the past,” she answered. When I asked how I could have had inflammation serious enough to cause scar tissue and not even realize it, she shrugged again. Our session was over.
I made a mental note to find an eye doctor who was more interested in these things than she seemed to be. The posterior vitreous detachment in my right eye seemed to resolve uneventfully, though, and then about a year later I found myself in another eye doctor’s office for my checkup. This time I was told that the cataract in my left eye was indeed bad enough to have caused my precipitous vision loss. But about the scar tissue no one had a clue. Must have been some inflammation, but for no seeming reason and outside of my awareness, which made no sense to me. But no one seemed to think that the scar tissue represented any particular problem.
By this time I knew I had to have cataract surgery, probably in both eyes. The vision in my right eye had become worse by this time as well, although nowhere near as bad as in my left. I thought maybe I’d have the surgery in the spring, but then COVID hit and elective surgery was out of the question. Meanwhile, both eyes got worse and couldn’t be corrected much if at all with eyeglasses. I started having more trouble driving, reading street or traffic signs, finding things in the supermarket, and even some difficulty on the computer although my near vision continued to be rather good in my left eye, which was so much worse at distance vision than my right. The only plus – if you can call it that – was that the halos around street lights were very beautiful, like enormous crystalline snowflake patterns made of hundreds of tiny diamond shapes, with each of the tiny diamond shapes having borders in the form of tiny rainbows.
Because of COVID I waited until the summer of 2021 and then went to the best cataract surgeon in my local area. He did a workup and said that sure, he’d do my cataract surgery. But my case would be more difficult than the typical one because of the scar tissue.
No eye doctor had ever mentioned this as a potential problem before; they’d all acted as though the scar tissue was a small and unimportant feature of my left eye. But this doctor was saying that the adhesions I had that were stopping the pupil in my left eye from fully dilating – adhesions which are called posterior synechiae – meant that my lens in that eye was somewhat stuck to my iris. And it’s the lens the surgeon must remove when cataract surgery is performed.
I asked him whether this scar tissue was from my iridotomy (I had looked online and read that scar tissue was more common in people who had previously had iridotomies). He said no, certainly not.
“Your cataract removal will take a little longer than usual,” he told me. “And your recovery will take longer, too.” Again, I felt an increase in fear.
I asked him whether he had seen this sort of thing in patients before. “Oh, sure,” he said. I asked him how often. “One or two times a year,” he answered.
One or two a year didn’t sound like very often to me. This condition was obviously not very common, and at that moment I resolved to go to Mass Eye and Ear in Boston, one of the most famous and highly respected eye hospitals in the country, for a second opinion and surgery there.
Unfortunately – partly because of backup from all the postponed surgery because of COVID – I had to wait six months for that appointment, which was this past January. The appointment was with a doctor there who specialized in complex cataract surgery rather than run-of-the-mill situations. I had great confidence that he would tell me that he was experienced at this sort of thing and that despite the difficulties of my case he had full confidence that my surgery would be successful.
When the day of my appointment at Mass Eye and Ear came, my workup with technician after technician was long. But I felt that at last I’d come to the right place. Then in came the doctor – actually, two of them. They examined me briefly and then spent some time softly discussing my case right in front of me, although not yet addressing me. Something in their tones made me feel uneasy, although I couldn’t understand exactly what they were saying.
Then my doctor turned to me and said, “Your case is a very difficult one and your surgery will be very hard to do. There’s a very good chance it won’t succeed.”
This was not what I had expected to hear and certainly not what I wanted to hear. I felt suddenly sick to my stomach as well as shaky.
[To be continued in Part III…]