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Chronically Upbeat

Operating to Save an Eye

Eye surgery brings one truth into focus: Keep your expectations in check

An unusual feeling of anticipation danced through me as I was wheeled into the operating room a few weeks ago. I was in an upbeat mood. "Here we go again" had become "This has to help."

Optic neuritis, a vicious condition caused by my long-standing multiple sclerosis, had taken away pieces of my vision over three decades, leaving black holes. A thousand microscopic blind spots that once were filled with light and color and the texture of what lay before me were now just empty spaces.

But there was something else now: a fog shrouding what I could see, an aura blanketing all that was visible. Each day was like making my way through a blizzard. No longer could I read a newspaper, a book, a menu, anything.

"You need to have those cataracts removed," my neuro-ophthalmologist announced after his last examination. These were steroid-induced cataracts, a consequence of decades of using powerful drugs to counteract the inflammation brought on by my MS flare-ups.  My right eye was too far gone and not worth treating. Vision in my left eye might be improved.

Cataracts hit nearly 22 million Americans age 40 and older. By age 80, more than half of all Americans will have cataracts. Some argue that much cataract surgery is unnecessary. For me the procedure was a necessity. My ability to function productively hung in the balance.

"We are not anesthetizing you heavily," the ophthalmologist explained. "I want you to be responsive." I had never heard so many alien sounds, whirring and hissing. That must be the laser, I figured. "We are going to shine an obnoxious bright light in your eye. Just bear with me," the doc had told me earlier. True to his word, he filled my eye with a light that could have illuminated a runway.

There was no pain, only pushing and pressure that made the procedure uncomfortable. "Tell me if you’re going to move," I was warned. I lay so still, they might have figured I passed on to another dimension. "We’re getting close," I was told. "I just need to put a few sutures in your new lens." A needle in my eye? Now wait a minute, I shouted in my head.  But even that needle and thread were not too bad.

There has been too much surgery in my life, all grim. This one wasn’t grim, but it was surreal. I realized how much trust I was putting in one person. Vision is precious.  Mine certainly was in a precarious place, even before the surgery. My vulnerability became acceptable when I reassured myself that I felt good about this doctor. All we can go on are our best instincts. The stranger the procedure, the more we feel out of control — as if we’re ever in charge in an OR.

I know myself well enough to realize that when I’m desperate for an outcome, I’m ready to go with my gut. I liked the guy. The hospital was great. Right there, I was in a new place. Still, trust does not come easily for me when it comes to doctors. I liked that he marked the left side of my forehead above the eyebrow with an X that could be read at 50 paces. At least I sensed my leg would not come off.

The operation failed to produce the desired result. But a month of steroid eyedrops did help, and I regained some vision. Still, it's a bitter pill — but it never was a sure thing to begin with. Long ago, I had stopped believing any new drug or procedure would help me when it came to multiple sclerosis. Nothing ever has. I just don’t ever want to look back and regret not trying everything I could.

I broke that rule this time around and allowed myself to think — really to hope — that the cataract laser surgery would be different. I really did believe my vision would improve. Optimism never has been my strong suit. A progressive, degenerative disease will knock that right out of you. I have learned my lesson. My mental health is protected when I keep expectations in check.

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