I began wearing glasses for nearsightedness at age eight or nine – I was the classic kid who couldn’t read the blackboard, back when children were not as routinely tested for vision problems. My vision got continually worse over my lifetime; I was accustomed to needing new glasses every year. At least my near vision was okay – until I hit middle age when, like everyone else, I also began to lose the ability to focus close up (presbyopia). Around 2008 I began wearing progressive trifocals, which gave me clear vision at a range of distances. It was never perfect correction – I had trouble reading street signs while driving, for example.
I had long been under observation and treatment for high pressure in my eyes, to make sure that this didn’t develop into glaucoma. For many years this was controllable with eyedrops, but after a while any given formula tends to stop working. My ophthalmologist tried me on several different kinds over ten years, but my choices are limited by a severe allergy to one whole family of these drugs – I spent about a month wanting to rip my eyeballs out to stop the pain and itching before we figured that out.
I twice had laser surgery in both eyes to relieve the pressure, but this was not expected to be a definitive treatment. After that, I was not able to get an eye pressure check due to rampaging COVID in California. So I kept using the drops and hoping for the best.
In parallel with all this, another problem was developing. By late 2019, I was having a hard time seeing at night, to the point that I did not want to drive because car headlights were so glary that I couldn’t judge distances at all. Then going into stores became torment: the strong overhead lights caused instant headaches, and I couldn’t focus to read ingredients on packages. My eye doctor told me that this was all caused by cataracts, but I was probably too young (58) for a US health insurer to be willing to pay for cataract surgery. When I did reach operable age, I could combine cataract surgery with a longer-term solution to the eye pressure as well. But I’d have to wait, with increasingly deteriorating vision.
For most of 2020, this seemed like a moot point as I wasn’t going into any stores, nor were we driving much of anywhere.
Before we left the US for Australia in December, I stocked up on my usual medications, knowing it might take a while to sort out healthcare in a new place and system. But I missed refilling one of my two prescriptions for eye drops, so I ran out of those around February. Since I was now only using half of my prescribed medication for glaucoma, I figured I’d better keep an eye (ha ha) on my eye pressure. In March, I picked a local optometrist and paid him up front since I had not yet got my Australian Medicare (public health care for all) sorted.
My concerns were well-founded: my eye pressure was up, though not yet in a danger zone. My cataracts were also now bad enough that, in Australia, I was definitely a candidate for cataract surgery, and could at the same time have stents put in to relieve the eye pressure. The optometrist recommended a surgeon, but I wouldn’t be able to see him for nearly two months. We didn’t expect this delay to be a problem, as my eyes seemed to be stable or at least deteriorating only slowly.
Then my vision went very bad very suddenly. I could no longer focus at any distance with my current glasses. The optometrist thought it might be because my vision had for years been corrected under the influence of the glaucoma drops, which tend to slightly dilate the eyes, and now after two months off the drops my eyes had reverted to their natural, unmedicated state, and the correction was no longer sufficient. Whatever the reason, I was miserable. Lunar eclipse? Wasted on me – I could only see a blur (except through Brendan’s telescope, bless him). While out on my own in Sydney one evening after dark, I felt very vulnerable because I could not read the street signs to navigate my way back to the train station. A completely new pair of bifocals might have helped, but they’re expensive, and with cataract surgery everything about my vision would soon change anyway.
After a few weeks I had an emergency pair of single-vision glasses made to enable me to focus on the screen so I could work, but they didn’t help at any greater distance. The cataract in my (weaker) left eye had grown intrusive enough that I constantly felt like I had something in front of my eye – which, effectively, I did.
I finally saw the surgeon in May. His staff put me through the standard eye tests, but also some new tests and machines I’d never seen before. One test was to determine which eye is dominant. Everyone has a dominant eye, and mine is the right – not surprising, because my left eye has always been significantly weaker. They also used a machine to measure the depth of my eyeball – this was needed to have the correct lenses made to insert into my eyes.
Surgery was scheduled for June 10th and June 24th, right eye then left. These dates were closer together than cataracts typically get done, but my vision was so bad that the interim between the two eyes getting fixed was likely to be difficult for me. The interval waiting for the first surgery wasn’t great, either. Even with the reading glasses, I was sometimes still getting headaches trying to focus on the screen for long (ie, do my job).
Meanwhile, I wasn’t sure how payment was going to work out between Medicare (I’d finally gotten enrolled) and the “gap” health insurance provided by my employer. The insurance company told me it was up to the doctor, the doctor’s finance person told me they typically give those discounts only to retired people. But I could afford it either way – in Australia the gull cost of the procedures on both eyes ended up costing me less than $10,000 in total, including the day surgery center and the anaesthetist, along with parts (lenses and stents) and labor (surgeon). I’m pretty sure the billed costs for all this would have been a lot higher in the US.
The anaesthetist’s office called a couple of days before the first surgery to tell me how things would go and to collect my portion of the anaesthetist’s fee ($183). The day before the surgery I spoke with the surgery center; they told me I was scheduled for 11am and needed to fast from midnight the night before. The evening before, the anaesthetist called me to introduce himself and make sure that I understood the fasting instructions. Yes, I did – so I had a big dinner the night before!
The next morning I was lazing in bed, trying not to think about how badly I wanted coffee, when I had a call from the surgery center: there had been a cancellation, could I show up an hour earlier? No problem, the place is only a ten-minute drive from our home. Brendan dropped me off – they did not want him hanging around waiting for me, but would call to inform him when it was time to pick me up.
Everything went without a hitch. I woke up in a recovery room, gratefully devoured a sandwich and milky tea, and sat around waiting for the post-op visit from the surgeon. In the minutes between him unbandaging the eye and putting on a new bandage and plastic eye cover, I realized something had changed in my vision – through my freshly-operated left eye, the sky outside the windows was bluer than I had seen in years. My right eye still perceived the sky with a dingy yellowish tone.
Two weeks later the other eye was done. A few weeks (or was it months?) after that my vision had settled enough in both eyes to get new prescription glasses. I no longer actually need them – my distance vision is 20/20 for the the first time in over 50 years. I do need them for reading. Because I’m accustomed to wearing glasses and Brendan likes me wearing them, I have stuck with my continuous vision lenses and still wear glasses all day.
My vision has stabilized to the point that I’m no longer changing prescriptions every year. Even after I had glaucoma surgery on my left eye last year, once my eye had recovered from the surgery I still did not need a new prescription. (Did I mention that my eye surgeon is wonderful?)
