From Cloudy to Clear

No, "cloudy to clear" doesn't refer to a change in the weather. In 2007 Dr. Liu told me that the lens capsule inside the eye tends to become cloudy after cataract surgery, at which time a simple laser procedure could be done right in the office to clear things up. When I asked him when the cloudiness would be likely to appear, he told me it would probably happen in a year or so. Two years went by, and I thought maybe I would be one of those lucky people whose lens capsules stay clear forever. Probably the clouding was something that just happened to "old" people, not to a young 51-year-old like me.

A few weeks ago I began to notice a distinct lack of clarity in my right eye. When I closed my left eye, everything looked blurry. Uh-oh. I went online and Googled "lens capsule clouding" and "lens capsulotomy." I found out that clouding of the lens capsule happens to almost everyone who has cataract surgery, and it usually happens more quickly in younger people. (Hmm, maybe I'm not as young as I thought. It took two years for my right capsule to cloud up, and the left one is still fine.) One website compared it to "looking through wax paper instead of Saran Wrap." Yes, that was an apt description of what I was going through. Thanks to the wonders of YouTube, I was able to view a video of an eyeball undergoing the procedure. Zap, zap, zap, and you're done. It didn't seem too bad, but I was still nervous.

In a lens capsulotomy, the eye surgeon uses a laser to open up a hole in the back of the lens capsule. There's no need to remove the capsule altogether--just open a window and you're fine. The clouding can't come back if there's nothing for it to stick to. I called Omaha Eye & Laser to make an appointment. Dr. Liu was on vacation, so I had to wait a few weeks to come in for a checkup. The exam revealed what I already knew--it was time for a lens capsulotomy in my right eye. "They do those on Mondays," the appointment scheduler told me. I took the last available opening on Monday, June 15 at 12:45 p.m.

On the appointed day, I showed up a few minutes early. A staff member put a hospital bracelet on my arm, even though the procedure requires no anesthesia. That spooked me a little bit. Did they think I was going to pass out? How bad was this going to be?

I sat in the waiting room pretending to be calm until my name was called. Then I walked back into the surgery area, where Dr. Liu was waiting. He greeted me and asked if I had any questions. Just a couple: "Will I feel anything?" No. "Will I notice any differences besides better vision?" More floaters, but they usually settle down in time.

The actual procedure reminded me of a glaucoma test: sit down, put your chin in the chin rest and press your forehead up against the forehead thingie. An assistant put some gel into my right eye and inserted a special contact lens to keep the lid open during the procedure. (You don't want to blink when the doctor is shooting laser beams into your eye.)

Was I nervous? Yes. I had to swallow a few times, and each time my head moved up a tiny bit. It's hard to swallow when your chin is pressed into a chin rest. I tried to make sure each swallow occurred between the laser pulses. Dr. Liu politely inquired if I was okay, and I said, simply, "Yes." (Scared shitless, but otherwise fine, Doc.)

There was no pain, and the procedure took only a few minutes. Dr. Liu told me to expect some cloudiness for a few hours, after which my vision would be clear. I was instructed to put a drop of Acular in my right eye four times a day for the next week, then come in for a follow-up exam. Acular is a special eye drop for people who have gone through laser eye surgery. The retail price of the medicine is $143, but thanks to my husband's insurance we paid only $29. I don't know how much the procedure cost, but Tom's insurance covered part of it. We had to pay a deductible of $500.

A few hours after the procedure I was marveling at the improved clarity of my vision. Wow! I had forgotten how good the distance vision had been in my right eye. The lens clouding had happened so gradually that I had accommodated to it without really noticing.

When will the left eye decide to cloud up? Who knows. When it does, I will be a lot less nervous.

New hairstyle?

It happened again yesterday. Someone who had met me before my eye surgery complimented me on my new hairstyle. I used to wear my hair chin-length, and I got a shorter style about a year before my eye surgery. I've been wearing my hair the same way for almost three years, so this is not a recent change.

I think casual acquaintances recognize that something is different about me, but they don't know what it is. Instead of noticing what's NOT there (glasses) they notice my hair. At any rate, the comments have all been positive!

Seeing and being seen in new ways

Switching from glasses to contact lenses at age 18 made me feel more attractive, more approachable and less "bookish." It gave me the little added boost of self-confidence I needed as a brand-new college student. I wore contacts until I was about 40, but the last few years were rough. My eyes would get red and irritated more quickly (the optometrist said I had "thin tears"), and I grew tired of the process of cleaning and storing the lenses after each wearing. When we adopted Philip in 1998 I gave up on contact lenses because I was too busy to deal with them and I decided they were no longer worth the effort. Appearance became less important than taking care of the needs of my family, including all the demands of a newborn baby.

When Philip was 4 or 5 years old I tried wearing disposable contact lenses, but they irritated my eyes almost as much as the gas-permeable lenses and were more expensive. I resigned myself to the fact that I would have to wear glasses "forever." I never felt attractive in glasses, and there were incidents that confirmed these feelings. For example, in January 2007 I was writing an article for B2B Quarterly and made a phone call to a person I had spoken with at a local event. At first she couldn't remember who I was, and then she said, "Oh--you were the one with the glasses." Ugh. It didn't help that she was a willowy, attractive blonde. I hated the fact that my glasses were the only thing she could remember about me.

Then in the spring of 2007 I was interviewing Dr. James Liu for an article in Women's Edition and I learned about refractive lensectomy. Finally, a way to get rid of glasses AND contacts forever! The cost seemed prohibitive, but my husband Tom was supportive. Finally I decided to "go for it" as a celebration of a new stage in my life.

On April 12 I will be 50, and it will be almost a year since the first surgery. Was it worth the expense? YES! I love the freedom of not wearing glasses or contacts, and I feel more confident when talking with new people in situations like networking events. Now there is no barrier between me and the world.

"You looked weird, Mom!"

When I first told my younger son Philip (age 8) that I was going to have eye surgery so I would no longer need to wear glasses, he protested that he didn't want me to look different. He wanted me to stay exactly the way I was.

More than four months have passed since I stopped wearing glasses. About a week ago we were watching part of a videotaped TV interview in which my husband and I talked about transracial adoption. The interview was taped in November. Philip saw me on the videotape and commented in surprise, "You looked weird, Mom!" Today I look normal to him without glasses. It feels "normal" to me, too, and I love it!

Aging, etc.

In some ways, clear lensectomy is like turning back the clock (or calendar). Unlike most people my age (including those who have had LASIK), I don't need to use reading glasses. It's as if I'm getting away with something! I also love the fact that I will never need to have cataract surgery. Been there, done that--albeit a few years early.

I went to Billings Photography on Saturday to get an updated business photo sans glasses. I will post it as soon as I have the JPG.

A New "Normal"

I'm amazed at how quickly it has become "normal" for me to be independent of glasses or contact lenses. I have almost--but not quite--begun to take my new freedom for granted.

Another source of amazement is how "invisible" the change has been when it comes to people outside my immediate family. No one has said, "Hey! How come you're not wearing glasses anymore?" But when you think about it, I probably wouldn't notice the same kind of change in anyone outside MY immediate family. I haven't become a raving beauty overnight. I look like myself, only better (in my opinion!).

My biggest worry is retinal detachment. I've had vitreous floaters for most of my life, but now they seem more ominous. Being a defensive pessimist, I need to have something to fixate on!

Janet

Zones and Focal Points

My new bionic lenses operate differently from natural lenses. Each lens has five different focusing zones, and the lenses in the two eyes are different. My brain is adjusting to this new way of focusing. Distance vision is easy; I don't have to do anything special to see faraway objects with crystal clear sharpness. The lens in my right eye seems to be especially good with distance vision. If I'm driving and I close first one eye and then the other, I can see a difference between the two. I'm certain that my distance vision with the right eye is better than 20/20. It reminds me of when I got my first pair of contact lenses at age 18, except that these lenses are a lot more comfortable and require no maintenance except for eye drops 4X daily as my eyes are healing from the surgery. I'll be done putting drops in my left eye on May 17 and my right eye on May 31.

For near vision, the two eyes have different focal points. The lens in the right eye was implanted only four days ago, and the two eyes haven't yet figured out how to work as a team with maximum efficiency. If I close one eye and then the other, and if I hold a page of text at varying distances from my face, small type will be sharp and clear with the left eye at one distance (about 10 inches) and with the right eye at a different distance (say, 12 inches). I also notice that I have to wait a bit for the text to come into focus. It's blurry at first and then clear if I'm holding the text at the right distance. For intermediate-range work (looking at my computer monitor), the left eye is a little better because it's had more practice over the past couple of weeks. The right eye is still a rookie!