With this blog post, let me introduce a guest writer and friend, Lorraine Vail (author of From Any Window). I am privileged to have her write for Aging With Pizzazz and share an experience I have not had. Several people I know, and many I’ve heard in passing, complain of aging eyes and possible surgery. It’s pretty obvious that this is common as our eyes age – even if our spirits don’t age along with them. I hope her informative story will be one that either you commiserate with, can use for up-coming plans, or file away for future reference.
drb
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Blind as a Bat
Even before I owned my first pair of high-heeled shoes, I wore glasses. Like my mother, I was very near-sighted. The lenses were thick as coke-bottles and left a deep ridge on my nose. Years later I switched to contact lenses and proclaimed this is forever. But, in my early sixties I sadly learned that dry eyes are as common as gray hair and wrinkles. Goodbye contacts and hello new glasses. But this time around the glasses weighed next to nothing, the lenses much thinner—plastics. (Remember Mr. Robinson’s advice.) I selected snazzy purple and black frames and loved my new scholarly-chic look. Once again, I had forever.
The Eye Chart Blues
Fast-forward a few years. Noticeably, street signs had blurred and car headlights had an ever-growing halo. At the eye doctor, the little letters on screen became harder to decipher. Was it a T or a P; maybe an F? My optometrist explained my vision had significantly deteriorated because my cataracts were worsening, another condition of aging.
Enter the Ophthalmologic Surgeon
With a little prop resembling an eyeball, the surgeon explained how my natural lens would be removed and a new synthetic lens inserted to restore the lens’s transparency. After the operation, I would see clearly again, maybe better than ever! Surgery for my “non-dominant” left eye would be done first and a month later, my right eye. The break between the two surgeries ensures the corrected eye has healed sufficiently with good vision before the second surgery is performed. (This reminded me of my mother’s quip – “hope is not a strategy; better to have a plan”.)
Making a Choice
Until recently, all cataract surgeries involved the standard monofocal lens covered by Medicare. In most cases, far-vision is restored and reading glasses are needed. Now, with advancing technology, other choices are available, for a cost premium. These lenses correct both near and distant sight much like progressive eye glasses. My doctor explained that this was an option for me (not everyone is a candidate) but I opted for the standard monofocal. The choice I made was partly that I liked how I looked in glasses (still useful for reading) and partly cost.
Note from drb. I asked Lorraine about the cost issue, as we often consider finances on Aging with Pizzazz. She explained that the type of intraocular lens (IOL) that you choose influences the cost (I would add the word ‘dramatically’). She said there are two basic categories in the “premium” range. Those are Toric, which correct astigmatism; and Refractive, used to correct presbyopia. The latter is a near-sighted problem extremely common as we age. So, here is the money kicker. The additional cost of the toric type is approximately $1300/per eye. Even more, the refractive IOLs are roughly $2100-2500/eye. Remember this is an ‘additional’ charge. Thus, no matter what the surgery feels like, your pocketbook yells ‘ouch.’ For those on Medicare, realize it doesn’t pay for the superior type lens.
Eye Drops on the Menu
Successful cataract surgery requires a month of administering eye drops. I was prescribed three different medications — an antibiotic, an anti-inflammatory non-steroid, and prednisone, a steroid. They come in tiny plastic bottles with different colored tops — beige, gray, and hot-pink. The trio prevents infection, swelling, and pain. For the three days prior to surgery, I applied all three of the medications, morning, noon and night. Sometimes I felt a slight stinging sensation but it only lasted a few seconds. The drops may be expensive depending on one’s insurance plan but there are cost-reduction programs available, so do ask your doctor.
Finally, the Day of Surgery
The pre-surgery routine is quite pleasant. Approximately an hour lying under warm blankets while your pupil is dilated (you guessed it) with drops that really do sting, but only for a moment or two. Vitals are checked and the intravenous “relaxing” medication is prepared. La-la-land.
My Turn
Finally, I was wheeled to the operating room. The brochure had described the surgery as uncomplicated. I thought this to be a very nice adjective for surgery. For the mere fifteen minutes it lasted, I felt nothing, heard everything. I could not “see” the surgery, but the surgical light did create a kaleidoscope of multi-colored (lots of red and pink) images.
My husband dutifully waited the ninety minutes and drove me home. No stitches; no patch; no fuss. No dizziness or vomiting. The first day I had slightly blurred vision and eye redness, but no pain or discomfort. That night I taped on the protective eye shield which is a grid with tiny symmetrical holes. The first time I taped my hair in-place but not the shield. On my second try, the tape stretched across my nose and came loose. On the third try I applied the strips diagonally from top to bottom on both sides, and voila, it stayed in-place until morning.
Post-Op is a Breeze
I had my first appointment the morning after surgery, then again a week later, followed in a month by my final scheduled visit. My vision is a delightful 20-20; the world is brighter and the colors vivid. I still marvel at the clarity. I can actually see the crisp line of trees at the top of the mountain above our home. And, lo and behold, I can drive at night, totally free of headlight glare.
Life after-surgery has a few requirements, namely administering eye drops (uh oh, the drops again) for the next four weeks according to the chart provided. I do think my hand-eye coordination improved by month’s end.
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With 20-20 vision in one eye, my eyeglasses were obsolete. And going without glasses wasn’t impossible, but the world was definitely misaligned. Fortunately, I had kept a few packages of contact lenses and I wore one in my cataract eye until my second surgery.
The YES List
Like all medical procedures, there is the post-op To-Do list. (1) Faithfully administer eye drops on schedule. (2) Wear the eye protective eye patch when sleeping or napping. (3) Wear sunglasses in bright light.
The NO list
The No list is slightly longer, and will vary by each person’s needs and surgical outcome. My post-op Do Not Do list: (1) No strenuous activity or heavy lifting. (2) No bending, exercising or similar activities. (3) No swimming or splashing water in the eye. (4) No eye rubbing. According to my surgeon, the ‘no eye-rubbing’ is a FOREVER no-no.
The Brain Wonders?
A month after surgery, I had a dream of looking for my glasses but never knowing why I was searching, since my dream-self knew I could see perfectly without them. The dream went on and on, as dreams do, and I never found my glasses. My doctor interpreted this as my brain trying to figure out why, after all these years, I could see. (I expect a psychoanalyst might come up with something more symbolic, or exotic, but I thought it perfectly suited me.)
On A Clear Day You Can See Forever
I chose to keep my snazzy purple and black frames and ordered new lens with a progressive anti-reflective coating that also darken in the sunlight. They weigh nearly nothing and with just this one pair, I have no need for additional sunglasses or reading glasses. Another alternative for used eyeglasses is to donate them to Lions International. This organization accepts prescription and reading glasses, sunglasses and plastic or metal frames. Here’s how you can help.
I understand that my prescription may change in my later years, but while nothing is really forever, I am one grateful and happy woman full of pizzazz.
Note from drb:
So far so ‘great’ for Lorraine. As she indicated, there will be post-surgical vigilance, especially for infection. While it’s normal to have blurred vision and some swelling after surgery, your doctor will want to know promptly of certain complications that may be worrisome. These include: any unusual discharge from the eye; Increasing redness; swelling around the eye (especially if persistent); pain that is increasing or vision that is decreasing. She may also ask you to watch for changes in your vision field, floaters or flashes of light.
If I could make a toast hoping that all our experiences would be as positive as Lorraine’s, I’d raise my glass and proclaim ‘Here’s lookin’ at Ya.’
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Credit: Lorraine Vail
Lorraine Vail’s career has included teaching women’s health at the State University of New York at New Paltz, directing a project for older women returning to college, management for Xerox Corporation, and risk consulting for GE Capital. In 2012, her novel, From Any Window, was named by Amazon as one of the year’s Top 400. Lorraine retired to Ashland, Oregon in 2013, and is very active in Southern Oregon University’s Lifelong Learning Institute. Lorraine holds a BA from the State University of New York and an MBA from The Wharton School.
— Title Picture credit: cocoparisienne via Pixabay.
Lorraine’s cataract surgery outcome is the happy story I was expecting. Since I had been wearing progressive glasses for a long time and had astigmatism, I opted for the expensive toric, multi-focus lenses. It has just been 4 weeks since I got my new lens and my night-driving vision has not improved. I still see the star-burst effect around on-coming headlights, and overall my vision is only very gradually getting a little better. My doctor will say, “give it more time, the brain needs to adjust.”
We shall see, everyone’s experience is unique, but I had really wanted to see the stars at night!