Monday, February 18, 2013

Personal Process Note: Cataract Surgeries

I have just completed surgeries on both of my eyes for congenital cataracts. Now that the new lenses are in, I can see better than I ever have in my life. This video is of the first surgery on my left eye. They inserted a toric lens to correct for nearsightedness and astigmatism.

I resisted the surgeon's offer of IV Valium because I wanted to be fully present during the surgeries. As an experienced meditator, I felt confident I could keep myself and Whoville calm throughout the procedure. This proved to be a challenge because I could see everything going on through the eye as it was being operated on, and I had to continually reassure Whoville that everything was fine and going as expected. I found the electronic warning beepers to be the most  alarming aspect of surgery, as they kicked in often to alert the surgeon to back off of whatever he was doing. I would recommend earphones and soft classical music as a soothing remedy to the patient hearing alarms.

I had put off cataract surgery for a couple of years as I could not decide which focal lengths to choose. These plastic intraocular lenses cannot change focus the way a natural lens can, so the patient must choose whether they want an eye to see only close, mid-range, or far. My surgeon prefers his patients to exit with no need of glasses at all, so he likes to use mid-range and far lenses, one for each eye. Then the brain is supposed to coordinate this monovision into a working facsimile of two-eyed vision. I did not like that option at all, because I am accustomed to being able to see up close for fine work and I never expected to be able to see far away without glasses, as I have worn glasses all of my life. I finally opted for my left eye to be set at mid-range, and my right eye to be close-up for fine work.

This is working out well because the close vision and mid-range vision overlap around 20", so I can use two coordinated eyes for most computer work and countertop work. Yet, if I need to see something close-up, I can focus on it clearly with the close-up lens in the right eye. The left eye's midrange vision extends from about 20" outward. Since I was born with cataracts and extreme astigmatism and near-sightedness, I have never seen across the room without glasses. Now, the left eye sees easily across the room and beyond. In fact, I can drive without glasses now. My distance vision is not 20-20, but it's tremendously better than ever, so I have no complaints. For someone who treasures distance sight, setting one eye to distance makes good sense. 

My color vision has also improved, since there were crystal deposits inside my original lenses that altered my color vision. I can now see subtle gradations of color that were previously undiscernable.

I also viewed a number of "entoptic" visual phenomena during the surgeries. Entoptic phenomena are visual images that occur within the eye or the brain, independent of normal visual channels. The most interesting thing I saw was during the period of time after the cataract was fully removed and before the new lens was inserted. The surgical light was still brightly lighting the eye. What I saw was a domed surface completely covered with tiny, tiny, iridescent spheres, all packed tightly close together. It looked like there were thousands of them, coating the inside of a dome. This was a single surface of bubbles, not like looking into a sphere of bubbles, but at a membrane of bubbles. Any thoughts as to what that may have been? Here's my attempt to render that entoptic image, but it was much more beautiful than this.