Lasers, Lenses, and You

A few months ago, I made an appointment with a local ophthalmologist because my eyesight was getting progressively worse in my left eye.  I already wear contacts for farsightedness and lean heavily on reading glasses, but it was starting to get bad.  How bad? Even when wearing my contacts, if I covered my right eye all I saw was a big cloud right in the middle of my vision where objects should be, with random spots hovering about.  I was essentially staring directly into my own anus.

When I showed up for the appointment, there were about twenty people in the waiting room, old and young, all sad-looking, with several random people standing around clogging up the halls and doorways. 

Nope.  I immediately turned around and walked out.  I went home. 

Incredibly, my eyesight did not improve on its own.  So a few weeks later, I made a new appointment with a different ophthalmologist in my neighborhood.  The first doctor came highly recommended, but in my mind this was still just an eye exam. No big deal. My new criteria were simple: pick a doctor whose office was within walking distance from my house and was less popular than the first place I went.  The office I found was situated in a brownstone in my neighborhood, but they seemed to have a bunch of machines and the wait was short. This was a win in my book. 

The doctor completed his examination and said the reason I was having trouble seeing was that I had a cataract in my left eye. “Do you want us to remove it?” he asked. I found it odd that this was presented as a question.  Didn’t he just hear me make up a bunch of random letters when trying to read the eye chart?

He told me what removing a cataract entailed.  It is an outpatient procedure where they cut open your eye and take out the lens—which sounds like not a big deal until you realize it’s not really a lens like we think of a lens, but part of your eyeball—and then replace that lens with a new synthetic lens.  The surgery is short and the risk of a complication is two percent.  Does that mean he did 50 surgeries and fucked up once? 

He asked whether I wanted them to cut it out with a knife or use a laser, the first and only time in my life I was presented with those options.  What do you think, Doc?  “Well, insurance doesn’t cover the laser part, so if we do that, it’ll cost about $1,000 out of pocket.”  Is laser better?  “Well, I prefer using the laser, but the risk of complication is the same.  It’s really your choice.”  I interpreted this to mean that he preferred having that $1,000. Nonetheless, despite providing no information, the doctor had successfully up-sold the laser.  I figured they were just better than knives.  My surgery was scheduled in two weeks.

There was only one person I knew who ever had cataract surgery—my 83-year-old father-in-law, whom we all know as Pappou (Grandpa, in Greek).  I asked him how it went.  He said it was incredibly easy, short, and it worked. “In and out,” he kept saying.  In fact, it worked so well the first time, he did it a few weeks later in his other eye.  Did he even have a cataract in the other eye?  I didn’t ask. Since I couldn’t have my elderly father-in-law out there seeing better than me, and if he went through it not once, but twice, I figured, how bad could it be?  I was all in.    

The Uber dropped me off at the surgery center right on time.  When you hear the words “surgery center,” what image comes to mind?  Is it inside a hospital?  A free-standing professional clinic?  What about the second floor of a building in Bensonhurst, Brooklyn with a Dunkin Donuts on the first floor?  That was when I had my first second thought. 

As I stepped into the elevator to take me up one flight, I began to take stock of my situation.  Even though Pappou said I would be “in and out,” he had used a different doctor.  I’m only 50 years old and I rely heavily on my eyesight for my livelihood, and I was about to trust my eye to someone whose only qualification was that he opened an office with machines two blocks from where I live.  In a few minutes, this person would be wielding the most high-tech menacing machine of them all—the laser—over my naked eye.   

In direct contrast to the madhouse of the first doctor’s office, there was no wait here at the “surgery center.”  In fact, there was not a wasted second from this moment forward, and it all happened so fast, it’s still mostly a blur.  The nurse took me into a side room, put booties on my feet, a net over my hair, and a mask over my mouth.  She took my belongings and put them in a locker.  I powered off my phone and watched it fade to darkness, a foreboding ritual.  Would I ever see it again? Would I ever see anything again?

I walked into a large open room where there were ten leather chairs lined up on either side.  There were already five other patients occupying five of the chairs, all of whom were much older than me, each older than the next.  In addition to the patients, there were a dozen medical professionals shuffling from patient to patient, station to station.  I was directed to a seat where a male nurse put no fewer than ten different eye drops in my eye.  He was asking me my entire medical history since birth, but since there were twenty people in my immediate vicinity, I just lied, figuring the only thing that was relevant was my name and that I was there for the left eye.

It worked. He covered my right eye with a piece of plastic then taped it to my head.  He said something to the effect of, “that’s so no one bothers your right eye.”  I felt both relieved and mortified at the same time.  What made them institute this practice in the first place?

The nurse took my blood pressure and said “Hmm, it’s a little high.”  I told him that’s probably because of the laser in the other room.

Next, an old Russian doctor came up to me and introduced himself as the anesthesiologist.  He also asked me for my medical history.  This time I provided a bit more information, just in case, but not everything.  Everyone kept asking me whether I had anything to eat or drink that day, and I kept telling everyone “no,” even though all I could think of was the glass of water I mistakenly drank that morning because I was thirsty.  He had a thick Russian accent, which reminded me of Father Igor, the old priest who baptized me as a baby.  It seemed like it was all coming full circle.  Was this new Father Igor going to read me my last rights?   

The anesthesiologist seemed to be providing a lot of important information and instructions, but I didn’t understand a lick of it.  In addition to the accent, my hearing is terrible, he was wearing a mask, and there was constant beeping and people running around all over.  I decided to ask one and only one follow-up question.  “Did you say TO look directly into the light or to NOT look directly into the light?”  “To,” he said.   

The anesthesiologist walked away to my right.  The nurse came back and put another ten drops into my eye.  Across the room there were two sturdy female nurses talking to each other loudly in Russian.  From the tone, they were not talking about eyes.  Another patient on a gurney was wheeled next to them and stopped.  The nurses got up and helped this man, who had to be at least 120 years old, off the gurney and into another leather chair.  It struck me that somewhere nearby there was a 120-year-old eyeball lens sitting in a wastepaper basket.  It was a good run.

The anesthesiologist then reappeared from behind me on the left.  How did he get there?  He poked an I.V. into my hand and provided me with more detailed information and instructions about the upcoming process.  None of them made me feel better.  First, you will be awake during the procedure.  This is just to calm you.  Two, don’t fall asleep.  Three, if you are going to cough, tell the doctor.  I reflexively coughed.  This is how humans work.  You would think a doctor would have known that.    

He disappeared to my right once again and the male nurse reappeared on my left.  The nurse said it was time.  He wrote something down on a piece of tape and literally taped it to my forehead.  What did it say?  I have no idea.  No doubt another high-tech safeguard to prevent catastrophe.  I assume it said “Do not euthanize.”

I walked into the next room where there were already two patients on gurneys lined up ahead of me.  I got onto the third one and lay down. Were they going to roll us down a water slide?  They put a pillow under my legs and hooked me up to a machine, presumably to deliver the anesthesia that was going to calm me down while they zapped my eyeball. 

An entirely new person then wheeled me through several hallways and rooms.  All I could see was the institutional lighting whizzing by.  Then they stopped under a giant apparatus, which one could only assume was the laser I had prepaid for the day before by reading my credit card number over the phone. 

A new man came into the room and introduced himself to me as my ophthalmologist.  I guess this was the doctor who was lucky enough to open his office two blocks from my house, but he was wearing a surgical mask, so I didn’t recognize him. I hoped he was my doctor, anyway.  He positioned the machine over my face and an intense light shined into my eye.  Was I supposed to look at it or not look at it?  I tried to remember.  I was sure at that moment that my lies and omissions and lack of diligence were all about to come home to roost.  After a millisecond of panic, the I.V. started working.

I don’t remember any of the actual procedure.  Probably because I was sleeping, or assume I was.  But I do remember the doctor saying, “Good job.  We’re just going to vacuum up some of this stuff in your eye and we’ll be done.”  I really don’t like the word “vacuum” and the word “eye” being used in the same sentence.  

They wheeled me back into the main room.  It felt so good to be back.  The two Russian nurses helped me off the gurney, which I now understood to be their designated job on this creepily efficient medical assembly line.  I sat in the leather chair designated for the survivors, most recently occupied by that 120-year-old marvel of nature.  I sat around for fifteen minutes while I got my bearings, then called an Uber to take me home.  One of the nurses escorted me outside and into the car, presumably to make sure I didn’t try to drive home myself with one eye bandaged, no depth perception, and still half-drugged.  For liability reasons, no doubt.

It was 11:15 a.m., a mere hour and 15 minutes after I signed in.  That’s only 75 minutes in Disney World. I woke up that morning with the two eye lenses I was born with, but walked out with one, plus a new fake one that I hope lasts a long time. How long? I should have asked that question.

I was sent home with a giant bulbous bandage over my left eye, which seems excessive considering I paid extra for the precision laser surgery.  They probably used a similar bandage when the Mongols poured lead into the eyes of their enemies.  This explains the ghastly looks I got from strangers as I walked the two blocks to my follow-up appointment the next day.  “I wonder who fucked that guy up.”

At the ophthalmologist’s office, they finally took off the bandage.  I blinked a few times.  I could tell immediately that I was no longer trapped in the cloud of the anus.  I could see faces, not feces.  My high spirits were short-lived, however, when the nurse handed me a pair of plastic amber glasses, which looked like something Bono would wear if he was an 80-year-old cross-dresser.  I laughed, until she said I had to “wear these whenever you go outside for the next month.”  Come again?  I have to wear these for a month?  This seemed like a bait and switch.

I sat in the chair studying the glasses.  Even though I was alone, I couldn’t bring myself to try them on in public, lest I completely and forever lose all self-respect.  They also gave me a plastic eye shield to wear at night.  Again, for a month.  It was just a triangular piece of plastic.  Next to it was a roll of tape.  These eye doctors love taping things to the face.

Eventually the doctor walked into the room.  He did quick scan and said the surgery went well and that my vision would be close to perfect in that eye in just a few weeks.  Fun fact: cataract surgery not only removes the cataract, but literally corrects the vision in that eye.  He asked me whether I had any questions.

I looked at the plastic glasses and said, “Um, yeah, I do have one.”

“You can wear any sunglasses you want.  It’s fine.”

I smiled and exhaled.  Pappou was right.  In and out.

I can’t wait to do the other eye one day.