June 2009

Jun
16
2009

Optical illusions, part two

(If you haven’t read part one, do that first.)

So by 2007 my base prescription had climbed to -14.50 in my left eye and -18 in my right. The best possible contact lens correction gave me roughly 20/40 vision in daylight, making me just barely eligible to drive.

A few years ago I had my own ‘you mean trees have leaves?!’ moment. Jak was thinking about LASIK surgery and I was researching potential side effects, one of which is that lights gain halos and a ‘starburst’ effect. And I’m reading these descriptions and thinking … yes? So? I started grilling Jak about exactly what lights-in-the-dark look like to him, and I eventually work out that oh, once again, I’M NOT NORMAL.

I’ve never liked driving at night, because I can’t read street signs in the dark. Which means I get lost a lot. Discovering that people with vision like mine are advised never to drive at night was alarming … and a problem in Seattle, where for about six weeks in midwinter the sun sets before 4:30p. This makes commuting without transit or carpool options rather dangerous for me between October and March.

As of yesterday my left eye measured -15.75, for a 1.25 diopter change in roughly two years. My right eye … well, you know those big ‘glasses’ on a metal arm that optometrists use to test different lens powers? I learned that they top out at -19 diopters. At -19 I was seeing a vague grey tint to the fuzzy white square, not even distinct blobs for the letters.

Let me pause for a moment and give all you non-pathological-myopes a bit of context. You know that big letter E on the eye chart? Without my contacts, not only can I not read the E, I can’t even tell that there’s anything on the screen. And that’s with my ‘good’ eye, the -15 one. If -10 diopters is ‘you mean trees have leaves?’ eyesight, -19 is more like ‘trees? what trees?’

Okay, I exaggerate a little. I can figure out if there’s a tree in front of me, as long as the trunk is a different color from its surroundings. Most of what I see, unaided, is color and motion; beyond that it’s all about extrapolating from prior experience.

Anyway, the next step was to put a contact lens of a known prescription — in this case -10 diopters — into my right eye and measure from that. Sounds simple, but. It’s a soft lens, and since I am not a soft-lens-wearer, the optometrist (not the same one as two years ago, but a younger woman with an office nearer my home) planned to handle the insertion and removal herself.

I’ve been sticking my own fingers in my eyes, like I said, since I was seven years old. No problem there. But other people’s fingers trigger my PTSD. I don’t really know why; it’s not like pokes in the eye were a particular component of my childhood trauma, but somehow, on a level I cannot control, ‘foreign-controlled object approaching my eye’ gets interpreted as ‘utmost threat to my safety’ and all bets are off.

This is only the second time I’ve had someone try to put a contact lens on me. The first time was around fifteen years ago, when I was much closer to the original trauma, and the optometrist was far less gentle. That time I blacked out for some unknown number of seconds; I remember actually backing away across the room, and a lot of uncontrolled bawling.

This time I at least knew what to expect, and I threw everything I had at controlling my reaction. Which meant I managed to stay in the chair, and not strike out at the nice doctor, and emit no more tears than could perhaps be physically explained.

I could not, no matter how hard I tried, keep from flinching away every time she got to my eye. I apologized and apologized and gripped the arms of the chair and clenched my jaw and … jerked my head. And apologized some more.

When she did eventually succeed, we ran into the next snag: with the lens in, my right eye tested out at about -14 diopters. Something was amiss. So now the contact had to come out again.

Same thing but worse, because taking a lens out requires a longer period of contact (not a pun!) with my eye than putting one in. She was as patient and kind as I can imagine anyone being, but I couldn’t help my flinching. After three or four quick successive attempts I’d have to ask her to back off for a minute while I closed my eyes and breathed, trying to shove the panic back down. Then I’d brace myself while she tried again.

If I’d been less panicked I would have been mortified; I babbled a constant stream of I’m-sorries as it was. This, too, was a little too much like my younger years for comfort.

Double-checking against the naked eye confirmed that I was well over the -19 diopter mark. The doctor explained that the layer of liquid between the lens and the eyeball can alter the refraction, though she was clearly surprised by how much of a difference it made. (Earlier I had noted her Doctor of Optometry certificate, dated 2005. Based on her reaction, I’m pretty sure this was the first time she’d had someone in the chair who surpassed the limits of the available equipment.)

Unfortunately, this meant we had to get the -10 lens back in. And out again. You can perhaps imagine my dismay.

This time around I convinced her to let me try. Though soft lenses are significantly bigger than the ones I’m used to, I was able to insert it on only the second pass. Getting it out was not so easy. At the moment, the nails on my right hand are about half a centimeter long, so my attempts at pinching the lens off left me scratching my own eyeball.

Note to self: in future, trim fingernails short before optometry appointments.

Before we were done her patience was visibly thinning and I had run out of creative ways to apologize. I’ll spare you the rest of the trauma and cut to the result: My right eye is now officially off the charts. The optometrist guesses it’s in the neighborhood of -20, but it’s impossible to measure with standard instruments.

Worse is that it’s deteriorated by at least 1.5 and perhaps 2.0 diopters in two years. Disturbingly, my actual contact lens prescription is holding more or less steady, not because my eyes aren’t getting worse, but because increasing the lens power doesn’t produce noticeably better vision. Following this logically suggests that my corrected sight can only get worse from here, not better.

On the up side, the doctor reports healthy eyes otherwise. I used to take this for granted; now that I understand how much my risk factor is increased above the norm (for things like cataracts, macular degeneration, and retinal detachment), I count it a specific blessing.

My eyes and my hands are the two things I don’t know how to live without. I’ve had a long glimpse of what it’s like to lose the use of my legs; it’s harsh but I think I could adapt, given time. Deafness would be half a blessing by comparison. But I need to see, I need it for everything I am that’s worth anything at all.

I would beg someone not to take that away from me, if I thought there were anyone to ask.

Jun
15
2009

Optical illusions, part one

Today’s adventure was a trip to the optometrist. You may be tempted to snort, but trust me, it’s a great deal more harrowing than it sounds.

First, a bit of history:

I’ve known my eyes were unusually bad since I was seven years old. I got my first glasses in kindergarten, a social stigma that was seared into my five-year-old brain. I don’t remember anything in particular about the next couple of years, but the story my parents always told was that my eyes were changing too rapidly; I needed a new prescription every three months. When I was seven, the optometrist convinced my parents to put me into hard contact lenses (the original, non-permeable kind), on the theory that the rigid lens would help my eyeball hold its shape. It wouldn’t stop the development of myopia, but he said it would slow things down.

I don’t know how well this worked; I was only a kid, and not following the details closely or with much comprehension. I do know that it was always expected that my eyes would stop deteriorating when I ‘stopped growing’. I suppose that’s how it happened with my parents, and how it works with most people.

My father was extremely myopic as well, though amazingly no one caught on to this until he was in high school. (I don’t know what age exactly, but I had two old photos of him; in the senior photo he had glasses but in the sophomore photo he did not.) I remember two stories he told about getting glasses. One was how he was surprised to discover that trees had leaves, ones that people could actually see! He’d thought everyone saw the same green blobs on brown sticks that he did.

The other was about playing tennis. He was on the tennis team at his high school, and I gather he was quite good at the game. However, once he got glasses he couldn’t hit the ball for anything … because he kept being distracted by being able to actually see it. Apparently up until that point he’d been reacting based on sound alone. He had to completely retrain himself to play tennis based on sight.

My father had glasses like the proverbial coke-bottle-bottoms. He had a deep permanent groove across the bridge of his nose from years of bearing the weight of them. His eyes were large and brown, but hardly ever visible — behind their lenses they were smaller than dried pinto beans.

Now, my father’s prescription topped out at around -10 diopters, where it stayed for his entire adult life until his forties, when presbyopia dropped him back into the -9s. I passed that mark — in high school, I think, or maybe college — and kept right on going.

All the way through my twenties I kept waiting for the promised plateau, where my prescription would level out. Didn’t happen. I started to wonder if maybe there was some predetermined level of myopia I was destined to reach, and wearing hard lenses all my life had slowed down the journey without changing the destination.

I tended to only go to the optometrist on the rare occasions when I had vision insurance to pick up part of the cost. So about two years ago, when I found a new doctor, it had been something like five or six years since my last exam. I had managed to maintain the same pair of contacts for all that time, without loss or breakage (though not, as it turns out, without a large number of scratches).

I picked an office near my then-job, based on a referral from my then-boss. This optometrist was an older guy, in the business 25 or 30 years (I forget), and he’d only seen a handful of people in all that time with myopia as bad as mine. ‘Pathological’ myopia, he called it, which I thought was darkly funny. That’s me all over, you know? I can’t just be plain old myopic, I have to be pathologically myopic.

But I brought that phrase home and presented it to the Internet, and a number of things became clear. Pathological or ‘degenerative myopia’ never stops. The eyes just get longer and more out-of-whack forever — or until the strain on the whole system causes the retina to detach altogether. Boom, just like that, you’re blind.

I’m a fucking graphic designer, I make my living with my sight. You can imagine how much this news thrilled me.

Jun
11
2009

Polyblogging

What was I thinking, going from zero blogs directly to two? I never seem to have the time to do more than one significant entry per day, and even that much is not indefinitely sustainable. I am a perfectionist who edits iteratively as I write; this is not conducive to speed. If I can get a single sentence down in fewer than four rephrasings, I’m doing well.

Anyway, if I’m not here for a little while it’s probably because I’m posting over there. If I’m not here or there, I’m probably up to my eyebrows in worldbuilding research. You can still talk to me though; I’ll talk back …