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.

4 comments:

  1. 16 Jun 2009 at 9:42 am

    That sounds just awful. I hope some intervention can be found.

  2. 16 Jun 2009 at 9:04 pm
    Lancelot

    Lady K, So Sorry. Hopefully researchers will find a way to at least stop the progression.

  3. 6 Jul 2009 at 4:06 am
    Alex

    Not a help for the myopia, but it looks like they’re having some success with macular degeneration: http://news.bbc.co.uk/1/hi/health/8135627.stm

  4. 31 Jul 2009 at 8:09 am
    Kim

    I’m sorry to hear about the icky experience :/ And about your eyes degenerating in general.

    Triggers are rough — my “I feel trapped” panic is around my face in general. I think it helps sometimes to frontload (I totally stole that phrase from you) helpful info first and let someone know about sensitivity first, and to tell them that broad/ resting-type touch near my face lets me get used to them, before I start panicking on them.

    But mostly, triggers are triggers, and it still sucks :/

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