The Gift of Sight
By Gene Aronowitz
Throughout my life, I have had many medical problems, some of which have been detailed in other memoirs (“My Mind, My Body, and its Prostate,” and “Knee Replacements”) I’ve had fifteen operations in my 83 years. Six of them had to do with my eyes.
Exotropia
When I was 6 years old, in 1943, I was diagnosed with exotropia, a condition that probably started at birth. My eyes would not work together resulting in double vision. The treatment of choice in those days, at least for children, was eye exercises rather than surgery. For years I would draw my index finger up to my nose, then reverse the direction, and repeat the process, trying to see one finger rather than two, presumably strengthening the muscles. I also worked with a stereoscope, a device for looking at left-eye and right-eye views of the same scene, trying to see just one image. I hated these exercises, didn’t realize the consequences of double vision, wanted to be out with my friends and grew increasingly frustrated because I never got better at it.
From elementary school through much of college, I couldn’t read well. As a sophomore in college, I had the reading ability of a 10th grader. To avoid double vision, my brain would ignore the image from the misbehaving eye as I read. Then, fatigue caused me to shift to the other eye and I would lose my place as well as my concentration. Not being able to read, I got terrible grades, a constant source of embarrassment and irritation. My high school guidance counselor (See the memoir “Miss McDonnal”) tried to dissuade me from going to college, a shameful possibility in the Wilmington, Delaware Jewish community.
During my junior year in college, in danger of flunking out, I left school to join the Marine Corps reserves. When I returned, six months later, I had an operation to pull my eye muscles together. Then, I went to a reading clinic and improved my speed and comprehension considerably. My grades improved well enough to just barely graduate, 334th out of 404 graduating students. But then, able to read, I went on to get a master’s degree from NYU and a Ph.D. from the University of Chicago.
Exotropia reoccurred 60 years later, troubling because I knew from my past how frustrating and debilitating a failure to read effectively can be. Also, I was becoming increasingly dedicated to my writing and finding it difficult to keep focused on my computer screen. In 2018, I made plans to repeat the operation, but it had to be shelved for over a month. When I went to my primary care physician for my pre-op evaluation, the electrocardiogram looked abnormal. I was referred to a cardiologist for further evaluation. She asked me if I had any difficulty walking. “When I walk up hills of steps, I find myself panting,” I admitted. She did a stress test that was inconclusive. A repeat stress test a couple of weeks later was no better. She referred me to a pulmonologist, still unable to account for my panting.
He performed a pulmonary function test and said “Your breathing is perfect.”
“That’s good,” I replied, relieved, “but what about the panting?”
“You’re fat,” he declared and walked out of the examining room. My primary care physician read the reports, laughed when I told him what my problem really was, and proclaimed me ready for surgery.
The Macular Hole
One day, in 2012, between the two exotropia operations, everything in my field of vision turned to a pale shade of green. It was a lime green like the green that you see when you cut open a lime. That was really scary and, like Kermit might say, it was not easy seeing green. I skipped an important meeting and, without calling first, went to see my very green ophthalmologist. He immediately sent me to a well-regarded retinologist who, after taking some photographs, said, “You have a hole in the macula of your left eye. You’ll need a vitrectomy, as soon as possible.” She explained that the macula is part of the retina at the back of the eye, responsible for central vision and most of color vision. The green world around me became understandable.
My exotropia operations had dealt with the muscles around the eye, but a vitrectomy invades the eye. The thought of someone sticking an instrument in my eye was repulsive. Back then, I blinked excessively when someone simply tried to put drops in my eye. I kept thinking about poor old Gloucester, who, in King Lear, had both of his eyes gouged out. I was scared and wanted to be asleep during the operation. But only my eye was anesthetized and I was awake for the whole thing. It seemed as if I was dreaming because I was able to see little wands moving around in front of the face of my surgeon looking down at me. The operation consisted of repairing the hole in the macula and then putting a bubble into my eye, which was intended to press against the wound like a bandage. However, the macula is in the back of the eye and the bubble would float to the top unless my head was down, my face facing the floor. I had to keep my head down for seven days. In that way, the bubble would reach and remain affixed to the repaired hole.
All of the necessary equipment was assembled when I returned home from the hospital. To watch videos, I had to rent the sort of chair used to get a seated back massage with a face cushion in front and a surface below for my laptop computer, its detachable screen lying flat. I had to rent a face cushion so I could sleep on my stomach as if lying on a massage table, difficult for me since I had always slept on my side. I needed another face cushion for the kitchen table to rest my head between bites of food. I had to use straws to drink since my head had to stay down while I drank.
Walking around for a week with my head down, caused extreme neck pain which affected every other activity. I was in pain for the entire week but in retrospect, I suppose it was worth the agony. The bubble did its job. A week later, photographs of my left eye showed that the hole had been repaired.
Unfortunately, three years after the operation, I began to see green again. The retinologist told me that my macular hole had reopened, an extremely rare occurrence. I had to go through another operation and another seven days of the head-down ordeal.
Because of the residual scar tissue in my left eye, my vision is currently 20/200, my right eye being the 20. If I close my left eye or my brain ignores its images, I can see well enough to get along.
The Cataract
Between the two macular hole operations, I developed a cataract in my left eye. I was also awake for that operation. My surgeon spent most of the time talking with the nurse but suddenly, became silent and seemed more focused. He later told me that some of the cataract material had gone back into my eye. He arranged for me to have an emergency operation by a retinologist the next day, to clean it out. For a moment or two, I considered suing him but concluded quickly that shit does happen and, besides, I was OK after the cleansing, which was fully covered by Medicare.
Macular Degeneration
Since 2016, I have had wet, age-related, macular degeneration in my left eye. I’ve had a variety of treatments. The worst was getting a series of Eylea injections in my eye. Even the thought of it was terrifying and I was uncomfortable for hours after the shot. But recently, I had a laser treatment after being injected with Visudyne, a light-activated drug. To avoid serious sun damage to my skin and eyes, I rode home wearing a complete face covering and sunglasses. Once home, my wife covered all the windows, and I could not leave for a week. I’ve had two follow-up appointments so far and so far the moisture has not reappeared. Nevertheless, every time I go to see that doctor, I fear the worst, never losing sight of the specter of an injection
Glaucoma
And finally, as I finish this brief memoir and get ready for bed, I will put a drop of Latanoprost in each eye to keep a check on increasing pressure, a never-to-end treatment for glaucoma. Tomorrow morning, I will wipe the lids of both eyes with OCuSOFT Lid Scrub to remove the grit that always develops overnight.
I've been given the gift of sight, for which I’m grateful, but, given all my trouble, perhaps this was the gift-giver’s idea of a cruel joke. It's a good thing I don't believe in divine retribution, or I would wonder, as many people do, if I had done something to deserve these rather punishing afflictions. No, I don’t think I’m being punished like the ancient mariner or tested like Job, but, of course, I would like to understand why this seemingly never-ending process is happening. Perhaps I’m doing this to myself. Physical illnesses are not all biologically based, and I do believe that my mind plays some role in creating illness. Whatever the reason, I hope I’m done with it but, given my track record, I’m afraid that there may be more. However, also given my track record, I know I will continue to deal with whatever comes my way. Perhaps, someday, the reason for all this, as well as my eyesight, will become crystal clear.
