Two years ago, my eyes tested at 20/"light perception." It means that standing 20 feet from a standard eye chart, I couldn't see the chart, not even the big E, but I'd be able to tell if a light were shone at me.
Now, after undergoing excimer laser surgery for nearsightedness and astigmatism, I can go about most of my daily activities, even driving, without glasses, although I now wear reading glasses for close work.I'm actually slightly over-corrected, making me farsighted for the first time in my life - a vast improvement over "light perception." While a little shy of perfection, it still seems like a miracle to me.
I had great difficulty wearing contact lenses, and gave up wearing them except on rare occasions. My glasses were heavy, Coke-bottle affairs, except for the last pair, whose special high-index lenses set me back a bundle and still weren't very thin.
I had heard about radial keratotomy, an operation in which eight slits are cut into the cornea in order to flatten it and reduce nearsightedness, but I couldn't imagine letting someone actually cut my eye. When I read a newspaper story about excimer laser surgery, the procedure just seemed more appropriate, maybe safer.
Several years ago when I investigated, I found that excimer laser surgery was in the final phase of Food and Drug Administration testing. The University of Utah ophthalmology department didn't expect to perform it until the surgery received FDA approval. (See accompanying story.)
I resigned myself to years of waiting. But then my mother, who lives in New Jersey, mentioned an advertisement in my hometown newspaper for the laser surgery. I asked her to get me more information, so she went to a seminar at the New Jersey Eye Center in Bergenfield, taking my nearsighted brother Jack with her.
They were impressed with the presentation by Dr. Joseph Dello Russo. They discovered that the surgery can be done now, provided patients meet certain FDA requirements. Jack was tested and qualified, having the surgery on his left eye in March 1992. He tested 20/20 a month later.
By then I was getting anxious to get my own eyes done.
I flew to New Jersey in April and underwent an extensive exam at the eye center. I was deemed qualified for treatment as a therapeutic case under the FDA protocol. "Therapeutic" cases are those in which the patient has a large difference in the vision between the two eyes.
The day of the surgery, I checked into the center and was given a Valium to keep me calm. Numbing drops were dripped into my eye every few minutes while I waited for my turn in the laser room.
I was brought into the room and told to lie down with my face under the laser. My right eye taped open, Dello Russo scraped away the protective membrane covering the cornea - I imagined a squeegee squeaking across a window.
Donna Wallum, an ophthalmologic assistant, held my hand and told me what seemed about a hundred times to keep focusing on the red light above me. After each "zap" of the laser, the light seemed to swell from about a quarter-inch wide to about the size of a half dollar. I kept on trying to focus on it.
In about five minutes it was over and Dello Russo was telling me I had done all the work and it was so hard, wasn't it? "Yeah," I agreed, and then realized what I was saying. "No, it wasn't!"
With the eye now taped shut tightly, I was brought back to the waiting room.
All the patients were given painkillers and a sleeping pill before leaving the center and we each took a painkiller right after the surgery.
I followed my brother's recommendation and did exactly as I was told. Jack had tried to be macho after his surgery by not taking strong painkillers; he described the result as stumbling around his room in the middle of the night "with an eyeball on fire."
The eye center recommends avoiding reading, watching television or anything that causes the eye to move for a few days. In fact, patients are encouraged to sleep as much as possible for the first 24 hours after the surgery.
That seemed like a good idea, though the pain interfered with sleeping the first day. The second day was mostly boring: I spent a lot of time sitting around, trying not to move my eye. (Patients are now allowed to take home the numbing drops, which dramatically lessen the pain after surgery.)
Several days after the operation I returned to the eye center for my initial exam. I had a bad scare when the eye patch came off - I could see the surrounding hallway, yet there seemed to be a dark blob in the middle of it.
It turned out that the patch had mashed my eyelashes down in front of my eye, causing the blob. I kept trying to bend the lashes back out, but they remained stubbornly in the way.
They didn't interfere with the exam, though. Dello Russo pronounced my vision 20/50. I was quite relieved.
Since then my right eye has progressed to 20/40 (legal for driving without glasses in Utah), and I have had the left eye done as well, with even better results.