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Thanks for Sight and Prayer for a Vision

September 4, 2013

I am a south-central Manitoba boy, born and bred.  Beneath the limitless vault of an uncannily blue prairie sky, the landscape of my youth was a patchwork quilt of grain fields, pasturelands and summer fallow, stitched together between a sashing of arrow-straight section line roads reaching for the horizon in all directions, embroidered here and there with farmyards, and smoothed out upon the dead-level bed of former glacial Lake Agassiz.  But its “far as the eye can see” vastness was largely lost on me during the later years of my childhood, for I became imprisoned by the gathering fog that hid the world from me, the myopia that during much of my childhood went uncorrected. 


I know I was not always nearsighted.  To the best of my recollection, my vision began to deteriorate after I started school.   I don’t recall any difficulties in the early grades, but unbeknownst to me, I was becoming immersed in “boiling frog syndrome”, unaware of the gradual change that was taking place. I didn’t recognize I was fighting my eyes harder than anyone else just to maintain a clear picture; how I saw seemed normal to me. The deterioration progressed quickly; by the time I saw an optometrist, my vision had declined to 20/85 (6/26 in the metric equivalent), which means that what I could just make out at 20 feet someone with normal vision could see clearly at 85 feet. 


At school, I came to occupy a front row desk, yet no matter how I screwed up my eyes, I still found the writing on the blackboard as indecipherable as Anatolian hieroglyphics.  As my visual borderlands moved in on me, hemming me into a small world on a big planet,I learned to leave the narrow, cramping circumstances of my life and make the most of what was left to me.   Often retreating into solitary pursuits, I became thoughtfully occupied with the fascinating minutiae of the world, the microcosmos routinely unnoticed or ignored by most.


Sports were for the most part out of the question.  Getting hit in the face by balls I never saw coming somehow didn’t appeal to me, and having someone both “blind as a bat” and athletically inept on their team apparently had little appeal for others.  However, I had my best friend and protector, Don.  The biggest guy in the class, and consequently always one of the first picked for any team, he would insist that he and I came as a package deal.  Few cared to argue.  He figured out how to compensate for my weaknesses, especially in football, turning me into an unlikely high-scoring running back.  He would hand off the ball to me and bulldoze an opening through the defenders.  All I had to do was follow in his wake. 


When I was in Grade 6, others finally recognized the forest through the trees:  I needed glasses.  I still vividly recall stepping out of the optometrist’s office onto Winnipeg’s Graham Avenue sporting my brand-new horn rims and being startled that I could read the route signs on the buses.  I could see the details of the faces of the rivers of people passing by, their expressions.  It would indeed be possible to recognize people at a distance.  Walking into our house yard, I marvelled that, without pressing my face into the trees that had long appeared as green blobs to me, I could clearly make out individual leaves.  I soon realized I also regained a measure of independence, able to locate things without long-drawn-out groping or pleading for assistance.


I am now revisiting that experience in a way.  Over the past few years I developed cataracts, first in my right eye and then in my left. Consequently my ophthalmologist recommended cataract extraction with intraocular lens implantation, scheduling the surgery first for my right eye since it was more affected, and two weeks later on my left.  As I awaited my surgery dates, the cataracts continued to develop and my vision progressively declined.  Recently my right eye had become for all practical purposes useless.


It is necessary to understand that consenting to eye surgery was a titanic decision for me.  All my life I have had a “thing” about my eyes.  I had a grisly recurring fantasy of having a needle stuck in my eye, and it always left me in a cold sweat.  I became certain I would much more readily have my right arm amputated without anaesthetic than have someone poke around at my eyes.   Prior to my first surgery, the anaesthetist gave me something that blocked my memory; I had no awareness of anything from the time I settled into the surgery chair until it was all over.


Immediately post-surgery, I found the vision in my right eye unsettling.  Portions of my field of vision were clear, others were cloudy.  Captions on the television appeared “crumpled”.  Additionally, my pupil was almost fully dilated, resulting in sunlight sensitivity.  Gratefully, by the next morning my pupil had contracted and my vision had cleared considerably.


Stepping out onto the deck overlooking the scenic Okanagan Valley, I gloried in the magical revelation of a new world.  The landscape spilled out before me sprang to life in “retina display”, as though I had clicked “enhance”, “definition” and “sharpness” on my photo program, colours resplendent, every hue deeply saturated, a show of bravura with powerful intensity. Whites were particularly dazzling.  Detail was astonishing.  I cannot remember ever seeing with such clarity.  But perhaps it is as John Dewey wrote, “Time and memory are true artists; they remould reality nearer to the heart’s desire.”


Having only one eye corrected resulted in anisometropia, unbalanced vision. The images from each of my eyes were now very different, and my brain had great difficulty reconciling them.  Since my right eye now required no further correction for distance, wearing my glasses was contraindicated.  However, without them the distance vision in my left eye was very limited.  I could read with it, but to my right, words in print or on my computer screen were now an out-of-focus smudge.  My middle distance vision was poor, but my ophthalmologist assured me it will improve with time.  Things like shaving became a challenge; either I stood back some distance from the mirror and singled out my new-found distance vision, ignoring the blurred image from my left eye, or put my nose right up to the mirror and tuned out the murky image produced by my right eye.  But the brain is truly wondrous, and I soon became able to shift preference according to need without conscious effort.   


Although my surgeries were closely spaced, the interim was not without its aggravations.  My visual imbalance strained my eyes and brought on fatigue.  At times I was troubled by  “dead spots” in my visual field, but these disappeared as my second surgery date neared.  After dark, my uncorrected eye flared lights dramatically, and only by closing it could I prevent my vision from being almost totally obscured. 


My second surgery was from my perspective very different from the first.  I remained aware of everything that was going on, but since my eye was frozen I felt nothing whatsoever, and what I saw was merely waves of colour with no definition.  When I took the eye patch off early in the afternoon, my distance vision was fairly clear, but my middle distance vision extended out several feet and was clouded.  I am sure that it will improve greatly when the swelling in my eye goes down.  Close up vision was extremely fuzzy, but with a borrowed pair of reading glasses I was able to read and use my laptop.  My ophthalmologist told me it will be six weeks until I will be able to have my eyes assessed for reading glasses of my own.


I know the myopic world of my childhood shaped who I am.  I very early developed a love affair with books and became a voracious reader.  Unlike much of the world, I could hold them at the perfect distance from my feeble eyes to see each word clearly.  Caught up in their pages I could tune out the world I saw only through a glass darkly, and as a consequence, had trouble understanding.  Books transported me, generated new times and spaces, and gave me eyes to see them with crystal clarity.


The close-up lenses that were my eyes encouraged my imagination and nurtured my creativity.  Since I saw so little detail at a distance, I had to guess at many things.  I was forced to fill in the blanks, to create my own reality to compensate for what was indistinct to me.  Though detail of the distance was lost to me, paradoxically, close up it was all about detail.  I developed a deep appreciation of the beautifully imperfect intricacies of nature. It has been theorized that myopics might be at an advantage in this, their narrower focus of visual attention facilitating superior concentration.    


Being nearsighted presented a very debilitating social problem.  Face perception plays a pivotal role in our everyday interaction with others.  We use the rich variety of information we detect in the faces of others— identity, emotional state, personality characteristics and much more—to provide vital social context, to guide our daily activities and interactions with others. Being unable to clearly see beyond a few feet the facial features and the often-subtle facial expressions that provide cues was a serious handicap.


Even my appreciation of myself was affected.  This, I believe, can be most easily explained through an account of my experience selecting eyeglasses.  In order to get an idea of whether frames suited me, I had to move to within a very few inches of a mirror.  At that distance, however, it was difficult to ascertain what they looked like on my face.  Inevitably I had to resort to having someone else choose for me.  Consequently, my glasses sometimes reflected the taste of others more than my own frequently far-from-conventional druthers.


As I move into a world far less dependent upon facial furniture, believe it or not there are a few things I am going to miss about being nearsighted.  I have never been well adapted to this frenetic world with its sharp edges and stark realities. So it has been a luxury to me to have the option, by simply removing my “corrective” lenses, to view everything with softer eyes, to move into a more muted, dreamlike world, like the effect of bokeh—the photographic technique of defocusing the lens slightly in order to create a soft borderless aesthetic in a picture—or a later Monet.


I am so blessed to be a Canadian and have access to both cutting edge health care and the financial means to deal with medical issues; I pray I never take that for granted.  For my Haitian neighbours, things are very different.  Health problems typically mean misery and frequently result in a greatly diminished quality of life. The impact of blindness is staggering, resulting in exacerbated financial instability, restricted mobility, social isolation, and loss of social standing.  When combined with abject poverty, most die within 10 years of blindness.


Woman I visited who is blinded by cataracts


Accordingly, cataracts are a massive public health and socioeconomic problem in Haiti.  Last winter, an American optometrist who has become a close personal friend conducted a vision clinic a couple of miles from the village where I live.  Afterward he shared with me how astounded he was that virtually every person over 50 who attended the clinic had cataracts.  Without surgery these people will progress into an uncertain life of blindness, like several others I have encountered during my time in Haiti.  As I understand it, the cost of surgery is less than $25 and takes about 15 minutes.  My friend told me that a competent eye surgeon could quite easily do 25 surgeries in a day.


The hospital in my village is already set up for eye surgery, and it is my vision to have a surgeon come, even for a short time, to change the lives of some of those who live in my community.  I prayerfully await his or her arrival.

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