intimations on mortality...

I wear contacts, and about a month ago, when two lenses unexpectedly and inexplicably tore within a day of first using them, I realized I was down to my last pair. As it’s been a little over 2 years since my last eye exam, I knew that 1-800-Contacts was not going to send me any more lenses without a new prescription. Earlier this year I’d tried to make an appointment with the optometrist who’s examined my eyes regularly since I first needed reading glasses, about 15 years ago, but I gave up going back to her when, in response to my requesting that the office schedule enough time for me to be fitted with two different types of lenses, as they’ve done previously, I was told I’d have to make two separate appointments. This is the same office that overcharged me a couple of years ago when Chris was still on my insurance and both he and I had eye exams within a week of each other. At the time, I thought I was paying too much, but the receptionist insisted that was what I owed, so I didn’t argue. I learned I’d been overcharged over a year later, when I went in for another eye exam, and a different receptionist cheerfully told me I had a $150+ credit on my account. I like the doc, but she's open until 6:00 one night a week, and between the poor bookeeping and that, given her hours, the new policy of requiring two separate appointments to be fitted with two different types of lenses meant I’d have to take two afternoons off work or telecommute for two days to have an eye exam and be fitted for contacts, I decided it was time to find a new doc. My oldest brother has glaucoma, and one of my sisters has a serious eye disorder in one eye, so I decided to see an ophthalmologist instead of an optometrist. Looking through providers on my insurance plan, I found a board-certified ophthalmologist with real extended hours (Saturdays!) and an office a couple of miles from my house. I went to see her this week.

I didn’t like her staff any better than the staff in the optometrist’s office. After a long wait, I had a brief vision test with my contacts in place, then I removed them and we repeated the test, after which a twenty-something asked me to follow her through the maze of the waiting room to a long, narrow room in the back of the office. The room was like a narrow bowling alley, lined with chairs on either side, half of which were occupied by patients avidly watching Court TV, which was blasting from a television set at the end of the room. “Sit there,” the twenty-something said, indicating a chair next to a rather elaborate machine, “and tilt your head back!” She came toward me with a bottle of drops. I knew she was going to put them in my eyes, but I couldn’t resist asking, “What are those?” “Numbing drops,” she said, sounding incredibly bored as she squeezed them into my eyes. Uh-huh. They stung like crazy for a moment before they worked their magic. She then proceeded to clean the tip of a wand-like instrument that appeared to have a needle at the end of it…at least that’s what it looked like to me, because without my contacts in, although I can see across a room just fine, everything up close is a blur…and I was rather alarmed when she brought this needle-like object toward my eyes. “Don’t move,” she commanded. Ha! No danger of my moving with that thing directly in front of my eyes. One eye at a time, she touched it to both my eyes and/or eyelids, with everything numb and unable to focus, I couldn’t tell which. To my relief, it didn’t hurt. “What does that do?” I asked, when she was done. “It measures your pressure,” she said. After that, she dilated my eyes and I sat with all the other patients, watching Court TV and waiting to be examined.

Eventually, it was my turn, and I went into yet another room where I met the ophthalmologist. In spite of the wait and the impersonal attitude of her staff, I liked the doc immediately. She introduced herself using her name rather than her title, and was very matter of fact and down to earth. She examined my right eye first, and then, as she examined my left eye with the ophthalmoscope, she asked how long since my last eye exam (a little over 2 years), whether my eyes were dilated then (yes). She said, “Your left optic nerve is a lot bigger than the right, did you know that?” “No…what?” I asked. She said, “There’s a deepening of the cup, with a widening of the cup-to-disc ratio, in your left optic nerve…” When I got home and googled it, I learned that the textbook term is “glaucomatous changes in the optic nerve”. She tried to reassure me. She told me not to be alarmed, that my IOP 's (intraocular pressures) were normal. She didn’t tell me that there’s a kind of glaucoma called “normal tension glaucoma”, but she did ask me to find out whether my brother's pressures were normal when he was diagnosed, and she said that because pressures tend to fluctuate in accordance with circadian rhythms, and be lower in the afternoon, she wanted me back in a week or so first thing in the morning, to check my pressures at that time and also to do a couple of hours of visual field tests, etc.

Uh-huh. We made the appointment then and there. At work the next day, I told my boss and said I’d need to go back for another exam. She said fine, but I couldn’t miss a meeting she’d scheduled…of course, it conflicted with the time of the appointment, so I called to reschedule and learned the next available is in a month. I took that, and come hell or high water, I’ve blocked out the time on the office calendar and I’ll be there.

Changes in the optic nerve…shoot. I haven't noticed any changes in my vision, and that's good. Best case scenario is that I don’t yet have glaucoma; next best is that we’ve caught it early, and that with regular monitoring and meds, we can slow down any changes and keep them from progressing. And that said…I’m grateful it’s one eye, not both. I’m grateful that this didn’t happen when I was younger (there are children, even babies, born with glaucoma). And I’m grateful to live in a time when there are ways to slow down and maybe even prevent the vision loss that used to be inevitable with glaucoma.