The dying of the light

Dylan Thomas wrote, “Rage, rage against the dying of the light.” He was talking about death and dying.

Having just visited my ophthalmologist, I suddenly see a different meaning in Thomas’s words. No pun intended. Bad things are starting to happen to my eyes and I’m not happy about it. Not at all happy. It was enough to have been stuck wearing glasses since my early twenties. Dry eyes kept me from wearing contacts, although I tried repeatedly over several years. That and allergies meant a lot of eye irritation. Now, adding insult to … insult … come glaucoma and cataracts.

The elevated intraocular pressure (IOP) of glaucoma can steal your sight, slowly, painlessly, starting with your peripheral vision and working toward the center. Generally the pressure can be controlled with eye drops or ultimately, if necessary, with surgery. But you must have your IOP monitored, because the nerve damage, once it occurs, is irreversible. I’m currently using two different kinds of drops to control my IOP. It took a lot of trial and error and a lot of visits to the doctor’s office to figure out which combination of drugs worked best for me. For now the magic mix is Lumigan, one drop in each eye at bedtime, and Combigan twice a day in the left eye. Yes, that means two different drops in the left eye at night, with a 5- to 10-minute wait between. And that’s an improvement. With a different kind of drops, it was three times a day in the left eye.

There are about 4 other kinds of drops in my bathroom drawer now; those are the ones I tried that didn’t get the results the doctor wanted, but might be used again if one of the current ones starts losing its effectiveness. You should see the notes taped on the inside of my medicine cabinet door. Use this one this one this one in the left eye once a day three times a day twice a day. Use this one this one this one in both eyes once a day.

(There also are artificial tears, and drops for allergies, but those are on an as-needed basis.)

Then there are the cataracts. Early stage, not very distinct yet. Enough to mess up my vision in subtle ways but apparently not yet enough to do anything about. I’m beginning to consider a second opinion on how soon this might become a situation correctable with surgery. Not that I’m in any hurry to have anyone poking around in my eyes, but knowing my vision is even one iota less sharp than it once was makes me crazy.

The doctor’s assistant did a refraction test to check my eyeglasses prescription and made some changes. When the doctor came in and asked how it went, I told him, “crappy.” Each of my choices had been the best of a bad lot. The result was basically crap, compared to 10, 15, or 20 years ago. He checked everything again and made some more changes. “Cataracts,” he said. Fine, I thought. Don’t just change my prescription. Let’s get those buggers out of there! Yep, definitely thinking second opinion …

A few of you may be able to appreciate that before computers came along and allowed us to enlarge tiny type for easier viewing and close inspection, I was routinely measuring and eyeballing differences of 1/72″ (in typesetting, a point = 1/72″; 6 pts = 1 pica; 6 picas = 1″). Or reading 6-point type and having to determine if it was set in the correct font — every single character. Or distinguishing one tiny font from another, when the difference was little more than the shape of the descender on the lowercase g, or a different crossbar on the lowercase e, or the slope of a certain letter’s serifs.

More of you may be able to appreciate having to slow down in order to read a street sign soon enough to make your turn onto an unfamiliar street. You used to read those signs clearly from a lot farther away and as a result could drive faster. It gets more frustrating when you know you’ll have to be in a different lane to make your turn, but you can’t move into the turn lane until you can read the sign and know you’ve reached the correct intersection.

It didn’t used to be like this, doctor. Fix it! Glasses aren’t enough anymore. What’s next?

Then there’s night driving. I’m getting no help there at all. I just don’t drive at night anymore. (Well, okay, maybe, occasionally, I’ll drive the 1.5 miles to my son’s house.) Think about all the things you couldn’t do if you couldn’t/didn’t drive after dark.

There’s only so much you can do to ensure optimal vision at night. First, four surfaces have to be spotlessly clean — the outside of the windshield, the inside of the windshield with that hard-to-remove layer of greasy scum, and both sides of your eyeglass lenses. Unfortunately, cataracts will still cause lights to appear as flares or starbursts rather than focused points and you can’t wipe them away with Windex and a paper towel.

I’m guessing maybe my problem is made worse by my car’s 16-year-old windshield. There’s got to be at least a minimal amount of pitting and scratching that probably would cause lights to flare and distort, right? And yes, I’ve seriously considered replacing the windshield, just to see if that helps.

Also, my car is very low-slung and the crowns of the roads here are quite pronounced. Even in daylight it can be difficult to see left turn lane lines on the far side of an intersection; at night … well … so far, not many headlights point around curves for you.

Finally, if all that weren’t enough, age slows your pupillary response time, the time it takes for your pupils to dilate or contract in response to darkness or light. Imagine if your eyes didn’t respond instantly when you drove from oncoming headlights to the dark road beyond. Or from bright sunlight, through a dark tunnel, and back into sunlight. Or just walked from bright sunlight into a dark movie theater.

Yes, yes, getting older beats the alternative. But couldn’t I just sag a little more, or ache a little more in the morning, or have a shoulder that goes out occasionally. Less hair, gray hair, more wrinkles. Age spots. Come on, I can handle those. Take an appendage or two.

But dammit, leave my eyes alone!