The New Normal

Disclaimer — I am not now and never have been an ophthalmologist or played one on television, nor did I stay in a Holiday Inn last night.

Last Saturday, while vacationing in Florida to celebrate my mother’s 103rd (!) birthday, Mrs. Barn and I spent most of the day and evening in the Emergency Room of the Bascom-Palmer Eye Clinic in Miami, perhaps the nation’s leading institution of its kind.  The evening prior I had noticed a dramatic increase in “floaters” in my left (good) eye and during the night saw flashes of light also in that eye.  These are almost dispositive indications that a retina is becoming detached, almost being the operative word, and my concerns were pretty stratospheric.  Hence, the two hour drive to the clinic, the seven hour wait to see a doctor, and the two hour drive home.

Floaters are usually the tissue debris remaining from some physical disruption inside the eyeball.  They can be as plain as a tiny speck that moves around as your eye moves, essentially not a speck “in your eye” but literally a speck inside your eye.  I’ve had floaters of some sort virtually all of my life, but the number and size of this new batch had me concerned.  I had a new floater that looked like a Klingon warship, another that looked like a spider web covering about 1/5 of my vison field, and a multitude of tiny floaters resembling a swarm of bees, all of them bouncing around as my eye moved.  These last ones were the most concerning.

Floaters by themselves are not debilitating, but merely irritating as they are so spindly and translucent and do not disrupt vision in a meaningful way.  If I was a sniper it would be a problem, for a woodworker not so much.  But, I was experiencing a new type of floater I had never before seen, similar to a small cloud of fog moving around in the exact opposite motion as the particulate floaters.  That was very bizarre and disconcerting.  This (these?) were much like smudges on my eye glasses, only moving.  The problem is probably exacerbated by the fact that I have preposterously luxuriant eyelashes, so most of the time I have eyelash tracks on the inside of my spectacles with the resultant blurring to my vision.

Combined with the flashes of light in my eye, I was in fact experiencing the symptoms they tell you accompany a detaching retina and to get to the hospital immediately, so we did.  Having a base vision that is extremely myopic, about -12 prior to my LASIK, I was and reman at high risk for a detached retina.  Two of my siblings have already experienced detached retinas so my spidey-sense is quite high when it comes to this.

When we finally did get to see a doctor the eyeball examination was very thorough, and I was complimented on my cooperativeness.  And why not?  I’ve undergone a similar examination perhaps 150 times over the years.  I know where to put my head, how to hold open my eyes, when to blink, when not to blink, and to not be concerned about the tears coming out of seemingly every hole in my head.  (Hey, according to BC/BS I’ve had 22 eye operations and been fully asleep for only one of them.  When I put my head in the frame and am told to hold still while the doctor is closing in with a scalpel or a laser beam, I learned to hold still.)  Although I am certain I have shoes older than the doctor who examined me, I am experienced enough to know that he did an excellent job.

The bottom line is that I was not undergoing a detached retina but instead a detached viscera.  The viscera is the transparent protein gel that fills up the balloon that is your eyeball.  With age and genetics for some fraction of the population that gel begins shrinking and eventually pulls away from the surface of the balloon, releasing a lot of tissue debris in the process.  The phenomenon is accompanied by some flashing light in the field of vision.  So, I was correct to be concerned but my self-diagnosis was incomplete, fortunately.

My “new normal” for that eye is the presence of a great number of distracting floaters that my brain will eventually learn to ignore.  The cloudy regions, again not debilitating, are either the result of the changed optical properties of the viscera gel/retina interface or perhaps even the refractive index change in regions of the viscera itself, or they could be simply shadows of the floaters themselves.  All I can do is wait and see.

I have an appointment with my brilliant ophthalmologist in Charlottesville in a couple weeks.  It was a regularly scheduled appointment (I usually go four times a year), and after speaking to his post-doc yesterday I was assured that there was no immediate or urgent need for attendance.  I will know more soon, but it looks like this is just another thing to get used to.

As for my right eye, there is pretty much no reason for optimism there.  Two corneal transplants have failed to provide good vision, although I am told the “transplants look perfect.”  Not from my side they don’t.  Added to that was the subsequent cataract surgery resulted in a defective lens being implanted, so the vision in that eye is always distorted and hazy, like I am looking through a piece of plastic food wrap on a foggy day.  On top of all that was my glaucoma was not attended in a timely or diligent manner after it was diagnosed and not treated properly until the damage was mostly done, so I’ve lost approximately half of my vision in that eye altogether.

Now I wait to get accustomed to my new normal.

When my daughters were very young they asked me what I thought Heaven would be like.  I told them that for me it would be, in part, a realm where when I woke up, with my newly perfected body to fit this perfect place I could see the world around me perfectly.

I’ll stick with that.