The Eyes Have It

My eyes have always been an issue in some way, and it started when I was very young. When I was a toddler I developed the habit of leaving the home and heading out to the wide world, to the despair of my mother. One possible reason this was attractive is that I would frequently get picked up by the police, who would give me an ice cream or other treat while they figured who I was and where I belonged. Locks never stopped me.

Then one day I walked out into a highway. I was 3 years old.

A car hit me, my skull was in pieces (literally), and I was rushed to the hospital. Now, this was no trivial matter, and it required emergency surgery to put my skull back together. Eventually I was sent home with my head completely bandaged, and few days later the police found me, bandaged head and all, climbing on a railroad trestle bridge. When they took me home the officer said to my mother “Lady, you need to keep this kid inside”, to which she replied “What do you suggest?” so when my mother says that of her 6 children I am the one responsible for all of her gray hairs, you have to admit there is some justice to the charge.

Well, with a serious injury to the head they had to do extensive testing to see if there was any damage that required therapy. Luckily, they didn’t find anything like that, but they did tell my parents “Oh, by the way, this kid will need glasses when he is around 10.” Apparently when they tested my vision it was a little too good, and that sort of thing starts to deteriorate over time. And sure enough, in 5th grade my teacher noticed me squinting and off to the eye doctor I went. I have worn glasses ever since. I never did get into contact lenses, and at this point I doubt I ever will. But it does mean I have a long-standing relationship with eye doctors.

Then, when I was diagnosed as diabetic in 2002, I was sent in to look for signs of Diabetic Retinopathy. This is a common side effect of diabetes, and occurs when high levels of blood sugar cause damage to the very fine blood vessels at the back of the eye. Nothing was found, but I began eye checkups every year at that point as part of my diabetic treatment. When my blood sugar was not well-enough controlled, my eye doctor was not happy, but left it to my primary care doctor to deal with it. Fortunately, as my article on Diabetes explains, I now have excellent control of my blood sugar, and all of my doctors are happy on that score.

Of course, changes can happen even without diabetes. Getting older can cause some things to develop, but things like cataracts and glaucoma are also more common with diabetes. And I have some very minor signs of those things, but nothing that bothers my eye doctor very much at this point. Sometimes he says that in 10 years he might need to do something about it, but for now don’t worry.

But in 2013 I had a scare. Suddenly in my right eye I had spots in my eye and flashes of light. I thought I might have gotten something like a detached retina, and immediately went in for a look. But it turned out to be something less serious. What had happened was that the vitreous humor, a jelly-like substance inside my eye, had pulled away, and that is fairly common as you get older. The flashing light effect came from it pulling on my retina. And the spot turned out to be a floater, another common issue. With time both symptoms seemed to mostly go away, though in the case of the floater it is not so much that it stopped being there as my brain learned to ignore its presence. I can force myself to see it, but I am just as happy not to. By the way, the closest I can come to describing what this looks like is like looking at an amoeba through a microscope. Odd.

Then my eye doctor started to see some other things that would bear watching, so he took photos of both of my retinas that he could refer to in order to detect any changes from year to year. And the most significant is macular degeneration. This is common as people get older (age-related macular degeneration), and is the leading cause of blindness among people 50 and 0lder. There is no known treatment to cure it, but symptoms can be delayed. What my eye doctor has me doing right now is taking a diet supplement called AREDS 2, which is really just a combination of vitamins. The macula is the spot in your eye in the back that provides the most sharp, central vision, and when it degenerates you lose visual acuity in front. If you get it, formulations like AREDS2 can delay the onset of symptoms, but once you have the vision loss the only thing left is essentially therapy to help you adjust.

There are lifestyle changes that can reduce the risk or slow the progression:

  • Avoid smoking
  • Exercise regularly
  • Maintain normal blood pressure and cholesterol levels
  • Eat a healthy diet rich in green, leafy vegetables and fish

I quit smoking in 2008, and as I mentioned in my article on Diabetes I exercise regularly and eat a lot of salad. As a result, my blood pressure and cholesterol levels are both fine. So I have done everything I can do to slow the progression. At this point, I do not see any differently, so it has not manifested itself, and if I keep doing the things I am doing I may be able to hold it off long enough that I never quite get any serious symptoms. I am 66 now, so I think I have a punter’s chance.

A few years ago I went in for my usual annual checkup, and my eye doctor saw some bleeding in my retina that he was concerned about. He said it might be significant, or it might be nothing, but he referred me to a retina specialist for a second opinion. Fortunately the specialist said it was nothing to worry about, though I discovered a mild allergy to the contrast dye they injected to make it easier to read what was going on. It makes the blood vessels at the back of the eye stand out so they are easier to inspect. But he said that I should now be checked every 6 months instead of once a year, so now I see my regular eye doctor, then 6 months later the retina specialist, then 6 months after that back to my regular eye doctor.

I continue to wear eye glasses, though now they are bifocals. And over time I find I need them more. For most of my life I only needed glasses for seeing things in the distance, such as when driving, since otherwise signs would be fuzzy. Generally I would take them off for other things since I didn’t need to use them. But then I found about 10 years ago that I could not longer read fine print, and 5 years ago it got to reading in general. I still take glasses off when at the computer, but I suppose that won’t last too much longer either. But having worn glasses for 56 years at this point I am pretty used to it and I don’t think that would be a problem. As Web Wilder says, “Wear glasses if you need ’em.”

So at this point my vision is fine for me, and I can do all of the things I want to do. That may or may not change as I get older, but I know I am doing everything I can do to slow the development of macular degeneration. Otherwise, as I always do, I follow my doctors’ advice and take advantage of the best care I can get.

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