Thursday, January 23, 2014

In Which the Scales Fall (Literally) From the Author's Eyes

Of late I have been noticing that a) my memory is not what it used to be and b) it was getting a whole lot harder to see. For a journalist, this is the old one-two punch: you squint to see where it is you parked the car, and then you have to think hard to remember what car you're driving these days. The memory thing I guess I can chalk up to Middle Age Brain, and I'm told that things actually improve after all the raging hormonal tides have ebbed, but the vision thing had to be dealt with, so I went to the eye doc. "Bad news," he said. "You are now so nearsighted that they don't make contact lens strong enough for you." (For vision wonks, we're talking about a minus 12 diopter; most nearsighted folks are a minus 6 or 7. For all you Spinal Tap fans, my vision impairment goes past 11.) "The good news," he continued, "is you have cataracts." Exactly how was this good news? "It means you can have cataract surgery and we can cure your nearsightedness." For a moment I thought I had misheard him. Cure, you said? "Cure," he said. This took a moment to sink in; then the next logical question occurred:  Well, why the hell didn't you tell me this years ago? "Because contact lens are a lot less expensive way to fix your vision than surgery," he said, "and Blue Cross wouldn't have paid for it."

Well, Blue Cross still doesn't completely pay for it, as it turns out. There are three levels of cataract surgery, and most insurers only cover what I will call the Honda Civic version. For me, that would have meant fixing my cataracts and my nearsightedness, but leaving me with my astigmatism, meaning I would still need contact lens/glasses for distance, plus reading glasses for near vision. Level Two, the Lexus version, cost an extra $1,900 per eye; that would correct my nearsightedness and the astigmatism. Level Three, the Mercedes Benz version, would do the whole shebang: it would correct my nearsightedness and my astigmatism and give me bifocal vision so that I would never need reading glasses, for a mere $2,900 per eye out of pocket.

On reflection, Level One seemed like a penny-wise, pound-foolish approach: undergo surgery but still need glasses? For the birds. Level Three seemed like a thrilling deal, until I thought about it. Problems with near vision (called "presbyopia") affect nearly everybody as we age, because the tiny little muscles in the iris that help change the eye's focus from distance to close vision age just like everything else, and get stiff and creaky. I asked the doctor: suppose I shelled out for those $2,900-per-eye set of new eyeballs--wouldn't those new lens still be at the service of those same old creaky eye muscles I have now? "Yeeessss," he allowed, with a small smile. "Which is why I don't always recommend that option to my patients. I don't really think they work all that well." Now he tells me. (Further proof that when it comes to health care in this country, the only traditional capitalist theory that applies is the Law of Caveat Emptor.)

Actually, the doc is a nice man, very kind, and on surgery day, when I was so nervous that my blood pressure was galloping way above the 100 level, he talked me through the whole thing. Well, almost the whole thing; for a crucial part of the festivities, I remember somebody mentioning I was about to get dose of something called Versed, and then it was nighty-night.

Now, two days later, I have a slightly swollen right eye that has perfect 20-20 vision--something I have not had since the day I exited my mother's womb. Got my astigmatism fixed, on the installment plan. ("If we don't pay," my husband asked, "do they come repossess your eyeball?") Colors look brighter. I see individual branches in trees two blocks away. The past two evenings, the winter sunsets have been glorious. In a week and a half, I get the other eye done. I cannot wait for the next warm, clear night, when I'm going to take a blanket outside, lie down on the lawn and look at the stars.

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