Blindsided: Staring into the murky abyss
On a recent Saturday evening, Becca and I were engaged in conversation when something looked odd. She kept talking, and I tried to listen through my distraction. Puzzled, I took off my glasses and wiped my right lens to clean off the smudge that made her face appear dark and blurry. I put the glasses back on, but my vision hadn’t improved. I wiped the glasses again to no effect. I closed my right eye, and Becca looked her normal bright and animated self. But when I closed my left eye, I could barely recognize her, as if a dark film had been drawn over her face. As we talked, I alternated closing my right and left eyes, thinking my imagination was playing a joke on me. But it was no joke. Without warning, my vision had dramatically deteriorated in my right eye.
I finally interrupted Becca and said. “This is weird, but the room is much darker when I close my left eye.”
She looked at me quizzically and pulled out her computer. After a few seconds, she looked up, concerned. “You need to go to the emergency room.”
“Seriously? You want to sit in the ER on a Saturday night?” Sadly, for years our local news has been filled with ER horror stories. I had little stomach for sitting in a waiting room filled with the coughing sick. Thus far, I’ve avoided COVID and felt pretty sure that if I sat hours upon hours in a waiting room my winning streak would come to an end.
But the internet did not give much solace for the possibilities afflicting my eye. Becca insisted I call a doctor friend of ours for his opinion on what I should do. I vetoed this. I hate bothering friends with my problems. So, I called our medical clinic and bothered my doctor instead, who happened to be on call. He said the ER would be a terrible place on a Saturday night, but a detached retina is no walk in the park either. Not that he knew my retina was detached, but the symptoms matched. And if it was a detached retina, the earlier the surgery, the better the odds that full vision could be restored. There were other possibilities as well, including: a very fast-developing cataract, or the dreaded, age-related macular degeneration.
Off we went, late on a Saturday night of the Memorial Day weekend, expecting a hellish experience. Surprisingly, it wasn’t. The ER wasn’t crowded and I was quickly ushered into a lounge chair in my own little booth. For a hospital, it turned out to be a delightful place to wait. When the pleasant young doctor arrived, he apologized for keeping us waiting, and then took an ultrasound of my eye.
The scan revealed very little, and after consulting with an ophthalmologist, he told me to make an eye appointment with a local eye clinic first thing on Tuesday morning. In the meantime, he strongly suggested I not do anything vigorous. All in all, I had a lovely time in the hospital. The doctor had a great sense of humor and the nurses were all kind and attentive. However, they really couldn’t tell why the view from my right eye looked like I was wearing scratched, dirty sunglasses.
Sunday and Monday were not fun. While I did take a couple of gentle, for me at least, three-mile walks, anxiety circled over me like a vulture ready to swoop. Something was wrong with my vision and I had no answers. Still, I had the trusty internet to either bring assurance or scare the shit out of me. I studied the symptoms of each possible diagnosis, and pored over the various treatment plans for each. My best hope seemed to be a very fast-developing cataract. A cataract could be fixed with surgery and leave me with better vision. Even a detached retina didn’t scare me too much. My doctor, when telling me to go to the ER, said he’d just had surgery for a detached retina, and now he can see better than ever. “Cool beans,” I thought. Better is always the way to go.
Lurking in the background, though, was age-related macular degeneration. This nasty disease has no cure and without treatment could leave a person legally blind in a matter of months. Becca’s father had it for several years and had to be treated with eye injections each month until he died, just to preserve his degraded eyesight. More unnerving were Becca’s stories about her great-uncle, who retired in the early 1970s only to go quickly blind from the condition. From what I could tell, the view from my right eye closely mirrored the visuals the internet provided about early stages of macular degeneration. None of the information about this disease alleviated my growing anxiety.
Tuesday morning I woke and dressed early, had a quick breakfast, and then sat with my phone in my lap, counting the seconds until eight o’clock came around, the time when the magic eye clinic office opened. When I called and explained my concerns, the receptionist said there was an 8:30 am opening. “Is this too early?” she asked.
“Not at all,” I fired back, even though we were forty minutes away. “I’ll be there, as soon as I can.”
Becca jumped up and we rushed to the car, where, with one and a half functioning eyes, I drove like a bat out of hell. (FYI… When I drive like a bat out of hell, it means ten miles over the speed limit, which is the speed ninety percent of the population of Asheville normally drives.) In spite of the morning traffic, we pulled up to the office only ten minutes late. I jumped out of the car and sprinted into the office, while Becca found a parking space. Once in, I waited twenty minutes before getting dilating eye drops and a series of blinding and bizarre eye scans.
After the preliminaries, we waited some more until the moment of truth arrived, and we were called to consult with the ophthalmologist. He was a jovial sort and a bit distracted, but he quickly focused on my eye scans before calling us over to have a look. Sure enough, the scan of my right eye proved I’m not a hypochondriac. My retina had a bulge beneath it. The doctor pointed to the image and said in a serious tone (not a good sign) “This is the problem.”
At this point he sounded as murky as my eyesight. “There are two possibilities: wet macular degeneration, where fluid is leaking underneath the retina, or Idiopathic Central Serous Choroidal Retinopathy where fluid is leaking underneath the retina.” Neither sounded as sexy as a detached retina, but at least the first one I could pronounce.
When asked about which seemed more likely, he said he didn’t really know. They have similar symptoms, but very different causes and outcomes. Macular degeneration is more common in an older population, which, when looking into the mirror, I had to admit applied to me. Idiopathic Central Serous Choroidal Retinopathy is more common among forty-something males who have taken steroids or are highly stressed. Being retired, two decades past my forties, and having never taken steroids, I did the math and realized that I didn’t run with this crowd.
Since he was uncertain, he referred me to a retina specialist who would have a better idea and be able to discuss a treatment plan. He then left, while his assistant scheduled me an appointment for sixteen days later. Becca drove me home at a nice leisurely pace, and during the ride I became resigned to the very real possibility that my vision might be permanently damaged.
That afternoon, I scoured the web for more information on wet macular degeneration. The news wasn’t all bad. By taking monthly injections for the rest of my life, the degradation of my vision could be mitigated, preserving some of my sight. And I still had my left eye. But, and this is a real big but, usually wet macular degeneration will move to the other eye within a few years.
So, the most likely diagnosis was also the worst one, an incurable disease that would leave me with degraded vision for the rest of my life. Ouch!
Of course, I also looked up Idiopathic Central Serous Choroidal Retinopathy and found a much friendlier prognosis. This condition tends to not get worse and often resolves itself without treatment in six to eight weeks. “Too bad,” I thought, “I’m not forty-five and working seventy hours a week.”
By that evening, I knew the next sixteen days would be an intolerable wait. Plus, everything I read indicated that the earlier one started treatments for macular degeneration, the better the odds of preserving some eyesight. I called the retina specialist’s office the next morning to see if they would slide me in early in case of a cancelation. The woman was a saint, and found me a 12:50 pm slot the following Monday, giving me only six days of insanity before I heard my final verdict.
After I penned in the new appointment on our calendar, a strange thing happened, strange for me at least. I calmly began to imagine a different life. While I hoped for the retinopathy diagnosis, I knew macular degeneration was a better bet. And I began to prepare myself for the news. This new reality made me quite sad. I’m in love with the visual world, as vibrant colors and appealing compositions never fail to take my breath away. Over the past forty-six years I’ve taken thousands upon thousands of photographs documenting all aspects of our life together. When we travel, it is rare indeed to find a photo of me without a camera around my neck, and more often than not, Becca ends up taking pictures of me taking pictures. Without crisp vision, I worried, how would I handle losing this part of myself?
And then there is reading and writing. How would I cope when I couldn’t decipher the words on a page, or see the keys on my computer? Already, my right eye had become pretty useless, especially in low light, where a book title morphed into a brown, unrecognizable smudge. When would driving become dangerous? One night, I drove home in the dark. With two eyes, I was fine, but when I closed my left eye, the scene in front of me became dark and ominous.
I worried about the impact of my disability on Becca. How much would my dependency on monthly eye shots affect our travel plans? Would I even want to travel if my vision was so muted? Would she tire of being my chauffeur? After all, she had already spent several years driving her father to endless doctor appointments. Would she end up doing the same for me? It felt so unfair to have her stay in that role. I even wondered how long I could live in this house we both designed, this house we love so much.
With all these thoughts rumbling around in my head, I tried to keep busy, running, weed eating on Bailey Mountain, moving patio stones, and editing one of my manuscripts. Other times, I would take a break and sit on our deck, marveling at the magnificence of our trees, with their fresh green leaves and their swaying trunks set against the backdrop of white billowing clouds and a robin egg blue sky. The longer I stared at the sights around me, the more I grasped the precious gift of sight. How in the world did evolution create such an intricate bundle of nerves, allowing us to see stunning beauty everywhere we look?
As the week wore on, I tried to reason with myself. I had no right to expect to live a long life unscathed by hardship. At least to this point, I’ve had a full life of good health. To expect more would be unreasonable, maybe selfish. Still, becoming legally blind had never occurred to me. Heart failure, maybe? Decaying joints, at some point? Maybe a terminal disease? But blindness? Would I spend the last twenty years of my life looking at a world through a muddy brown lens?
That Sunday night, my exterior calm gave way to fear. On edge, I scolded Sergi for barking. He punished me with his stunned and hurt expression. He only wanted a cookie after all. Besides, I never yell at him, and he didn’t understand. (He did keep barking though.) But Monday loomed like a bruised storm cloud. I knew the next day I’d be given a verdict that would rule the rest of my life.
I woke the next morning feeling jittery. I ate quickly and went for a long run over the steep roads circling our town. After a short rest, a long shower, and lunch, it was finally time to drive the thirty miles and get it over with.
This time we arrived ten minutes early, checking in with a kind receptionist who remembered Becca’s dad from his several years of macular degeneration eye shots. How weird that felt. Then I had more scans and another reading test. My previous 20/20 right eye vision had been downgraded to 20/40 with my glasses on, and this was in bright light where I see best. I took this as a bad sign. Finally, we were moved into the doctor’s office, where we waited and waited. I came armed with questions about all the scenarios I could imagine, and Becca sat ready to fire off her own questions, while recording everything said.
Without warning, the doctor breezed in. He was young, carried himself with the confidence of Harrison Ford and was just as good looking. I said something about being grateful for the quick appointment, and he nodded before getting right to the point. No messing around with this man; his time was too important for small talk.
“You have a classic case,” he said right away.
“A case of what?” Becca shot back. Speechless, I leaned forward with eyes as wide as saucers.
He looked at us like we were stupid and said “Idiopathic Central Serous Choroidal Retinopathy” as if this fact were as obvious as the heliocentric theory. I wanted to leap out of my chair and hug him. But he didn’t look huggable. Still, never has such an ugly name sounded so beautiful. I might even learn how to pronounce it. Unlike me, who kept a goofy grin plastered on his face, the doctor kept his cool and said the new scan showed a slight reduction in the fluid around my retina. He went on to say that he could tell in our few seconds together that I have a type “A” personality, and stressed people are ripe for this condition. Even better, he expected a full recovery within six to eight weeks without any intervention.
I felt giddy, lightheaded. I’d just won the lottery. I would have been thrilled just knowing the condition would not worsen. But to think my vision would improve! And without needles poking my eye once a month!
After telling me to avoid stress, the doctor stood up, cutting me off midsentence, and shook my hand. “See you in three months,” he said. With that, he strode out of the room leaving Becca and me alone with his assistant, a young woman who then scheduled a follow up appointment. With Becca driving, we went home to resume our lives.
Days later, as I write this, I notice marginal improvement in my vision. The world looks a touch brighter and maybe not as blurry when using only my right eye. But inside I’m glowing all over. Someday, my vision will dim again until it fades all together. For now, however, I’ve been granted a glorious reprieve. Having stared into the murky abyss, I intend to bask in the shining light for as long as my eyes allow me to see.