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Putting off vision care leads to (surprise!) impaired vision

When you’re having problems with your eyesight, there are probably worse places to work than on a university campus that has just opened a state-of-the-art eye care facility.

And I’ve always had problems with my eyes.

Staring down the business end of the laser. (Photos by Kalani Simpson)

Staring down the business end of the laser. (Photos by Kalani Simpson)

I remember when I first realized my eyes were bad. I was an entertainment reporter for a small newspaper in upstate New York, and I’d been sent to review an opera.

To help the uncultured, the opera was translated via subtitles. As the mezzosoprano belted out the Italian aria, an English translation ran across a thin screen hanging high above the stage.

The problem? I couldn’t read a word. And no one around me was having any trouble at all.

To that point, I’d never realized I had a vision problem. Sure, things got blurry in the distance, but at some point, doesn’t everything? I never knew that my definition of “too far to see” was much closer than a normal person’s.

Still, no long-term effects. I got a pair of glasses, spent a week or so marveling at how crisp the lettering on stop signs was, and life went on.

Many years later, I was put on prednisone for a medical condition. The drug did what it was supposed to do, and I was pleased – but apparently, one of the possible side effects of prednisone is that it can cause cataracts.

The laser wasn't as frightening as I thought it would be. (Photos by Kalani Simpson)

The laser wasn’t as frightening as I thought it would be. (Photos by Kalani Simpson)

I began to realize something was wrong the following summer, when it became increasingly hard to see people’s expressions clearly — especially if they were facing me with bright sunshine behind them. (It was a problem most common in the late afternoon.) A trip to an ophthalmologist showed that I had what the doctor described as “classic” cataracts.

So two cataract removals later (I’m counting one per eye), I was fitted with a pair of trifocals and sent on my merry way, once more able to ascertain whether people were smiling at me after 4 p.m.

Oh, it wasn’t a perfect situation. To remove the cataracts, they also had to replace the lenses in my eyes.

I wouldn’t have cared, because quite frankly I was beginning to feel that my eyes had been letting down the team through the years – but in one area, they’d always been perfect.

There was a point of focus maybe two feet in front of me, right about the place you’d hold a book, where my vision had never wavered. But as a result of the surgery, that point of focus was lost. Now, to read, I would have to wear glasses. (And I read a lot.)

Dr. Gulati takes a photo of my repaired left eye.

Dr. Gulati takes a photo of my repaired left eye.

Still, I’m nothing if not adaptable. And the advent of Kindle, with its adjustable type sizes, has made reading super easy. So my eyes and I were going along quite nicely together, although let’s face it, I no longer trusted them.

Fast forward to this past year, when I began working at UNMC (and receiving health care here), and you find me interviewing a medical student about the VISION Clinic. In the course of the interview, we talked about how people often put off their vision care.

“They don’t realize how bad it’s getting,” UNMC medical student Matt Maslonka told me. “They don’t realize that their field of vision is shrinking until they start walking into things.”

Oh, (insert expletive here). As my colleague Elizabeth Kumru – who has a corner cubicle — can tell you, I walk into things constantly – particularly her cubicle as I’m turning the corner. I used to consider this a result of my preoccupation with deep and meaningful thoughts, such as “Is anyone ordering Jimmy John’s today?” Now, I was wondering if my evil eyes were letting me down again.

Stanley M. Truhlsen, M.D., right, and Dorothy Truhlsen

Stanley M. Truhlsen, M.D., right, and Dorothy Truhlsen

So, you may not have heard, but UNMC has this really big, really new Stanley M. Truhlsen Eye Institute, with state-of-the-art equipment and internationally known ophthalmologists and all sorts of cool stuff.

Even though I hadn’t had my initial eye surgery at UNMC, I decided to amble over to the new building one afternoon to see if our UNMC ophthalmologists could tell me what was going on.

The verdict: My left eye had some buildup – “capsular haze” was the term the doctor used – on the lens. Apparently, when you have cataract surgery at a young age, it’s common for the eye to try to repair itself even though a new lens is already in place. Laser surgery would be needed to clear away the gunk that had built up behind the lens. Speaking with Vikas Gulati, M.D., who is on the faculty at Truhlsen/UNMC and a glaucoma specialist, and who would be performing the procedure, I got the impression that it would be as easy as squeegeeing slush off a windshield – with lasers!

In reality, it was even easier.

For one thing, it was an outpatient examination, and the “laser-into-my-eyeballs” machine (actual name: Nd:YAG, or neodymium yttrium aluminum garnet laser) looked just like any other eye exam equipment. Dr. Gulati had me look through the machine – why do ophthalmologists always want you to look at their ears? – and a couple of bright flashes later, I was done.

Walking back to the 4230 Building from the Truhlsen Eye Institute, I was amazed at how quickly my vision had improved, and how much.

It was something, I realized, I should have taken care of much sooner. The improvement was almost frightening – just how bad had I let my eyes become?

Maybe this time, my eyes hadn’t let me down – maybe I’d let them down.

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