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  Features 10/30/02

Living with glaucoma: an appreciation of sight

By Melanie Steele

Dad is a lot quieter these days. He can often be found in an easy chair with his eyes closed. His 6-foot-2-inch frame is routinely bent in an athletic position with his elbow propped on his knee and his hand cupped on his chin. His normally light blue eyes have been overtaken by cherry veins, and his eyelashes are unusually long. He does not smile nor does he frown; he just seems to be thinking.

My father sees a different world than I do. His world is one of distortions and misinterpretations. His reality is created by imperfect eyes. He has battled with his vision since I was a child. He has battled with his vision since he was a child.

After spending his toddler years with a lazy left eye, he got his first pair of eyeglasses at age six. Dad says the change was immediate, and for the first time he saw things as focused images rather than in pairs. He remembers commenting to his mother, "Man, I thought this door had two doorknobs. I had just learned to grab for the one on the left."

However, despite the corrective eyewear, Dad's depth perception was non-existent. "I was very clumsy as a kid. I spilled a lot. Because of it I learned to view life in relative terms."

I am now 21 years old. I share a couch with Dad in my childhood home. We are in an adequately lamp-lit room with cream walls. It is dusk and I am positioned less than three feet away. He has just undergone his seventh eye surgery. I can see his soft, well-aged 52-year-old face and his extremely thick, silvery hair perfectly in the low lighting. His eyes are returning back to a nice, white color but his eyelashes will probably always be long; the redness and the long eyelashes are side effects from his eye medication.

"So," I say, "how well do you see me, Dad?"

I have asked my father millions of questions in my life. Probably too many. I don't necessarily ask him because I don't know the answer. Often times I ask him questions just to hear the wording of his answers. Dad does not answer questions with one word answers; he responds in metaphors.

"Well, you have a very non-descript look. I can't see your facial expressions," he says. "It sort of reminds you of looking through a latex glove or a fish bowl that has no water. You're milky."

Of course, this is an improvement over other times in his life. Dad has been blind on a few occasions, each episode occurring after a surgery.

"It's not a black blindness: that's a total inability to see anything. You can recognize your world but you can't really see it." The post surgery blindness was caused by extremely low pressures in his eye. The lack of pressure keeps the eye from forming any sort of imagery.

"It's like the dirtiest contact lens you can possibly imagine, or having Vaseline on the front of your eye," Dad says. "Life is a total blur."

He has even had one episode of the "black blindness." Dad was bending over to push the trash down in the kitchen garbage when the room suddenly went dark. He had just had his first surgery the previous week, and one of his restrictions was never to have his head below his shoulders during his five weeks of healing. "It was literally like putting a hand over my eye. Just blackness."

His eye had hemorrhaged, flooding the cornea with blood. It was late on a Saturday night, but he called the surgeon immediately. They met at the eye clinic 30 minutes later. "We're in luck," the surgeon said. The blood had coagulated and sealed itself off. Dad had dodged a life-altering bullet. The hemorrhaging had not done damage. However, the frailty of his sight was now ever-present in his mind. That frailty was caused by glaucoma.

The discovery

In 1994, Dad lost a contact. He had "dropped 'em before." He says he went through all of the procedures that someone who has worn contacts for 20 years goes through: Check the clothes. Make sure you aren't stepping on it. Assume the crouched position on the floor and begin a search. Conditions were pretty good. The bathroom was bright, the vinyl floors where white, and the area was free of contact-hiding rugs. The blue-tinted lens should have been easy to detect.

He never found it.

Replacing the gas-permeable lens required an examination because his prescription had lapsed. The nurse blew the puff in his right eye. The nurse blew another puff in his right eye. A third and fourth puff occurred. Others came and puffed his eye. The puffing ceased and Dad said he sat down with the doctor.

"I am positive you have glaucoma," the doctor said.

"What's that?" Dad asked.

Eight years have passed since his consultation with the doctor in the Shopko Optical Center. Dad is very learned now on what glaucoma is, how it has affected his vision and what the possibilities for the future are. He is one of 3 million Americans who have glaucoma, which is the leading cause of blindness. The Glaucoma Foundation's analogy is that your eye is like a "sink in which the faucet is always running and the drain is always open... When this drain becomes clogged, aqueous [the running water] cannot leave the eye as fast as it is produced, causing the fluid to back up. But since the eye is a closed compartment, your 'sink' doesn't overflow; instead, the backed up fluid causes increased pressure to build up within the eye."

Often, glaucoma can be effectively suppressed with medication. When the meds don't work, though, surgery becomes the only other option, according to the Glaucoma Foundation. Eye surgery is very dangerous because the eye is a closed system, giving it no way to fight off infection. Dad always says to imagine that the eye is like a petri dish; a perfect environment for bacteria to grow.

Medication didn't curb the pressures in Dad's eyes enough, so he turned to surgery. His first surgery failed and led to an immediate second surgery. The second surgery held for awhile, after being touched up in a third surgery. However a cataract, a common side effect of glaucoma surgery, formed right in the center of his vision. In order to maintain a visual balance within the eyes, the doctor had to operate on both eyes.

The cataract surgery posed two threats: one, that it could compromise or even undo the glaucoma surgery; and two, that his left eye could contract glaucoma due to the obtrusiveness of the surgery. Statistics indicated that neither possibility was very likely.

Dad's long road has shown that statistics don't mean very much. He now has glaucoma in his second eye and had to re-enter the surgical room in order to have the glaucoma surgery done again, this time in both eyes, after it was eradicated by the cataract surgery. He says he supposes he could feel angry or cheated. Generally, he wishes he just didn't have to deal with it. However, he says his ordeal has brought him a new appreciation for his sight.

"I wake knowing I see today, and I am glad on those days because there are mornings when I have awakened to blindness."

Glaucoma is a hereditary affliction, so I pay attention to my Dad's condition. It's not just the information I try to absorb; it's the process of living with glaucoma.

Dad's latest surgeries, which took place in September, seem to be working so far. But small surgeries loom in the future, and nothing has proven trustworthy in his long fight to see.

"The net effect of glaucoma is that I can no longer take my eyesight for granted. I am a guy with glaucoma. Every six months I get to go see if I am still in remission."




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