Cataract Surgery, Dick Cheney image, Kellogg Eye Center, Modern medicine, The University of Michigan

Cataract Surgery

I’m having cataract surgery tomorrow, July 16, on my right eye. My weaker left eye is scheduled for August 6.
My surgeon, Jonathan Bennett Greene, is young and tall and cheerful and resides on the fourth floor at the University of Michigan’s Kellogg Eye Center, which with typical UM bombast (which I hope is true) calls itself “the premiere eye center in the country.”
I’m nervous about the surgery despite Greene’s aura of competence.
I had a preoperative physical last week and either at that part of the complex, the plush facility at Domino’s Farms–the building, I believe, that Tom Monaghan built for the pizza dynasty–or maybe at the Turner Geriatric Center (a UM facility for older people like me), or maybe at Kellogg, I picked up the current news letter from UCLA’s Division of Geriatrics, Healthy Years, with a variety of articles I wouldn’t have read 10 years ago: How Probiotics May Benefit Your Health, or, because older people “are more vulnerable” (than normal people, I guess) “to hot weather for a variety of reasons,” Protect Yourself from Heat Stroke and Other Summer Dangers (like memories of drive-ins). The lead story, however, was just for me: Is it Time to Consider Cataract Surgery?
Light, I’ve now learned, should pass cleanly through the cornea and lens to the retina, where by the alchemy of our marvelous brain it is transformed into images such as naked women and Dick Cheney. Often, however, as we get older, the lens begins to cloud and can become “opaque,” according to Dr. Kevin Miller at UCLA’s Jules Stein Eye Institute (NOT the country’s premiere eye center, which raises the question of why UM is passing out UCLA’s newsletter rather than writing its own).
In any case, the clouded lens “blurs the image we see,” Miller says, adding poetically, “The effect is almost like looking through a fogged-up window.”
Corrective surgery, he says modestly, “in the hands of a competent, well-trained surgeon,” is “safe and effective.”
It takes less than a half hour. An incision is made in the cornea and then an “ultrasound probe” is inserted and its pulses break the lens “into small pieces” which are sucked out by a vacuum cleaner probably not bought at Sears.
Then a new plastic lens is inserted–I’ve opted for the “monofocal” lens, which allows for fixed distance vision–and the patient is moved to a dim recovery room to recover from, I hope, the effective sedative which had plunged him into a grinning, insensible stupor.
Kellogg has put together a series of short videos about the condition and the procedures, and they are comforting.
If it goes well, Greene told me, I won’t need glasses anymore except probably for reading. I will see just about as I did at age 7 and 8, before everything went blurry and outfield flies began hitting my forehead.
When Greene said “cataracts; textbook,” I was relieved. It took him just minutes of studying the images from the machines technicians had used to peer closely at my eyes.
I was relieved because I have been going blind. As I sit just now writing and raise my head to look out the window, my glasses seem dirty. I can see the green grass and blue sky, the pine in front of the red-roofed building across the street, but it is all dim. It’s gotten much worse in the last 18 months. In India, I avoided going out at night because I couldn’t see well enough in the blare of lights to walk India’s rubbled streets.
I had recited my symptoms to optometrists in South Burlington and Ann Arbor, but neither saw a need to refer me to an opthalmologist, even when the vision in my left eye worsened dramatically, a change, Greene said, that is a classic symptom of cataracts. I don’t exactly fault the optometrists. They saw what they saw, and both worked in mall outlets that in factory style pass patients to the adjoining eyeglass emporium.
Anyway, such MBA efficiency is the face of our style of medicine, where a doctor no longer knows his patients but analyzes strictly by the numbers. I’ve visited the UM clinics six times, I believe, and haven’t seen the same person twice.
My old family optometrist, Dr. Allen Hilbert, who practiced for many years in Hicksville, Ohio (and is now writing a history of the village in his 95th year), was trained in the 1940s (and many workshops over the years). We used to talk about books while he examined my eyes. He much appreciated Gore Vidal. I remember once, in the 1970s, when I had sharp pains in my right eye, he met me in his office on New Year’s Day to take a look.
He perhaps would not have seen the cataracts either, but he knew me, and he would have listened carefully to what I said, and I think he would have sent me to an opthalmologist he trusted a couple of years ago. We have lost that quality of care, though our machines are wonderful.
And now: take a shower tonight and tomorrow morning with a soap like Dial ( no lotions); eat nothing after midnight; drink just water or apple juice or suchlike; go the Kellogg Center at 1 p.m.)
Despite the assurances of safety, the form I signed covers UM’s corporate ass: The risks of cataract surgery include “bleeding, inflammation, infection, pain, redness of eye, loss of vision, loss of eye, overcorrection, undercorrection, difference in vision in the two eyes, a difference in vision from what is expected, drying of eye, double vision, drooping of eyelid, numbness, swelling of the cornea, corneal abrasion, closing of post-cataract membrane, increased eye pressure, retinal detachment, need for further surgery,” and, the cherry on the top, a “rare need to remove or reposition the lens implant.”

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