Many people have cataracts as they get older, but in their mid-50s? Christine Hohwieler definitely felt too young for bleak prospects.
One day in the summer I noticed the birds. I stood in the living room and looked out the window. They flew close together, always in pairs, in perfect synchronicity. Maybe they were in love? Or drove out rivals? I am not well versed in ornithology, but the fact that all the birds were traveling in pairs seemed unbelievable to me. I thought: oh, optical illusion, it’s the double glazing! After that, another six months passed during which I couldn’t read street signs despite wearing glasses. When I did go to the optician, he canceled the eye test and sent me to the ophthalmologist. The diagnosis: cataracts. Both eyes need surgery.
I have a rather rustic approach to my health. That is one explanation for so much ignorance. The other is my age: At 57, there isn’t much that I feel too young for anymore, but I would never have considered cataracts – the technical term for the eye disease cataracts in which the lens becomes cloudy. According to Deutsche Ärzteblatt, over 90 percent of people aged 80 and over are affected, and less than four percent between the ages of 55 and 64. So why me? “In such cases, the cause of lens clouding can be trauma, for example a blow to the eye. Radiation can also cause cataracts, as can some metabolic diseases. Drug side effects, such as cortisone, are relatively common,” says Dr. Lars Wagenfeld, specialist and my surgeon at the eye day clinic at Rothenbaumin Hamburg. I took cortisone for a long time because of a chronic illness, that explains it.
Surgery is the only solution
Cataract surgery, in which the body’s own lens is removed and replaced with an artificial one, is one of the most frequently performed operations. In Germany there are 600,000 to 800,000 procedures annually. Dr. Wagenfeld says he himself gets 1,500 to 2,000 a year. In fact, everyone I complain to about my eye problems has friends or relatives who have had the problem and are seeing great again. Everyone has it done because no surgery is not an option: “Any form of lens clouding can only be treated surgically,” says Dr. Wagenfeld. “There is no drug that can make them go away.”
On the morning of my preliminary examination, the corridors of the eye clinic are just as busy as those at the passport office before the summer holidays, only the average age is higher. I am met by an optician who checks my eyesight and advises me on the choice of intraocular lenses – the two small acrylic things that are to be inserted into my left eye and then into my right eye a few weeks apart. I had already spent hours researching on the internet and still didn’t know what I wanted. Would you rather have monofocal lenses that let me look sharply into the distance because their focal point is set to this viewing distance? The health insurance pays for that, but then I would need glasses for close vision. The other way around would also work: close up sharp, far away glasses. But there are also trifocal lenses that enable good vision near and far and in the intermediate area. Because of the more intensive diagnostics and the price of the lenses, this option would involve an additional payment of 1,000 euros or more. Side effects can also occur – a halo effect, for example, in which you see a kind of halo around light sources. Fortunately, the friendly optician has another suggestion, viz Monovision. One eye is set for the distance and the other for the middle area. If the difference in vision is not much greater than one diopter, the brain ignores the visual impression of the eye that is not being used and you can see clearly at both distances without glasses. Sounds great, I want that!
No more going back
The closer the operation gets, the scarier I find the idea of someone messing with my eye. I lie awake at night and would rather have a general anesthesia. In the morning I think: hiring, as an outpatient is much less effort.
In fact, it’s incredibly quick. I go into the operating room at nine, and at eleven I’m sitting on the sofa at home, with an ointment bandage on my left and reading the eye drop instructions on my right. I know that I chatted with the anesthetist in the operating room while she put a brown tube in the back of my hand for a bit of propofol to help me sleep – because of the anesthetic injection next to the eye, brrr! And that Dr. Wagenfeld told me in the operating room that it would start now. I didn’t notice the small cuts in the cornea and the hollow needle with which the lens core was washed and sucked out, nor did I notice the insertion of the new lens into the empty lens capsular bag. There was light and flickering and next thing you know, the nurse saying, “Let me get you some coffee, your blood pressure is a little low.” When the cup was empty, a friend picked me up and drove me home.
Everything went well?
When I wake up the next morning, I alternately cover my eyes and feel irritated. With the right eye, the unoperated eye, my surroundings have the familiar, friendly, even golden tone. With the left, everything seems cold, clear and too blue.
At the check-up appointment in the clinic, Dr. Wagenfeld said that it wasn’t because a strange lens had been inserted into me – my suspicion – but that “the golden thing” was the yellowish opacity of the lens. And that the world doesn’t look like that – with healthy eyes.
The next shock comes three weeks later. One Friday evening I suddenly notice flashes in the corner of my eye. And black dots wafting through my field of vision. The cause – I found out on Sunday morning in the eye clinic at the university hospital – is one removal of the vitreous body, which, according to the doctor, can be caused by cataract surgery. I don’t have to worry about the so-called mouches volantes (French for flying mosquitoes, because the dots look similar), as long as new streaks don’t appear. These are collagen fibers that are particularly irritating when they bunch up directly in the line of sight. Sometimes the “mosquitoes” decrease over time. And you get used to it – your brain eventually ignores the dots.
In the case of lightning, however, a quick visit to the ophthalmologist is recommended. During the detachment of the vitreous body, tensile forces can arise that lead to tears in the retina. These, in turn, can result in a detachment of the retina and possibly blindness if they are not lasered quickly. Luckily my retina is fine. Even after the second operation, when the same thing happened again.
A few months have now passed. The little dots that I still see don’t bother me and I’m happy about the bright, clear, well-defined world. Only the birds have become lonelier. You’re flying alone again.
After the operation Christine Hohwieler discovered her love for e-readers: in bed with big letters – an unexpected reading pleasure!