Cataracts I Have Known

A Brighter Shade of Everything

Image | Pixabay

Many of my age-peer friends beat me to the punch and had one or both eyes treated for cataracts--a leading cause of blindness worldwide, and so also one of the most frequent surgeries. It is hard to imagine, but the first such surgery was done around 600 BC. Can you imagine?

The History of Cataract Surgery | Byrd and Wyandotte Eye Clinic 👁️

I walked into the the Surgery Center south of town on the morning of December 16, 2024 with not the least bit of apprehension. And this chill attitude persisted, in spite of the fact that just a few hours before that, I had convinced myself it would be useful to know what to expect, to better explain the experience to myself afterward.

This six minute video I watched the morning of the procedure showed every puncture and poke, every irrigation, every aspiration, and another punch and out goes the old--in with the new. But what was the patient experiencing with all these metal objects jabbing and prodding? How would an eyeball feel after it had been a piñata, a punching bag and dart board?

I had asked the surgeon in the pre-op visit how long the actual procedure would last. “Eight minutes" had said. Wam-bam.

I was determined to pay attention throughout—to find a balance between the personal experience from the inside and a Spockian outsider account, as a disinterested but observant watcher and recorder from the corner of the room during the brief intervention.

The patient was laid out on a typical hospital gurney, fully dressed, shoes on was optional. A surgical cap was placed over the hair; and IV port was plunged into a tender vein in the left arm, and a pulse oximeter placed on the left index finger. Numbing drops were administered to the right eye periodically. A blood pressure cuff on the right arm automatically constricted and progressively relaxed every five minutes or so over a half hour wait for something to happen.

In the open space between the pulled curtain and the next cubicle, I could watch and listen to a dozen other patients, also getting their prep, interacting with the staff. For several, this was Eye Number TWO, so they knew the drill.

There was far more laughter than medical chatter—a far less serious atmosphere than in full med-surg settings I have known. Gurneys with IV poles came and went regularly. This was just another day for these folks in scrubs. But I would not treat it as ordinary. And I would purposefully remember, in order to write about it the next day; to tell myself the story. A guy only gets two shots at this experience, so might as well take notes.

After the IV had been placed, I let myself imagine that the early anesthesia had already started, and I entered a peaceful state of alert watchfulness. Any calming was from within, it turned out. The anesthesia nurse came into the cubicle, while another nurse repeatedly washed my right eye and brow, and applied a surgical drape over the area.

My least favorite part was when my head was taped to the gurney and my neck was not at all comfortable. I almost complained. But maybe it would be less of a problem after the meds kicked in. And then…

"I'm going to start the anesthesia now" she instructed, but I was not asked to count backwards from 100. I felt a cold sensation moving up my arm. Ten seconds passed. I noticed no change at all. Beyond that point, it would almost be accurate to say that I didn't remember anything. I was aware of sounds but no voices or meaning. Light and dark and movement came without shapes or colors or words to describe them. I remember the state but not the experience.

I also have no recollection of "waking up" but was just suddenly standing, fully dressed and without pain or excessive unsteadiness. I walked out into the waiting room in my new sunglasses and was driven home.

And here we are on Day 3 after cataract surgery with a new outlook (where whites are WHITE!) and we got it done.

I asked the surgeon in the follow-up visit a few hours after the surgery about the anesthesia. Versed was the agent for conscious sedation, he told me.

“Conscious sedation involves a combination of medications that help you relax (sedatives) and block pain (anesthetics). The primary mechanism of action for Versed is its ability to enhance the effects of a neurotransmitter called GABA (gamma-aminobutyric acid) in the brain. This leads to decreased neuronal excitability, resulting in sedation, anxiolysis (reduction of anxiety), and amnesia.” You.com ai

Amnesia indeed. If there was discomfort or distress, there is no record of it in my memories. I was just a bit unsteady that afternoon, and took several short naps but was 100% alert and steady by dinner time.

Colors are true, not tainted the tawny tint of the cataracts. Vision in my operated eye is better than it has been in a very long time, and I don’t need glasses now to drive or watch the tube. Reading, however, is going to require bifocals. Meh.

So if Eye #2 needs this same treatment down the road a year or three, I will know what to expect, and try to pay attention and enjoy the ride, at least up to the odd ambivalence of Versed. If you have this procedure coming up, no need to dread it.

The trips to the optometrist for all new glasses to accommodate your newly-added artificial lens--you can dread that.