I had Strabismus surgery almost two weeks ago, to correct a wandering right eye. (Pinches and well-timed smacks have largely corrected that other kind of “wandering eye.”) While my vision in the right eye is poor to begin with, its sensory input, misaligned with that of my left eye (that’s my good eye) was becoming more and more distracting. I’ve had two similar surgeries in the past; at three years old, and again at about 40. Both earlier surgeries operated on and “adjusted” the muscles of the right eye.
“I lost a superpower. With my right eye distractedly veering 20 degrees to the right, my peripheral vision provided me a power few can claim. A long way from 20/20, the right eye contributed shapes, shadows and movement to my immediate awareness. Now that my eyes are newly realigned, I’m a mere mortal. ”
That's not me.
I’ve experienced a range of reactions – to the eye, and to the surgery itself – ranging from “why did you wait so long?” to “I never even noticed.” Likely you fall in-between. Two anecdotes add context. Before my previous surgery, I went for a series of job interviews at a small tech company, and got the job. I learned later that they chose me in part because of my “crazy eye,” which they felt was appropriate since the company was – crazily – gearing up to challenge Cisco as a dominant router company. More recently, I’ve been teaching groups of fresh university graduates. When someone has a question, I look at them and say “yes?” I often get a confused look; “You talking to me? Or to the person to my left?” It may just be a sign of these PC times that people no longer call me by my native Lakota name Crazy Eye.
Preparing for this surgery, I knew that the scar tissue from previous operations could limit the range and precision of another surgery. The doctor and I agreed that, should that be the case, she could operate on the left eye muscles instead. (The muscles work in tandem.) I’d prefer accuracy, and the risk from cutting into my good eye was low.
Have you ever had a similar discussion with a plumber? Or a software developer? The preference is always to work with new pipe, write new code, rather than fight with old joints or interpret someone else’s crusty work. Eye doctors are apparently of the same mold, as I learned in the recovery room.
Recovery
My doctor prefers a “90/10” approach to the corrective surgery; ninety percent of the work is done under general anesthesia, leaving the stiches exposed until I was conscious in the recovery room. At that point, she would do some alignment tests and make the final adjustments. I woke, quickly realizing my good eye was under siege. (Linda later recounted her moment of panic in the recovery room; I hadn’t mentioned the possibility of the good eye being the target, and she thought the doctor went after the wrong eye.) As the doctor pulled and measured, twisted and snipped, I became aware of the small crowd watching, in particular of the revulsion on one of the nurse’s faces. In her defense, I guess there aren’t many body parts more sensitive to poking than an eyeball.
Surgery on the good eye changed the anticipated course of my recovery. I had planned on a patch to cover the redness in my bad eye; I don’t use the eye much anyway, and my unaffected good eye would continue doing all the work. Instead, my good eye became an angry bright-blood monster, a tiny pot of tomato sauce boiling over in the socket. You’d have to look closely to realize there’s still a pupil there.
For the first few days, my vision was hit-or-miss. I was often unable to blink away the film or ignore the discomfort of the stitches. I could still work productively at my PC, thanks to the combination of prescription glasses and zoomed screens (Ctrl + mouse wheel zooms many apps and browser windows quite nicely). Of course I couldn’t venture out without shielding the public from something they might not be able to un-see. The pair of dark Ray-Bans that my son gave me a few years ago were great, but images – without my prescription glasses – were either very blurry, or dramatically double – often both. So cool, yet so not cool. The pirate patch I ordered? Useless; navigating using just my bad eye is never a good idea.
Muir Woods
After a few days, I got used to the soft edges and blurriness around me, in place of the sharper contrast that most of us enjoy (and that I look forward to). Could this haze be a more informative way to see things? Instead of clean edges separating things, everything is softer. Objects run into each other, become more connected. There are no individual leaves hanging from graceful tree branches; I see a child’s watercolor of green and brown. Instead of individuals – that’s Bob, there’s Melissa, hi Calvin – I see small groups of people shuffling as one, impressionist-painted individuals. John Muir wrote “When we try to pick out anything by itself, we find it hitched to everything else in the universe…” He suggested that the poetry of Nature, it’s connectedness, becomes more and more visible the farther we go and higher we climb. I let my blurry vision temporarily stand in for Muir’s mountain climbing.
Reliving a science experiment
I’ve re-experienced the temporary – and therefore comical – rending of the connection between my vision and the physical world. My brain has, for years, compensated for the deviation of the visual stimuli from my right eye. Post-surgery, it was still doing that; somebody forgot to inform my brain that the right eye input is now aligned with the left. The result is that I often misjudged how close objects were to my left side. (Message to my brain: objects are closer than they appear.) Funny is putting the coffee cup a few inches to the left; my first post-surgery cup went directly into drip drawer. Slightly less funny (for me, not for Linda; she has had a few good laughs) is walking into door jambs, chairs, tables. I remember clearly a documentary film from elementary school. In it, the test subject wore a contraption made of lenses and mirrors that turned everything he saw upside down. Obviously disorienting, and the antics – try to catch a ball, pick up a cup – were comical. But after a few days, his mind learned to compensate, inverting the images somewhere between his eyes and his brain, restoring a normal view of his world. I can vouch that this actually happens, with no training – just time.
The disorientation forces concentration. Not wanting to advertise my tendency to bump into things, I adopted what most self-help books promote these days: an in-the-moment singlemindedness, an intention of purpose, often which is simply to get from point A to point B without acquiring a new bruise.
Advancing medical science
One morning over coffee, I thought about a comment my brother made. Upon learning that they found excessive scar tissue in my right eye, he suggested that there should be some sort of pre-surgery imaging to detect this in advance. (He was probably thinking of how to reduce costs; he’s the former CFO of Ohio State Surgery.) My mind wandered to an old Star Trek episode; I probably have the details way wrong, but the gist is intact. Spock – some 300 or so years in the future – walked into an operating room and yelled at the doctor who was about to operate on a dying patient. “That’s barbaric!” As he pushed the doctor aside, he held a device over the wound; a few beeps and maybe a blue aura (special effects were crude in those days), along with some Star Trek magic, and the patient was healed.
While we’re on the topic of advancements, why can’t they use lasers to adjust the eye muscles, without cutting? If that can be a thing, I want credit.
I also suggested to the doctor that she install some set screws (surgical grade, of course) for future external tuning. She said she had heard that comment before, but didn’t know what a set screw was; so much for a well-rounded medical education.
Prognosis
Two points of reference. I drove the car yesterday – 12 days after surgery. For the first time in a few years, I didn’t have to close my right eye as I was backing up; no more double-vision. And now, when I shave, I can see my right sideburn almost as good as my left, not because my vision has improved but because my brain’s not getting conflicting information. No more fake news from my right eye!
Like hearts and minds, I expect that my eye will one day wander again. Until then, I’ll enjoy seeing straight.