Sweet sight

This doesn’t happen often, but last week after performing my first surgery of the day, I ended up in tears.

About a month ago a gentleman from a neighboring island came into my office, unable to see. When he was a child, he was hit with a rock in his left eye, and he has been blind on one side since then. Anyone who has one blind eye is usually vigilant about taking care of the eye that is left. After all, there is no spare, and any problem with the good eye can lead to a lifetime of darkness. If you’ve already lost one eye, you don’t take it for granted that you’ll have the other one the rest of your life.

So, like many people with one blind eye, “Mr. Smith” had visited a lot of eye specialists during his life. As he grew older, the vision in his good eye began to grow dim. He was told that he was developing a cataract. A cataract occurs when the lens inside the eye gets cloudy. Usually, the cloudiness develops gradually over a number of years. The treatment is a straightforward operation to remove the cloudy lens and replace it with a clear new artificial lens. It’s a safe procedure, but like any surgical procedure (or like anything in life) it has certain risks. The risk that is so very rare, but so very important to someone with only one eye, is that any surgery can result in bleeding or infection, and if that happens around the eye, the vision can be lost.

For someone with one eye, that’s not a risk you want to undertake lightly. So, Mr. Smith kept putting off the surgery year after year. After all, he could still see and get around. Why take the risk? But with each passing year, the cataract got a little cloudier, and the vision got a little worse. Until he felt he had not choice but to get the surgery. He had gotten to the point that the vision was so cloudy, he couldn’t see anything but shapes and shadows. He had difficulty walking because he couldn’t see clearly. This is what it was like a month ago when he walked into my office. Mr. Smith had checked around—visited eye specialists on neighboring islands, and decided to come see me for his cataract surgery.

Last week we took Mr. Smith to the operating room. When a cataract is as dense as Mr. Smith’s, the surgery is quite a bit more difficult and the risks of complications higher. Mix this in with the fact that this is Mr. Smith’s only eye, and any complications could leave him completely blind for the rest of his life, and you can see that the stakes are pretty high.

One of the wonders of modern cataract surgery is that the person is awake during the surgery and the eye can still see while the operation is taking place. So Mr. Smith is watching the surgery as it’s taking place inside his eye. A lot of time is spent removing the pieces of the cataract from inside the eye. It’s a tense time, but as the final pieces of the cataract are removed, the riskiest part of the surgery is over. The next step is to put the artificial lens into the eye. The lens will bring the world into focus. I carefully place the artificial lens and feel relieved. The surgery is completed. Everything has gone very well. I move the operating microscope out of the way, and no one is quite prepared for what happens next. Mr. Smith, with a bit of shock, says, “I can see.” He lifts his head and looks around, and says again, with more excitement, “I can see!”

Of course, the reason we do the surgery is to help someone see, but sometimes we forget how dramatic it can be for someone who has been in darkness for years to suddenly see again. The members of the operating room team look at each other with a sense of satisfaction. By now Mr. Smith is exuberant and is shouting, “I can see! I can see! I can’t believe it! I can see! I can see your shirt! I can see your face! I can see the colors!” And as we’re wheeling him to the recovery room, we’re getting choked up by his excitement and he keeps saying “I can see!”

I walk out to the waiting area to let his wife know that everything went well. The problem is that by now, my eyes are full of tears and I can hardly talk. Mrs. Smith takes one look at me and I see horror in her eyes. She sees the tears in my eyes and must think I’m coming to tell her that her husband died in the operating room. I realize I need to talk quickly, but I can barely speak. I manage to get three words out: “He can see.” Those are sweet words to a woman who thinks I’m coming to break bad news. She jumps up and half screams and half asks “He can see?!” and jumps for joy and now both of us have tears streaming down our face.

It’s nice to feel the sweetness of someone else’s joy once in a while. To become aware of the miracles that take place every day around us, sometimes close, sometimes far. And to remember the things that we take for granted can be so dearly missed by others and so deeply cherished.

(David Khorram, MD is a board certified ophthalmologist, and director of Marianas Eye Institute. Questions and comments are welcome. Call 235-9090 or email eye@vzpacifica.net. Copyright © 2006 David Khorram.)