Reprinted from the March, 1999 issue of

 

     I'm blind as a bat and I don't wear my glasses. Vain. Ridiculous. Except that vain, to me, is about a person who finds her looks so fabulously irresistible that even a little flaw -say, a pair of glasses - constitutes a sort of unbearable aesthetic pollution. Glasses, on me, however, are something different: the straw that breaks the camel's back, the unwanted accessory that tips the scales from "presentable" to "homely."

      Glasses are also jangly, undependable items that bounce and slip and slide and collect scratches and pinch the bridge of one's nose. They either grip the ten­der spot behind one's ears like a vise, or they wave a single arm -- crablike -- away from one's head, tilting crazily and eventually plummeting head-first to the pave­ment/off the ski lift/into the pot of lentils.

      If I can avoid it. I don't wear them (I tried contacts, and couldn't deal). So people think I'm a horrible snob: They wave and I don't wave back. Everyone looks fabulous­ -- no wrinkles, no acne -- everything is soft-focus. But every person I see coating toward me when I'm out running in the woods by my house strikes desperate fear into my heart -- I can't see whether they're simply smiling or are about to attack me (perhaps I'm a bit neurotic along with the vanity? We'll revisit this topic). And I can't see my daughter’s expressions across the room.

      A friend with the same eyesight appears one day in the office. She looks like she always looks: fabulous. "I had eye surgery last night," she says, sounding a bit stunned. "Didn't feel a thing. Took twenty minutes." Her eyes are clear, bright - you'd never know she'd done anything, let alone let loose a laser on them. "I can see everything," she says. "I can't believe it. It's incredible."

      The next day, I'm running past another would-be ax murderer on the trail, and that's just it. I have to have it. Being able to see would be better than just about anything else available for $5,500 (about what it costs for both eyes, depending where you live; insurance rarely covers it). Home improvements? Gym membership? Part of a car? Clothes? A vacation? Everything pales in compari­son. I make an appointment.

      The first thing I notice about Martin L. Fox MD, at­tending corneal surgeon at New York Eye & Ear Infirmary, is that he's wearing glasses. "Farsighted," he says. Appar­ently there's a similar opera­tion just approved by the FDA for farsightedness, but he hasn't gotten it yet. And the operation I'm proposing to get? It used to involve knives (eyes are nearsighted when their focusing mechanism is too steep, by weakening the corneal tissue in one part of the eye, normal vision is re­stored), pain, and extended recovery periods. Then they discovered they could re­shape the cornea using a laser. The procedure, PRK, was much easier, but-ouch. Then they had a truly brilliant idea: By creating a small flap at the top of the cornea­ where all the nerves that would tell your body to have a reaction (swelling, tearing. generally freaking out)-and holding it out of the way while they used the laser on the interior of the cornea, they almost completely eradicate any negative reactions to the surgery. This relatively new tech­nique is called LASIK, which stands for laser assisted in-­situ keratomileusis, a fascinating and lengthy term.

      After the laser has done its’ work, the corneal flap is brought back down and the pressure within the cornea holds it in place (i.e., no stitches); within twenty-four hours, the ep­ithelial cells around it have grown back and healed it.

      In terms of pain, or "discomfort" (as health-care profes­sionals crazily insist on calling it), LASIK is "less bothersome than a checkup at the dentist," Fox says. "It's nothing for most people." Except for the undercover narcotics police­man he recently treated, who fainted during the procedure.

      Fox is mapping the topography of my eyes with some sort of space-age computer. "So we know exactly where and how to treat each of your eyes," he says. He checks for every sort of eye disease, checks and rechecks the proper prescription. I'm sent home with a date to meet him at TLC, the facility where the actual operations are performed. Lasers are pricey items, I gather.

      I get a TLC packet of things to sign that, when I open them up at home later, are a little alarming. Anything you have to sign for any surgery is alarming, because of our lawsuit-driven world. But having to sign a frighten­ing statement is nothing compared to having to write it out in your own hand: "My vision may be made worse," I scrawl. "There are risks and there are no guarantees."

      "Why are you getting this plastic surgery?" my husband asks.

      "It's not plastic surgery. It's my eyesight."

      "Well, you don't need it, do you?"

      TLC is in a huge tower on 57th Street-just down the street from Prada. It's decidedly spa-like: lots of plants, lots of teal. The waiting area is full of ner­vous people and reassur­ing employees. I'm not the slightest bit nervous: "The smell of that hazel­nut coffee is going to make me scream!" I whis­per to my friend, who's come to hold my hand. She opens a magazine and places it in my lap.

      A calm, lovely, hand­some TLC employee takes us to a room and explains what's going to happen, gives me antibiotic eyedrops for the week following the opera­tion, and explains about follow-up appointments.

      Dr. Fox appears and checks my eyes on some incredibly high-tech-looking machine. "Great . . ." he says, and into the OR. The laser machine looks like a giant beige copier. I lie down on what looks like a massage table.

      Okay. So here it is: It's five or so minutes of extreme, extreme anxiety. People are operating on your eyes, and you're there watching it, full-on, with no mood-altering

substance to blunt your heart-thumping panic.

My friend held my hand, but I was terrified. "I'm so afraid, I'm so afraid," was all I could say. I simultaneously felt full of adrenaline (leap out of this chair and bolt for the door now) and completely drained. Unsurprisingly, all I wanted to do was close my eyes.

But there's no pain at all. And it's five minutes (per eye; it can take up to ten, depending on your prescription): They prop open your eyes with a series of medieval torture-looking devices, tape back your lashes, drop in var­ious liquids (topical anesthetic, disinfectant), and flash a light or two at you. The actual procedure involves increas­ing the pressure in your eye (one of the medieval-ish things does this) for a moment, causing vision in that eye to go blank. Many people don't like the sensation; I enjoyed it, as it was a brief respite-a split second of not being there.

      While the pressure is high, they slice the flap with the keratome (which I unfor­tunately envisioned as a razor blade, and, truth be told, did feel-not in a pain way, but in an uhnh-l-can­tell-something-is-going-on way). Your vision returns (the pressure goes down), and you stare at a little red light very intently while the laser does its twenty to forty seconds of work. You don't feel anything; there's just a tick-tick-ticking sound of the laser. I was incredibly tense: If you look away from the red light, it throws off the coordinates for the laser (which Dr. Fox instantly stops). I felt like I was on the ledge of a cliff, unable to step back from it, know­ing I might leap off at any moment. It was exhausting, even though it was only a few seconds.

Martin Fox is exactly the kind of doctor such a situation demands, because he tells you what he's doing every step of the way, and more importantly, how you are doing every step of the way. "Perfect. Perfect. Oh, this looks great. Oh, you're doing so well. This is really perfect."

      And then it's over and they take off the medieval eye­openers, and you're done, and though my vision at that point was sort of blurry and bad, I looked across the room and noted that I could read the clock-a complete impossibility for me just five minutes before. It's absolutely a mir­acle, plain and simple.

      But peering across the room is made difficult by very, very bad light sensitivity; I closed my eyes and only opened them to let Dr. Fox have a look at them and to get special plastic shields taped to my face-so I wouldn't rub them in my sleep.

      A prescription for Percocet is dispensed-I'd advise get­ting this ahead of time, rather than dealing with brightly lit, unresponsive pharmacies in this condition-and that's that.

      I was so tired that I didn't need the Percocet at all. I went home, ate dinner in darkness (lights were still awful to con­template), and went to sleep.

      The next morning, howev­er, was a gorgeous and brilliant day - and the light didn't bother me a bit: I woke up, peeled off the shields ("very sci-fi," my hus­band noted), and looked. Every leaf on every tree, every tiny twig that I never used to see was right there, crisp and unbelievably beau­tiful. The river, which I can see from my bed, glittered; I could see little whitecaps.

      The verdict at Dr. Fox's of­fice is better than 20/20: 20/15, in each eye. Seeing my daughter's expressions from across the room is huge. Looking in the mirror is a little disconcerting, be­cause it's more of a com­plete picture than I'm used to, The view -- of anything­ -- is amazing. People still look beautiful, surprisingly. It's thrilling to watch TV, or to drive, and have this moment of "Where are my glasses?" and realize I don't need them. I still haven't thrown them out yet.

      Human nature drives everyone to ask the same question, first: "Yeah, but what if it goes back to the way it was?" As long as you visit your eye doctor every year for nine years, TLC guarantees the surgery for life. Then they want to know how much it costs. And then they want Dr. Fox's phone number.

It's one of the best things I've ever done. My life is dramatically improved. Hindsight is 20/20.

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