Friday 1 October 2021

Seeing - myopia, presbyopia, astigmatism - why can't children get new lenses?

 Seeing is an essential part of being

Being able to see matters. If we can't see, we are unable to take a full part in normal human activities. Replacing our natural lenses with plastic lenses is an amazingly effective way of restoring sight to people with myopia, presbyopia and astigmatism, but it is usually only used when people have cataracts.

I have been short-sighted (myopic) all my life - before my lens replacement, I was measured as being -12 diopters in terms of my myopia, my astigmatism was extreme, and, beyond that, I was able to see things less clearly, and differentiate colours badly, because of my presbyopia (old-age related vision decline) and my cataracts (that were clouding my vision).

This is not a sob-story about me. Many people are in just this position, and, often, when much younger than I was when my lenses were replaced.

When I was very young, my myopia was diagnosed, and I was prescribed the usual thick bottle-bottom lenses. I thought these were a huge improvement.

Later in life, I heard about Lasik, laser surgery to improve vision. So, I went for it. It was one of the most painful experiences of my life. As the laser cut away my eye, I could smell the burning. I was unable to be exposed to any bright lights, without pain, for three days afterwards. It took me several weeks to recover. I still felt pleased, after that, that I had done it, because I thought that my vision was so much better. I still needed glasses to read, and I still couldn't see things as other people saw them, but I didn't know that, so I thought it was a brilliant improvement.

Several years later, my optician examined my eyes, and said that I was developing cataracts. He referred me to a surgeon. This was a major turning point in my life.

The surgeon arranged for an operation to replace my lenses with plastic lenses - not the lenses in my glasses, the lenses in my eyes. I was quite apprehensive about this, because the lasik surgery had been so horribly painful for so long.

I need not have worried. My lens replacement surgery was completely painless - I really mean that, I had no discomfort whatsoever, none at all.

I could not believe the difference! Suddenly, colours were bright and I could see a huge range of colours. I could also see features far away, on the mountain, so clearly that I thought they might be artificial. When I went to the supermarket, for the first time, I could read all the signs, above the aisles, saying what was being sold there - before, I'd thought it was some sort of joke to expect people to read them, unless they were immediately below them, and I wondered why they bothered... Now I could see that the far aisle was for pickles and pasta - it was a revelation!

Yes, I still need reading glasses to see something close up. Yes, years, now, after the operation, the unbelievable brilliance of colour that I saw after my operation has settled down - our brain accommodates to things and they seem less exceptional. Still, my experience of the world is so rich and varied, and clear, compared to what it was during the first fifty years of my life that it continues to amaze me. Just this afternoon, I was looking at a tree at the bottom of the garden, and marvelling at how I could see all the leaves, not a a blur, but as leaves, and I could see the bright blue of the sky and the many different greens of the tree - for most of my life, this has been impossible.

So, with all this wonder, and improvement, what is my point?

Why can't we offer young children, with bad myopia and bad astigmatism, lens replacement? Why should they wait until they are old enough to have cataracts?

If only, as a child, my lenses had been replaced, my life would have been quite different. I'd have found microscopes and telescopes useful instruments - as it was, I wondered why anybody bothered, because, to me, they just offered blurs. I could have seen the beauty of mountains, I might have been able to play sport - I hated rugby and cricket because I could not see the ball. It seem silly to say this, but, when they sneered at me for dropping the ball it was because I only actually saw the ball when it was a metre of so from me, far too late to catch it.

Can't we spare children this diminished perceptions?

Can't we give people with bad eyesight good lenses?

I really think that we should. Contact lenses, glasses, laser-eye-surgery, all seem to offer improvement, b ut, from personal experience, I know they are actually quite useless. The only thing that really works to fix your eyesight is new artificial lenses.