When I was in first grade my teacher suggested to my mother that I should get my vision checked because I seemed to be having difficulty in class. There is not a history of poor vision in my family and I had been checked the year before so my mother did not believe there was anything wrong, but she finally consented to get it checked out. When the optometrist asked me to read the chart I asked him what chart he was referring to. He said that there was a chart on the wall with a letter on it and asked me what the letter was. I questioned him once again and said that I did not see any chart. My mother scolded me and told me to stop playing around and the doctor asked her to leave the room for a moment so that he could speak to me further without my worrying that I was in trouble. What my mother simply could not comprehend was that my vision was so poor that I truly did not see the chart on the wall, much less any letters. The optometrist could offer no explanation for my sudden extreme nearsightedness, but this was the beginning of my life of “almost” blindness.
It is difficult to describe your life when you are “almost” blind. People have a clear understanding of what it would be like to be completely blind. I’m sure that most of you at some point (usually after reading “Helen Keller”) have closed your eyes and tried to make your way around your house. It is terrifying and that does not even take into account the unimaginable reality of not knowing the different colors or seeing a sunset. These are things that I do not have to deal with and I am grateful for that every day. “Legally” blind is the term used for people who are considered to be disabled by their blindness. In order to be considered legally blind you must have vision that cannot be corrected to better than 20/200. Although I cannot remember a time when my vision was able to be corrected to 20/20, I can at least make it to around 20/35 or 20/40 with my lenses, which allows me to pass the driver’s test and keep my independence. However, there are still some real difficulties that come with vision such as mine. When people ask if I am nearsighted or farsighted I usually say that it really doesn’t matter. I simply cannot see. Technically, I am nearsighted but it is not physically possible to hold an object close enough to my face for it to become clear. Without my glasses I can see blurs of color for things near to me. Once they get farther away they simply disappear the same way that first eye chart did against the wall. A person can be standing directly in front of me and I cannot tell who it is until they speak. If I tried to walk through my house without my glasses I would be able to see and avoid the couch, but if there was an item on the floor I would almost certainly trip because I would not be able to see it.
When I was growing up I could ignore my vision troubles for the most part. I had my glasses, of course, and although there were the usual comments regarding my appearance they did allow me to see. I could go for months at a time with no problems. The trouble was that I never knew when it would become a problem. There were several times that I had a lens fall out of my glasses during school. This was incredibly frightening and embarassing because my mother would have to be called immediately to pick me up and take them to get the lens fixed and then I would have to actually be led out of the school and to the car. This is a very sobering experience, even for a 9 year old, because it reminds you just how close you are to being dependent on others. As a child I learned to be very careful to always put my glasses in the exact same spot on my bedside table each night. Even still, there were a couple of times when I accidentally knocked the glasses off of the table as I was reaching for them. My mother came in once trying to figure out why I was so upset and I was on the floor frantically patting the ground looking for the glasses. It turned out that they were just in front of me, but far enough under the bed that I couldn’t reach them. She could not understand how I missed them or why I was so upset, but it is always frightening to be reminded so suddenly how dependent on the lenses I am.
There are many things that people take for granted if they do not have very poor vision. The biggest one is peripheral vision. This became clear to me the first time that I was able to wear contacts. Until I was a sophomore in high school they did not make soft lenses in my prescription. I tried the hard lenses for a little while, but they irritated my eyes too much and I could not continue wearing them. My main purpose for trying the contacts was simple…vanity. I was 15 and was very tired of feeling trapped behind thick glasses. However, once I put in the contact lenses I learned something shocking. I had lived for 10 years like a horse with blinders on. The trouble with glasses is that they only work if you look straight ahead. You cannot look to the sides or up or down because the lens does not surround the face. With contacts they go around your whole eye and so you can see in every direction. This was completely amazing to me! I will never forget that feeling that suddenly I could REALLY see. It is a constant source of frustration for me that vision insurance will cover glasses, but not contacts even in cases like mine because it is considered a “cosmetic” expense. Since then, despite the cost involved and many budgetary restraints I have managed to still pay to keep my supply of contact lenses because I cannot go back to seeing only straight ahead.
Once I got my contacts I thought that my days of worrying over my near blindness were over. All I had to do was keep my contacts in and I could see fine. I could even sleep with them in and have that amazing privilege of waking up in the middle of the night and still being able to see. Sure, there are risks associated with that but even my optometrists have always said that in my position they would do the same thing. The contacts allowed me to pretend that my eyes were just as good as everyone else’s. I carried extra boxes with me everywhere so that I was prepared if a lens ripped or got irritated and there was no more rushing to the optometrist to get glasses fixed. I could do it myself. It was great. It lasted for 12 years.
Last year I developed a new problem which is complicating things again and reminding me of that scary out of control feeling that I had as a kid when my glasses were just out of my reach. For the first time I developed an astigmatism. This is a condition that causes people to see shadows and halos around objects, especially if there is any light. It makes it very difficult to focus and can cause depth perception issues and distorted vision. I can no longer drive myself at night because the headlights of the oncoming traffic mixed with the streetlamps cause too much distortion for me to drive safely. During the day I can drive in areas that I know well, but I have a lot of difficulty reading signs because the letters blur because of the shadows. I went to see the optometrist again and I was told that they do not make contact lenses that correct for a prescription as high as mine and also correct for astigmatism. The only option that I have now is to actually get glasses to correct for the astigmatism and wear them over my contact lenses for reading and driving.
I have consulted with doctors about LASIK, but my vision is beyond the range that they will perform the surgery on. I guess I will just have to hope that the technology improves and in the meantime learn how to deal with wearing contacts and glasses at the same time. It is definitely scary when you feel like your ability to do normal daily tasks such as driving is being compromised. I was much more secure when I could pretend as long as my contacts were in that my vision was fine. At this point I am just hoping that I do not have any more sudden problems added down the road. I am only 27 and the idea of my vision getting much worse frightens me quite a bit because I know that it won’t be long before I am out of the range that I can keep wearing contacts and I will be back to only seeing straight ahead in glasses or worse. I hope that I will be able to see my daughter clearly when she stands before me in her wedding dress or holds my grandchildren in her arms. I am optimistic, however, because new advances are made every day.
Although there are some people with 20/20 vision and some who are blind, there are many many more who fall somewhere in the middle. Considering that, it is surprising to me that there are still so many companies that do not offer any kind of vision insurance to help defray the costs. After my most recent visit at the optometrist and the discovery that they could not recommend any treatment other than adding reading glasses over my contacts I debated going to see an opthamologist. I felt that perhaps since my vision was so extreme they may have more knowledge and be able to offer other suggestions. I found out to my surprise that although an opthamologist was covered under our medical insurance, it was only covered if you had a specific medical condition such as glaucoma or cataracts. Anything else was considered “routine care” and not covered. When I asked if my vision insurance would help cover any of the costs I was told by all of the opthamologists in our area that they do not accept vision insurance. In order to be examined it would be anywhere from $180 to $375 due date of service and they could not tell me where in that range my exam would fall until I was actually there. Could an opthamologist offer me any options that I haven’t been told about so far? Perhaps, but I will never know because I do not have $300 to find out. I will wear my contacts with glasses over the top and hopefully keep at least somewhat decent vision when the lenses are factored in. It does beg the question though…how blind do you have to be before it is no longer considered “routine”?