10. Getting cataract surgery

This winter, I got cataract surgery to remove the cataracts in both eyes that had been accumulating for over four years. In 2019, I got a new glasses prescription, but by 2020, they said the cataracts were getting bad enough that they couldn't do anything more with the prescription to help me see. By 2023, they were getting so bad that I couldn't even read street signs, and glasses barely helped the blurry vision — in fact, it was almost easier to not wear the glasses and just look at everything from three inches away without them.

So I made an appointment to get cataract surgery in September 2023. Then I promptly became incredibly anxious about the surgery. No matter how many times anyone told me that it was a super easy procedure, far less invasive than wisdom tooth extraction (which I had gotten in 2015), and the most common procedure worldwide, I got sick to my stomach every single day just thinking about it. That anxiety persisted until the day of the surgery, when we were halfway to the clinic and got a call that it had been canceled. That was the worst day of it all, since I was finally ready to accept that this had to happen no matter what, and I had gone through the dreadful preparation of not being allowed to eat or drink water for 12 hours beforehand, and suddenly I would have to live with this horrible anxiety for an undetermined amount of time afterward.

Following this, the surgery got rescheduled a total of six times, twice through conflicts with me and four times through conflicts with the surgery center. It was supremely frustrating, as soon it got pushed back far enough so that I might not even be able to view the total solar eclipse that would take place on 2024-04-08 with new vision (more on that in another topic). But eventually the surgery did take place in January for the first eye, and in March for the second.

Since cataract surgery is usually done on old people (70+ seems to be average), I was by far the youngest person getting it done when I went there. I was also by far the most nervous, since all this anxiety was catching up with me and I broke down crying in the waiting room because of it. I had asked my grandparents, who both had gotten it done before, how so many people can go through this without completely losing their heads like I did. They said that much of it is really just down to being older and having more life experience, particularly in medical stuff. I'm sure they're right, and that I'll get there one day.

The surgery itself went fine, although the surgeon had to yell at me to stop moving my eye around several times, which I kept doing because I was so nervous. It made the healing take a little longer than it would have otherwise, but I still healed well. The second eye went much more smoothly — I wasn't nearly as nervous since I knew what to expect that time. The eye drops that they make you use for four weeks afterwards were a bit annoying, but I'd rather have "a bit annoying and able to see better than I ever have" than "not annoying but also not being able to read".

In the week after surgery for the left eye, my vision went from 20/200 or worse (6/60 for any Australians reading) to 20/25 (6/7-ish). And with the right eye, my vision went from 20/100 (6/30) to 20/20 (6/6)! This is the first time I have ever been 20/20 vision, ever, and it blew me away that it's normal to see with this much detail and acuity. It was actually overwhelming and made my head spin for a few days at first.

But not to worry — there's always a catch. With the implants they put in my lenses, my focal length is now locked at arm's length, so I can't see or read anything up close, and my distance vision isn't ideal either. So I'm getting glasses in a couple weeks — I even ordered new frames for the first time in seven years! Very flashy. But the real issue is the scar tissue. Since I'm so much younger than most people getting this surgery, my body is rejecting the lens implants much faster than it would if it were older.

The scar tissue is accumulating on the lens implants pretty quickly, and blurring my previously crisp eyesight. When I went in to get my new prescription, I was reading only 20/45 to 20/50 (6/15) with my right eye. This means that the only way I can read text on a printed page is by using a magnifying glass, and I have to zoom text in on the computer to a ridiculous extent in order to read it clearly. It's so frustrating, because in the period after my left eye got done but before my right eye did, I could still put my face super close to a page to read it, but I can't do that anymore! So I'm hoping that the new glasses, which are progressive lenses, will help me read better, or at least hold me over for the next six months (ughhhhhh) until I get the scar tissue BLASTED away by a laser. I think that's technically another surgery, since they have to have a surgeon do it, but apparently it's super easy and takes less than a minute, and then I'll be able to see and read again!

But coming from four years of progressively blurrier vision to much clearer vision, even without glasses, is truly life-changing. That makes it sound stupid and dramatic, but it really was a huge, huge change and desperately needed to happen. I took a walk up a small mountain on 2024-03-31 and even though it had already been a few weeks since surgery, my head was still overwhelmed by the detail that I could see in the leaves and trees, even with scar tissue clouding the lenses. I'm so thankful to be living in the 21st century, where such a surgery is quick and easy and has such good results.

Very excited for my new frames, which complement my face much better, and I'm looking forward to playing games and seeing Marble Blast with new eyes. Maybe I won't even have to zoom my computer screen in so far anymore! And the anxiety has pretty much gone away since the second eye got done, but that means it was six whole months of awful anxiety, which I'm still trying to recover from mentally.

I still don't think I'll be learning how to drive, though. My peripheral vision is as bad as it ever was, and I think it would be dangerous and foolhardy to be on the roads when I can't see out the entire windshield at once, or even out the side window. Not to mention that the very idea of driving is terrifying. I'll let my family keep driving me places.

Well, a full week sooner than I thought, my new glasses arrived! The frames are fantastic, and look so much better on me than the ones I had before. I couldn't stop smiling looking at my reflection in the mirror, so that's great. As for the prescription itself... well, that's another story.

It sounds like I'll have 30 days in which to make one update to the prescription for free. When I first put the glasses on, I got super dizzy. I've never used progressive lenses before (basically bifocals without the line), so these will take some getting used to. I imagine this will get better pretty quickly, but for right now, whenever I move my head, I get all dizzy and have to stop moving. While writing this post, the text is only clear if I look through a very specific part of the lens, and only through my right eye. This is a problem, because obviously I'd like to be able to read with both eyes, and the reading through my left eye only works at a distance. These lenses are supposed to let me read close up, and for some reason the left lens doesn't do that properly. I'm going to call the eye care place tomorrow and see what they can do.

The optometrist did have to make quite a lot of adjustments to the frames, including bending them slightly at the bridge to follow the curve of my face more. Maybe that has something to do with only being able to focus on text through one area of the lens. If I look more toward the right of the right lens, everything gets blurry again.

The other thing is that the prescription for distance is ±0.0 dpt for the left eye and −0.5 dpt for the right. Since the scar tissue on my lenses is blurring my vision, the eye test that I did a couple weeks ago wasn't super accurate, but now that I have the lenses in front of me, I can tell that the −0.5 is actually worse for my right eye than no lens. This makes sense, because the whole point of getting lens implants in my eyes was so that I wouldn't need distance correction in the glasses lenses at all, so I want to go back and ask for ±0.0 in my right eye and better reading capability for my left.

The other annoying thing is just how far down I have to look in order to read. At my preferred reading distance (about a handspan away from my eye), my eye needs to be looking through the very bottom of the lens in order to read clearly. I suspect that when I spend a long time reading, this could lead to eye fatigue, since it feels kind of uncomfortable even for a short while. I don't think it's designed to have to look that far down. So I have many followup questions for the optometrist and the eye doctor. Guess we'll have to wait and see how things develop, and I will of course keep a running log here.

Today I went to see if they could adjust my prescription to help me read with my left eye and see better farther away with my right. After trying to do that by holding different lenses up to my left eye, it turns out they can't. The scar tissue is apparently preventing me from being able to read in the left eye but not in the right eye.

I only have 30 days after getting the initial prescription to refine it once. But for now, they plan to keep my prescription where it is and try to get the insurance company to cover a prescription change after the scar tissue is taken away, since that won't be happening until July/September, well after 30 days have passed.

They did say I could try to get the scar tissue removed sooner than July, but not only would that mean I'd have to go far away for that "surgery" (technically surgery since a surgeon has to do it), the surgeon might even look at my eye and determine it's not healed enough to do that procedure. So I may as well just wait until July anyway. They're going to call me to schedule an appointment with the surgeon, but I don't even think I want to take it, since I can read with one eye and see well enough to function until the scar tissue gets removed. Basically, I'm not in any rush, and I'd rather be safe than sorry.

It is annoying that they couldn't do anything to help with the glasses, and that the problem is in my eye itself — in fact, it's heavily reminiscent of when I had the cataracts, since the problem was in my eyes and not the glasses back then too. So even though it's not actually cataracts and the way to fix it is much easier than cataract surgery, it still feels like a "round two" for this whole situation.

What a day. Today was my long-awaited appointment to get the scar tissue removed in my left eye. I was not nearly as anxious as I was for the cataract surgery itself, but there was still a certain amount of apprehension as the day approached. I had to take time off work in order to go to the clinic, and once we got there, I had to wait for a typically long time. It looked more crowded than usual. After over an hour, a nurse called me to check my eye pressures and dilate my eyes. Once that was done, I had to wait another half hour before I was actually called into the exam room itself. Then we had to wait like ten more minutes for the doctor to come in and see me.

At this point, it's well over 90 minutes after my appointment was scheduled for, but I'm so used to that that I wasn't even really bothered by it, I just wanted to get the laser treatment done so that I could see again. So he finally comes in and looks at my eyes. He said that I have two things obstructing my vision: one is the scar tissue, which has accumulated and turned much more opaque since the surgery was performed, and the other is part of the actual eye itself. It sounds like during the cataract surgery, they made an incision to put the lens implant into, and since the surgery, the eye has sort of—constricted around the implant. At least, that's how he made it sound, so it's affecting the edges of the implant and reducing my vision even further. But he said that both of those things could be fixed with this laser treatment in under five minutes.

So I was happy to hear that. It sounded like it would be a quick and easy procedure. I even asked him if I could blink during it, and he said yes, that it wouldn't have any effect except making it take slightly longer. He said that for the procedure, I sit in a standard exam room and look through a machine that is similar to the standard one, except instead of a white light, he shines two red lights in my eye and there's a lot of clicking noises.

But then he drops the fact that they just heard from the insurance company this morning that they have not yet cleared me for this laser treatment. So he can't even perform the laser stuff today at all. My mom and I were pretty upset by that, and it sounds like the clinic didn't even think to ask the insurance company for authorization until this morning. So we essentially went all the way there and waited all that time to be told a description of the procedure which I mostly already knew, and that it couldn't happen today. We scheduled for early August so that I can actually get it done then, but only for the left eye, because he has to do both eyes separately anyway. While we were trying to schedule that appointment, slots were getting filled in real time, so it's later than it would have been if I'd just been a bit quicker to confirm. That was pretty annoying. Either way, we'll have to go back to the clinic at least two more times before this is all over and I can read comfortably again.

While we were in the car on the way home, I called the clinic and asked if I would get billed for this visit, since they didn't do what they said they'd do. They'll have an answer tomorrow, and it's all down to the doctor's discretion, but since he was sympathetic, and said he'd love to do it now if he could, I'm hoping he won't charge us for this appointment. He said that insurance companies love nothing more than to string you along for a good few weeks before they make any decisions at all. So I'll be sure to call the place before my appointment in August and make sure that they have clearance to do it, so that I don't have to waste time and gas money on another trip there.

By the time we got home, well over four hours had passed since we left. And my eyes are dilated for the rest of the day, so my reading ability is even worse than normal. I had to wear those silly little plastic shades that they give you because the sun was too bright. And I thought it was supposed to rain today! Oh well. Now it's nearly 17:00 and I feel like the day has been taken away from me. I feel more badly for my mom though, because she had to take over four hours out of her busy day in order to drive me there and back.

Last Friday, I called the eye doctor to make sure they had received authorization from my insurance company. My appointment for laser treatment was this week, so I wanted to confirm that they could give me the treatment before I made the trip there. Unfortunately, they informed me that they had not been granted authorization. So I called my insurance company to ask about the request. They checked everywhere they could, and didn't see the request for authorization anywhere. I called the eye doctor back and asked for details, and it turns out they had FAXED the request to my insurance company a full week after they couldn't proceed at my last appointment. I couldn't believe they seriously thought they were going to get a result by faxing something without even telling the people they were faxing. After calling my insurance company back, confirming they hadn't received the fax, and then receiving instructions on how to submit the request electronically, I called my eye doctor back and told them what to do. They said they'd call me when they had submitted it properly. I also canceled my appointment, because they didn't think the request would go through fast enough for me to keep it.

Yesterday morning, I was woken up by a call from the eye doctor's office. They had submitted the request again. But yet again, they hadn't followed the instructions and had simply faxed it. I called my insurance company at once, and asked if they had just received a fax. This time, they actually were able to find it. And guess what? They told me that this procedure DIDN'T EVEN REQUIRE AUTHORIZATION. So I could have had it anyway at my last appointment. I was properly pissed.

But I called the eye doctor back, and they said they would get me in as soon as possible for the laser. They called back only a few minutes later, asking if I could come in later that day. Very luckily, neither my mom nor I had anything going on, so she was able to get in the car to drive me there with only an hour of notice. I didn't have to wait as long this time, and before I knew it, my left eye was dilated, and there I was in the room just like a normal exam room, with a piece of equipment very similar to the standard lenses they make you look through. And there was the eye doctor, explaining that the hardest part was indeed looking at the bright red and white lights.

The red lights are not the laser, he explained. I'm still not entirely sure what they were for, but I think they were to help him aim properly. I had to keep my eye and my head still, and he said that every time I blink, my eyes move up, and he has to reconfigure where he's aiming. My eyes are quite sensitive to bright light ordinarily, and even more so when dilated, so I had to blink a lot. Because I blinked so much, the procedure took longer than it otherwise might have. As for the laser itself, whenever it removed scar tissue, there would be a clicking noise of the laser, and the machine would make a beep, what sounded like square wave of the pitch E-flat 4, reminding me heavily of the bad RAM beeps of 2008–2013 Macs. I could feel a tiny amount of pressure on my eye whenever the laser hit it, but barely anything at all. Sometimes I could feel more pressure than other times, and I don't know if this is actually true, but I imagined it was at those spots where the scar tissue was thickest.

After about four minutes, it was done. I could see better immediately! There was a green tint for a few minutes as my eye adjusted to no longer staring at the bright red light, but after that wore off, I was right back to the 20/25 vision that my left eye had had in the few days following cataract surgery. Once again, I was blown away by how much detail there was to see in the world, and I could spend minutes at a time just staring at the ground, at all the individual stones on the pavement, or at all the little leaves on trees. Just like with the actual cataract surgery, it will still take some time for my brain to adjust to my left eye being much better than my right. It kind of hurts and makes my eye water to look at small high-contrast patterns, like through a window screen or at brightly patterned clothing. Good thing I only wear dark, solid colors. After the procedure I went immediately back to work without even stopping at home. I felt badly because I had needed to quickly take a couple hours off to get this done, so I wanted to put in as much work as I could that day.

As for long-term plans, the eye doctor said that the scar tissue in my left eye was much thicker than he normally saw when doing this treatment, because I was young and my body responded more acutely to the presence of the lens implant in my eye. Since it was so thick, it took a longer time to complete the treatment, and the scar tissue may even reform. But regardless of what happens, I still have to go back in six weeks to get the same done to my other eye. And I hope to crap that I won't have to go through all that trouble with the doctor's office next time, especially if I'll be doing all of this again later down the line.

I guess I should have updated this last month, but I forgot. So here it is now. In September, I went back to the eye doctor to get my right eye lasered. The good news is that I didn't have to go through any more administrative crap with the insurance company—I called them beforehand, just to be sure, and they said that all future occurrences of this procedure would be covered without need for authorization.

So I went back and got my right eye lasered. I was glad that I had asked the doctor to look at my left eye as well, because for the last several weeks I had been convinced that the vision in my left eye was getting worse. He took a look at it, and told me that the scar tissue wasn't returning, but rather my eye was sort of constricting on the lens implant, leaving a smaller hole for light to pass through, and hence blurrier vision. I asked him if that was normal, and he admitted it wasn't, but that we could fix it in a few months once it settles—he could just use the same laser to make a larger opening, and I'd be able to see better.

But anyway, I was expecting the laser for the right eye to be the same as it was for the left eye. They dilated my eye, and then I went in the room where they did the laser again. But this time, going in, I knew my vision in the right wasn't as bad as it had been in the left, and they did say the scar tissue was not as thick as it had been in the left eye, i.e. a much more normal amount. So it didn't actually take as long to remove it in the right eye, partially because I knew what to expect and partially because there wasn't as much of it.

After they removed the scar tissue, I was expecting an immediate improvement in vision like I had had with the left eye, but I didn't see that. I actually walked out of the eye doctor's office and told my mom that I saw no difference at all in the quality of my vision. Granted, my eye was still dilated, which makes normal daytime vision worse anyway. That night, when the dilation was wearing off, I went to choir practice, and as I was leaving, I was struck by how sharp and clear the street lights appeared, even at a distance. That was the first time I really noticed the difference in my right eye.

In the weeks after that appointment, I could tell that my vision was slowly getting worse. The way the cataract surgery had initially been explained to me, there were typically a concrete set of steps: surgery on one eye, then surgery on the other, then an eye test for prescription glasses once you finish with the eye drops, then several months later you get the scar tissue lasered off, and that's it, unless you need a new prescription after the laser, which is rare. But my case has already been more complicated than that, and I could tell something fishy was going on. Luckily, I had another appointment a month after the second laser treatment to test my eyes again, in case I needed a new prescription.

So a couple weeks ago, I went back to the regular (non-surgery) eye doctor for that appointment. He dilated my eyes and looked at them, then sat back and told me that, somehow, the scar tissue in my left eye had indeed reformed, and it had done so incredibly quickly—so quickly that he could see no difference between how it looks now and how it looked in July before I had gotten the laser done. He has been working in his profession for about 20 years, and in all that time, with all the countless patients he has seen, he can count on one hand the number of times he has seen scar tissue reform after the laser treatment, and he has never seen it reform as quickly as it did in my left eye. He told me too that this is not my fault. I was worried that maybe I had done something during the cataract surgery itself that caused this to happen, but he and the surgeon both agree that this is just because of my screwed-up eye and not because of anything I did. So we made another appointment for me to go back to get the left eye lasered again. If the surgeon doesn't feel comfortable doing that, he could also send me to another doctor farther away who specializes in more complicated cases. But that appointment is for this coming week, so of course I will update after that happens. He also reassured me that there is no scar tissue reforming in my right eye at this time.

But then he tested my vision. My left eye was pretty hopeless—I think it was even worse than last time I had the scar tissue, because I could only get down to about 20/50 (6/15), and everything was blurry, even the large letters. It lines up with how I remember the scar tissue before, where my distance vision in the real world is okay, but I legitimately cannot read with this eye no matter what I do. Then he tested the right eye, and to my surprise, the prescription changed, and quite a lot at that. I was concerned about this, because I had thought that the whole point of cataract surgery was so that a prescription was built into my eyes, and that it wouldn't need to be changed. He said that's usually how it works, but since I'm so young, and my eyes are so compromised in other ways, he's not surprised that I needed a prescription adjustment so soon.

But even before the cataracts became a problem, I remember that the last major prescription change I had was between 2017 and 2019, when it got more powerful by about 1 diopter for the right eye and 2 diopters for the left, over a period of two years. But in this case, since I got the surgery on my right eye in January, my prescription is now going to be −2.5 diopters in the right eye after only nine months. That's a lot more change than I've gone through before, and I'm worried about what this means for the future. At least with the new prescription, I was seeing 20/20 with the right eye, so he's not worried about it right now.

Even so, we have to wait until after I get my left eye lasered again to give me a new prescription, because the eye test he gave me at that appointment was only valid for my right eye. And who knows—maybe my left eye will end up needing a stronger prescription too. So after my left eye laser next week, I will probably have to wait another month, while my vision keeps getting worse, before I can get a new prescription and actually see properly again. And it is getting worse, not only in a quality of vision sense, but also in the sense of not being able to work around it. When I still had natural lenses in my eyes, at least I could always rely on looking at things close-up without my glasses to see them clearly. But now I can't do that, so I am just stuck with perpetually blurry vision, no matter what I do, until I get that new prescription. So that's incredibly annoying. Once again, I'm relying entirely on my right eye to read, but I can tell my reading isn't as good now as it was before, and my distance vision is getting worse too. Removing the glasses doesn't really do anything except make it basically impossible to read, so I keep the glasses on. I've also noticed that I've gotten more headaches lately, especially at work, because of having to strain my eyes way more than usual in order to read small print. So needless to say, I can't wait until I at least get a refreshed prescription, however long that may take. And I'm remaining optimistic that my left eye will finally get the message that the scar tissue doesn't belong there, and that I'll remember to update this topic once that procedure happens.

I went back to the eye surgeon to have him look at my left eye and laser it again if he was comfortable with it. After two hours of waiting for the doctor, he finally looked at my eye first, because he wanted to see what he was dealing with. Apparently he couldn't tell if it was scar tissue, "capsule" (which sounded like it was the same thing?), or something worse that was blocking my vision, like some gluey substance that I can't remember the name of, which he really didn't want to touch. He said he'd know more when he actually takes a laser to my eye, so that's what he did, and he lasered it off in just a few minutes, exactly like last time. And just like last time, I noticed an immediate difference.

Now my left eye is once again better than my right. Apparently my right eye isn't bad because of scar tissue, it's just getting more and more nearsighted. I hope I'm not doing that to myself by leaning closer and closer to things I'm trying to read, simply out of habit. But regardless, next week, I'll go to the eye doctor again, hopefully for the last time in a while, to get a new prescription. I've got my fingers crossed that he won't tell me I need to get my right eye lasered again before he can give me a prescription. And I really hope I can get over this overwhelming muscle memory to lean in super close to a page when I'm writing on it, since that's how I spent the last two years of college, and now that I'm taking notes again, I'm realizing just how strong the muscle memory is. I'll back away from the page to see it better, only to subconsciously lean in far too close to it just a few seconds later. It's super annoying.

Glad to hear the laser treatment helped! That's a relief. Yeah, that leaning-in habit is tough to break. Maybe try using a bookmark or something to consciously remind yourself to keep a good distance.