Cone-Eyes

The goal of medicine should be optimal health. You can achieve optimal health through all sorts of pathways.

Tomorrow, they will slice into my eye (graphic representation). I’ve been eagerly awaiting this day for years.

Fifteen years ago, I learned I have keratoconus, a degenerative eye disease that prompted my sister to nickname me “cone-eyes.”

I first wore glasses at ~12, contacts at ~15. Hated both. The etiology is unclear: maybe the growth plates that jammed in my cheeks as a child; maybe eye-rubbing caused the mis-shape; maybe the mis-shape caused the eye-rubbing. By the end of one’s twenties, the cone generally stabilizes.

Most people avoid elective medical interventions. As my mother likes to say: “You only get one body.” That logic explains why most people stop at the first reasonable doctor, take the standard recommendation, and live with whatever they’ve been handed.

I know at least three ways to play this game better. You can hire the world’s best, every time (expensive, not always available). You can take what’s offered, set low expectations, and hope (cheap, sometimes works). Or you can attack the doctors until you find one who doesn’t buckle.

I do the third.

For my eyes, one optometrist wanted me to harden my corneas. Standard of care. I declined for my case. Another doctor, in southwestern Spain, wanted to harden them and then install hard plastic lenses. Closer.

Now, in Paris, I’ve found the Center for Keratoconus and the Cornea. The practice literally says “keratoconus” in its name. This specific surgeon looks at eyes like mine all day, every day. 700 of these surgeries; 0 major complications. Of the ~2 million performed worldwide, the number who have gone blind doesn’t appear in the literature. I believe it’s either 0 or close to it.

The risks:

• The lens rotates (a second procedure is then needed to re-seat it).

• If my vision deteriorates, I will need to replace the lenses. (The lenses won’t cause this deterioration: it’s just a natural occurrence for some people as they age.)

• A punch to the eye becomes a much bigger problem.

• Worse night vision.

• Infection (very unlikely with proper care).

The benefits:

• Perfect vision, no glasses.

• Perfect peripheral vision. Today, to look at something off the edge of my vision, I turn my whole head. The edges of my glasses cap my field. After tomorrow, just my eyes move.

• Better at sports.

• A weirder benefit: I’m less anxious without glasses. Legally blind without them, but calmer. I don’t know why. After tomorrow, I won’t have to choose.

I already spend most of my life attempting not to be eye-gouged. After tomorrow, that preference intensifies. In exchange, the head-swivel stops.

Today, walking through the park, I removed my glasses and looked at them. Despite the humorous engraving on the side[1], I’ve never liked them. I hope tomorrow evening to jump up and down on them in glee.

I feel nervous. That’s why the surgeon gave me xanax. That, and he’ll be operating on my eyes while I’m still using them.

Will it go well? We’ll see, I hope.

[1] It reads “HURRR DURRR !!!”