At first, I thought the haziness in my left eye was some morning goop I hadn’t blinked away. Or maybe a dirty contact. It was most noticeable outside, in bright light, and it was a curiosity more than anything.
Two months and a new contact lens later, I saw my eye doctor and was floored by his diagnosis: a cataract. And I would probably need surgery within the next year or two.
I was only 42.
Apparently, I wasn’t the only one amazed. My doctor’s surprise — partly because of my age and partly because I had shown no sign of a cataract at a routine exam just six months earlier — indicated how unusual it was.
“Wow,” I remember him repeating softly as he wrote down notes in my chart.
My doctor estimates that only 1 percent of his cataract surgery patients are as young as I am. That’s the same figure given by David Chang, clinical spokesman for the American Academy of Ophthalmology.
A cataract is the clouding of the eye’s lens, and it’s something that happens to many people as they age.
People with cataracts usually don’t notice them until they have developed to the point that they interfere with their vision. For most people, this happens in their 60s, according to the National Institutes of Health.
Chang equated it to hair loss in men. “When does it happen? Well, we could say it’s pretty common in our 50s, but there are plenty of people who have a full head of hair in their 70s. There are also a lot of people who get bald spots or start to see their hairlines recede in their 30s,” he said.
But having a cataract grow as aggressively as mine was unusual at my age. The typical reasons young people get cataracts failed to apply to me: I didn’t have a traumatic injury, diabetes or a family history that predisposed me to getting them prematurely. I also wasn’t taking steroids or other medications with side effects that often lead to cataracts. Sometimes it just happens, my doctor said.
When he mentioned surgery, though, all I could think of was my late father-in-law. He used to wear a patch over his eye because a botched cataract operation had ruined his vision.
I sought out friends on Facebook for anyone who’d had the surgery and for advice on how long to hold it off. I already knew the medical mechanics behind it and that, theoretically, I could return to work the next day. But what about the logistics that really mattered — like picking up my kids up from school or taking a shower?
Not even one person in my age group could offer advice. Instead, I got kind notes from friends who said they would check with their mother or with older siblings.
I felt like an anomaly. Yet it turns out in one respect I was not unusual. Older patients dealing with cataracts often delay surgery, according to Rosa Braga-Mele, head of the cataract clinical committee of the American Society of Cataract and Refractive Surgery, while younger ones don’t. Their active lifestyles make them less tolerant of any visual problem and more willing to deal with it quickly.
Baby boomers are likely to have surgery as soon as the cataracts bother them, whereas the generations before them tend to defer to the physician on whether to have surgery, she said. Older people also are less likely to rely on their sight for work or heavy-duty driving, since many of them are retired.
“A lot of times, these patients may be seeing on the eye chart 20/30 or 20/40, but they can’t drive at night because of the glare issue from their cataracts,” she said. “If you, at 50, can’t drive at night, that’s a huge impediment if you have to drive your kids to an event or you want to go out to dinner with your friends.”
“People are staying more active. People are working longer and driving longer,” said Bonnie An Henderson, a clinical professor of ophthalmology at Tufts University School of Medicine. “Cataracts are often more noticeable during certain tasks such as driving at night. Because people are not retiring until a later age, people continue to drive and may notice visually significant cataracts earlier than before.”
She added that greater use of smartphones, computers and tablets also may allow people to notice visual problems sooner and be bothered by them sooner.
It took me about a year from the time I first noticed hazy vision to have surgery. During that interval, I increasingly felt as though my left eye was looking through a Vaseline-smudged window. This was particularly noticeable when I played with my kids outdoors or drove them around on sunny days. Last summer at the beach, I felt as if I was looking through a sandstorm.
That’s when I knew I had reached my annoyance threshold.
More than 3.3 million such surgeries are performed in the United States each year, Chang said.
“It’s the most common operation performed anywhere on the body,” he said.
Braga-Mele describes the surgery as “about as easy as going to the dentist.”
That was mostly true for me. While the paperwork and surgery prep took two hours, the actual procedure was a mere 20 minutes. I was awake for all of it except for four to five minutes, when I was under light general anesthesia, so that my doctor could give me local anesthesia to paralyze my eye muscle.
In most cataract surgeries like mine, the doctor makes a small incision in the cornea to remove the cloudy natural lens. It is replaced with an artificial one that becomes a permanent part of the eye. I didn’t feel anything, aside from an occasional gush of water. When the procedure was done, my eye, with its new and improved lens, was covered with gauze and a metal patch. And a few minutes later I was out of the operating room and changing into my clothes. I waited for my husband in a recovery room where I was by far the youngest patient wearing an eye patch. (Earlier that morning, my ophthalmologist joked it was his “young day,” since all his surgical patients were younger than 70.)
The patch came off the following morning at my doctor’s office. Aside from looking a bit bloodshot, my eye appeared relatively normal, with some minor swelling. Although I was advised to wear the eye patch at night for another week, I had no physical restrictions. I was driving my kids around that afternoon and went swimming with them the following weekend. I felt no pain from the procedure and, most important, I could see perfectly.
Initially, my vision was probably 20/15, something I’ve never had, even with the glasses and contact lenses I’ve used since I was in the sixth grade. Over the next few weeks, my vision fluctuated, getting slightly blurrier and then clearing up again to what it is today, close to perfect.
However, for the first time in my life, I use reading glasses.
Before my surgery, I was told my new lens would allow me to see at a distance but not up close. That’s because, unlike a human lens, an artificial one isn’t elastic and doesn’t allow the eye to focus clearly on objects both near and far.
I still wear a contact lens in my other eye, but with one eye that can see at a distance, I can actually read the time on my nightstand alarm clock when I wake up in the morning.
Because I lived with cloudy vision for only a short time — perhaps six months — I have almost forgotten what it felt like.
Sometimes, however, stark beauty reminds me of how precious the gift of sight is.
One afternoon last fall, right before Thanksgiving, I went running through the park, enjoying the autumn colors on the ground and still clinging to the trees. I was struck by how crystal clear everything was. More recently, on days when the sun shines blindingly on a blanket of snow in my yard, I’m almost gleeful that I can enjoy the glare.