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A Wrinkle on the Retina

I first noticed that I wasn’t focusing very well last November and decided I probably needed new glasses. I was struggling in my studio to see my paintings from any distance other than up close, with my reading glasses on. I was frequently closing my left eye whenever I stepped back to take a look at them from a distance, in order to see them in focus.

Odd, in retrospect, how stupidly and deliberately I was refusing to connect the dots. I’d known for more than a year that I had a small “wrinkle” on my left retina (also known as a piratical membrane, or cellophane maculopathy, or premacular fibrosis, or macular pucker — something that happens to a fair number of people over 50, although mostly in a way that’s not noticeable) and was having six-month checkups to keep an eye (like that?) on it. My ophthalmologist had told me to come in if there were any significant changes.

But what’s a significant change? How do you know one if it slowly creeps up on you? My strategy was like that of a frog in a pot of cold water who does nothing even while the water is slowly heating up to boiling. You’d think that I — an artist — would not have played frog, but instead would have gone screaming and yelling to my doctor. Yet I was not acknowledging to myself that my eyes weren’t working right.

My ophthalmologist is a fairly calm guy. When I finally went to him in February, he said, “The vision in your left eye has really deteriorated since I last saw you,” which can be translated as, “That eye is in really bad shape.” He then added that I’d be all right because he knew the best retinal surgeon in the world — Dr. Stanley Chang.

Dr. Chang is the Edward S. Harkness Professor and chair of the department of ophthalmology at Columbia University, and the director of the Edward S. Harkness Eye Institute at New York Presbyterian Hospital, where he performed surgery on my eye March 18th — two and a half weeks after I first met with him in his office.

There was no waffling or waiting on this one. While pointing to the pictures of the inside of my left eye, compared to a picture of the inside of a normal eye, Dr. Chang very clearly explained to me what had gone wrong. My retina had a strange mountain in its middle, whereas the normal eye was smooth and flat. Only surgery could fix it.

I asked Dr. Chang what would happen if I chose not to have surgery. “Eventually, complete blurriness in your eye,” he said. I asked him if the surgery was difficult to do. “It’s delicate,” he said.

I sat back and said, “Well, I hear you’re a great surgeon, and I see no reason to wait.” Dr. Chang, a fairly laconic man, accepted my compliment by nodding. The thing is, it turns out that he truly is a great surgeon — as I learned afterward, from my friend and painting colleague, Doug Hilson (among others). Doug lost the sight in one eye several years ago and knows an awful lot about eye doctors. “If you’ve got Stanley Chang doing your surgery, you’re as lucky as can be,” he told me.

I didn’t consider myself very lucky. I thought a lot about my left eye and subjected it to continuous tests that it failed miserably. (The wiggle refused to go away, no matter how much I squinted.)

I studied retinal wrinkles on the Internet, which only made things worse. I also studied as many Internet sites on the workings of the eye as I could find. I even watched a short video showing the early days of a developing fetus, in which its two eyes desperately shoot out from the brain, proving their primary allegiance is to the mind, and not the face.

I couldn’t stay away from the bitter irony of being a painter with an eye problem. I know that I am hardly the first — I know more than one painter who works with monocular vision, for one reason or another. Then there’s Monet, who went blind at the end of his life, and Degas, who had terrible retinal problems from early on. When nature gets really nasty with a painter, it mercilessly attacks what matters the most to him or her — the eye’s 120 million or so rods and 7 million cones.

The surgery was performed while I was awake, using a happy drug to prevent me from leaping off the table in a fit of panic. I vividly recall Dr. Chang talking to other doctors who were in the room observing him while he worked. He was saying something like, “It’s hard to know how much to take out here, and you have to be careful.”

I also vividly remember watching the surgery itself. It sounds odd, I know, but I could “see” it from inside (upside down, of course). It looked like a black, white and gray early surrealist film. Dr. Chang was using a tiny forceps under a microscope to tug at the membrane that had grown on my retina. What I saw was a gigantic, black crane.

Drugged, I lolled about in lazy-time during the surgery, watching the forceps gently tug, over and over again, at a tangled mass of stringy and resistant membrane. I remember vaguely rooting for the forceps to win, and then watching as they finally achieved victory. They then headed for a lone, leftover, bouncy string. That, too, took several tugs before it was vanquished.

It’s been almost three months since my surgery. Dr. Chang never promised me a complete fix, but he did say that no matter what, my two eyes would work together a lot better after the operation than they were working on the day I first met with him.

When I see him for my next visit (in about six weeks), I’ll be able to tell him that I can again spend hours in the studio with my paintings, and things are in beautiful focus. I’ll also add the words that I’ve already said to him, that he must hear many times, from many patients, that I suspect surgeons must hear a lot, and ought to hear a lot: Thank you.

(Image from photobucket.com)

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