Postcards from the Rogue Valley

“I think you put too much contrast in my eye,” I told my eye surgeon at the one-week post-op visit following my first corneal transplant. Tony and I had driven that morning from Ashland to Portland, where the surgeon, Dr. Mark Terry, weaves his magic. The night before, the air bubble that had been holding my transplanted cornea in place had started to dissolve, revealing a world of color and contrast I had forgotten.

I work with Adobe Photoshop all the time, and I’m used to adjusting the ratio of light to dark in overexposed photographs. “Which image is real,” I asked Dr. Terry, “the technicolor I see through my operated eye or the whitewash in the other?” The operated eye, he insisted.

On our early morning drive up through Willamette Valley to Portland, I oohed and aahed at the unfolding vista: the verdant green pastureland dotted with white sheep, the weathered stockade fences that minded the livestock, the red barns with tin roofs, the slate-colored mountains that rimmed the valley, the dark maroon soil that reminded  me of East Africa.

The clouds, moving through the sky like a Calder mobile, stole the show.  Rain had given way to clearing, and the once all grey sky was now alive with stratocumulus clouds— navy blue, black, lavender, robin’s egg blue, turquoise.

One eye open, one closed, I took stock of this new world and couldn’t stop exclaiming at its magnificence. “I can do without the narration,” Tony finally said.

We were an hour early for our post-op appointment and headed to Portland’s huge Powell’s Books. My eyes were still unfit for reading, but Tony grabbed the current edition of Foreign Affairs (“Who Will Run the World?”) and settled down on a bench. I watched him from across the lobby, then rushed over to give his head (yes) a close going-over. 

“Tony, you have more black hair than I thought!” I cried. I knew I was losing contrast when the black font on my computer had turned gray. “And you have age spots!”  I studied my spouse of almost 40 years until he told me to go away.

When I went to the store bathroom and looked at my face in the mirror, I took my own measure. I, too, had grown brown spots­—and wrinkles, lots of wrinkles. I washed my hands and whispered goodbye to the “youthful look” that had been a point of pride all my life.

When did this clouding of my vision begin? Fifteen or twenty years ago, during a routine eye exam, my optometrist had asked, “Do you know that you have Fuchs Dystrophy?” Like most people, I had never heard of it.

Fuchs’ (fooks) dystrophy, she explained, is a hereditary disease of the cornea. It occurs when cells in the corneal layer called the endothelium, which normally pump fluid from the cornea to keep it clear, die off. When they die, fluid builds up and the cornea gets swollen and puffy; vision becomes increasingly cloudy or hazy. The disease usually shows up in both eyes, beginning in one’s fifties. Ophthalmologists keep track of Fuchs’ progression by measuring the thickness of the cornea, until the point where transplant surgery becomes advisable.

For years, the transplant surgery had involved replacing most if not all of the cornea, which led to longer recovery, more rejections, and increased complications. The new cornea, as you probably guessed, comes from people who choose to donate this tissue when they die. 

The partial transplant (DMEK), perfected by Dr. Mark Terry in Portland, exchanges just the endothelial layer and the membrane above it. It has been a game changer, producing better results on all counts, though it’s trickier because the donor tissue is thin and fragile. Eye surgeons around the world come to watch Dr. Terry operate and learn from him. With both of my surgeries, I overheard him explain every step of the procedure to a team of visitors. (Thanks to an eye block, I felt nothing but heard everything.)

Mark Terry is known for ending the surgery by asking his patient, “Now tell me a joke.” 

I saved my joke for the following day. “Thanks to your narration, I think I’m ready to operate on myself next time,” I told Terry and his colleagues as they took turns peering into my freshly transplanted cornea.

These days, my newly operated left eye is catching up with my right. The steroid drops I take four times a day are not only fighting my body’s drive to reject the new corneas but also fueling my new “steroid” vision—more color and depth than I thought possible. The drops also make my eyes light sensitive, so I must wear sunglasses outdoors even when the sky is grey (though not at night, like Lady Gaga and Madonna). But this side effect is easing. 

Recovering from DMEK surgery takes six months or more, as the corneas re-shape to their new (human) host. Rejection, though rare, is possible at any time. It’s up to me whether to continue the steroid drops for the rest of my life or try going without them but switch back at the first sign of rejection. 

In my case, once my corneas hit their stride, I will still have a “vision thing.”  A wrinkle in the retina of my right eye makes the images appear larger than normal plus tilted. My brain quietly but constantly struggles to manage the dissonance between the two eyes (and wouldn’t you know that the distorted eye is dominant), but I figure it’s good practice for living in today’s divided democracy. 

I have thought a lot the past few months about what’s true when we look out through our eyes. Glasses can correct for near or far-sightedness and crossed-eyes, but there is so much more to vision—colors, depth, crispness, breadth, size. Our brains and emotions edit our vision, we know but can’t tell, reflecting what we value, our biases, our blind spots, our interpretations. But I am left with a possibly crazy question: Do I see the same green as you? The same contrast? The same size ball? The same sunset? Is one image more “real” than another?

And the mirror’s reflection of a more “real” me, without the airbrushed wrinkles or the crevices from dropping skin, reminds me of my age—and mortality. At my first wedding (I was married before), outdoors by the Narragansett Bay in Rhode Island, my partner, our guitar-playing minister, and I sang Bob Dylan’s “May You Stay Forever Young.”  Then, I privileged the forever young stanzas. Now I cherish: 

“May your hands always be busy
May your feet always be swift
May you have a strong foundation
When the winds of changes shift

May your heart always be joyful
May your song always be sung
. . . And may you stay forever young.”

SUBSCRIBE

Add your name to the email “blast” announcing new posts. Please send your name and email address to: