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Three cheers for innovation in medical sciences | Just Reflections - Issue #20
In the past 2 weeks, my wife and I have been on vacation. Because I was driving every day, I was putting on my contact lenses every day. This is something I should do all the time, but I don’t because sometimes it’s a bit of a hustle to put them on and to take them off. And I can see well enough to do most common tasks without them. I use a type of contact lense called a scleral lense. Scleral lenses are very comfortable. Once you have them on, you can forget that you do because you can barely feel them. But they’re larger, so putting them on for someone like me, who has been squinting all his life and has tiny eyes, is a struggle. So is taking them off.
Anyway, today I want to talk about my eyesight.
I was born with vision problems. I remember vividly that when I was in preschool, I always had red, itchy eyes. I started wearing prescription spectacles when I was six (yes; I had a colorful frame with strings around my neck so that I didn’t lose them. I lost them a few times). They made a pretty marginal improvement to my vision.
At age seven, I got diagnosed with a condition that called keratoconus. Keratoconus is an eye disease that affects the structure of the cornea, resulting in distortion or loss of vision. It occurs in approximately one in 2,000 people, typically beginning in puberty and progressing into the mid-30s. The picture below shows the difference between a normal cornea and one from someone with keratoconus.
It got so bad in my left eye that I had to get a corneal transplant. I also remember vividly that a month or so before the surgery, I had lost almost all sight in the left eye. I had to put on some eye drops every hour, but I was too young to do it myself, so my relatives came to camp at our house to help my parents. My aunties and grandparents would take turns waking up at night every hour to give me eye drops.
I eventually got a donor for the cornea and had my surgery. Travelling to South Africa with my dad for the operation is one of my fondest father-son memories. After the transplant, I still had keratoconus, but it was manageable. But there was still talk that I might need the same surgery on my right eye eventually as well. There were some issues with my body rejecting the graft, but that’s a story for another day. For about two decades after that, I just kept getting progressively thicker lenses on my spectacles every two years.
In 2019, when I was going for my regular checkup, the doctor asked if I have any known conditions. I said I have keratoconus; she said in that case, spectacles won’t really help me, so she will refer me to a specialist who deals with contact lenses for people like me. This was quite interesting for two reasons. One, every other doctor I’d seen for my specs before that knew that I had keratoconus but still prescribed specs to me. And two, it was not news to me that specs don’t really help me. I always knew it, but I had accepted that it’s something I just have to live with. So the prospect of getting something that would make a real difference got me excited.
I saw the specialist and, after an enormous struggle to fit the lenses in my tiny eyes, I was given a pair of scleral contact lenses. Scleral contacts are large diameter contact lenses specially designed to vault over the entire corneal surface and rest on the “white” of the eye known as the sclera, hence the name. In doing so, scleral lenses functionally replace the irregular cornea with a perfectly smooth optical surface to correct vision problems caused by keratoconus.
Scleral contact lenses completely changed the way I see! I particularly remember the first time I saw lights with my contacts on. I couldn’t believe how bad my vision had been my whole life. Because keratoconus causes irregularities on the cornea, which affects the way light is refracted, the effects are strongly noticeable when you’re looking at lights. I immediately understood why the doctor couldn’t believe that I had been able to drive for over 10 years. Here are some pictures that try to depict the vision of someone with keratoconus when looking at lights to give you an idea.
Getting contact lenses also made me realise that I had subconsciously developed some crutches to aid my weak vision.
I rarely look at anything with both eyes. My left eye is better at seeing things that are far (far-sighted) and my right eye is better at seeing things that are near (near-sighted). So when I look at things, I change from one eye to the other based on how far the thing I’m looking at is. This is not something I consciously think about, it just happens. I guess I’ve learned to just do it automatically.
Our eyes see slightly different images and, because of stereoscopic vision, our brains use the two images from each eye to register a sense of three-dimensional shape and form. Only after I had contact lenses and both my eyes could see with better acuity did I realise I don’t really know how to look with both eyes. I have to continuously remind myself to look with both eyes and I’m still fascinated that when I do that, I can see a more 3D image. It’s something i haven’t gotten a grip on so I’m still learning but I’m thankful every day.
Three cheers for innovation in medical sciences.
Last, I vaguely remember the details, but when I needed a corneal transplant, they put me on a waiting list for some time before they found a donor for me. I finally got a donor somewhere out of Africa because organ donation was just not a thing we did much, if at all, in Africa back then. I doubt that much has changed. To give back, I registered to be an organ donor for all the organs they need. Some stranger donated their cornea to save my vision. When I’m done using my organs, I think it’s a noble thing to let someone who still has some years to live use them and get a better life. I’d like to encourage you to do the same.
If you’d like to register as an organ donor, go to NHS Organ Donation if you’re in the UK and Organ Donor Foundation if you’re in South Africa. These are just the countries I’ve lived in and registered with. If you’re in another country, it’s easy to find where you can register via a simple google search. Search for “become an organ donor” followed by your desired country.
That’s all I have for you this week. If you like the newsletter, consider sharing it with others on Twitter, WhatsApp or Facebook. Hit the thumbs up or thumbs down below to let me know what you think about the issue.
I hope I’ve given you something to think about this week and I wish you ever-increasing curiosity.
Until next week.
Impactful ideas that challenged my thinking.
I have a lot of interests so I'm always learning all kinds of things, some of which really challenge my thinking. In the Just Reflections newsletter, I'll be sharing with you a summary of the ideas that challenged my thinking recently and hopefully they will challenge yours too and we grow together.
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