Saturday, November 20, 2010

A New Friend, Unwanted and Self-Detached

I have a new friend. Without invitation or welcome he first came into my sight on a recent Monday. One minute he wasn’t there, the next he was, off to my right and a little above center of whatever I was looking at. I call my friend “Maejong” because he reminds me of some of the characters on the playing pieces of that game. This new friend looks like a nest of folding dark lines with weighted strings hanging down, at times appearing as a jellyfish, at times like a ranger dangling from his parachute. I knew from first sight that my new friend was somewhere in my eye, my right eye. I can’t see him well as I can’t focus on him; he moves with my eyeball, always off to the right, always a little above the level of the object of focus.

I thought it was my cataract. About a year ago my family doctor (yes, I have one) told me I had an immature cataract in my right eye. I just thought it had caught my attention for the first time, that I was seeing it layered onto whatever I focused on. There was, however, one problem. The parachutist swung in the breeze at the end of his lines. Whenever I looked quickly to the left, as my eyeball came to a halt, and with it most of my friend, the lower “strings” of my new friend swept up and left. When I looked right, my friend’s dependencies swung up and to the right. This is not what a cataract should do. Then the lights came.

Six days later after I first saw my friend, on a Sunday evening just as dark fell I was walking out to the Blessings Hospital portal to welcome some friends who were driving out to visit us. I was reading in the dim light and my eyes were flitting back and forth across the page. When they moved to the right I saw a flashing band of blue light, over and over and over, line by line on the page, running from the top of my eye to the bottom flashing through the spot occupied by my new friend. Light flashes are associated with retinal detachment which may cause loss of sight. My friend had my attention. But my impression was that there was no ophthalmologist living and working in Malawi.

Early the next morning I called my friend Perry Jensen, another family doc who has cared for AIDS patients in Malawi for ten years. Perry knew of two opthalmologists in the country, one at Kamuzu Central Hospital, the referral hospital for the central region of the country, the other was at a Nkhoma Mission Hospital about 40 km south of the capital, and Perry knew him. I chose Perry’s friend, gave him a call, and was encouraged to show up as soon as possible that day.

Mtendere’s driver was able to accompany us, and we took off, arriving a little before noon. After discovering that we had met the hospital’s volunteer optician from Luxembourg in the immigration office, I had a thorough exam by a young ophthalmologist who looked younger than my son. You know you’re getting old when your doctors look like your children, and I got another gentle reminder when the doctor told me my new friend was nothing to worry about, just the result of a “maturing” eye. It seems the vitreous in my right eye, the gelatinous stuff that fills most of the eye ball, back in the back, is drying out, shrinking, getting a little wrinkled, and doesn’t need as much space as it once did. Thus it has pulled away from the eyeball, a “posterior vitreous detachment”. Some strings of tissue are literally hanging loose in the space that is left. There is a slightly increased risk of a future retinal detachment, which would be accompanied by a different pattern of light flashes, but nothing really serious at the moment. He will see me again at a hospital closer to home in about six weeks.

So I confidently play with my new friend, aware of his faithful presence when I move my eye, especially at night, enjoying the blue light, usually a bar, at times a ring around my visual field, but always a reminder of the sixty-one years walking on this earth.

“Today I’m nearer to my home,

much nearer than before.”

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