You Can, See Again
Thursday, August 10, 2006 (17:38:39)

Posted by SwampFox

You Can, See Again

By: Ed Harmon

"You are legally blind." That statement, made by a doctor and especially by your doctor, will wake you up. The statement will also take the starch right out of your collar, all at the same time.

1986-87 was my best year shooting in competition. By the end of 1987 we had attained the scores, experience and skills necessary to become a state small-bore International Handgun Metallic Silhouette Association (IHMSA) aggregate champion and an IHMSA small bore 12 state region champion. For the uninitiated, the most difficult silhouette competition to master, is the small bore competition.

With 3 world records in shooting, including the new bowling pin record, we were "on a roll." I had bested John "The Kid" Robbins' Second Chance record, a record that had stood for 9 years, by almost two tenths of a second. At the very next pin match, I came right back and bested my own new world record. Speed, accuracy and consistency were all in one place at one time. Then, like a slow motion nightmare, it all went away. By 1989 I could only shoot with optics, I was legally blind.

The decline came rapidly, all too rapidly. My eyesight changed in jumps, sometimes as much as three full increments, per year. The doctors ran tests. We went through exam, after exam. Nothing seemed to help or explain the sudden change in my vision. Diabetes tests were run, not once, but three times, all with negative results. As my sight grew worse by leaps and bounds, I tried various aids including, lenses, loops, bifocals, line-less bifocals and the Merritt system. Nothing, by itself seemed to help, nor did the paraphernalia help when combined.

A questionnaire program was run through the IHMSA's monthly publication, in an attempt to determine if anyone else had been or was on the same route that I was so obviously taking. There was no answer to my problem, derived from the questionnaire, except to determine that the shooters that are myopic (nearsighted) loose the ability to compete with iron sights, much earlier in life than do the farsighted shooters. The situation pretty much boils down to this, in very simple terms, as you get older you loose the ability to see up close. If, in the beginning, you can see up close, but you can not see at long distance, then as you loose the ability to see up close, the ability to shoot with iron sights is pretty much destroyed. The loss of the ability to shoot with open sights is due primarily to the need for glasses with multiple distance lenses, lenses that never focus at the required distances. Frustrating? You bet!

Natural 20-20 eyesight is one of God's true miracles. You can see one image from two eyes, that image appearing as one image, even when the eyes are divergent by as much as 8 points. That is to say that the eye-brain combination sees one object when in fact the eyes are separated and not on the same horizontal plane. The two eyes can bring various objects at various distances into focus, all at the same time. The multiple distance focus is visualized as instantaneous or instant focus if you will. Try that combination with two digital cameras and the best computer on the market.

As my eyesight became worse, I started looking into surgery as a possible alternative. I was lucky to have a number of customers and friends who are doctors to talk with and with whom to discuss the alternatives. It did not take very long to rule out RK and PRK as possible solutions. These surgery techniques can leave one with the ability to read a newspaper. However, the surgery results are permanent and can not be corrected, or altered to any meaningful degree. I saw a film about cornea (the lens of the eye) shaping that was being done in California, by an experimental machine. The technique involved surgically removing the cornea, then while the patient waited on the table, the cornea was chilled and shaved by a diamond blade. The cornea was then returned to the eye. The cornea removal, shaving and replacement process seemed much to convoluted for my tastes.

Several plastic surgeons that I know purchased Excimer lasers for skin treatment. The Excimer laser is quite an ingenious medical instrument. The laser's footprint can be altered into different shapes, including circles, ovals, squares, rectangles, etc. The Exemer laser can then be set to remove tissue by tiny increments, almost single cell depth increments. The Excimer laser does not remove low places in the surface, only the high places. The process is much like sanding a scratch out of wood. You remove the surrounding area, in stages, until you reach the bottom of the scratch, one final pass and the scratch is gone. The Excimer Laser does much the same thing in layers of tissue, which regenerate. It can be used to remove scars, wrinkles or even tattoos. What does all this have to do with eyes?

Lasik surgery is the use of the Exemer laser to reshape the cornea of the eye. Lasik eye surgery is not approved by the military. However, Lasik surgery, as I understand the process, produces a result that is virtually undetectable during a regular or normal eye exam. Lasik also produces a result that can change a pilot or aircrew member's status from grounded to flying. I talked to several pilots who were looking for a surgical answer to vision loss. Lasik surgery offered them some hope. I discussed Lasik with several air crew members who said that they knew men who had the surgery performed, with perfect results and who were currently on flight status.

The best chance, always, to get a real answer is to go to the horse's mouth; so, I decided to contact a well-known eye surgeon in the Southeast. My base criteria for a doctor, in such an instance, is very simple, if a surgeon does 1,000 similar surgeries per year, he may have the experience to fool around with my eyes. Eyes can not be replaced; so, we do not allow OJT on our eyes. The surgeon, Dr. Samuel Poppel, of the Emerald Coast Eye Institute was just the person we were seeking. He had his very own, newest version, Exemer laser. He had done thousands of surgeries and came with a bushel basket full of recommendations.

Off to see the wizard we went. What I found was that Lasik surgery can correct near-sightedness, far-sightedness and astigmatism. Lasik can correct these as individual ailments or as a combination of ailments, all at once, in one surgical procedure. The Lasik result can be altered, after surgery, by additional surgery and can be tweaked to a fine adjustment, if needed, after recovery from the initial surgery.

Lasik surgery is a four-step process.
1. Your eyes are examined to make sure you are a candidate.
2. Your eye or eyes and systems are examined and the cornea mapped.
3. The surgery,
4. The recovery.

The first step was fairly simple, a routine eye exam including dilation, pressure check, etc., standard stuff. The last part of the exam, the interview, was very different from the normal examination. "What do you expect and what result will satisfy you?" My first preference was to shoot with iron sights, without corrective lenses. The doctor indicated that my first preference was a tall order. It could not be guaranteed, or even really attempted with much of an idea of success, even with his experience. I thought about that for a moment. Well, my second preference was to be able to shoot with iron sights using a single vision corrective lens. The lights came on in his eyes and the doctor's face lit up. That preference he thought, he could do with a high margin for success. However, even with my second preference he was not absolutely certain of the results and could not guarantee the outcome, prior to the second exam or the surgery itself. The first exam was free, and is normally free, regardless of the surgeon you select. I was asked to consider the next step, very carefully. The doctor asked that I go home and consider the operation, then contact his office after several days, if I wished to go to the next step, a very through exam and the mapping of the cornea.

It is not wise to make decisions based on partial information; so, I decided to go on to the next step. The next phase was a very thorough eye exam, including extensive imaging of the cornea. The two-hour exam included tests of virtually every function of the eye and the body systems connected to the eye, even the ability to produce tears During the course of the second exam, digital photos and 3-D images were made of my corneas. Yes, both eyes.. The digital images produced by the camera-computer combination that were processed the computer program into visual contour map of the existing shape. The existing topography then produced a solution and the image of the desired shapes of my corneas. At the end of the exam, the doctor was fairly certain that my second preference, shooting with a single vision lens, could be met. He also thought that within one year after surgery my first preference might very well be attained. However, he cautioned that there is always a risk of complications or problems that are unforeseen.

That unforeseen risk factor was made very clear to me and should be very clear to anyone contemplating eye surgery. After careful consideration and two extensive discussions, a date for the surgery was arranged.

The day of the surgery was a day of nerves and being on edge. We knew what to expect and had been briefed. However, having anyone monkey with your eyesight is not a lighthearted idea; nor, is it something you should journey into without some serious reflection. The surgery itself is a fairly simple process. Your eyes are numbed using drops, no needles. A suction cup is attached to the eye ball itself. A flap is cut in the "skin" of the eye, above the cornea. The flap is laid back, exposing the cornea. The suction cup is then attached to the lens of the Excimer laser. The laser is focused on and to the diameter of the cornea. The digital firing solution, for the correction to the cornea, is fed into the computer that controls the laser. The laser is then pulsed (fired). The result, if done correctly, is a near perfect cornea, reshaped to all corrected surface dimensions. The flap is then folded back down and smoothed out with a small brush. No stitches are necessary to reattach the flap, as it adheres to the eye instantly. Sight correction by a CNC machine, if you want a comparison. The actual surgery on both eyes took less than 30 minutes.

The evening after the surgery was spent wearing plastic "bug eyed" goggles, while sleeping under heavy sedation. Sleep is the best medicine to aid and speed the healing of eye injury or surgery. Wearing the goggles prevent you from rubbing your eyes during sleep. Rubbing your eye might dislodge the flap, before it heals. The surprise was waking up and having to put drops in my eyes. Just to open the eyes and trying to move around the house while trying to see through tiny slits was quite different. Vision with wide-open eyes is not recommended or approved for some time, after the surgery.

The first thing you do, the day after surgery, is to go see the doctor. So, the morning after surgery, first thing, we were off to the doctor's office for a quick look-see, to make sure everything was OK. All went well.

My "naked eye" vision was in the 20-30 range the next morning, after the surgery. However, reading was pretty much out of the question as was watching television. The next few days, it was difficult for me to look at anything for an extended period, without my eyes starting to tear. The eyes also felt very tired in just a few minutes of looking. So, I tried to catch up on my sleep.

A week after the surgery, I went in for my second, after surgery, checkup. A problem had developed, an infection in the left eye. Why? I had done everything necessary, used the drops religiously, was very careful not to get dust or dirt in the eyes, etc. Then, the doctor said, "That infection looks like a virus infection." Then it struck me, 17 years before; out of the clear blue I had contracted a serious infection in my left eye. The infection was eventually diagnosed as a viral infection. I informed the doctor of the prior infection. The doctor's response told me instantly that I was in trouble; he visually winced. He said that viral infections are a major cause of permanent eye damage and the cause of most of the cornea transplant surgeries done by him. Oh, great.

Virus infections are very diabolical. Most everyone has had, or more correctly has, a virus infection someplace on his or her body. Chicken pox, shingles, fever blisters, herpes simplex, etc are all a form of virus infections. The virus never goes away, it lays dormant in your system until an injury or low resistance allows it to rekindle, like a smoldering fire. When I told him that I did not remember the infection until he mentioned it, the doctor said, "You might forget, but the virus never forgets."

We then went through two weeks of eye drops every two hours. The infection died or went dormant. However, the infection left a scar on my brand new left cornea. Remember the caution about anything can happen? Well, my telling this story, in its entirety, is to give credence to the fact that the caution is indeed very real. My left eye can be corrected at this time to 20-30, minus one, with glasses. This is OK, not great, but OK, and I am very, very lucky. One thing, to be clear, the infection could have reoccurred by itself at any time. The surgery undoubtedly aggravated an old injury, but neither the surgery nor the doctor was to blame. We will have to wait for 6 months to a year to see what will be needed to correct the problem.

The vision in my right eye is 20-20 without correction. However, like most things done by man, there is a fly in the ointment. In this case, the fly is the loss of my near vision, without glasses. Now I have to wear reading glasses to read. My 20-20 focal point appears to be near 4 feet without glasses. I tried several off-the-rack reading glasses. I finally settled on a 1.25 lens.

So, what about the right eye and shooting? I waited for one month after surgery to try shooting. The wait was probably not necessary, but that is what I did. Being that I am right handed, the right eye being in good shape was great. My first outing was standing with a red dot sight, just to get the feel. The result or score was not too bad; nor, was it too good, either, just a so, so performance. I wanted to get the feel of shooting without corrective lenses, so I felt that the outing was a success. One real good thing did come from the match. Wayne Lowery, a champion speed shooter, lent me his .50 reading glasses. Wayne had the glasses made to shoot with open sights. The result was amazing; I could clearly see sights and targets both, with the .50 glasses. It was then and there that I resolved to take a trip over to the next silhouette match being held at Mobile, Alabama, the next weekend. I wanted to try big bore production as my first real test for the new eyes. Now, if I could just get a pair of shooting glasses made in a couple of days.

Back to the doctor the next day, exam for glasses, prescription for .50 reading glasses and off to the vision center at Wal-Mart. Yep, Wal-Mart, Why? It is the fastest place in our area to get lenses made. The next day, glasses in hand, I was ready to reload and take the ride to Mobile.

Now, all of a sudden, the reality of the situation hit me. Most of my iron-sighted guns had been sold over the years and I had long ago thrown away all of my old sight settings for iron sights. I dug around, Friday night until finally, in an old file cabinet, I found my 12 year old, Merrill 10-inch production gun, 30-30, standing, sight settings. The settings were for a fairly light cast bullet load. Yes, I still had the gun and the 30-30 barrel for the frame. We were in business, I had the gun, the load and the sight setting.

Off to Mobile we went, Saturday morning, five weeks after surgery, no practice, new "reading" glasses, and a gun and load I had not shot in twelve years. However, I just might be able to shoot iron sights again; so, who cared? All that other stuff was just window dressing; we were going to burn powder.

I decided on the drive over to Mobile, to try standing first, just to determine if I could actually see the sights and if the sight settings were even remotely close, for my old, rusty self. In all my figuring and planning, I did not count on one thing happening, something that had not happened to me in almost 20 years, a very bad case of match jitters. The jitters jumped on me like I used to get when I first started, 20 years before. I could not hold the gun still, not even reasonably close to still. The result was a pretty miserable 13x40 final score, standing. For a few seconds, after I finished shooting, I was a pretty dejected. However, after over 20 years in competition, it did not take but a moment for me to realize that this was my first outing, and I needed to straighten myself up, get down to business and get going. "Spit teeth and cuss," as the old saying goes. I gathered my self back up and pressed on. We were going to shoot production, without sight settings and without a spotter.

The first three chickens were missed, all while trying to get the correct sight setting. Then an additional chicken was missed in the second bank, due to the need for a bit of additional tweaking of the rear sight. That is 6 chickens of 10 at 50 meters. One pig was missed in the first bank, sight setting again, with the second bank of five, going down clean. That is 9 of ten pigs at 100 meters. The first turkey was missed due to the sight setting, and a turkey in the second bank was flat missed. That is 8 turkeys of 10 at 150 meters. The first 200 meter ram was missed, requiring an adjustment to the sights. The second bank of 5 rams went down clean. That is 9 of 10 rams at 200 meters. The final score, a 32x40, in production with iron sights. Of the eight misses, 7 were from not having the correct sight settings! I was elated. This was 5 weeks after eye surgery!

The proof is in the pudding; I can see to shoot again. If you love the shooting sports, the ability to shoot is worth every penny that the surgery cost. Lasik surgery is not cheap; the going rate in this area is in the $1,500 to $2,000 range, per eye. The cost in some areas of the country is less.

This article is intentionally written without technical jargon and is worded to help the average shooter achieve a level of understanding. The article is not meant to be accurate as to the surgery. Let us leave that up to the doctors. I think the article describes fairly, the idea of the surgery and accurately describes the facts before and after the surgery.

Would I do it all again, even with the infection? The answer is yes. It has now been two months since the surgery. I am getting more and more accustomed to the arrangement. 30 odd years of glasses has required some adjustment. However, like most things worth doing in life, you adjust as necessary and go forward. I must say that shopping for sunglasses is a whole new experience. I have only had photo gray glasses from the first pair of glasses to the last pair.

Update:
It has now been four years since the surgery. The left eye is now at 20-30, without correction. However the right eye is at 20-15. I hunt, fish and shoot without carrying anything but a pair of reading glasses. The surgery continues to be one of the better things that I have done for myself, in my lifetime.

A similar article first appeared in the IHMSA News. This article has been revised and rewritten by me, the author, to constitute a new article for publication on this site.