I Can See Clearly Now (Well, Not Really, But Give Me Six Months)

For the past seven months, I’ve been viewing the world through what I can only describe as several layers of industrial-grade Saran Wrap. My right eye, which had faithfully served me over numerous decades, decided last June that it had seen enough of my shenanigans and essentially went on strike. Two weeks ago, I had surgery to address the problem, and I’m pleased to report that I am apparently healing ahead of schedule. The doctors tell me it will be six to eight months before my vision fully recovers – which, coincidentally, is about the same timeline required to conduct a utilization review in some states.

The condition responsible for my visual vacation is called an epiretinal membrane, or as it’s more colorfully known, a “macular pucker.” Yes, that’s actually the medical term. Apparently, my macula – the central part of the retina responsible for sharp, detailed vision – decided to pucker up like it was waiting for a kiss that would never come. What happens is that a thin layer of scar tissue forms over the macula, causing it to wrinkle. Imagine putting a piece of cellophane over a photograph and then slightly crumpling it. That’s essentially what was happening inside my eye. The result is blurred, distorted vision that makes straight lines look wavy and fine details look like they’re being viewed through a foggy shower door.

The irony is not lost on me that I have spent years looking at workers’ compensation through a critical lens, and now one of my actual lenses had actually become critical.

The problem first became noticeable last June while I was traveling to California for the California Coalition on Workers’ Compensation Conference, better known as the CCWC. I noticed my vision in my right eye seemed off, and I naturally assumed it was my contact lens, which I had just opened that morning. After all, that’s the logical conclusion when you’ve been wearing contacts for years and suddenly can’t see clearly.

What followed was a comedy of errors involving me, an airport bathroom, and the desperate attempt to address what I was certain was a defective contact lens.

For those of you who have never tried to change a contact lens in an airport bathroom, let me paint you a picture. First, you must navigate to the sink while dodging the parade of travelers who apparently all decided to use the facilities at the exact same moment. Then you must find adequate lighting, which in most airport bathrooms ranges from “interrogation room” to “romantic dinner for one.” You balance your contact lens case on the edge of a sink that was clearly designed by someone who has never actually washed their hands, all while trying not to make eye contact (pun intended) with the gentleman at the next sink who is conducting what appears to be a full sponge bath. 

And all of this with the knowledge that should you drop it in that sink, it’s a goner, even if you can easily find it. No way it is going back in the eye after that. But I digress…

I removed the lens, cleaned it thoroughly, inspected it for defects like a jeweler examining a diamond, and carefully reinserted it. No improvement. I repeated this process approximately fifty-two times over the next several days, convinced that I had somehow acquired the world’s most stubborn piece of debris on my contact lens. Spoiler alert: it wasn’t the contact lens. I soon realized my eyeglasses were producing the same result.

By the time I finally accepted that the problem was internal rather than external, I had returned home with the realization I needed to see a doctor. My right eye had become about as useful as an actuarial table at a poetry reading.

The Surgery: Close Encounters of the Medical Kind

The surgery to repair an epiretinal membrane is called a vitrectomy, and if you’ve ever wondered what it might feel like to be abducted by aliens, I can now provide some firsthand insight.

Here’s what happens: The surgeon makes three tiny incisions in the white part of your eye (because apparently one hole isn’t enough – they need a full set). Through these ports, they insert various instruments including a light pipe for illumination (because you want the person poking around inside your eye to be able to see what they’re doing), an infusion line to maintain pressure, and various tools to accomplish the actual repair.

The vitreous gel – that’s the jelly-like substance that fills the center of your eye – is removed. Let me repeat that: they remove the jelly from inside your eye. If that sentence doesn’t make you slightly uncomfortable, you’re a braver soul than I am. This gel is replaced with a saline solution that your eye will eventually replace with fluid it produces naturally. Then, using instruments that I can only assume were designed by someone who also builds ships in bottles, the surgeon carefully peels the membrane from the surface of your retina.

Throughout this process, you are awake. Mildly sedated, yes. Comfortable, surprisingly. But awake. You can hear the surgical team talking, as well as see them through a plastic sheath with your one good eye. You can even converse with the doctor, like when you hear him say, “Oops, look what happened. Nurse, get my lawyer on the phone.” A large robotic-style device is lowered close to your face. You can hear the sounds of the equipment, including what sounds like tiny drills and a little Shop-Vac working inside your skull. The bright lights and strange sensations create an experience that I can only compare to every alien abduction account I’ve ever heard. If anyone ever asks me if I believe in extraterrestrial visitation, I can now honestly say I’ve experienced something close to it – I just had to pay a copay.

The good news is that the surgery went extremely well, and I appear to be healing ahead of schedule. The bad news is that “ahead of schedule” in eye surgery terms still means months of recovery. The doctors tell me that full vision recovery typically takes six to eight months. In the meantime, I’m navigating the world with one eye doing the heavy lifting while the other catches up.

For the first few days after surgery, I had a gas bubble floating around in my eye – which is normal and intentional, helping the incisions heal. Watching that bubble drift around while you are moving is an experience I can only describe as “distracting” in the same way that a marching band in your living room might be considered “noticeable.” If my doctor had left guide marks on my cornea, I would have had a built-in level.

The bubble has since dissolved, and each day brings slight improvements. Things are still blurry, but it’s a different kind of blurry – more like looking through a frosted window that’s slowly defrosting rather than the crumpled Saran Wrap effect I had before. Progress, as they say.

Now, I know what some of you might be thinking. You’re wondering if this visual impairment will affect my ability to spot the absurdities, inconsistencies, and questionable decisions that permeate our beloved workers’ compensation industry. You’re concerned that perhaps my snarky observations might be diminished by my reduced visual acuity.

Let me put your minds at ease.

While my right eye may currently be operating at diminished capacity, my ability to see through the bureaucratic fog of workers’ comp remains unaffected. The problems in our industry have never required 20/20 vision to identify. You don’t need perfect eyesight to notice when legislation runs to 800 pages to “simplify” a process, or when reform efforts somehow manage to make things worse, or when the latest technology solution creates more problems than it solves.

I could identify these issues blindfolded. In fact, given the state of my right eye for the past seven months, I essentially have been.

So, rest assured – or be forewarned, depending on your perspective – that From Bob’s Cluttered Desk will continue its mission of providing the workers’ compensation industry with the irreverent commentary it has come to expect. My vision may be temporarily compromised, but my insight remains intact.

Besides, I’ve been told that dealing with workers’ comp issues requires a certain blindness anyway – at least to logic, efficiency, and common sense.

I’ll keep you updated on my recovery. In the meantime, if my writing seems a bit off, you’ll know why. And if it seems exactly the same as always, well, that probably tells you something about my baseline.