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Nicolais: I can see clearly now — finally — without glasses

After decades of contacts and reading glasses, I finally navigated the eye surgery industry

For the first time ever, I wrote this column unaided by glasses or contacts. It is actually the first time I have written anything substantive without visual aids since the fourth grade. After decades of acute myopia — nearsightedness — I had corrective surgery a week ago.

And I can see clearly now. Mostly.

As is the case for many people making health care decisions today, I did not see the path toward better vision with 20/20 acuity. It took months of research and visits. It was dotted with contradictory advice and opinions. It took perseverance and an ability to look past frustration.

Mario Nicolais

It took rolling over in bed one day and hearing the arm of my glasses snap.

Broken at the hinge, I went to a couple big-box lens dispensaries and three jewelers hoping to get a repair. The damage was irreparable. The expensive frame and the lenses fitted to them got chucked in a wastebasket on my way out the last door.

At the same moment, I decided to give corrective surgery another try.

I have been basically blind most of my life. I have always been the guy who needs to take two steps forward before the big “E” at the top the vision chart becomes anything more than a fuzzy dark spot. Forget about anything below that.

Consequently, I have also not been an ideal fit for LASIK surgery. In a nutshell, LASIK uses a laser to re-shape the cornea. The more nearsighted an individual, the more re-shaping is necessary. At some point the necessary adjustment leaves too little cornea to be re-shaped.

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Furthermore, the procedures can be expensive. While some less scrupulous providers advertise super low rates, they almost always come with an asterisk.

The actual rate is usually close to a couple thousand dollars per eye. Because it is not “medically necessary” — despite the fact that I am likely to walk into a wall without correction — insurance generally does not cover such procedures. 

Medicine regularly takes steps forward, though, so I set a few appointments. Owning an MBA with an emphasis in Health Administration and experience working with multiple health care companies, I knew better than to see a single provider.

I went to five different offices.

As it turns out, the eye industry does not advance as quickly as my eyes have deteriorated. Three of five doctors told me I was not a candidate. Two said I was on the bubble, but they thought they could do it. Anything less than universal consensus is unsettling when talking about someone poking around in your eyeball.

However, after the 20/20 Institute told me they would not even consider LASIK for me they also took the time to discuss other potential options. Specifically, they suggested I would be a good candidate for ICL (Implantable Collamer Lens) surgery. Effectively he advocated taking a knife to my eyeball and cramming a permanent contact lens behind the iris and in front of the natural lens.

Yeah, I winced, too.

Because 20/20 does not perform those surgeries, they recommended a few surgeons for me to follow up with. I ended up choosing the Mile High Eye Institute. They have a clean, well-lit office with a full surgical suite on site. Though the wait time after check-in was usually rather lengthy, a busy medical practice is also often a good medical practice.

What convinced me, though, was the follow-up schedule they set. After morning surgery, I was set to come in again later the same afternoon, the following morning (a Saturday!), a week after surgery, and a month after surgery.

That is the sign of a practice that truly cares about outcomes. They could have made as much money performing the surgery and giving me a phone number to call if something did not feel right.

A week post-op I can see things in the distance more sharply than I ever did in contacts or glasses. 

TODAY’S UNDERWRITER

My near vision is fuzzy — presbyopia, the loss of lens elasticity that makes reading hard happens to almost everyone eventually, can become more noticeable post-surgery.

I realized I had been unconsciously correcting for it for years by taking my glasses off and holding whatever I read right up to my nose. I will need to get accustomed to carrying around readers. 

I also may need to have a follow-up procedure for an astigmatism and there is still no reasonable fix for color-blindness.

But this holiday season, for the first time in decades, I will be looking at light displays absent the frozen condensation fogging up my glasses. Who could ask for anything more?


Mario Nicolais is an attorney and columnist who writes on law enforcement, the legal system, health care and public policy. Follow him on Twitter: @MarioNicolaiEsq


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