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Wednesday, October 29, 2014

Every time I open my eyes, I'm reminded how lucky I am that I can still see what bothers me

Many Armenians accept blindness as inevitable.
The Armenian EyeCare Project is trying to change that.
I got my first pair of eyeglasses soon after starting school, when it became apparent that I couldn’t make out the letters on the blackboard.

My near-sightedness worsened as time went on, and eventually I needed glasses not only to see across a room but to walk across one. I took it in stride when I was young, and even when I was not so young.

I was happy as long as I could see. If glasses made me look serious and bookish—good! I thought they suited a journalist’s image just fine.

I took comfort in the assurance of every doctor I’d seen that my eyes were healthy. I didn’t need a doctor to tell me when that was no longer the case because I could see for myself.

I was helping our daughter move into her college dorm in the summer of 1999 when I looked up into the sunlight and saw what looked like black snow falling. In my native New Jersey, I’d have shrugged it off as soot from a factory. In Tampa, Florida, this was no shrugging matter.

I should have gone straight to a doctor, but I told myself the problem was eye strain. All through the four-hour drive home, I kept seeing lightning-like flashes in my left eye. I blamed the reflection of headlights in the side mirror, but the flashes continued when I got home.

The eye doctor who examined me the next day diagnosed a PVD (posterior vitreous detachment), a common event for the near-sighted in middle age. It means the squishy middle of the eye (the vitreous) has shrunk and pulled away from the retina. If the vitreous is a bit sticky, it pulls some fibers along with it. You’ll see a few sparks and some bits of debris floating through your field of vision.

It’s not a big deal, except when it is.

Usually, PVDs require no treatment but my sticky vitreous yanked hard enough to tear a tiny hole in the retina, the crucial light-sensitive layer at the back of the eye. The blood and tissue that spewed from the tear is what looked like black snow. Those lightning flashes were the retina’s way of shouting, “Ouch!”

Despite my delay, I reached a retina surgeon quickly enough to prevent further damage. He used a laser to stop the bleeding. It was a good rehearsal for both of us: six weeks later, the same thing happened to my right eye.

Left untreated, my retinas might have continued tearing and even detached. The consequences of such complications, including vision loss, can be permanent.

Trust me on this: If you see flashes and floaters, get examined right away.

The most serious consequence of my PVDs so far is a swirling profusion of permanent floaters in both eyes. The effect is a lot like looking at the world through a dirty fish tank.

In the long term, I’ll have to be alert for further retinal deterioration but for now I can still see and I can still read—although, large type helps because those damned floaters tend to settle in the curves and valleys of small letters until each sentence looks like one wriggling smudge.

These distractions are a small inconvenience but they’re a powerful reminder that I’m lucky to live in a place where laser-wielding retina surgeons are a cell-phone-call away. I often wonder how well I’d be able to see, or whether I could see at all, if I lived somewhere else.

I think of Armenia, for obvious reasons.

That poor and tiny country wobbled into independence in 1991 just a few years after a devastating earthquake, and it quickly plunged into war with neighboring Azerbaijan. Among the tragic consequences of both events was a spiraling increase in blindness, particularly among children.

Dr. Roger Ohanesian, a California ophthalmologist, responded by founding the nonprofit Armenian EyeCare Project (AECP) in 1992. The organization has been ferrying American eye doctors and surgeons to Armenia since then, reaching hundreds of thousands with its mobile hospital. 

Now the AECP is joining the Armenian government in building five regional eye-care clinics, and it's looking for support.

These clinics are a necessity because the situation remains dire. According to the AECP, “the accessibility and affordability of eye care in Armenia continues to be extremely limited and disproportionately affects the poor and those living in remote regions. Just four towns outside of Yerevan provide basic eye care and most surgery is available only in the capital.”

The cost and hardships mean that many go without vital care. I was stunned to learn from the AECP’s literature that cataracts are the country's leading cause of blindness, affecting nearly a third of all Armenians over 65.

Cataract surgery is common in America, but it’s available to only one in four Armenians who need it. As a result, “Armenians have learned to accept blindness as part of growing older . . .”

How sad is that? 

I get a hundred reminders of my good fortune each time I open my eyes. It's good to know someone is working to bring that same good fortune to people who so desperately need it.

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