Tuesday, June 29, 2021

some of the lesser known signs of cataracts in younger people

 If I had known these were cataract symptoms - I would have pushed harder for them to diagnose and treat them.  But, it took me nearly two years of rapidly declining vision, among all of the other anxiety-causing and terrible upheavals in my life, for them to finally 'see' that problem.  And now, after all that time, I am reading my screen again without a magnifier - and with black text on white background.

The signs I missed (and they did, too)

Everything seems dark or dim - even when you have the lights on!  You seem to need to a lot more light for everything, and especially direct or 'sweet spot' light on what you are doing.  Going outside is amazing, things are sparkling beautiful colors, but as the months progress - it produces a 'London Fog' type effect that makes it very hard to see long distances.  

Anxiety - You have a definite sense something is wrong, but you probably ascribe it to other things.  You probably have been adapting to doing things differently, but your body knows something is up, even if you're ignoring it.

Small text was hard, and now is nearly impossible. Up until now, your closeup vision has been what is mostly affected, but you're getting older, right?  It should be 'natural' in your thirties or forties to need stronger and stronger glasses to see small text.  But, every three months or so your prescription isn't good enough, anymore.  You need magnifiers over your glasses or small magnifying glasses to see phone numbers, mail and magazines.  You didn't need these last year - and even bifocal glasses only help at some distances with 'most' type.  You may feel depressed, or incompetent, or both. Everything has gotten harder, paying bills, reading recipes, checking receipts, cleaning up and sometimes when you set paperwork down on the desk or table you have trouble finding it later without looking closely at every item.

Clear shapes in your vision:  The one that confused my ophthalmologist the most?    I was complaining of these 'clear overlays' like patterned glass that would show up in my vision.  Some people might call these artifacts - but they are not the typical type.  They were not 'floaters' or strands of white blood cells like most people describe.  These were bullseye patterns, small triangles, bumps and circles like pixels that would appear and then 'travel' with my gaze across my line of sight.  They would be there worse in some lights, and disappear in others.

Polarized or Fishing sunglasses help some : I would put on polarized glasses towards the worst part here and the London Fog would diminish a lot.  I couldn't see a person on the other side of the room before I put them on, if fluorescent lights were on overhead. The polarization stops certain wavelengths of light from getting to your eye, which cuts down on the interference overall. But, those clear overlay patterns were STILL there.   That was because they were caused by light reflecting wrong inside the eye, through and bouncing between the separated layers.

You want Dark Mode for everything, even in the daytime.  Dark mode on facebook and tablets and readers helps SO much - you can read small type in white on black background fine, but not the other way around. 

Night Driving is difficult or impossible:  Every car that drives by in the opposite lane fills your eyes up with the headlight glare, and it doesn't go away for several seconds.  You find yourself having to slow down for every oncoming car, and/or weaving off the road and missing turns.

Streaming Eyes : Your eyes seem dry a lot, but then at other times they stream for no reason.  

partial Double Vision : You may see 'double vision', partial double vision, or one and a half vision, especially when focusing at near distances but not far.

You keep getting a new prescription, but it only lasts a few months.  It gets worse and worse as the months progress


I was diagnosed with posterior subcapsular cataracts (PSC) in January, after noticing changes for more than a year, and only getting new glasses which failed the solve the problems.  I was told they are VERY hard to see, and if they aren't thinking that is the problem, they might not look for them in the right places under full dilation.

They can also progress VERY fast.  At the beginning of the year it is just a magazine that is difficult but possible with a magnifying glass.  By the end of the year you can't see yourself in the mirror (but can still see the road to drive, but not read the street signs or exit signs!) or read your own handwriting or phone screen.

They are becoming much more common in younger people, but the medical profession has not yet started looking for them as routine in these age groups.

What Causes This?

They can be caused by diabetes, genetic conditions (like collagen disorders, yay me), any condition that causes excess inflammation or has trouble with healing, those that have been regularly prescribed steroids for lungs or other conditions, or the result of head, eye or face trauma.  They can also be caused by lots of UV exposure, stress or past alcohol abuse.  Put any of those together and it increases the risk.  It sounds like they're still sorting out what 'really' causes it, and how to identify it early - but a little knowledge to the public can only help.

The layers of the back of the lens get separated for some reason (you might not even register it as a real injury or think 'I'm fine' - because this takes months to years to develop the initial condition, and then it begins to grow & change exponentially after that like a nick in a windshield that one day begins to crack all the way across...), and the cataract forms as a 'bubble' in between these layers, in the back inside of the lens, where the problem can only be seen 'through the axial lens'.  

But - won't I know?   It's obvious, right?

It's invisible to the naked eye, and hard to find even under dilation by the eye doctor.  So, no, you probably won't know, and their job is to get you glasses - so that is what they will try. One of your first signs in the office will be that the little floating balloons or Aladdin swirling lights machine - the spectroscope - will try and fail to get your prescription.  Your ophthalmologist may or may not say anything at all about it, or may brush it off - 'that's weird, this never happens', 'you can't trust the machine, it's just there to get a basic reading', etc.  That machine works by bouncing light into your eye and measuring how fast and at what angles it comes back to measure the shape of your lens.  If your lens has bubbles or clouded areas in it that is not going to work as expected.

So, how does your Ophthalmologist recognize it early?

If you see these symptoms listed above, you need to tell them, or they'll just keep up with glasses until they can't match you up any more.  Enough warning signs, we hope they will look, but nowadays everybody is in a rush and they have to have enough reasons to look and check everything.  That is what finally alerted them that I had a 'real' problem.  The vision machine - spectroscope - could not read the worst eye.  The problem was already progressed quite a bit, but at that point they still hadn't identified it.  

They failed me on the vision machine with the floating balloons twice.  I failed the reading test in the chair as well.  Then - they gave me another dilation and looked hard and detailed at my eye, and found the problem after looking back and forth through the lens across my optic nerve and cornea for several minutes checking and rechecking.  This occurs on the inside back of the lens and can only be seen by looking at the 'axial' or side of the lens and realizing you are seeing the problem in the lens - like a spot on your glasses when you keep trying to wipe your computer screen.  

After seeing this finally, the eye doctor referred me to the specialty clinic, which also had to go through all the same things, including the spectroscope confusion.  But, the specialist doctor knew what he was looking for, any and all types of cataract.   As a note, there is a cataract in my OTHER eye, as well, but not as large, and they were still able to get prescription on that one.  

Why does cataract surgery fix it?

I was a bit pessimistic, after all this, that it wouldn't be entirely fixed.  I thought the overlays would still be there, because they were there even with the polarized glasses.   But they remove the entire lens, and replace it with an artificial one.  This problem is in the bottom inside of the lens- if it was a plastic cereal bowl and you placed it upside down on your counter, it would be a separation in the layers on one side near the countertop, flaking upwards.  They remove all of that - not just the top section of the lens, and put a new 'fake' lens in, that reflects light properly.

Will they come back?

Once upon a time, I've been told, they used biological lenses, donated from cadavers to replace the lens after cataract surgery.  These lenses were susceptible to the same stresses, fractures and cloudings as the original lens you were born with.  So yes, THEN they did come back.  Now, with artificial lenses, they should not come back.  But, you do have to protect your eye from UV much more with an artificial lens, to protect your retina from macular degeneration.  The retina is in the back of the eye, and with improper diet, dry eye or blocked eye drainage or other genetic conditions, it can be damaged even more by UV exposure after cataract surgery.  This is why most people after cataract surgery will continue to wear sunglasses outside whenever possible.

Will I still need glasses?

Maybe. But they won't be able to tell until a week to four weeks after your surgery, because the new lens has to settle and your focusing power (your eye bends the lens to see near or far) will be different for each person.  Once your eye has settled, any prescription you get should be the one you will have the rest of your life.

The outcome for me:

With the cataract gone from the left eye - I am reading with no glasses at all, and I only did the basic replacement because of insurance, not the fancy ones.  The ever-stronger prescription in my glasses was not because of 'age' only - as we often think of it - but because the specific cataract type disrupting the light reflecting in my lens.  Cataracts can come with age, but this type specifically can hit anyone of any age, if the conditions are correct.   

I've tried to hit as many of the keywords and search terms as I can in my text that I was looking for when I was going through this problem in the beginning.  Maybe, it will help someone.  If I could go back to the 'everything is dark - turn on the lights' stage and whisper into their ear - it might be a posterior subcapsular cataract.. I would.  I would definitely tell myself it wasn't that I was suffering from depression and anxiety - my dad had just died, I had quit a soul-sucking job .. all of that -- But I wish I had known it was possible that it was a physical problem with my eye, and it needed to be taken care of.

Thursday, June 24, 2021

short story : Apollo's Phaeton

Apollo's Phaeton, by Marie Lamb

 It was the oddest job request I ever had.  It was literally 'out of this world' and right into the next one.  The little silver car didn't seem like much, so I signed off on the contract to take it to Mount Olympus, Georgia, and deliver it to a man named Apollo Zeiss.  I got in, turned the key, and at first thought there must be something wrong with the transmission.  The vehicle glided smoothly through all gears entirely by iteself, and with a strong odor of honey in the air.  Then the little car put itself in reverse and I was no longer in control of my limbs.  I imagined my name burning away from the contract in the back of my mind - all evidence of my existence being destroyed by some supernatural force.

I knew this area quite well, but, after a while I had lost track of the twists and the runs, the hills and the little dirt roads winding over creeks and through fields I had never laid eyes on before.

I was already quite worried by this time, but no moreso than when the little car began to climb a hill that seemed to go to nowhere - and kept climbing, until I could have sworn it had no tires on the ground and it was simply pedaling through the clouds on a full tank of ambrosia.  And that , my friend, is when the lightning began to strike.  Inside, the well-upholstered coupe sedan I was insulated, but the flashes of light cracked everywhere, pink and purple arcs that then became blindingly white.  It left little red streaks in my vision that faded to green slowly.  Then the clouds began to converge around me, like vaporous horses pulling along a chariot toward its awaiting master.

The car came to an uncertain footing at the edge of a white sand beach that spread out for miles.  I had been at least half the country away from the nearest ocean - so I immediately began to crane my neck through the windshield trying to see any landmarks, houses or other roads.  There were none.  White sand stretched out unblemished in either direction.  Then, the door of the car opened up with a shot and I could feel the tendrils of the air itself form tiny whirlwinds about my arms and legs.  I was fully and completely jerked outwards and held down into the fine sugar sand.


I got up spitting, only to see a flashy young man in a white suit and bright gold lame tennis shoes stroking the side of the car with obvious affection.  I've seen men fawn over numerous things, including vintage machines worth hundreds of thousands of dollars.  If I had not just been taken for a completely inexplicable ride in said car, I would have wondered even more what a mid-2000s sedan could do to evoke such tenderness.  In fact, most people would have called the car a dog, but I knew for a fact that it was quite the opposite.  I could swear, having had that trip, that if a car could arch its back and purr like a cat, this one definitely did.

The man dropped his shades for a moment and peered down at my kicking body.  None of my extremities were entirely cooperative yet.  He stooped down to get a closer look at me and cocked his head.  He laughed a strangely musical noise at me and then thwacked me with his finger and thumb right between the eyes.  The world looked very bright for a moment and I felt like there was a fish inside my brain gasping for air, flopping uncontrollably, and then disappearing.  

"Miss Madison, I presume?" he said with a voice that could cure all ills.  'Ye..e...s..sss', I stammered in return.  He reached a hand down and now carefully took me by the hand and pulled me to my feet.  "I am so happy you could take the position and bring my transportation with you.  It has been a LONG time since he had a good run through the countryside.  And if you knew how long it took to find him and then get him to agree to a new form in the first place... Well, what he lacks in pizzazz he has always made up for with enthusiasm."  He was, of course, talking about the car.

"What WAS that?  What IS that?  Who are YOU and..."  Although I wasn't sure what I wanted to hear for answers... I saw his joy turn to slight annoyance and stopped in my tracks.  The distant summer horizons were turning a little dark, and the air had a crackle about it that I did not want anyone, or anything, to elaborate upon further.  He had dropped my hand and was beginning to heap the sand from the beach up in great net-like swathes around the little car.  I had no idea how he was doing this with just his hands, but any questions would have fallen more productively upon a brick wall at that point.  "Are you Apollo Zeiss?"  I asked, pulling the crinkled contract out of my pocket.  "Miss Madison.  You know I am.", he said, and removed his shoes, one by one.

I was still staring with  what must have been a fly-catching expression as he set one shoe on the back of each side of the little sedan's trunk and then gave it a huge slap on the trunk.  The car reared up on it's hind wheels and shot off into the sky before I could barely blink.  What in the world, or at least this place, was going on?

"Well, now we have to figure out what to do with YOU, Miss Madison.  I have to admit, most of the contracted help don't actually make it much past the first few miles.  They err.. disintegrate."  He said this last bit while staring at some bit of sand caught up under his fingernails, but then immediately flashed a huge blinding smile back at me.  "But NOT YOU, my dear girl.  I think he likes you."  I felt taken aback, horrified and a bit relieved all at once.  I took a step back from this avant-garde Greek God and looked soulfully up and down the desolate but stunning beach.  "So, I lived.  Is that a good thing?  Do I get to go home?"  

Apollo looked me in the eyes with a slow smolder and said 'You could.. perhaps.. I could pluck this memory out of your mind and send you back with a nice bankroll.  But, then you'd right back to where you were, running 'important' things around the country back and forth, back and forth... is that what you want?  Or are you interested in things of a less.. mundane.. nature?  It isn't every  day I find a mortal brain that can withstand electrically conducive embrosia AND form a complete sentence afterwards."  He raised two very shaped and sculpted eyebrows at me from beneath his shades, struck a pose against a car that was no longer there, and waited for my response.  My eyes drifted down, uncontrollably, to his bare feet that did not actually sink into the soft white sand.

I had to admit, the offer was out of this world.  And, so was he.  Could it hurt to try at least one more job?  Mr. Apollo Zeiss held out my contract, smoothed and only still slightly singed at the edges.  He handed me an expensive Italian pen.  "Sign on Miss Madison, and we'll get you your wings."  I set the tip of the pen to the paper and a silver ink came out nearly of it's own accord and signed my name.  "Welcome my dear... let's go meet the Family.  But first, these CLOTHES...'

Tuesday, June 22, 2021

short story - The One Hundred (philosophy)

The One Hundred  by Marie Lamb

"Out of the One Hundred, broken on the way down." This was scratched laboriously into the side of the mountain we passed today. We all paused, and read it, and looked from one to the other to see if anyone understood. I looked up at our goal, the peak, dizzyingly high, and wondered: 'What was broken? Or, who?'

How did they fall?

Were we climbing the Mountain, only to fall ourselves?

My guide was not enthusiastic about telling me. He doesn't like questions, he says. He just likes the Traveler's to follow along. The road has become so full of ruin and sharp edges that he seems to spend most of his time dealing with it by knives. It was not that there was nowhere else to go, but that we were drawn by something so strongly that we could go nowhere else.

Even so, it is not a wonder to me that there are so few of us who come these day. The ones I stand among are thin and weary in the eyes, but still they look at the Mountain. One must feed up on hope, even when it is doled out in only small spoonfuls. We are all thirsting for the water, and hungry in our souls. And we feel the pull of the Mountain in our blood, calling us.

I fear to ask more while he hacks away at the path. Perhaps our guide was one of the One Hundred, or that he knew one of them. I tread a little more carefully, not to step upon his grief. But still, I wonder how we will not relive the trials of the past if we sit in ignorance of them. We walk along the same paths, and look for the bones, but refuse to speak of them.

We reach the door in the Mountain, and our guide opens it up with a twist of the flywheel. It cranks slowly, on what sound like ropes and not chains. Within the doors the market is bustling and the world is different and full of life. I see the eyes of my fellow Travelers light up with wonder and disbelief.

We look for projectors and speakers, and try to reach out and touch the fruit. But we are pushed forward, our hands batted away. We have come through but are told our journey is not yet over. Instead we are pointed to the Hill, up a set of clean white stairs. We huddle together, our hope held on strings, and begin to pull our ragged bodies up one bit at a time. It is only as a group, with hands together and much strain, that we finally reach the top.

And for the first time, since I began walking, I am counting. I did not count on the trail, or as we entered the gate. I saw and felt only a sea of dead eyes and misery and strife, keeping my sights on the trail and begrudging that there were not enough answers.

Now I see. As the last small child has been pulled up on the top stair we stand together. We are the One Hundred, for this time and place, as was written. We were broken on the way down. And now we have come up.

Monday, June 21, 2021

short story Final Dispatch - two bits

 this is the unedited story - it may undergo a few edits before it is done.  It will be part of the House of Sunlight anthology, c. Marie Lamb.

Final Dispatch, Two Bits

Friday, June 04, 2021

short story Shadows in the Lens

 It began several years ago, the white shadows. I would see them, walking across the room - from here to there, every day, the same ones, shadows of a past gone by. I began to realize, the older the place, the more populated it had been, the greater the number of shadows. In some places, they were stacked on each other so deep it was like looking through a London Fog. 

For example, the airport. The first time I had to go through O'Hare to get to a plane they thought I was having a panic attack. I don't know how I made it through - mostly by following the feet of the people in front of me. When they called our plane, I knew the number, and it was only by luck and chance that the man and woman who jumped up and began to run for the other gate were really going the same place I was. The plane was not old, but while it was on the ground the shadows continued to walk through, around, and up and down. When we left into the air, things cleared. When we landed, I was so glad to have someone there to pick me up and take me home. 

Now, I actually have to employ someone to walk me through the crowded places. I bring a cane, and dark glasses. Sometimes they are in the know, and sometimes they really think that my panic attacks render me blind. But mostly, I try to find the quiet places - the out of the way places, where few have come before. It isn't an easy life, trying to photograph the beauty through what is invisible to most - to see only through my camera lens that which, when I view it with the naked eye, is nearly obscured. 


I guess that is why I have thrown myself into my work so completely, and why it has shown in the sheer number of awards that I have now raked in. 'Most Remote Photograph of the Year', yes - that's me. 'To Go where None have Gone Before', yes, I'd love to. For someone who once was so entranced by history, by the bright lights, the stages and the exuberance of life, now I seek solace, vast empty spaces and the quiet of the midnight and dawning hours in the places where most would have been asleep and dreaming. 

 Perhaps I am dreaming all of this. It is hard to prove that Mr. Alistair came down these stairs one night at two a.m., and yet, I see him - just once - carrying the lantern. It is hard to know or investigate who the little girl is running up the mountain path, on this farm that has been abandoned for a hundred years - or that she also sits on the beach down there by the rocks, huddled against some storm that no one remembers. 

Perhaps one day I will wake up and there will be no fog in the social places, no strange things to catch the corner of my eye when a reporter is asking their questions on the phone, no mysteries that I really do not wish to solve. 

Tomorrow I will take these bandages off and we will see if the surgery has made any difference at all. I am ready to wake up from this dream into a new day. But if I stop seeing the past, what will I do with my future? If I see nothing at all, will I have a future? If I start seeing the future, will it be black or blindingly white? //fiction -- first draft, thoughts floating through my mind today