The world through a bubble

June 5, 2015

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I have a bubble in my eye.

My doctor jokes that I can use it to make sure the photos on the wall are level.  He tells me that, eventually, it will dissipate and disappear.

It’s easy for him to joke: He’s the one who put the bubble there.

In his defense, he did it to help save the sight of that eye.

Once he did his work, then it was my turn. My assignment: Help the bubble in my eye do its job by lying on my right side for the remainder of that day and the five days that followed.

Essentially, the prescription called for a week of bed-rest. That prospect terrified me more than the procedure that would put me there – and that procedure involved sticking a needle into my eye.

Six days of inactivity? Of lying still? Sure, I could watch TV or movies – if I didn’t mind that the image was sideways. But, essentially, I would be out of commission for six days. It sounded like torture – more so than having someone poke a syringe into my eyeball.

It started innocently enough, with a routine eye exam. It had been a few years and I felt like my glasses were no longer strong enough to provide the kind of visual acuity I sought. As a film critic, eyes are, after all, one of the tools of the trade.

For the previous month, I had noticed a floater in my left eye. That wasn’t new; floaters are a fact of life as we age and the liquid inside the eye begins to dry out. What was unusual was that this particular floater would occasionally obstruct part of my vision when it floated into view. It seemed to have the grainy texture of those paramecium that you’d see through the microscope in biology class.

But at the end of my eye exam, after first checking my vision, then looking inside my eye, the ophthalmologist smiled and said, “It’s remarkable that your vision is still so close to 20/20, because you have a detached retina.”

The condition required immediate attention and the practice’s retinal specialist would be in the next day. I scheduled an appointment and went home to study up on the retina.

As I discovered, the retina is like wallpaper on the interior wall of the eye and does for the eye what film does for a camera: It captures the images. Then it starts processing them as they make their way to the the brain.

It’s a fairly delicate tissue, easily separated from its moorings by a trauma — a tennis ball to the eye, a violent car collision. But it also is another victim of aging: As the liquid in the eye (which is attached to the retina) begins to dry, it shrinks and pulls the retina away from the wall of the eye.

The next day, the specialist offered the wallpaper analogy, saying that, if the liquid of the eye gets behind the retina because of the tear, it can exacerbate the problem and lead to a full detachment. The worst outcome would be loss of sight in that eye or diminished vision.

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There were two possible courses of treatment. One was surgery to reattach the retina, and he said that was never the first choice, if it could be avoided. Instead, he thought I would respond to a treatment which I later learned was called pneumatic retinopexy. It involved injecting that gas bubble into the eye and then letting gravity and physics do the work.

The bubble was composed of a gas that couldn’t pass through the membrane of the eye to escape, but which would attract gas molecules from the bloodstream. I would lie on my side until the middle of the following week; while I was on my right side, the bubble would be floating against the left side of my left eye, gently massaging the retina back up against the wall of the eye. If the procedure was a success, the retina would be smoothed back into place and he could then use a laser at the next appointment as a welding torch to secure the retina back in place.

An injection in the eye: A description seems pointless because those words alone are enough to conjure a sensation in the reader that undoubtedly is far more painful than the actual event. I tried not to psych myself out unnecessarily.

I had a professional obligation that evening and so decided to postpone the procedure by a day – a decision that seemed to shock him. When I told him I could not miss the event, he looked like a man who had just pulled the pin on a grenade, only to be told, “Hold on a second…”

So he scheduled the procedure for the next day, in a different office. As he printed out directions from his computer, I wondered aloud whether I understood correctly — that he would be sticking a syringe into my open eye while I was consciously keeping that eye open.

That was correct, he said, intent on writing something on my chart, adding without looking up, “It’s usually well-tolerated.”

Talk about a phrase guaranteed to induce anxiety. I was sure that my limits of tolerance would be put to the test.

As it turned out, we were both wrong. My 24-hour postponement of the procedure did not lead to further tearing in my retina. And I tolerated the procedure quite well.

The anticipation was the killer. The thing itself was over quickly.

I sat in a pneumatic chair and put my head back. He proceeded to drip so many drops of anesthetic into the eye that, when he subsequently put in drops of iodine to sterilize the field, I felt nothing. Nor did I feel it when he put one of those “Clockwork Orange” clamps on to hold the eye open.

“You’ll feel a pinch,” the doctor said about the injection, then said, “Look up to your left.” As I did so, he came at me from below, so I couldn’t actually watch the needle’s approach. Indeed, it was just a pinch.

It’s just that I’d never been pinched in the eye before.

As quickly as it happened, it was over. As he’d described beforehand, the vision in that eye went black. He sat me up quickly, put my head in one of those chin/forehead rests, then apparently used another needle to draw off a little liquid from the eye to reduce the pressure. Gradually, the black gave way to flashes of light and color, then to actual, if blurry, vision. And then back to clarity.

Plus a bubble.

Just as the lens of a camera turns the image upside down on to the film, so it is with the retina. So this bubble, floating at the top of my eye, appeared to hover in the lower half of the field of vision. It’s like my eye was perpetually on the verge of releasing a giant teardrop.

From start to finish, the entire thing took less than 10 minutes from eye-clamp to “OK, we’re done.”

I spent most of the next six days lying on a couch in my office at home, on my right side. When they heard about this phase of the aftercare, friends said, “How will you eat? Or go to the bathroom?”

It wasn’t as draconian as that: Essentially, the doctor wanted me to spend 45 minutes of each hour lying on my right side. But I could take 15-minute breaks. I quickly learned just how much activity you can pack into a quarter-hour of freedom, including meals, showers and other essential functions.

As for the rest of it, well, I had to remind myself that, first of all, what I was doing might help fix my eye – top of the list. Then I noted that, when I went to film festivals, I often see five movies a day, which is a lot of sitting. This prescription was limited: just six days, with the goal of helping the bubble do its work so I could avoid surgery.

Six days? I could do that standing on my head – or lying on my side, as the case may be.

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So I took the same approach that I did when I had knee surgery 20 years ago: I wanted to be an active participant in my recovery. Back then, that meant pushing myself at physical therapy and doing the exercises that I’d been assigned to do at home with maniacal discipline and regularity.

In this case, being an active participant meant approaching each lying-down segment as a kind of work-out. I was going to hit that couch, roll on to my right side — and stay there for at least 45 minutes, if not longer.

Reading on my side, however, proved problematic and typing (except on my iPhone) simply was off the table. Even the iPhone presented a challenge: to keep the screen and keyboard upright while keeping my head tilted to one side.

Luckily, I could watch screens, again with the proviso that I lie on my right side. I alternated between watching screeners for work on my computer and watching things simply to distract myself and fill the time on my TV. Lying on my side, with the bubble pressed against the retina deep in my peripheral vision, it was usually out of the line of sight, at least until I sat up.

What did I watch? Online screeners for new TV shows, old films I wanted to revisit or become acquainted with. Initially, I thought this would be my chance to dive into a stack of foreign-language classics I’d intended to watch while walking on the treadmill. But while I could read sideways given enough time, the subtitles (even on something with dialogue as sparse as “Knife in the Water”) went by too quickly.

So I finally gave in to the notion of simply watching things I enjoyed, to pass the time in one and two-hour bites. A documentary about Allen Iverson. “Pulp Fiction.” “From Russia With Love.” “Jacob’s Ladder.” Albert Brooks’ “The Muse.” A boxed set of “SCTV.” “Quackser Fortune Has a Cousin in the Bronx,” a favorite I’d purchased on DVD a while back but never watched. I turned to Netflix to watch a documentary about Harry Nilsson and the final episodes of a series from a few years back, “Terriers,” whose ending I’d never seen (I wound up watching its entire single season).

After six days on my side, I went back to my doctor, who pronounced the procedure a success. There was still more blood than white in my eye, but that was cosmetic; the important thing was that the bubble had flattened the retina into place. He used a laser to essentially spot-weld the retina into position. Which, hopefully, is where it will stay.

I admit to having an active metabolism: I like to work, I like the work I do and I want to do more of it. I’ve reached an age where many friends have either retired or are on the verge of retiring. But when I look at the future, all I see is the huge stack of ideas I have and how precious the time to attempt them is. So I tend to view time spent not pursuing those projects as time squandered. And what’s more wasteful, time-wise, than lying around watching TV for six days?

But this experience once again taught me about the value of unplugging and letting go, at least for a little while. It is always therapeutic — always.

It also reaffirmed for me the value of intelligently mindless entertainment. I have spent my career doing a job that most people do for fun. I still love movies and realized in the past week how rarely I simply sit down and watch something for pleasure, without some other agenda: as research or background for a story or some idea I have, or as an assignment.

With luck, it won’t take another detached retina to get me to do it again. In the meantime, I have a bubble in my eye to remind me.

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