Friday, April 3, 2009

Thoughts on Nearsightedness

This is pure speculation on my part. But I've often read that nearsightedness and intelligence/being good in school are correlated. I've also often heard people claim that reading too much causes nearsightedness.

What if it's the other way around? What if some people, like me, are born moderately or severely nearsighted? As an infant/toddler/young child, it might be years before the condition was diagnosed. Meanwhile, activities like throwing/catching balls and climbing trees, which involve gross-motor skills and major physical activity, would be challenging. But reading and fine-motor skills, done close up, would feel much more natural. So nearsighted kids would naturally pay more attention to manageable, nearby things like books and blocks; might become early readers; and might develop a tendency towards the "intellectual/internal" and away from the "adventurous/physical."

Like I said, pure speculation, but it does seem like it might make some sense. Of course, I can also imagine some co-evolution going on (intellectual ability as a compensatory trait to protect us hapless nearsighted organisms).

Lasik - Two-Week Followup

I had my two-week followup today in Rockville. I continue to be a near-textbook example of Lasik surgery success. :-) My vision is still 20/20 in my dominant eye and 20/40 in my other eye, and I could read the smallest line of text on the "presbyopia" card. (Today's appointment was also quicker -- I was in and out in less than half an hour.)

I do have some minor annoyances, which I hope will fade over time. My eyes are occasionally dry, but really no worse than before the surgery -- I think I just notice a bit more, because the dry eyes do seem to affect my vision a bit. And they say that using artificial tears regularly helps with vision and with corneal healing.

As far as the monovision, I basically have no difficulty at all with normal distance vision -- I do notice the imbalance between my eyes occasionally, but it doesn't bother me much at all. The near vision is a bit more problematic -- I think that's because for near vision, my right eye needs to "take over," and it's not used to being the dominant eye, so my brain has more trouble adapting to that situation. I expect this will keep getting better over time.

I definitely notice that my vision is worse in low light than it was before. I think this is partially related to the monovision -- my theory is that whichever eye is having more trouble focusing on whatever I'm looking at tries to dilate more in order to see better, and this actually makes my vision worse in the other eye. I'm not as confident that this will fix itself over time, but hopefully I'll at least get more used to it. It's not *bad*, but it can be annoying at times (e.g., when I'm trying to do a crossword puzzle or read in bed before bedtime).

I do see very noticeable "starbursts" around any light source when I'm driving at night. I find this pretty annoying, and on top of the increased difficulty in focusing in general, and reduced depth perception from the monovision, it definitely makes me a little nervous. But I'm fine, really, I just need to concentrate a bit more than I used to (which is actually a good thing!) and to slow down a bit (ditto). Driving in the early-morning fog yesterday, driving Heather to school for her spring trip at 5am, was definitely not a great experience. But it's not anywhere near debilitating, and definitely very worth the tradeoff! I do think that the starbursts will improve somewhat over time, as my corneas heal -- as I understand it, while the flap is healing, there are imperfect contact points between the corneal flap and the cornea itself as the re-adhesion process occurs, over the 3-6 months after the surgery.

All of these minor side effects were exactly what I had expected from my reading about the Lasik surgery, and they're actually much less severe than I worried they would be.

It really is pretty amazing to wake up in the morning, look out the window, and be able to see every single plum blossom in bloom on the tree outside. At night, when my eyes start to get tired, I still have this moment where I think, "Oh, I should take my contacts out"; and in the morning, when I wake up, I often start to reach for my glasses before I realize, "oh, yeah, I can already see the clock and everything else I need to!" I've worn glasses or contact lenses pretty much every single waking hours for the last 38 years, and if I could ever make out any details on object smaller than a foot across, more than a few feet away, I couldn't remember it. (I started wearing glasses when I was 5 or 6, and I imagine that my eyes were quite nearsighted for years before that, before anybody realized how nearsighted I was.) Now I can just simply *see*, after an incredibly quick operation with near-zero complications. What's not to love?!