Shades of Blindness

I think it is fair to say that my cataract operations were successful. For the first time in three years I can read print, the world is so bright and colourful it feels like I am on the set of The Wizard of Oz, and all my friends and colleagues look about twenty years older. But whilst my sight is better than it was when I was an undergraduate student, I am still legally blind. I feel like I can see again but it turns out I still can't read the eye chart, see detail close up or at a distance or recognise people. Navigating in crowded or unfamiliar places is still tricky and stressful and I still need my reading glasses, my telescope and my white cane. And now I also need shades. I used to hate wearing sun glasses. By blocking out what little light made it into my eyes, they made me even blinder than ever. But now I can't go out without them. My new cataract-less eyes are amazingly sensitive to light. Even with my shades, I can see colours more brightly than I could before. But wearing shades has a drawback I hadn't expected. By hiding my eyes, the shades also hide my blindness. And because my eyes look different they work a little bit like my white cane - they tell people that because my eyes do not look the same as theirs, I might not see the same as them. So when I go out with my shades but without my white cane I look completely sighted. And this can cause problems. Last weekend I went to a music festival with my family. We had a lovely time camping, eating bacon sandwiches and drinking wine (not necessarily all at the same time). But when I went down to the front to watch a band (without my white cane), a rather irate lady accused me of pushing in. I honestly had not meant to push in front of her and was genuinely shocked at her anger. I was also upset because I realised that I do not in fact see as well as I thought. I still miss visual cues (and clues) and without my white cane this makes me look at best clumsy, and at worse rude. So even though my cane is heavy and cumbersome, and even though my new sight makes me wonder if I am really as blind as the medics' measurements suggest, I will still be using my cane and still proudly defining myself as 'partially blind'.

My cataract operation 2: what I see now

This time last week I was awaiting the first of two cataract operations. On Friday, medics removed a dense cataract from my right eye. Thanks to the magic of general anaesthetic, I was blissfully unaware of the whole procedure. And since I removed the bandages on Saturday morning, I have of course been trying to work out what difference this operation has made to my vision.

For the first 48 hours or so after the op I couldn't see much of anything out of my right eye. It felt very sensitive to light and I kept it closed most of the time. When I did open it for a few moments, everything was very blurry. But I could tell that the colour of the light I could see had changed. Instead of seeing everything through tinges of yellow and brown, I could definitely see white and blue again.

A few days later I am managing to keep my eye open most of the time and I have noticed three interesting things. Firstly, and not unexpectedly, my glasses no longer work. Because the new plastic lens is not exactly the same shape as the one that was destroyed along with the cataract, I'll need to get a new prescription. Apparently this will only happen around 8 weeks after the second operation. So I reckon I'm looking at at least three months of blurry. At the moment this isn't too much of an issue. I got used to life without my glasses when I broke them in November and I do my reading with my left eye so for now if I close my right eye I can more or less see as well (or as badly) as before my operation. This will of course change after the second op.

Secondly, things start getting very weird when I use both eyes for reading. This afternoon I was reading a text (appropriately enough, Kate Tunstall's translation of Diderot's Letter on the Blind) using the kindle app on my iphone:

This photo shows some text in the kindle app on my iphone. The text is enlarged so that there are 20 words on the screen. The words are white against a black background and towards the top of the screen a small blue footnote number (52) is visible. 

When I look at this screen with my right eye closed, the text is yellow and the footnote number is invisible. But if I use both my new cataract-free eye and my old cataract-obscured one, something very odd happens: two screens appear next to each other. The one on the right is the one I was looking at before. On the one on the left, the text is dazzlingly white and the footnote number is a beautiful, incandescent blue. It is pretty disorienting to see the same thing in two different ways. But it is also a useful way of measuring the difference the cataract operations will eventually make.

When I'm not reading, I've given up using my now redundant glasses. So, thirdly, everything is a lot more blurry than it was. But it is also much more colourful. I've discovered that my favourite grey cardigan is actually a lovely shade of navy blue and that I own a set of very brightly coloured plastic bowls. I'm still getting used to my new psychedelic world. I hope this post will give my friends a sense of how it is that at the moment my vision is both better and worse than it was before.

My cataract operation

As Kate Tunstall shows in the Prologue to her important essay 'Blindness and Enlightenment' (2011), the cataract operation, or, more precisely, its triumphant post-operative illumination, is a familiar trope in the narrative of blindness. Three hundred years ago it was the focus of sustained philosophical interest; today it is used by international charities to construct sentimental stories which encourage western generosity. The operation to remove cataracts is a simple one; it takes around 20 minutes and is usually considered low risk, almost always resulting in improved vision. So why do I have such distinctly mixed feelings about this Friday's operation to remove a cataract from my right eye?

Cataracts are the most common cause of vision problems in people over forty. Their removal is a moment of joy and revelation as the world's blurriness is corrected and colours become vibrant once again. 'It is like being a child in a sweet shop' someone once told me. But my case is a little different. Even if my cataract operations go smoothly (something which is far from certain because of the shape and size of my eyes), I will still be registered blind. My underlying condition - retinal coloboma - won't change. What will happen is that I stop seeing the world as I do now. Instead I might see things more clearly, more colourfully, or I might no longer see anything at all.

For most people, the decision to have a cataract operation is a straightforward one driven by the understandable (although ocularnormative) desire to see as well as possible. But my decision to finally allow surgeons to remove the dense disks which cover both my eyes is more complicated. My ophthalmologist first noticed my cataracts 20 years ago and they have been growing, and thickening, ever since. They now prevent me from distinguishing colours and make reading difficult, even with my special glasses and my beloved kindle. I have always used sight where I can but increasingly I am finding that the flawed sight I have is more of a hindrance than a help. Sometimes I think that it would be easier to have no sight at all than to have this unpredictable, fallible sight which I can no longer rely on. And I have noticed that most people feel more comfortable relating to a totally blind person than to one who seems to be able to see some things but not others. Since I started properly exploring my blindness four years ago, I have learnt braille, become a more confident white cane user and discovered the pleasure and potential of the audio book. If the operations don't work, I am confident that I will be happy to live, love and work as a totally blind person.

I know that most of my friends and family are hoping that these forthcoming operations will lead to a marked improvement in my sight. I know that they are hoping for a cure of sorts and I know that they will be upset if I end up blinder than ever. I know that despite my best efforts, most people still think that sight is better than no sight, and that partial blindness is better than total blindness. And on one level they are right. We live in an ocularcentric world in which life is certainly less complicated with sight than without it. Of course I am hoping for some improvement in what I see. Believing that blindness is not a tragedy does not stop me from wanting to be able to read as I could five years ago. The fact that I have had some sight makes it impossible for me not to remember that I used to be able to see much better than I can now. But if the operations lead to total blindness - which is a distinct possibility - I don't think I'll be as upset as those around me.

Any operation performed under general anaesthetic is a little bit scary so whatever the outcome, I am looking forward to several days of enforced bed-rest, accompanied by Radio Four, my new audio book reading machine, regular cups of tea and copious amounts of flowers and chocolates.

But What Can You Actually See?

What I see on a sunny day

Sighted people are often curious about what I can and cannot see. I am not completely blind but I am not completely sighted either. With my reading glasses I can read very small print but I cannot tell the difference between buses and lorries after dark. What I see varies constantly: it depends on whether I am somewhere familiar or foreign, on levels of light and dark, on the weather, on how tired I am, on how much reading I've been doing. This is unsettling for those who like to put people into categories. One day I am pretty much blind; the next day I am mostly sighted. This is confusing, but it also makes my life exciting. I never quite know what I'll be seeing from one day to the next.

Today is the kind of crisp, clear, cold November day that I used to love. The kind of day when colours seem extra vibrant and leaves crunch underfoot. I used to love days like this because the extra light in the air seemed to make my vision sharper. It was on days like this that I felt most sighted. But in the last two years, my attitude to crisp autumn days has changed. At the moment my underlying eye condition, coloboma, which has been relatively stable all my life, is being complicated by cataracts in both my eyes. With eyes of standard shape and size, the removal of cataracts is a routine operation. But this operation becomes highly complicated and risky with eyes like mine. So I am waiting until the cataracts have taken away all my sight before I have the operation. That way, if things don't go as planned, I won't have any vision left to risk.

Having cataracts does very odd things to my vision. Everything now has a slightly yellow tinge and I can't tell the difference between black, blue, purple and grey as well as I used to. Instead of entering my eyes, light bounces back off them as if they were made of shiny metal. The resulting dazzle and glare fills my eyes with whiteness and hides everything else from view. Cars, trees, pavements and people vanish into a bright white mist. But as soon as I step into shadow everything reappears, paler and more misty than it used to be but still mostly recognisable.

Dark winter nights are just as much of a challenge as bright winter days. I am at my blindest after dark. My eyes might look like cat's eyes, but they have none of a cat's night vision. After dark my problems with dazzle and glare are compounded by the halos and starbursts which surround any light source. These effects, illustrated here, convert my nighttime world into a kind of other-worldly psychedelic wonderland.  On balance I rather like the disorientating effects of cataract vision. Now that I have lots of practical solutions for doing what I want to do I like being living proof of the subjectivity of vision.