I can see clearly now — finally — without glasses, writes Nicolais

For the first time, I wrote this column without glasses or contacts. This is actually the first time I’ve written anything substantial without a visual aid since fourth grade. After decades of acute myopia – nearsightedness – I had corrective surgery a week ago.

And I can see clearly now. Most.

As is the case with many people making health care decisions today, I couldn’t see the path to better vision with 20/20 acuity. It took months of research and visits. It was littered with conflicting advice and opinions. It took perseverance and an ability to look past the frustration.

Mario Nicolais

He had to roll over in bed one day and hear the arm of my glasses snap.

Broke at the hinge, I went to a few big box lens dispensaries and three jewelers in hopes of getting it fixed. The damage was irreparable. The expensive frame and the lenses fitted to it were thrown into a wastebasket as they exited the last door.

At the same time, I decided to try corrective surgery again.

I have been essentially blind most of my life. I’ve always been the guy who needs to take two steps forward before the big “E” at the top of the vision board becomes anything but a blurry dark spot. Forget everything below.

Therefore, I was not an ideal candidate for LASIK surgery either. In a nutshell, LASIK uses a laser to reshape the cornea. The more myopic an individual is, the more remodeling is needed. At some point, the necessary adjustment leaves too little cornea to reshape.

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In addition, the procedures can be expensive. While some less scrupulous providers advertise very low rates, they are almost always accompanied by an asterisk.

The actual rate is usually close to a few thousand dollars per eye. Because it’s not “medically necessary” — despite the fact that I’m likely to walk into a wall without correction — insurance usually doesn’t cover such procedures.

Medicine regularly takes steps forward, so I set up a few appointments. Having an MBA with a major in health administration and experience working with multiple healthcare companies, I knew not to see just one vendor.

I went to five different offices.

Turns out the eye industry isn’t moving as fast as my eyes have deteriorated. Three out of five doctors told me that I was not a candidate. Two said I was on the bubble, but they thought they could do it. Anything short of universal consensus is troubling when it comes to someone poking into your eyeball.

However, after the 20/20 Institute told me they wouldn’t even consider LASIK for me, they also took the time to discuss other potential options. Specifically, they suggested that I would be a good candidate for ICL (Implantable Collamer Lens) surgery. Indeed, he recommended taking a knife to my eyeball and shoving a permanent contact lens behind the iris and in front of the natural lens.

Yeah, I grimaced too.

Because 20/20 does not perform these surgeries, they recommended a few surgeons to me for follow up. I ended up choosing Mile High Eye Institute. They have a clean, well-lit office with a full surgical suite on site. Although the waiting time after check-in is usually quite long, a busy doctor’s office is also often good medical practice.

What convinced me, however, was the follow-up schedule they established. After the morning operation, I had to come back later the same afternoon, the next morning (a Saturday!), a week after the operation and a month after the operation.

This is the sign of a practice that truly cares about results. They could have made so much money doing the operation and giving me a phone number to call if something was wrong.

A week after the operation, I can see things in the distance more clearly than I have ever done with contacts or glasses.

My near vision is blurry – presbyopia, the loss of lens elasticity that makes it difficult to read, eventually happens to almost everyone, may become more noticeable after surgery.

I realized that I had subconsciously corrected this for years by taking off my glasses and holding everything I read up to my nose. I’ll have to get used to carrying drives.

I may also need a follow-up procedure for astigmatism and there is still no reasonable solution for color blindness.

But this holiday season, for the first time in decades, I’ll be looking at bright screens without the freezing condensation fogging up my glasses. Who could ask for anything else?


Mario Nicolais is a lawyer and columnist who writes about law enforcement, the justice system, health care and public policy. Follow him on Twitter: @MarioNicolaiEsq


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