The Stigma of Astigmatism

Dear Diary,

I’m giving up.

I can’t take it anymore.

For as long as I can remember I’ve been misunderstood.  I get blamed for things that aren’t my fault, most people don’t know anything about me, and I’m never spoken of in a positive light.

I mean, for starters, most people seem to think that I can cause irreparable damage to their vision, and that’s a dirty lie!  If only they knew how prevalent I am and all of the different types of vision correction that can make me pretty much unnoticeable.  Glasses, contacts, laser surgery.  And yet they still say that I have an effect on their vision!  Dude, your LASIK surgeon obliterated me when you had your procedure – if you still can’t see clearly, then it’s not me, it’s you.  Maybe you need laser BRAIN surgery HAHAHA.

I’m sorry Diary, that was crude.

But darnit, it’s just so FRUSTRATING.  I’ve never purposefully done anything to hurt anybody.  I mean I guess there was that one guy in Minnesota who slid off the road because he couldn’t clearly see the patch of ice ahead of him.  Or the lady from San Francisco who was injured in that car accident because she was squinting to see a billboard.  But that’s not MY fault.  I mean it is, but it isn’t.  I don’t deserve this.

Two foci are better than one!

To make things worse, all those eye doctors explain what I am in the same way.  It’s always “your eye is like a football not a baseball.”  What the heck is that supposed to mean?  Personally I’ve never seen a person in side-profile whose eye jutted out from their head like the cone of Madonna’s bra.  A football?  Really?  Let’s call a spade a spade:  all I am is a difference in the steepness of the cornea; that’s it.  Kind of like if you held a balloon and gently squashed it between your hands – in one direction the curvature of the balloon would be steeper than in the other direction.

But NooOOooOOoo, I’m a football.  Most people are pear-shaped or apple-shaped, but I’m a pigskin.

SPORTS EQUIPMENT PROPAGANDA

And then there are those people that say they can FEEL me.  Really?  I’m a microscopic change in steepness in your cornea and you can FEEL me?  Maybe your eyes are dry, or you have allergies, or you have some other foreign body in your eye, but your astigmatism is not something you can feel!  Does anyone ever think about how I FEEL?  It’s depressing to be thought of as a blinding eye disease when all that’s really needed are glasses.

Diary, I know I’m complaining a lot today.  I guess I should just be thankful that so many people know me.  What I need is a good PR campaign to put a positive spin on things.  Like a catchy slogan or something.  Let’s do some brainstorming, Diary.

Astigmatism:  It’ll Make You A Sandwich.

Astigmatism:  It Won’t Get Mad When Your Dog Poops on the Sidewalk.

Astigmatism:  At Least It’s Not Dysentery.

Astigmatism:  It Doesn’t Think Twilight is the Epitome of Fiction, But It Won’t Judge You if You Do.

Astigmatism:  It’s a Party in Your Eye!

Any other ideas?

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The truth about what optometrists do.

My profession is well known for many things: glasses, contact lenses, dilating drops, etc., etc., etc.  But it seems that optometrists are most easily recognized by the infamous phrase, ‘which is better: one or two?’  It’s a phrase borne of routine, something repeated at every eye exam; those who wear glasses or contacts are well aware that when they sit in that chair to get an updated prescription, they will hear those familiar words.  It is a phrase associated with decision-making; which one truly is better?  Sometimes it’s an easy choice: ‘one’ is clear as a bell while ‘two’ resembles what comes out of your computer printer when it’s low on ink.  But then, slowly but surely, the decision becomes more and more difficult, and before you know it, one and two are nigh indistinguishable from each other.  This is when you separate those people who are truly decisive from those who spend an hour every morning just trying to pick out a shirt.  The human brain can think many thoughts within a space of milliseconds; as a person who has been on both sides of the ‘which is better’ coin, I can sympathize with said thought process:

“Which is better they both look the same but I answered two last time and surely he wouldn’t make two the right answer twice in a row so the answer this time must be one but what if he knew I would think that and so he made two the right one again but there’s literally no difference between them and maybe I can ask him to show them to me again but then if he does that and they still look exactly the same and I hesitate he’s going to think I’m trying to give him a hard time but if only he could see what I see and what if I answer wrong and I get my new glasses and they’re the wrong prescription and I won’t be able to see road signs so I’ll get lost whenever I try to drive somewhere new and I’ll have to only go places that I’ve been before so that I don’t get lost.”

It only spirals downward from there.  This is the process known as refraction, or the determination of one’s spectacle prescription (It also refers to the bending of light, which always blew my mind in school.  I mean, who knew light could be bent?  That’s almost as cool as those straws that have the little accordions built into them.).  Refraction is a standard component of every eye exam, which is why the whole ‘one or two’ thing is so well known.  Here’s a little secret:  your eye doctor is not screwing with you during this procedure, I promise; in fact, sometimes I wonder if people are screwing with me while I’m doing my gosh-darndest to get them to see better.  It’s like this little dance we do, call it The One or Two-Step.

For many optometrists, the art/science/alchemy of refraction is not sexy (oooo, he used the S-word).  Many of us are much more interested in the more medically-oriented facets of the profession, and I’ll admit, eye diseases can be interesting to diagnose and treat (though not as interesting to the person afflicted by said disease).  I’ll also admit that there are times when refracting a patient is one of the last things in the world I want to do at a given time, behind folding laundry and ahead of clipping my cat’s toenails (don’t tell him I said that; not that you could tell him, he’s unconscious 25 hours a day).

I can has narcolepsy?

But there are also times when refracting is very rewarding:  when a child who has been squinting at the chalkboard (Smartboard?  What the heck are teachers using these days?  It’s like I graduated high school and suddenly all of the tech from Minority Report became ubiquitous.) realizes that all he/she needs is a pair of glasses and no longer needs to sit right under the teacher’s nose, or when a 40-something looks through those lenses at a reading card and proclaims that the words look so bold and clear, followed subsequently by the depression that sets in when you tell them they need bifocals (see previous post).  These are the times when refraction shines.

So when I (or whoever your optometrist is) ask you to tell me which one looks better, don’t fret.  I’m not going to say there is no right or wrong answer, because that’s not true.  All I want you to do is be honest – with yourself, with me, with the phoropter (yes, that’s what that lens-flippy contraption is called).  Don’t dwell on the question too much; if they both look the same, say so.  We want to help you to see as well as you possibly can, not to try to trick you into wearing some gaudy Pepsi bottles (not Coke but Pepsi, I hear they pay more in sponsorship deals, hint hint Pepsi) that weigh five pounds and leave those permanent gouges in the bridge of your nose; we don’t secretly have a deal with a plastic surgeon who has promised us kickbacks for every nosejob we refer as a result of tissue/cartilage damage from a pair of titanium-framed window panes.  We want you to see clearly and look cool in a pair of snazzy specs.  Scout’s honor (Disclaimer:  I was never a scout.).

One more question, or more of a public poll:  would this phase of the examination be more interesting if the ‘one’ and the ‘two’ were replaced?  For instance, ‘which is better:  Abbott or Costello’, ‘iPhone or Android’, ‘chocolate or vanilla’, etc.  I’d like to mix things up, but only if it makes things more lively without making them more confusing.  As they say, variety is the spice of life.

Speaking of spice, which is better:  coriander or oregano?

The impression that I get

“Take away those vulgar things!”

If you are a near-sighted individual, take off your glasses and look at something that’s at least twenty feet away.  Now imagine painting what you see, exactly as you see it.  If you’re not near-sighted, drink a six-pack of your favorite beer and follow the same steps listed (not recommended for those readers under the age of 21).

The above quote is attributed to Impressionist painter Paul Cezanne (I can’t say how accurate the provenance of this quote is, but let’s roll with it.), an artist who shared his genre with Monet and Renoir.  In case you’re not familiar with Impressionist art, picture your favorite nature scene as a Polaroid; then, picture the same photograph laying under the sun on a summer day for a few hours before having a glass of water spilled on it.  Essentially, the artists painted scenery or people using short, abbreviated brushstrokes that, when viewed at a short distance, looked like hundreds of blobs of random colors; however, if you take a few steps back from the work, you get the impression of the scenery that the artist was depicting as all of the individual blobs blend together into a more coherent piece.  This technique very often softens the edges of its subject and gives it an almost dreamlike quality, much like the world looks when a near-sighted, or myopic, person removes his/her glasses.

Artists of the Impressionist genre have produced some of the most iconic and recognizable paintings of all time, and the theory is that they did so with the help of the imperfection of their eyes.  This imperfection has a name, and that name is “refractive error.”  This is what we mean when we say that a person has myopia (can’t see far away) or hyperopia (difficulty seeing up close, although this one is a little more complicated).  Refractive error is all about how light enters the eye and where it focuses.  Imagine throwing a grenade (or if you’ve actually thrown a grenade, remember throwing a grenade); now let’s say that you are attempting to blow up a cardboard cutout of a television celebrity who you don’t particularly enjoy – for our purposes let’s say Guy Fieri, but this is open to your interpretation.  It’s important to remember that the target is just a cardboard cutout; I won’t stand for any real (imagined) violence in my blog.  Besides, if we were imagining throwing a grenade at the actual Guy Fieri, I’m 97% sure that his hair would deflect it.

So, your goal is to pull the pin on that explosive and chuck it so that you utterly toast the cardboard cutout of Guy Fieri.  In this illustration, the grenade represents light, and Guy Fieri (the cardboard Guy Fieri) represents the retina of the eye, which is where we want to light (grenade) to focus (explode).  The variable here is of course how do you time the release of the grenade from your hand so that it blows exactly when it strikes Mr. Fieri.  In a sense, you (the grenade-chucker) are acting as the refractive system of the eye, which includes structures such as the cornea and the lens; you are almost wholly responsible for where the light (grenade) focuses (boom).  If the grenade strikes Cardboard Guy at exactly the time it explodes, then we’ll say that you made no error in your throw – that is, no refractive error (this analogy seemed so brilliant when I first started typing it, but I’ll admit, it’s wearing thin).  Should you hold the grenade for too long, it will detonate in front of Cardboard Guy; your toss was myopic.  Conversely, if you throw too soon, the same will happen except behind him; this time it was a hyperopic effort.  Now, for the sake of taking this visual into even deeper cringe territory, let’s say that someone corrects your error by telling you exactly how long it will take for the grenade to do its thing after you pull the pin.  This information is analogous to giving spectacles or contact lenses to a person with refractive error.  Now you can let Guy Fieri have it.

Wow, that was…something.  In short, light can either focus in front of or behind the retina, causing optical blur.  Glasses or contact lenses refocus the light so that it lands in a distinct, singular point on said retina.  Going a little more in depth, a myopic individual has a refractive system that is too powerful and thus focuses light to a point anterior to the retina; these people need minus lenses to correct them.  You can guess where this is going next: hyperopic people have a refractive system that does not have enough power and needs plus lenses to bring the focus of light from posterior to the retina onto the retina.  Refractive error goes both ways, as you can see (there’s a pun here that I won’t make).

And by the way, who decided to call it refractive ERROR?  Who are you to tell me that my eyes have made a mistake?  The phrase inherently implies that my eyes are wrong.  I think Mr. Cezanne would have taken great umbrage to such a phrase, given the feelings that the above quote exemplify.  In this day and age of political-correctness-gone-wild and in which everyone who participates is labeled a winner, I think it’s due time that refractive error was re-branded in a more positive light.  Shall we say that people are refractively different, optically challenged?  Nay, say the Impressionists of yesteryear; do not be ashamed of your ocular shortcomings, but embrace them and utilize them in ways no man has yet to explore.  Proclaim from the mountaintop: “I am not hindered by my myopia, because from up here everything is blurry and I am no longer afraid of heights!”  Be proud of your so-called refractive error!

Or, put on your glasses and blow Guy Fieri to smithereens.