The Eyes Have It: My Vitrectomy Adventure

Every transparent body, Novalis judges, is in a higher state and seems to possess a kind of consciousness. Like Iceland spar. Like the faithful fauna of definitions, or the anatomy of the human eye. Cornea, iris, pupil, lens, retina, and optic nerve. Is the iris of the eye a muscle or a fairyland of everything in the world? I think it’s the sparkle in your eyes. I think it’s blue. I think it’s green. I think it’s brown. I think it’s brown, green, and gold, which is called hazel, and is a domain of vision, a dead soldier, a stream in the woods, Arthur Rimbaud hiking to Paris. Though I don’t know why, in this scenario, I imagine Rimbaud’s eyes as hazel. Ernest Delahaye described Rimbaud’s eyes as pale blue irradiated with dark blue. Emily Dickinson described her eyes as like the sherry in the glass, that the guest leaves. That would be one mighty sip. Sadly, Dickinson suffered from a painful eye condition, most likely diagnosed as iritis, an inflammation of the eye causing severe light sensitivity, which left Emily with a restricted ability to read or write that lasted for eight months, which she described as eight months of Siberia.

I find that relatable, as my ophthalmologist discovered a macular hole in the retina of my left eye several weeks ago. I also have cataracts in both eyes. I see almost everything through a scribbly tangle of squiggly, transparent shapes called “floaters.” I thought these were the cataracts but they’re not, they’re collagen fibers clumping in the eyes vitreous humor, though I see little humor in it. Cataracts make things blurry. The macular hole distorts things. If I close my right eye and try to focus on someone’s face, their head shrinks and their features distort into monstrous, disproportionate, lopsided expressions, somewhat similar to Francis Bacon’s portraits. It’s kind of fun to do that. Of course, the person you’re talking to doesn’t know you’re doing that. It’s a domain of private fun. Like daydreaming when you’re supposed to be paying attention to something, a lecture or a poetry reading. I always considered myself fortunate to find a job that afforded me vast, endless opportunities for daydreaming. This is monotony’s gentler, more amiable side. So, if you ever see me in conversation tilting my head to the side and closing my right eye firmly shut consider your head shrunk.  

I went to see a retina specialist this morning - a young Asian woman I’ll call Dr. Yanjing. Before her visit, I went through several eye exams—similar to ones I had done before—identifying letters and focusing on a tiny blue dot. After each test, I returned to the waiting room where R immersed herself in a recent issue of Harper’s and a man sitting to my left watched videos on his smartphone with the sound barely audible. I brought Du monde entier, Poésies completes, by Blaise Cendrars, which made me feel adventurous and carefree. The waiting room grew increasingly crowded as several new patients arrived, two elderly Asian woman whose clothing was soaked with rain. When the time came for my meeting with Dr. Yanjing, R accompanied me. We sat in an exam room with complex eye examination machines. I thought the rather sterile décor of the room could use an uplift, and that this might be easily accomplished if one of the drab, off-white walls were painted with eyes, wall-to-wall eyes, blue eyes, brown eyes, black eyes, pink eyes, eyes upon eyes upon eyes. Eyes like jewels outshining the fire opals of Querétaro, Mexico, or the black opals of Lightning Ridge, Australia. Eyes with the soul-piercing intensity of Van Gogh’s uncanny blue eyes. The electrifying eyes of Gustave Courbet’s The Desperate Man. The music of ambiguity in Mona Lisa’s gently smiling eyes.

Dr. Yanjing arrived with two young women in tow, students, presumably. She got down to business right away, and delivered some good news: I might be able to cure the macular hole with eye drops and avoid surgery altogether. The eye drops – ketorolac and prednisolone – would have to be applied four times a day. Ok, I said, sounds like a wonderful solution. Let’s do it!

If, on the other hand, I return four weeks later with no improvement, then surgery becomes my next option. The surgery itself does not pose a big threat. It takes roughly 15 minutes, and is performed with the aid of very pleasant sedation allaying all fear and anxiety. The horror comes after, in the week following surgery. A temporary gas bubble is injected into the retinal membrane to serve as an internal bandage, pressing against the macula to encourage the hole to close. I would need to maintain a "face-down" position for a week to keep the gas bubble in the correct position. This would entail, more precisely, a week hunched over in a chair, my head resting on a face cradle while staring at the floor. Sounds like some bizarre feat of extreme asceticism that an aspiring holy man or woman must undergo before entering into a life of sacrifice and divinity.

It’s been eleven days since I started using eye drops with the intention of closing the macular hole in my left eye. So far, there has been no change. If I close my right eye and focus on the text I have just written with my left eye, I cannot distinguish a single word. All I can see is a blur with very distorted letters. I feel very discouraged.

The two types of eyedrops I’d been prescribed - prednisolone and ketorolac – come in squeezable plastic bottles like most eyedrops. The prednisolone - a topical corticosteroid - works by reducing any inflammation-induced edema around the hole and by dehydrating the retinal tissue, allows the edges of the macular hole to move closer together. The ketorolac - a nonsteroidal anti-inflammatory drug - helps heal macular holes by reducing retinal inflammation and edema, and by decreasing fluid accumulation around the macula allows the edges of the hole to flatten and move closer together. I take both four times a day. I tilt my head back, pull down on my lower eyelid, let a drop of prednisolone fall, wipe any excess dripping down my cheek with a napkin, apply pressure on my tear duct with my index finger and lean forward and tilt my head down for two minutes. I wait ten minutes, then apply the ketorolac in the same manner. The reason for applying pressure on the tear duct is to keep the medicine from tricking into my bloodstream. My biggest problem is in remembering to do it.

Tonight, as I kept my head down and my eyelid firmly closed, the light from a nearby lamp penetrated my eyelid and I could see what appeared to be a red, velvety fabric. This gave the interior of my head – the realm we call consciousness – the illusion of being infinitely huge. When I opened my eye again, I felt confused and disoriented. I got so immersed in that other world, the one behind my eyes, that I felt somewhat divided from the external world. This, of course, is an illusion. Consciousness is a diffuse phenomenon that in no way implements a palpable division between inner and outer. My neurons – which are the specialized cells of an evolutionary process that occurred in the physical dimension of the external world - are neuronally connected to the roots and rocks surrounding my architecture of bone and skin. Nevertheless, the illusion of fabric and tissue is quite compelling. It’s not always a fabric, sometimes it’s a textured wall, sometimes a pebbled floor. Sometimes there are edges and holes, rooms to explore, sophisticated cushions, translucent problems, karate prophets, polka dot operas.

I saw the ophthalmologist, Doctor Yanjing, yesterday. There has been no change to the macular hole. I suspected this to be the case when - day after day - I applied the eye drops four times per twenty-four hours. I kept testing my left eye on anything with words on it – Marcel Duchamp Nude Descending a Staircase, Tums assorted berries, sparkling flavored water, pocket dictionary, Shakespeare, The Bard’s Guide to Abuses and Affronts, Deak Harp “That’s Alright,” the trending searches on Google, Ted Rall GoComics, magic vs pistons, Hulk Hogan, the Lyrids meteor showers, song titles and lyrics on YouTube, she said so, she’s in love with me and I feel fine, Michael Jackson’s “This Is It,” Burger King Star Wars menu, organic molecules on Mars. Sometimes I could make out a letter or two, but most of it was far too blurry to read. Rituals like applying eyedrops four times a day do develop a certain charm after a while, a rhythm, a story, a structure, but when the underlying purpose of doing it expires, it feels desperate, an act of theatricality rather than a meaningful practice with a tangible goal. Having a surgical procedure in my future has the cachet of science, which – despite my lifetime contrariness against the rigidities of measurement and logic – inspires more confidence.

The face cradle with a massage pillow arrived today. I had to order it from Amazon. There are no stores in - or near - Seattle that carry medical supplies. All I could find on the internet were companies that offered rental plans, everything ordered by email or phone and delivered by truck. None of them offered a brick and mortar store we could visit. I found this deeply frustrating. I need to try something out before I pay for it. This is especially critical when it comes to medical equipment. Fortunately, after we struggled to figure out how to maneuver the contraption, my face fit comfortably within the welcoming confines of the massage pillow. R did much better at figuring things out than I did. Were it not for her, I’d still be on the couch, lifting it, exploring it, testing it, careful not to use too much force and break it. The instructions were abysmal, tiny, illegible fonts and grammatically curious sentences. The diagrams, too, were confusing and useless. R found a video for the product and a chipper young man happy with his gadget who demonstrated how things worked. It was also R’s idea to put the bottom framework under a cushion on the couch so that I could comfortably lean forward and let my head rest on the pillow, gazing down at the table and imagining how it might be to lose myself in a book for 45 minutes a session, with a 10-minute break. I did have to remove my reading glasses. R let me try one of her glasses which was quite smaller, but fit my head ok, and nestled comfortably within the hollow of the pillow where my face rested, cradled in a feeling of hammock-like coziness. She tells me we can find a pair of cheap reading glasses the same size. Hurray.

I was wheeled into the operating room on a warm, sunny morning on May 28, 2026. The operating room was—by contrast—white, bright, and chilly. A cool room prevents the surgical team from getting too hot or sweaty, which can compromise sterility. I felt quite calm, almost jovial. There were four people in all: the vitreoretinal surgeon (Dr. Yanjing), an anesthesiologist, a circulating nurse, and a surgical technologist. Everyone seemed to be in a very good mood, which put me at ease. There’d been a delay due to an unanticipated development with the patient ahead of me. The anesthesiologist – a man in his late 40s who shared the same birth date as me – was alert, curious, and genial: he asked if I was retired. I said yes, and I loved it, I found myself busier than I’d been when I was working – but it was difficult framing the sense in which I was retired since I was a writer, and writers never retire. Nor do they make enough money to maintain a sustainable income; unless a writer gets extremely lucky à la J.K. Rowling or Dan Brown or Stephen King, a freelance writer typically must find other ways to make money which, in my case, generally meant menial work in a warehouse or office. That’s what I was retired from: soul-sucking, brain-numbing, demeaning menial jobs. Now I could devote my time to writing, as I’d been longing to do for all the years I had to drive a mail van or install overhead lights or paint or garden or mop or deliver hospital supplies. He nodded in sympathetic agreement, and explained that he would be giving me propofol (I’m a fan) and valium (also a fan). I’d been given propofol for all my colonoscopies, and knew what to expect: I was gone in half a second. When I came to, I could feel people fiddling around in my eye socket but no pain whatever. The operation seemed to be over in less than ten minutes. I was rolled back into the pre-op holding area where I was permitted to put my shoes and cardigan back on.

R came to join me and a nurse appeared who went down the list of everything I wouldn’t be able to do: I wouldn’t be able to lift anything over ten pounds or sleep on my back or bend over with my head below my heart; I would have to spend the entire day with my head bowed, for which a face cradle is recommended (mine was already set up at home); nor would I be able to run. She recommended I take a 10-minute break for each 45 minutes I kept my head bowed. I could use the time to walk around and stretch or eat a meal. If breakfast or dinner were to exceed the ten minutes, she demonstrated how I could eat my keeping my head bowed and lifting spoonfuls and forked morsels of food to my mouth. When showering, I would need to keep water out of my eye and at night I would have to wear an eye shield consisting of a framed aluminum cup constellated with little holes.

I was also presented with another round of eyedrops: ofloxacin – an antibiotic – and prednisolone for ophthalmic suspension. Day one through day seven I would need to apply it four times for the first week, just the prednisolone three times for week two, two times for week three, and once for week four.

The vitreous humor in my left eye had been removed and replaced with a gas bubble. All I could see was a blur. The purpose of the bubble is to apply steady pressure to the retina and hold it in place and block fluid from seeping behind the retinal membrane while the tissue heals. I found it curiously entertaining when, preparing for bed, R helped put the basket-shaped, post-operative eye shield in place, securing it with strips of tape; sometimes the holes looked like a constellation of portholes in a spaceship which was also partially filled with water, and sometimes like a shower of meteors, or twinkly Christmas lights. It was trippy, and I liked it. There were several instances in which I could see what looked like spidery creatures on the other side of the portholes. Perhaps they were cataracts or blood veins, I don’t know, but I found them entrancing.

The seven days I lay crosswise on the bed with my head nestled in the face cradle were quite difficult. My back began to hurt almost immediately; I made a hillock of pillows to lie on which helped take some pressure off my back, and angled my head more comfortably in the cradle. I wasn’t able to use my noise-canceling Bose earphones since they didn’t fit comfortably with the cradle. This left me vulnerable to external noises, such as the rhythmic thud of an upstairs neighbor walking heavily on a hardwood floor or a neighbor’s dog barking or children squealing loudly in the park next door. I have a nasty affliction called tinnitus, a continuous ringing in the ears which is actually a phantom sound whose origin is in the brain rather than the auditory system, and which is often accompanied by a condition called hyperacusis, which is an acute sensitivity to sound. I do not do well with noise.

I used a Gymboss interval timer I sometimes use for structuring a run between running and walking - X minutes for running and X minutes for walking - to time my 45 minutes on and my ten minutes off in bowed head positioning, a practice which is sometimes called posturing, but frequently forgot to set it, or fell asleep and didn’t hear it go off. Such a structured approach turned out to be too rigid to be observed with anything like true accuracy. Sometimes I used the length of time I’d been listening to an audiobook or YouTube video to approximate my time spent prone on the bed. I was also stunned to find how quickly 15 minutes go by. It felt that as soon as I sat down on the couch to relax and have a brief conversation with R it was already vibrating and beeping frantically on the table, urging me back to my face cradle jail.  

I’d hoped to be able to watch some movies, but my right eye fatigued quickly. It was easiest to listen to audiobooks I was able to check out from our local library. I listened to Michael York read Brave New World with such clear diction and expressivity that the stark events and ideologies of Aldous Huxley’s dystopia were more easily digested. I hadn’t read that novel since age 15, in 1963, and I was as confused by some of the concepts as I had been at 15; for example, the people of the World State are described as being divorced from nature and biologically engineered to perform various functions; that I got. That the people are also encouraged to enjoy promiscuous sex seemed to contradict that. Back in my day, we called it free love, and despite its many defects and liabilities, such as gonorrhea and crabs to name several, I felt pretty close to nature whenever I got lucky. I know that Huxley was illustrating the damage promiscuity does to intimacy and love, but still: human sexuality is a very broad and complex arena and however mechanically porn movies represent it, the pleasures sex provides can be quite intense, and it will most definitely enhance one’s sense of animality and natural being.

Why sex ever became ‘dirty’ is a mystery. In ancient Greece they gave the name of erotic beauty to the goddess Aphrodite, who was also aligned with qualities of intense desire, deep passion, emotional complexity and the joyful indulgence of sensual pleasure. And originating in southwestern Nigeria in the Yoruba religion, the female deity Oshun is the divine patroness of fresh waters, love, beauty, creativity and music, pleasure and abundance. She is depicted as a charming, sensual young woman fond of honey and sunflowers, cinnamon and oranges and fried bean cakes, yams and sweet wines and vibrant marigolds, peacocks and quail and honeybees, music and singing and lithe, supple dances that evoked the serpentine movement of rivers. Huxley’s ideas of sex seem to be at odds with life’s more sybaritic pleasures, which are all intrinsically linked to nature.

My other confusion had to do with soma. I easily understand the dangers of such a calming and soporific drug and its huge propensity for addiction. The zombie-like passivity of the World State population seemed very similar to our own population of people damaged by social media and pixels and screens and electronic devices, clickbait videos and brain rot due to endless scrolling, not to mention easy access to drugs like fentanyl, which help ease the trauma of becoming homeless and a society whose complete loss of humanitarian values is as devastating as it is shocking, but the idea of pleasure being employed to enslave people seemed far less offensive than the protagonist John Savage – the one truly authentic human being in this Brave New World of propagandized fools -  flailing his back to the point of bleeding with a whip of twisted horsehair as a form of ascetic, spiritual penance and self-punishment. Later in the narrative his lashings become even more vigorous and severe as a means to purge his body of not just the contaminating soullessness and shallowness of civilization but more importantly his lingering desires for Lenina, a woman he loved and passionately desired but could not abide the openness of her sexuality. That just seemed sick to me. I mean, there are healthier ways to cope with inner conflicts like that. Running a marathon, for example, or rock climbing, for which the Japanese have a term: misogi. The current meaning of misogi – which originally referred to the practice of washing in cold water, often by standing under a freezing waterfall, has been expanded to include any challenging, personal test of resilience, and is said to be purifying.

There is also the challenging ritual of lying crosswise on a bed for a week with one’s face in a doughnut-shaped cushion listening to audiobooks and watching an endless array of YouTube videos. I don’t know how purifying it is, but it’s spartan as hell and austere as a monk’s cheerless cell.

The various cerebral knots and entertainments were what kept my mind alive during its week-long hibernation in a face cradle. When it ended, when I could get up in the morning and could walk about freely and could once again sit at my desk and practice French and read and sip coffee, I felt as if I’d risen from the dead. I also had an appointment with Dr. Yanjing: she showed me the tomography scan of my retina. The macular hole was gone. It would take about another four weeks for the gas bubble to totally dissipate and the few imperfections left to heal. On the way back to the elevator, I felt 50 pounds lighter. Reborn. Renewed. Regenerated.

I had, however, lost my superpower: I could no longer shrink heads or distort faces so grotesquely they resembled those grisly portraits by English painter Francis Bacon. Faces kept their just proportions, and although letters were still a bit distorted, I could see them becoming legible. I was returning to the world of clarity and light and legibility. Faces looked as they normally do: happy, forlorn, angry, perplexed, startled, pensive, speculative, scornful, wistful, joking, impertinent, apathetic, sympathetic, dreamily romantic, sexy, sultry, and openly, quintessentially, alluringly enigmatic. Translating life’s sometimes illegible spectacles requires more than a network of optical nerves. There is also the health of a third eye to consider, to purify and protect from the corrupting glitter of avarice, and the blinding disease of greed.