The biggest event on Kate’s birthday was her semi-annual visit to her ophthalmologist. We have been monitoring her cataracts for the past several years. During the previous two visits, they had reached a point that her doctor said we could go ahead or wait a little longer. After our discussions, I decided her vision wasn’t poor enough to necessitate surgery. Since the last visit, however, I had noticed what I thought was a significant decline in her vision. She was being exceedingly careful when going up or down stairs or curbs as well as pavement with light and dark sections or cracks. I wasn’t sure if the problem related to her Alzheimer’s or the cataracts or something else. Yesterday’s examination confirmed my suspicions about the decline and that the cataract in her left eye is the problem. We spent most of our time talking about the procedure itself and how comfortable the doctor felt about doing it with Kate at this stage of her Alzheimer’s. She was quite comfortable but said it was my call. At first I said I wanted to think about it and would call back with an answer. We talked a little bit more, and I decided to go ahead. We made an appointment for surgery on February 12. We have no plans to follow up with the right eye since it is a long way from requiring surgery.
It was interesting to observe Kate during yesterday’s examination. At the very beginning the woman who took care of the initial eye test asked how she had been getting along, if she had noticed any changes since last time. Kate said she could see just fine and had no problems. As the technician was about to jot that down in her record, I asked if she would like my impression. Then I told her that I thought the cataracts were causing more problems now.
It wasn’t easy for her to follow the instructions. When asked what she could see, Kate often asked, “Where?” She actually expressed some irritation when the technician tested her peripheral vision by holding up her fingers and asking how many fingers she could see. Twice Kate said in a stern voice, “Wait a minute!” The biggest challenge involved her reporting if she could see the “Big E.” That’s the one that encompasses the whole screen and must be 12” high. Kate first said that she couldn’t see anything. I think this was a result of her Alzheimer’s and not her eyes. I believe she saw the E but interpreted it as a bunch of lines and not a letter. Finally, she recognized it as an E.
The exam made me more appreciative of the challenges Kate has seeing everyday things. This happens a lot when we are in the car. I will say, “Look at that” and point to something. We often have passed whatever I was pointing out before she can figure out where to look. There are also many times that she doesn’t see objects that are in plain sight, for example, the clothes I lay out for her. She doesn’t know what to focus on. I believe this is largely a problem created by Alzheimer’s and not a physical problem with her eyes.
Having made the decision to have the surgery, I am now eager to see how much her vision improves. I am optimistic that it will help her feel more secure when she goes up and down curbs and stairs and across pavement. It would be great if it also makes it easier for her to work her jigsaw puzzles. We’ll soon find out.