Reading Between the Lines, or A Scanner Darkly


A sign beside the receptionist’s desk in an eye clinic reads:

Pensioners will be bulk-billed for any consultations only.

While waiting for my first appointment there, I asked the receptionist what the sign meant. Did bulk-billing apply only to consultations and not to extra procedures (like scans)? The receptionist said that, yes, pensioners would be bulk-billed – an imprecise answer. I tried rewording my question. She repeated herself. I tried again. She got crosser. ‘It’s a grammar problem,’ I finally said, and she glanced at me irritably. Presumably no other patients had found the syntax ambiguous.

Clear sight is prized in our society, so eye surgeons command fat fees. But clear communication is relatively worthless, with ever more writers working for free. What’s wrong with my eyesight? Well, most people who read a great deal – i.e., most people, in an ‘information society’ – will at some point find that misuse, such as constant reading, weakens the eyes. And most of us will then resort to glasses, contacts or laser surgery; the more serious the problem, the more advanced the technology. Few of us question this downhill progression, though worsening eyesight makes us dependent – initially on the judgement of narrowly focused experts.

My doctor recently sent me to an ophthalmologist because I said that writing (not reading) had been giving me headaches. And when I returned, alarmed, to ask her for another referral, she gave me a copy of the letter she’d received from the specialist. An abridged version follows:

Dear _____,

Thank you very much for your referral on _____. She has noticed some decrease in her night vision which is due to slight decrease in her accommodative strength. She does not have any cataract but I have advised her some pencil push up exercises and convergence exercises and that just might help her with her focusing slightly. […] Eventually she will most likely need some reading glasses and when the cataract develops she will need to have that removed.

At this stage she does not have a cataract so I will just get her to do the exercises initially.

I also noticed some very early optic nerve changes suggestive of very early glaucoma in the left eye […] and she needs some monitoring of that at this stage […] In the initial phase, there is nothing serious happening with her eyes which is good to know.

Kind Regards,

Dr _____ _______
_____, PhD (Cataract), _______ (____).

My first point of concern was his error re night vision. I’d mentioned doubling of images, more obvious at night (with the contrast of bright light against blackness), but it would appear he didn’t listen – due to some decrease in his hearing? Secondly, why three references to cataracts, though my eyes show no signs of any? What’s behind this premature fixation, this unbalanced bias? A PhD thesis, apparently – note his assumptions that (1) I’ll get cataracts, certain as death and taxes, and (2) I’ll bow to his authority and come back.

Why wouldn’t I? Well, he talked too fast for me to keep up in the 15 or so minutes he spared me, and never once mentioned my main symptom: headaches. But I wasted almost two hours in the waiting room. His practice hinged on a $100,000 scanner operated by an abstracted assistant fresh out of uni, with an irrelevant degree in molecular biology and the social skills of a robot. (She: ‘Have I given you drops yet?’ Me: ‘Not that I’ve noticed…’)

On the strength of one scan – he discarded two others after a minute’s scrutiny – the specialist diagnosed early glaucoma in my left eye and urged me to return in six weeks for monitoring – glaucoma can cause tunnel vision and eventual blindness. According to his handout explaining the need for regular scans, glaucoma ‘steals sight’: emotive language, that. My GP deleted him from her database when I described his style. (She used the word ‘factory’.)

Finally, in his letter to her, my condition sounds less serious. Did he hope to elicit my patronage through fear? Yet, why pay heaps for scans that only show whether I need invasive treatments, subject to interpretation by someone with dollar signs in his eyes, who doesn’t know what’s caused my ‘disease’, much less what I can do on my own to reverse, halt or even just slow its progress? (According to The Glaucoma Foundation, ‘[Imaging] software and technology are developing rapidly and show great promise. However, they have not yet evolved to replace ophthalmoscopy, where the doctor looks directly at the optic nerve.’) Such faith in an unproven machine mirrors publishers’ haste to churn out e-books. Hello, statistics. Goodbye, editing.

And so, two months later I sought a second opinion from someone more experienced, who pronounced my optic nerves healthy and my eye pressure normal. However, I needed reading glasses immediately. I voiced ambivalence. Oops. He grew fiercely insistent, scorning the idea of natural vision improvement and calling the famous if scientifically dubious Bates method ‘dangerous’. Why so defensive? Don’t most of us lack the discipline, patience and/or interest to explore the subtle complexities of our own eye–brain and eye–body connections? Clearly, there’s more than one kind of tunnel vision.

These ophthalmologists, for all their knowledge re what’s anatomically possible, don’t seem to be up to speed with current research suggesting that natural vision improvement works via the brain rather than the eyes. Which might account for the lack of scientifically documented successes pertaining to countless reports of eyesight improving through active and mindful use (vs. passive dependence on external lenses). The second expert I saw would, I’m sure, view such testifiers as deluded.

If he and his kind were books, they’d be the equivalent of traditional genre fiction: ubiquitously popular (even if mediocre, like the first expert); conducive, like most quick fixes, to habitual mental laziness; and above all, reassuringly predictable. As an aficionado of literary fiction, I’ll be seeking a third opinion.

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