Day Surgery is the commonest planned surgical procedure in the
world. When I was told I would need it done on both eyes, I
had no qualms at all, despite my distrust of the medical profession
in general, and hospital administrations in particular.
UK, routine surgery like this involves a long period of waiting,
because its National Health Service is geared more to emergency
treatments, to expensive amd complicated procedures which are
more interesting to surgeons - and (of course) to cancer treatments
because of the glory of the 'fight against cancer' and huge
public pressure to treat tumours which are largely (but not
entirely) a result of the West and North European way of life
which afflicts more and more of the world. This way of life
involves a great deal of stress, the consumption of huge quantities
of meat, refined carbohydrates and sugar, and little natural
joy in living.
digress. Eight months after I was told that my cataracts were
large, I went for day surgery to my worse eye - the right eye.
I had been given leaflets on the procedure, which I read carefully,
and I had no qualms at all. The operation was performed at my
local hospital - a brand-new, depressing and labyrinthine place,
obviously designed and built on the cheap to last no more than
twenty years - but only 8 km away from my rural home. (I noticed
the cheap vinyl on the floors, laid with joins which had shrunk.)
marvellously well: a painless, very slick and smooth piece of
teamwork with plenty of friendly reassurance by all (except,
of course, the very handsome young surgeon himself). I was discharged
within two hours of my arrival, after liquid refreshment, with
my right eye suitably covered.
recently, cataract operations were performed with general anæsthetic,
and patients remained up to two weeks in hospital, forbidden
to move their heads more than necessary.
worn glasses since I was six - that is to say, for 67 years.
After the operation I had reasonable monocular vision through
their left lens, and I felt that I would have no problem at
all while I waited for an unspecified period to have the lens
replaced (with a plastic membrane) in the left eye. In this
I was sadly mistaken.
and advice I was given covered only the strictly medical aspects
of cataract day-surgery.
the hospital with two bottles of drops, instructions on how
to use them, and another booklet on coping with life after my
little operation. I kept the covering on my eye until the following
morning, as recommended. It was when I removed this covering
that I was surprised to find that, with my "new" eye
the world was not only painfully bright, but very blue. This
was due to the fact that my cataracts were rust-coloured, so
tended to tinge the world reddishly.
problem was the fight that started in my brain between what
each eye was seeing. This was somewhat disorienting, but, the
booklet assured me, the diorientation would not last long. Nevertheless
I quickly sawed off most of the plastic in my very thick, rimless
glasses, so that each of my eyes would have maximum vision.
What the booklet did not mention was the basic law of refraction:
light coming into my left eye was refracted by the thick lens
and thus came at a different angle to the light which came directly
into my right eye. This created a large parallax problem, known
as 'refractive error'. Distant vision was affected only slightly,
but near vision was poor. Close-up vision was even worse.
actually recommended that I could continue to wear my old glasses.
Even with one lens largely removed, this was a recipe for an Accident
In the Home. Nevertheless, I managed to steer myself around the
house, and cooked a meal without too many awkward moments involving
parallax: pouring liquids, for example. One-eyed people get over
this, of course, but only over a long period of being unable to
judge the relative positions of tap and kettle, kettle and vessel,
vessel and plate.
a great deal (maybe two or three books a week), and run three
websites and four blogs. It was impossible to do this with my
two very different eyes. The only solution to this was to use
either one of my eyes: the new eye with a magnifier for reading,
or the old eye with the bifocal lens of my glasses.
actually recommended the purchase of off-the-peg plastic reading-glasses
(commercial objects which I have always believed to be dangerous).
So I bought a pair with a two-dioptre magnification, even though
I established that my right eye required a 1.75-dioptre magnification.
This was not available in the various local suppliers. I blanked
off the left eye with black insulation tape. The result was
that I could read maybe one or two pages of normal book print,
but then my 'new' eye would get very tired and red.
put a piece of black card over the now-removed right lens of
my prescription glasses, so that I could read a bit with my
still-cataracted left eye through the bifocal lens. This was
not very satisfactory, and soon my left eye suffered strain.
I had an almost continuous eye-strain headache.
My various pathetic aids to my surgically-impaired
vision - frequently mislaid
and occasionally sat on.
I had been assured that a member of the cataract-support team
would phone me the day after my operation, to find out how I
was coping. This call never came. I checked my phone that evening
and found that I had received no calls whatever that day - so
I did not miss the call. In any case, I have an answering service.
It was not until four days later that I got the check-up call,
when I was untruthfully told that I was phoned the day after
the surgery, but there was no reply.
not play the usual grateful and subservient patient when I talked
to this member of the 'care' team on the telephone. Had I fallen
down the stairs or scalded myself on the Friday, Tuesday would
have been rather late to do anything, since I live alone in
a remote spot
and she probably would not have flagged up
an emergency but just shrugged her shoulders, assuming that
I was not at home.
was pretty sharp with this young woman, and I suspect that she
may have marked my file
DIFFICULT PATIENT - which, I am assured by a
friend who is a nurse, is not unusual.
be no surprise to readers that 'people-skills' in the
socially/religiously-divided and divisive cultural desert of
Northern Ireland are extremely rare. My own aren't great, and
tend to be bipolar...
I asked how long it normally takes for the second cataract to
be removed, she told me (truthfully) that it is two to three
months. I was dumbstruck. This is utterly outrageous. In other
countries with free medical care (France, Germany, Scandinavia,
Finland, etc.) the second operation is carried out within 3
weeks (all being well). I had to wait eight months for the first
operation (partly because my optician failed to notify my doctor
for two months, and then only when my doctor told me that he
had not been notified). I wont have full vision until
a year after my cataracts were deemed to need removal. Meantime
I could be categorised as VISUALLY IMPAIRED,
unable to do some fairly 'normal' things.
after the operation, I went for a routine check-up. This was
not a pleasant experience. In Northern Ireland (if not the entire
hitherto United Kingdom) patients are treated like morons -
by people with practically no education. Their attitude towards
patients concerns is exactly as it was in the 1940s when
I had a totally unnecessary tonsillectomy. The auxiliary who
checked my eyes regarded me with that slight smile indicating
stretched toleration of a patient who is, in his field, at least
as qualified as her. Nevertheless, my age (71) put me into a
category in which I am treated with infuriating condescension
bordering on contempt. She told me, however,that my case would
be marked Urgent - adding that it could not be the following
week (three weeks after the first operation) ! As if there was
an ice-cube's chance in Hell of my being moved up the queue
so dramatically. Needless to say, my file was NOT marked Urgent.
certainly the case that the continuously-depleting gene-pool
in Northern Ireland (due to the island's main export: intelligent
people) means that many patients seem indeed to be semi-moronic.
This, however, applies equally to the nursing staff who dealt
with me. When I talked of my liking for rural France and the
quality of life there (8 on a 10-point scale on which Ireland
barely touches 1), one nurse told me of her outrage that people
in Brittany did not speak English, and how offensive they were
not to keep their shops open during the obligatory and traditional
French lunch-break (usually two or three hours) just so that
she could buy alcohol to drink with her young friends.
glasses have been for nearly 30 years Reactolite - self-darkening
in bright sunshine because of my photophobia. So I had to buy
sunglasses to deal with the intolerable increase of light in
my right eye.
not long before I began to regret having the surgery. Better,
I thought, to go blind slowly and gracefully, than have to swap
various adapted visual aids - which of course I tended to mislay.
began to erode - especially after tripping over a kerb and falling
flat on my face. I bumped into things, and had difficult reading
notices and documents when the appropriate visual aid was not
to hand - or mislaid. I lost a credit card. I cut my toes in
mistake for my toe-nails. Three times I was nearly knocked down
because cars suddenly appeared out of the mist in my left eye.
My confidence eroded further. It is through this kind of experience,
unmoderated by non-existent or negative after-care that old
people are hastened towards dementia (see
same reason (of panic in the usual cramped and tacky post-office
in the usual overlit, brash and noisy tacky supermarket), I
dropped my wallet on the street. After several hours of near-despair,
I was phoned by a kind shopkeeper to whom some youths had handed
compiles the advisory booklets - probably a qualified doctor
who has never undergone cataract surgery and who, like most
doctors, has little imagination - has not considered that someone
who has worn spectacles for 67 years might feel bereft and vulnerable
without them. Every morning, on waking, I look around for my
glasses. He or she has no interest in colour (and is certainly
not a painter) and does not consider that seeing the world blue-tinted
with one eye and reddish with the other might be disturbing.
worse, refractive-error problems when using a keyboard lead
to continual mistypying if one is not a touch-typist. But at
least screen-text can be enlarged.
my brisk, not to say brusque, check-up I waited to hear when
I might have the second eye operated on to match the first.
Notice is sent out at least three weeks prior to surgery. It
comes, poorly presented and containing acronyms such as "the
ICATS team", which, I later discovered, is the pre-
and post-surgery team about which I am complaining.
a month I had heard nothing. So I wrote to the Downe Hospital's
Commanding Officer or CEO or whatever title he glories in -
and received neither acknowledgement nor reply.
I wrote to the Appointments Manager - and received neither acknowledgment
The appointments system does not believe in e-mail as a back-up
to postal notification.
It has an automated telephone service on which the message is
inaudibly faint, and on which, consequently, I could not leave
a message myself.
I wrote to my Member of Parliament, and not only got a reply,
but follow-up letters.
I wrote to the complaints department of the regional health
board, and received an immediate reply and excellent follow-up
which resulted in my having to wait "only" two months
rather than three for the second operation.
normal (or recommended) period between eyes is 3 weeks. Had
I not had some intervention, I would have waited three months,
with only slightly-diminishing headaches and need to lie for
periods a darkened room during the daytime. Thank goodness for
BBC radios 3 and 4, and RTÉ Lyric !
now even less faith in BritIrish hospitals than I had before.
I underwent the completely unnecessary ordeal of having a tonsillectomy
when the NHS was first set up. It was horrible: bullying nurses,
uneatable sloppy and meaty food on bent tin plates, and a régime
for a 6-year old which would not be considered suitable in a
prison hospital today.
years ago I made an appointment to see my then GP in a
particularly noisy Health Centre which was more like a
busy bus-station. As I entered his cramped consulting-room,
he announced: "I see you have a weight-problem,
Mr Weir". I have always been thin and now weigh
exactly the same as I did at 18.
Dr Moore was reading an incorrect weight-to-height
ratio on my file and had not even looked up from the computer-screen
screen as I entered.
globe-trotting mother descended into dementia as a result of
someone leaving a swab in her after a routine operation
for a prolapsed rectum when she was in her late seventies. She
nearly died, had to have a colostomy, then submitted to a colostomy
reverse: two further general-anæsthetic affairs that completely
removed her previously sturdy confidence. It is worth remembering
that far, far more people are killed (often slowly and painfully)
by doctors than by 'terrorists'.
had her life painfully and callously prolonged (in the same
Ulster Hospital) as they kept pumping antibiotics into her for
terminal pneumonia, even though she kept saying I want
to die. I want to die.
had an unnecessary prostatoscopy which left me with worse Benign
Nocturnal Polyuria than before. My prostate remains healthy,
if slightly enlarged - as is to be expected. It was not the
consultant urologist who told me about BNP - but the internet.
He should have diagnosed this at the outset. This was yet another
(if very minor) case of routine medical incompetence.
from the actual cataract operations I had in Downpatrick (as
opposed to the 'ICATS Team' there), the only not-unpleasant
experience I have had of a hospital this side of France was
when I arranged, of my own volition when I was younger and of
indeterminate sexuality, to have a vasectomy, for which I paid
very little: just the basic fee to the anæsthetist, and
nothing to the sympathetic, antinatalist surgeon.
certainly not go into hospital voluntarily again. Preferably
for nothing more than an autopsy. I don't like being shunted
and abandoned like a railway-wagon. Replacement knee ? forget
it! Replacement hip after a 3-year wait - no thank you. Besides,
they last only 8-10 years, and I think it somewhat immoral for
the old in rich countries to get that sort of operation for
nothing, while millions in the world don't even have a lavatory
of any kind, much less access to basic medical care and prophylaxy
- let alone day-surgery for cataract and glaucoma.
- absolutely not.
should I end up in hospital involuntarily, upon
my belly is the tattooed instruction:
You can see that my right eye (to the left)
is red and tired-looking
after writing just one-third of this web-page
seven weeks after the eye was operated on..
Click the picture to see a close-up.
to expect after cataract surgery:
painful excess of light
colour discrepancy between one eye and
of wearing proper glasses for three
months or more - a serious
drawback if you have been
glasses for a long time.
inability to read, due to parallax problem
('refractive error') close-up
with metal money. I could not tell the
difference between 20 UK pence and a £1 coin,
nor between 20 cents and a €1
coin. This is most
headaches due to eye-strain
ache in and above the eye which was
operated on (this is only to be expected)
danger of tripping over kerbs and steps
with subsequent loss of confidence : use a white stick
and sunglasses if confidence ebbs too much
mislaying of objects, especially reading-glasses, and
difficulty in finding them
DO NOT BUY NON-PRESCRIPTION READING GLASSES
IF YOU DO, YOU MAY STRAIN YOUR TREATED EYE
CHEAP PLASTIC GLASSES QUICKLY DETERIORATE.
Since my vision became a problem, my defective hearing improved,
and I had to turn down the volume on live radio and recordings
of music. Simultaneously, my not-unpleasant and intermittent
tinnitus became louder.
My mother, one of the many rape-victims
on British soil in World War 2, was unfortunately influenced
by two men: her GP brother and her own doctor. Both of these
Royal Navy Surgeons were appalled at my sensitivity as a child,
and persuaded her to send me, at her own considerable expense,
to send me to a private school, which, they said, would
"rub the corners off" me.
It was not a coincidence that her GP was also the doctor attached
to that second-rate college in the leafy eastern suburbs of
was of course a disaster from their and her point of view:
I became a blind Resister,
and, after leaving that outrageous and expensive Presybterian
institution of poor education,
I thought before I ever conformed again.
I am still reaching for my glasses every morning.
After the second eye was eventually treated (one month before
the usual but scandalous three-month wait), the surgeon himself
telephoned me -
which is how it should always be. While the first eye saw the
world very clearly
after the operation, the second eye sees rather less clearly.
Nevertheless, one day after the second operation I was able
to read without much difficulty,
using the off-the-peg glasses which I do not approve of.
I spent up to an hour at times looking and feeling for my crude
plastic reading-glasses (recommended even by the RNIB, although
they are suitable for only one of my eyes)...feeling stupid
and silly and slightly desperate. If I had worn them on a string
around my neck they would soon have been crushed. I cannot understand
why these cheap and inadequate prostheses are not sold in half-glass
stability also was restored.
had to wait six weeks for the left eye to 'settle', before getting
and the prescription glasses I needed due to 'refractive error'.
this time, my right eye was extremely tired, I had continuing
eye-ache and headache, and deteriorating vision in this 'good'
could hardly be an easier and surer way
of pushing an older person with long-term bad eyesight into
a very alert and active seventy-two year old)
than a double cataract operation in the UK.