Gear Up: How Blurred Vision Clarifies Things

The bright, very bright, sunlight flickered through the Mercury Tracer's side window making a strobe light effect. The snow was piled high on the sides of the road and the sunlight on the snow was overwhelming my sunglasses. As I drove down the 19-degree hill, in the 19-degree weather, the combination of frost on the window and the intermittent shadows cast by bare branches flashed like an old movie. No wonder they call movies "flicks."

Stopped at the bottom of the hill, the flashes continued. Movement couldn't explain them. They were green. Even without moving, I was seeing flashing lights. Later that day, vision in my left eye was blurry.

Over the next several days, the flashes persisted. I didn't want to alarm my family. Maybe, I thought, they'll just go away. By the time the winter vacation was over and I had returned home to the warmth of Tampa, Florida, I was concerned. Though it was a Sunday, I called an ophthalmologist acquaintance for reassurance. He heard the concern in my voice. Though the symptoms seemed to relate to a retina problem and although he's a Lasik guy, he met me at his closed-for-the-weekend office. After dilating my eyes with drops related to those used for centuries (belladonna was used by the ancients to make a woman's eye more attractive by dilating the pupil, hence the name "beautiful woman" for the drug), he peered into my eyes. With relief he said that he could see no major retinal detachment. He mentioned that the symptoms sounded like vitreous detachment to him.

I asked about the blurred vision. "It's like looking through ground glass," I told him. He tested my visual acuity. Even with the symptom, my vision was good, equal in both eyes.

"People get used to this," he explained. "The mind tunes out the blurring. You do need to see a retina specialist soon, though."

I was relieved — sort of. At least an emergency retinal catastrophe had been ruled out, but the persistent symptom was troubling. My mind was not so expert at tuning out the fuzz.

Over the next several weeks, I saw two retinal specialists in Philadelphia and Tampa. They all agreed that I had vitreous detachment, which sounds a little like a lapse in virtue. The Tampa specialist discovered drusen in the retina, a finding associated with macular degeneration, a disease that has left my father sightless. I had inadvertently found myself in a position I have always sworn to avoid: I had discovered the precursor of a bad problem for which there is no known effective treatment. I have always maintained that I would rather not know about things about which I can do nothing. Though not everybody with drusen gets macular degeneration, they are associated with the disorder, especially in patients with a strong family history.

Up until now, my happy life has been centered about four things: family, friends, flying and surgery. Sight is preferable for the first two and essential for the last two. I have watched my dad deal with his waning vision with equanimity and patience. I do not feel prepared to exhibit these strengths, at least not yet.

As January melted into February, I learned a few things. First, I could fly and I could cut. In these two realms, I was unaware of any impairment. I asked our circulating and scrub nurses if they detected any change. I was relieved when they said no. Flying was the same. In cruise, I would be aware of cloudiness in the left eye, but when concentrating on the flight instruments or reading the approach plate, I was oblivious. In these circumstances, my mind had learned to tune out the blurriness. This wasn't the case anywhere else though, and I spent many months closing my right eye in the midst of conversation or covering it while watching a movie. Most people tried not to notice this social tic. I tried to practice with my left eye by closing my right in the highly unproven theory that such exercise might make things better. It didn't.

What my mind did do was reassess. Up until now I have been sailing along, content in late middle age, feeling active and fit, wiser than before, but still very much in the game. This visual warning shot worked its way past my vitreous humor into my central sense of things as they are. Humor was not part of the experience. Though my job as a cancer surgeon has given me plenty of evidence over the years that life is a fragile affair, the problem lay with the patient. I knew intellectually that someday I would diminish and later die, but the event seemed far off. The dying was the thing I worried about. Now I started to worry about being alive and being diminished, not being able to fly.

My aspirations for owning a jet had already surrendered to the economy and entrance into my seventh decade (doesn't that sound old?); my attention had turned to keeping a 30-year-old airplane with elderly engines. Suddenly these worries seemed like luxuries. Forget about the money — what if I couldn't fly or work at all? This would jeopardize my income, my passions and even my privilege of writing for this magazine. Who wants to read something by a blind guy who can't fly?

As with most dramatic events in life, I soon found a sense of balance in the knowledge that things will inevitably go downhill. We all know this fact but try to ignore it. In a way, the recognition means a new look at things, and that view is anything but blurry.

On a commercial flight, I watch with persistent interest a spectacular sunset. As the orange fades and the blue above it deepens, I vow to remember this sight. The solemn countenance of my new granddaughter, Ada, as she surveys her beginning life, sticks in my mind in a new way.

The flying sights are especially dear, and I try hard to make myself memorize them in a way I hadn't before. I'm storing views like a squirrel might hoard chestnuts. On a trip into White Plains, New York, on a spanking clear day, I commit the sunlight shimmer on Long Island Sound to memory. I'm too busy maintaining 180 knots until three miles from the airport to examine the mansions surrounding the airport, but I drink in their visage once I'm on the ground and making the leafy trip to the interstate.

The instrument panel holds more than its usual fascination. I've always loved looking at the dials, especially when they are lit by sun over my left shoulder, but now I'm even more reverent. Even the fuel flow gauge that has stuck at 230 pounds per hour looks crisp and alert to my savoring eye. It will be repaired soon. Maybe a new gauge will have an even more brilliant green arc. I like the way the printout of's prediction of our flight looks when I fold it just so and place it just above the throttles. The steady march of waypoints is not unlike life itself.

My Cheyenne simulator ride in FlightSafety's elderly box has me straining to remember what everything looks like — even in the dark. The layout of FlightSafety's Lakeland facility, the color of the carpet, the formality of the blue jackets worn by the instructors, all things I have previously taken for granted or even held in mild wonderment or smart-aleck smugness, now seem to have more importance than before.

The outside of our beautiful Cheyenne brings me more pleasure and not just a little solace. Those hulking engines — man, do they exude a look of muscular fitness. The shine on the prop spinners begs for you to examine your own face. I find the lights on the airstairs all the more soft at night. They are a gentle stairway to aviation, and I imagine myself as a young corporate pilot, waiting for my passengers to come roaring up in a limousine in the dark of the night. There is never any convective activity in this fantasy.

On a flight from Delaware back to Tampa, I watch Chesapeake Bay slide under the nose, look down at the tiny huge ships in Norfolk, Virginia, and wait for the Abermarle Sound to roll into view. I've seen all this before, but now I am watching closely, hoping there is time yet to add to these visual inscriptions on my mind. With some luck, I'll see a lot more before this is over.

Dick Karl
Dick KarlAuthor
Dick Karl is a cancer surgeon who appreciates the beauty and science involved in both surgery and flying. Dick’s monthly Gear Up celebrates the human side of flying. He writes about his enthusiasm for both the machines and the people who fly and maintain them.

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