“Yup,” he said, “you’ve got some fluid in there.”
Had he been a mechanic discussing my car’s brakes, I’d have been happier than a puppy chewing a bone. But no, this was a doctor. More specifically, an eye specialist. And as he was discussing my left macula, any barks could only be gasps.
“But no worries,” the doctor went on, “we’ll just give you an injection in the eyeball. Your condition isn’t curable, but monthly injections should help.”
Which immediately reminded me of the scariest mantra of my ancient childhood: “cross your heart and hope to die, stick a needle in your eye.”
And that’s when the panic set in.
I should probably pause here to offer some background. My eyes and I are not close. Though I have provided them with minimal care over the years—mainly eyeglasses—we rarely speak and never touch. That’s why contact lenses are not an option. Because they would require, well, contact. And that’s something I simply can’t tolerate. The reason is pretty basic: it terrifies me.
So, you can imagine my consternation upon being told, years ago, that I suffered from age-related macular degeneration. Simply put, it’s the gradual deterioration of the macula, the part of the retina responsible for sharp, central vision. Which means that any downgrading eventually results in blurriness, distortion, or blind spots at that vision’s center.
The good news back then was that my AMD was “dry,” i.e. slow-moving and relatively stable. I could take a few vitamins, ignore it, and hope for better days. Ah, but now, I’m told, the condition has escalated to “wet,” meaning new blood vessels have grown beneath the retina, leaking fluid that could cause scarring. So, what once was stable is now not-so-much. And what used to mean blissful forgetfulness now literally requires a needle-in-the-eye.
In other circumstances, one might take comfort in the old adage that misery loves company. A study published by Lancet Global Health and Nature reported that, in 2020, roughly 196 million people worldwide suffered from AMD, with that number expected to reach 280 million by 2040. While the US, China, and India lead the race for top spot, the Philippines has its own problems with roughly .2% of the population—about 210,000 Filipinos—suffering from damaged or deteriorating maculas, according to a study by the Department of Health’s Philippine Eye Research Institute. And, due to an aging population, that number is growing.
None of which comforts me at all. The bottom line: I’m scared to death, not just of sight loss but perhaps even more of that needle.
Beyond the terror of inserting a sharp object into a soft fleshy sphere, of course, there are practical considerations. Soon I’ll be seeing a retinal specialist in Palm Desert, California, near where my family and I are spending our annual sojourn in America. Not long after that, however, I’ll be back in the deep provinces of the Philippines where needles aimed at eyeballs are fewer and farther between.
And here’s the thing: I’ve got no health insurance there. Which, given the estimated cost of 6,000-12,000 pesos per injection, is more than a minor consideration. Especially as I will require at least one prick per month.
So, here’s my list of questions for that specialist: Is there an alternative to injections (I don’t think so); what happens if I refuse them (probably nothing good); and can they put me to sleep during the puncturing process (I doubt it). Finally, how on earth will I be able to sit still?
“Oh, no worries,” the other doctor repeated in response to that question. “They’ll clamp your eyes open.”
Somehow that wasn’t reassuring.
Here’s the main question: which scares me more, that sharp hovering needle or being blind in one eye? Hey, I hear there are some really cool-looking eyepatches on the market. Then all I’ll need is a sword.
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David Haldane is an award-winning American journalist and author with homes in Southern California and Northern Mindanao. His latest book, Dark Skies: Tales of Turbulence in Paradise, was a finalist in this year’s Next Generation Indie Book Awards. This column appears weekly in The Manila Times.
