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I woke up one morning and found the sight in one eye was impaired. How doleful it would be to go blind!


Clear to see: more treatments are becoming available that help the visually impaired

Clear to see: more treatments are becoming available that help the visually impaired

Clear to see: more treatments are becoming available that help the visually impaired

On the morning of Saturday, July 28 this year, I opened my laptop as usual, and something seemed rather weird about the screen. It wasn't quite in focus: it was as though I was wearing the wrong glasses.

Oh well, I thought: better get a check-up. But in the meantime, life was busy. I had a French student coming to stay, and I needed to do a major blitz on the house.

As it happened, I couldn't get an appointment with the optometrist for about 10 days anyway, so I just muddled on with what I gradually realised was impaired vision in one eye. When I finally had a test, the eye man said, rather ominously: "Yes, you've had a macular bleed into the left eye. Better get you to a hospital appointment, pronto."

Worrying. My elder brother, who died in 2010, suffered from macular degeneration - in effect, the onset of virtual blindness due to damage to the macula, the central part of the retina.

Although he had several physical ailments and mishaps over his eight decades of life, he said, with uncharacteristic dolefulness: "Macular degeneration is the worst thing that's ever happened to me." It removed the much-loved pleasures of reading, writing and watching movies.

I've known other cases of this condition, and it can be a stinker, plunging the sufferer into chronic depression, robbed of independence, deprived of the joy of looking at a painting, seeing the faces of friends and family, and of using personal and even public transport easily.

I had some melancholy thoughts about what it might be like to go blind, with the concomitant reflections about how we take the gift of sight for granted.

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It was the end of August when I got a hospital appointment, where, after more examination procedures, there was a diagnosis that there had been "some further deterioration" in the left eye since the initial bleed.

The ophthalmologist then prepared me for an inject of a medication fluid known as aflibercept (trade name: Eylea) into the left eye. I knew this was coming and was braced for it. It's not a pleasant procedure, but it's done skilfully: local anaesthetic numbs the eye, the face is covered with a phantom-of-the-opera type mask with a small optical peephole, and the needle goes into the white of the eye so quickly you haven't time to dwell on it.

When I used to moan about returning to boarding school after the holidays, my mother would say: "Be glad that you CAN go back to school. Wouldn't it be much worse if you weren't able to?" This memory came, unbidden: be grateful that you can have this injection.

Wouldn't it be much worse if there were no treatment at all? There was to be a follow-up injection each month.

"Nothing reverses a macular bleed," said the ophthalmologist. "But this medication, which is relatively new, can halt the deterioration and may inhibit further damage." The treatment, which only became available over the past eight to 10 years, works by shrinking and sealing up the "leaking" blood vessels in the eye, hopefully preventing further loss of vision. It can be expensive ($1,000 a shot across the Atlantic) but I'm lucky to be covered by the health service.

And so I duly attended the hospital eye clinic for the monthly injections. Despite some apprehension about the procedure, I kept thinking that I was more fortunate, in my timing, than my brother, who had been told back in the 2000s, "there's nothing at all we can do for you".

And I thought of a friend, too, whose AMD (age-related macular degeneration) had a swift onset in her 60s, and who has lost almost all her sight: she feels everything has been taken away from her. To become blind in later life is a tough call - it's harder to adjust, to learn compensatory skills that can perhaps be exercised in youth, to master new technologies that assist the visually impaired.

After three months' treatment, it seemed I was doing reasonably well. My condition hasn't got worse, and I'm managing. I've been given the OK to drive (the test: read a car registration number at 20m - that's 66ft, or, alternatively, five cars away), although my old-fashioned liking for road maps rather than satellite guides may have to be ditched. The right eye, weaker in vision but not so far affected by the macular problem, has had to work harder in compensation.

I think the brain, which interprets vision, has made adjustments too. I've been advised to upgrade all lights to a brighter level, and to keep torches and magnifying glasses handy.

Why does AMD strike? Too much sunlight, age, genes, family history, blood pressure, cholesterol, smoking, drinking, being overweight - they're all suspects. Stress from doing a blitz of housework cannot, alas, be blamed. The inevitable fact is that, as we age, faculties decline. When Prince Charles hit 70 in November, he remarked ruefully: "Bits keep falling off." Conversations between oldsters often begin with the "organ recital", as geezers go through their various ailments and the medications they're taking.

People can have awful problems with ill-health and disability. You become aware of that. And yet, medical science improves all the time, and there are new treatments constantly coming on stream, and that is, after all, a cause for optimism.

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