I’ll never forget the humiliation of the school eye test. The nurse would whip off my glasses, stick a postcard over one eye and demand I read aloud the tiny letters on the chart. ‘But I can’t,’ I’d protest. ‘That’s why I wear glasses.’
Cue: laughter from my meaner classmates.
My life changed at the age of seven when a teacher spotted I couldn’t read the board. At first, I wore my light pink National Health glasses with pride, but over the years, as my sight deteriorated, the bottle-thick lenses became a barrier between me and the world. They steamed up, made sport a nightmare, and never fitted comfortably (I broke several pairs trying to adjust the sides).
A kindly optician prophesied that, in my sixties, I would develop cataracts (a cloudiness in the normally clear lens of the eye). After surgery to remove them, I would receive new artificial lenses and much of my sight would be restored. It seemed like a very long wait for a seven-year-old - but then, last year, aged 59, it was finally time to investigate.
I admit I was terrified. Most patients who have cataract surgery are in their 70s and at the end of their career. I’m self-employed and being able to read is essential to my job as a writer.
But I knew I couldn’t go on pretending that my eyesight issues were a minor inconvenience. There were too many bruises and missed steps. I just wish I’d realised how utterly transformational surgery would be.
Today, when stars such as Harry Styles and Cara Delevingne choose to wear glasses to look brainy (unimaginable when we were growing up), it’s hard to explain how stressful poor vision was in the 1960s and 70s.
Back then, my sister and I were sent to see the optician Mr C, a man mountain in a pinstripe suit, who barked instructions at us as he balanced the trial lens frame on our noses. It felt like he’d come from another century.
Poor eyesight tends to run in families. My maternal grandmother had an operation for glaucoma in her 40s, which aged her overnight. Both my parents wore glasses (my mum for reading). I was born with high myopia (short sight), astigmatism and an invisible squint (only spotted by an ophthalmic surgeon in my 40s, who said: ‘That could have been corrected with patching in childhood’).
'A seed of torture'
Consequently, I was shy and poorly co-ordinated (my clumsiness drove my father mad), avoiding camping trips and outdoor sports. My teenage eye journey was a triumph of hope over experience. I saw the film, Love Story, and fell in love with Ali MacGraw’s horn-rimmed specs. But when my dark brown National Health frames arrived, they were a disaster. My German pen friend thought I looked like the devil (bless her, she still came to visit!).
Today, looking at the photos, you can see her point. Because the camera flash distorted my pupils, I had to draw in my ‘eyes’ with biro. They say men don't make passes at girls who wear glasses. That was certainly true for me.
My only hope was to get hold of a pair of contact lenses (invented in 1928 but only commercially available from the 1970s). But they were expensive and fragile - well beyond my teacher-parents’ budget.
Finally, when I was 18, and my prescription had ‘settled’, my parents relented. Mr C prescribed hard lenses. It was like having a seed of torture implanted in your eye. But I persevered, desperate to look ‘pretty’.
Eventually, after both lenses blew out on a cross-channel ferry, Mr C sighed and prescribed soft lenses (why hadn’t he mentioned them before?). It was revolutionary.
Suddenly I could see to apply make-up for parties and meet people face-to-face.
The trouble is my sight never did settle. My prescription kept changing, and the tests were punishing. I loathed the air puff test for glaucoma where a machine blows into your eye, making you rise up like a startled horse. Ditto the visual field test where you focus one eye into a dark box and signal when a light is seen off to the side (a device run by Stasi-like operatives).
By my thirties, I was pretty much blind first thing in the morning, which made staying the night with partners tricky. I’d grab my glasses and bolt for the bathroom.
In my 40s I was prescribed multifocal contact lenses for astigmatism (I was minus 13 in my right eye and minus 12 in the left, so I wore different-strength lenses to read). In the evening I’d gratefully switch to glasses, but gave up trying to cross roads in specs (my all-round sight was too poor).
I grew to hate my mirror image. The optician would ‘over-correct’ my sight but with such strong lenses that every physical flaw was magnified. It was like a form of body dysmorphia.
It also cost a fortune - £60 a month for disposable contact lenses; £800 for prescription glasses (and I could never wear stylish frames with my milk-bottle lenses).
By my 50s, I was bruised from bumping into furniture. Walking down stairs, I couldn’t see the bottom tread. Negotiating the dark, I had no depth of field. I was ageing fast - and badly.
Disaster strikes
I spent weeks trying different brands and, eventually, asked my GP to refer me to a London hospital (funnily enough, commercial opticians never mentioned cataract surgery; maybe because I was paying them hundreds of pounds for lenses).
But when I arrived at St Thomas’ Ophthalmology Department (one of the leading research centres for cataracts in the UK), life soon improved. After a battery of tests, I was told I had bilateral cataracts and was eligible for free surgery. They recommended waiting because of the risk of retinal detachment from high myopia, a 1 in 500 chance of a severe complication after surgery, so it’s best to hang on until the cataracts are ruining your daily life.
Like many people with cataracts, I had no symptoms. For three years, during visits to the hospital, my eyes were monitored. I had slightly high pressure (when people are short-sighted it can predispose them to glaucoma). I was also sent to the strabismus (crossed eyes) clinic to check that my squint wouldn't return after surgery.
The lovely orthoptist asked questions that made me tearful - did I trance out a bit at the end of the evening? Did people say I had problems meeting their eyes? Did I occasionally see double when tired? Yes, yes, and yes. I realised how much my invisible squint had affected my life.
Eventually, after detailed discussion of my lifestyle, work and personality, my brilliant Consultant Ophthalmic Surgeon at Guy’s and St Thomas’, Dr Sancy Low, advised me to have the operation or I might fall off the waiting list (anything from 10 weeks to two years due to the Covid pandemic).
So in November 2021, age 59, I had surgery on my right eye under local anaesthetic. I won’t lie, it was slightly frightening having surgery to remove my cloudy lens and implant an artificial lens - and not painful, just uncomfortable.
But as I walked out of surgery (it took about half an hour) with my transparent eye shield, miraculously I could already read signs. Even the strict regime of eye drops and a six-week Pilates moratorium was bearable.
Thanks to Covid, I had to wait five months to have my left eye done. I couldn’t wear glasses and relied on a single contact lens. After my second surgery I was discharged to a Minor Eye Conditions (MECS) optometrist who provided prescription glasses for reading small print. Today I have pretty much perfect all-round sight. The squint never became visible. I can’t stress how patient-centred the process was. ‘We took everything into context to give you the best and safest vision outcome,’ says Dr Low.
And my mirror image now looks, well, just like a face. Not a mass of faults. No wonder eye surgeons love their jobs - they transform people’s lives. Dr Low sees patients blossom, lose weight. ‘Vision, balance, confidence, all those things make a huge difference.’
'Psychologically triggered'
According to a University College London study released this year, there’s been a sharp rise in short-sightedness in people born in the 1960s because of more years spent in education poring over books and doing jobs that involve reading indoors.
I feel sad that my short-sighted generation were treated so badly. Visiting In Plain Sight, a fascinating exhibition about eyesight, at London’s Wellcome Collection (until 12 Feb 2023; wellcomecollection.org), I felt psychologically triggered when I saw the dreaded Snellen eye test of my childhood.
The good news is that optometry has improved so much for patients. Young people won’t be made to feel ashamed or called ‘Speccie Four-eyes’, like we were (less than half of the UK population have 20/20 vision and 69% need corrective eyewear, according to the NHS).
I realise just how much poor vision held me back. Not just in terms of the way I look, but my clumsiness and difficulty negotiating crowds (my poor brain is still forced to override my squint).
Little wonder my eyesight ‘heroes’ are novelist Richard Osman (who has nystagmus, an eye condition that dramatically reduces his vision) and Vogue editor Edward Enniful (who has endured poor vision most of his life and had numerous operations). Both have achieved so much, despite the challenges.
I’m all too aware of the politics of eye care (it depends on where you live and who funds it). But I feel I’ve broken a taboo, by telling friends and my partner about my sight issues (cataract surgery is definitely not considered sexy).
And today I am part of a ‘cataract club’ of cool 50-plus women who can genuinely say it changed their lives. When we meet, we marvel that we can read the menu, or the departures board. One friend who paid £8,000 to have private surgery estimates she wasted thousands on lost glasses.
I’d recommend cataract surgery to anyone - or at least recommend you investigate the options. Never mind Botox and fillers, it’s the best anti-ageing trick of my life!
How cataract surgery works
In most people, cataracts start developing around the age of 60, although there are often no symptoms and patients in the UK are, on average, 70 by the time they have surgery. The procedure is straightforward and takes 30 to 45 minutes.
The surgeon makes a small cut at the edge of the eye, to remove the cloudy lens and replace it with a clear plastic one, which lasts for life. For 95% of people this is done with local anaesthesia only.
With the NHS, you’ll be offered monofocal lenses, which have a single point of focus. This means the lens will be fixed for either near or distance vision. Most people still need reading glasses after surgery. In some patients it is possible to opt for one eye fixed for distance, and the second eye at arm’s length (monovision), so that the two eyes work together to correct your vision, reducing the need for glasses, but not everyone is suitable.
If you have cataracts in both eyes, surgery is generally done one eye at a time, 6 to 12 weeks apart, to allow recovery. Some centres offer cataract surgery in both eyes on the same day, but this is only suitable for about 20% of patients.
Risks include blurred vision, some loss of vision and detached retina, but these are rare, at around 1 in 100 cases. There is a very small risk of 1 in 1,000 of permanent sight loss, usually due to a severe infection or a devastating bleed. (You can help prevent infections by doing regular hot compresses to your eyes with a cotton pad soaked in boiled water.)
The surgery is generally offered on the NHS if your vision problems are affecting your quality of life. Your GP or optometrist can make a referral.
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