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I Can See Clearly Now (with Significant Correctional Assistance)


I’ve made a bit of a habit out of discussing my medical adventures on this blog. Maybe it’s a little weird, but I also find it kind of cathartic—and I think it’s a good thing for people to be able to see the human side of Penn Medicine employees. We get sick or hurt, too, and hopefully sharing our experiences within the health system helps others see it in a different light. With that in mind, I figured I’d share my experience at Penn Presbyterian Medical Center’s Scheie Eye Institute:

My vision was going downhill for a long, long time before anybody ever thought to get me to an eye doctor. It took all the way until middle school.

That might make my parents sound a little negligent, but the truth is I never really complained about not being able to see more than three or four feet in front of me, in part because I didn’t notice. The change occurred gradually. It wasn’t like in Spider-Man, when Peter Parker wakes up the morning after getting bitten by a radioactive spider and suddenly his vision is better than perfect; it was a very slow decline, and the only outward sign was my growing inability to hit a baseball (or play outfield). It’s gotta be pretty easy for a parent to miss that. Surely, he’s not going blind and just failing to tell us, I can picture my mom thinking. Surely it’s just that our short, chubby child is not very good at sports.

Putting on my glasses for the first time was a revelation. Trees had individual leaves again. Signs in the distance weren’t just square blobs anymore. And stars! The number of stars blew my mind. I thought there were only, like, four. Ever since that day, I’ve actually enjoyed going to the eye doctor.

Which means I didn’t really have any excuse for not going from 2010 to the end of this past July.

The Scheie Eye Institute at Penn Presbyterian is a busy facility. After having to make my appointment a month in advance, I was ready for just about anything. I was not, however, ready for the welcome desk to give me something I'd never received at a medical office before: a buzzer. The kind you get when you go to, say, a really busy Applebee's.

I stared at it for a second or two, wondering whether I should ask if there was any seating available at the bar. It was only after I actually got to the waiting room that I realized how much sense the buzzer made.

Scheie is big. Really big. The waiting room is a massive rotunda of sorts, with seating that snakes throughout. Check-in desks and hallway entrances leading to clinical space are distributed around the room, and because of the space and sheer number of people waiting at any given time, it can be easy to miss when your name is called. Hence the buzzer. Fair enough.

It was maybe ten or fifteen minutes before someone at a check-in desk called my name. I was a little disappointed they didn't use the buzzer, but there were more important things going on. Checking in took only a few minutes, and involved making sure I was who I said I was. I was.

"You're going to be seeing Dr. Cesarano, just inside that hallway right there," the lady at the desk told me, pointing toward one of the entryways, labeled by letters. "Take a seat and she should be with you shortly."

"Should I give this back to you?" I asked, holding up the buzzer. Rob Press asks the important questions.

"No," she said with a smile, "you're going to hold onto that."

After another fifteen minutes or so, I was paying absolutely no attention to anything other than my phone when the buzzer went off, startling me. Again, just like you'd expect of these things, it lit up and vibrated.

Dr. Cesarano greeted me at the entryway, and led me back to the exam room.

I sat in the exam chair, and the doctor asked me about my eye care history, which turned into little more than me listing a small parade of ways in which I've been horribly negligent to the two things I depend on for taking in the entirety of the world around me: Last eye exam? Six years ago. Change your contacts when you're supposed to? Try to, sometimes. Any eye trouble in the past? Major, nearly blinding infection—due to misuse of contact lenses—back in 2008. Sense of irony? Intact, thank you.

After a brief, friendly-yet-stern discussion of why it's important to change your contacts when they're supposed to be changed—a conversational genre physicians keep at the ready, since nobody's flossing as much as they should or eating as well as they should—we moved on with the examination itself.

I love the technology behind eye examinations, but I understand next to none of it. Dr. Cesarano moved implements in front of my face and told me to look in various directions, all while using a series of lights and lenses to look at my eyeballs. No doubt each part of it has its purpose, but I'm clueless as to what those individual purposes are or what metrics they use to determine my ocular deficiencies. In the end, I suppose it doesn't matter: I'll get to see better, whether or not I understand exactly how. I just wish I could speak more to the science of it, instead of treating it like it hails from the land of wind and ghosts.

It was after that first series of examinations that things took a bit of a turn. Dr. Cesarano, to complete the exam, needed to dilate my pupils. If you're familiar with eye exams, you probably know this is absolutely nothing new.

I considered myself familiar with eye exams. I'd never had my eyes dilated before.

The doctor placed the drops in my eyes and said it'd be about fifteen minutes before the exam could continue.

“You can go look at frames, if you like,” she said, and off I went, completely oblivious as to what would follow.

If you've had your eyes dilated before, you already know that it creates a rapid drop in your ability to, y'know, see things. You also know that this is temporary. I knew neither of these things. I spent the first few minutes of my frame browsing squinting progressively harder, wondering if maybe I'd put my contacts back in incorrectly.

After a few minutes I was standing in the corner, frantically holding paperwork at varying distances in front of me and trying to bring it into any sort of focus. I couldn't bring myself to look at frames, partially because I couldn't see them and partially because I didn't know if I was having some sort of horrible reaction to the drops and my eyeballs were getting ready to pop out, howling cartoon wolf style.

To my credit, it was a very quiet type of panic. The gentleman who approached me to ask me if I'd chosen my frames apparently had no suspicion I was such a nervous wreck until he said hello and I said, “um, I'm a little concerned about my eyesight right now” in about thirty different ways. All at once. Sometimes backwards.

He stared at me, perplexed, and then very calmly asked, “Have you...have you never had your eyes dilated before?”

I hit the pause button on my verbal nonsense. “No,” I said, hurriedly. “Is this, like, supposed to happen?”

The gentleman was still laughing at my visible relief when Dr. Cesarano swung by and, like a parent apologizing for the jar their toddler just broke in the grocery store, patiently led me back to the exam room to finish things up.

Once I understood what was going on, everything else went smoothly. My eyes, it turned out, were almost exactly the same as they'd been six years ago. My right eye had gotten very slightly worse, but that was it. Dr. Cesarano sent me on my way, and I went back to the gentleman from before so I could finalize the purchase of my glasses.

“Feeling a bit better?” he said with a chuckle.

“Very much so,” I said, and apologized for my silliness.

IMG_1429He guided me through the rest of the process. I picked out a set of frames, despite my dilated pupils, and was sent out the door with an absolutely awesome little pair of disposable shades. They looked like something from the future: They came in a tiny cylinder, and would wrap themselves around your face. They were also completely necessary, since—and again, this is something you're probably well aware of if you're not a clueless adult like myself—dilated pupils make sunlight an absolute nightmare. That didn't stop me from taking them off for a few seconds on the walk from the office, because I grew up watching Johnny Knoxville and just don't know any better. The shades went back on very, very quickly.

(A brief aside on why your eyes need to get dilated in the first place: You know how people say the eyes are the window to the soul? Scientifically speaking, I don't think that's accurate—but pupil dilation is extremely helpful because it enables the eye doctor to see more clearly into the actual goings-on of your eyeballs. They need to know what's going on all the way in the back of the eye, and that sort of thing requires the pupil to be nice and open. Hence: dilation. When Dr. Cesarano shined the light at a certain angle into my eyeball I could actually see some of the eye's vascularity, and it was basically The Coolest Thing.)

As far as the actual visit with the eye doctor goes, that's pretty much it. Pleasant and uneventful, with the exception of my unnecessary mini-panic. There is a bit of a punchline, though:

When I went to pick up my new frames a week later, I wasn't expecting any surprises. I had, after all, tried them on—and while my vision was severely hindered by the dilation, I had no reason to think there'd be anything amiss. They're just glasses.

So imagine my surprise when I got my new glasses and saw that what I thought was the nifty white-on-black pattern on the inside of the frames was actually John Cena's to-do list:


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