The PHurrowed Brow

A valuable drug helps me regain 20-20 vision. A podcast of a radio program reveals that this compound has almost extinguished a critical species of birds because of its overuse in large-animal veterinary medicine. Finally, I see that millions of people in the U.S. benefit from that same medicine in an over-the-counter topical gel. The drug is a thread entwined with several others in strands that stretch from Denver virtually to Delhi, then in real life to the Caribbean and back.

This post is one in a series stretching from Dec. 3rd forward to the 24th.
If the post seems to lack context, I’d encourage you for continuity’s
sake to go back and read earlier ones in order of publication.

I. Eye surgery

Cataracts hit me earlier in life than they do most people. In 2018, I underwent lens replacement for the cataract in my right eye. The clouding of the natural lens had considerably obscured that eye’s vision in ways that glasses or contacts could not adequately correct. Yes, I could wear ever stronger glasses with progressive lenses for close vision, i.e., to read, do computer work, and engage in all the eye-intensive tasks that come with teaching (my profession at the time).

But on the trails, and on my motorcycle, in the fields of Kansas (as I came to take on more farm tasks), there was nothing that an external apparatus could do. In ordinary light, the opacities in my natural lens blurred just about everything. In bright sunlight, the opacities created glare that overwhelmed and distorted what I might otherwise have seen through the unobstructed portions of the lens. Sunglasses helped reduce the glare. But sunglasses don’t help after sunset. In the dark, the glare comes intermittently but with greater intensity and with greater potential for disaster. The headlights of oncoming vehicles and bright roadside lamps diffuse and distort, while all background is obscured by ambient darkness. (Nope, no Sunglasses At Night for me, even if they work for Corey Hart. I was more like Manfred Mann, Blinded by the Light.)

Even in daylight, the varying sorts of vision needed for an adventuresome life outdoors become near impossible. Consider what happens when one is engaged in rapid shifts from distance vision to close-up. In close succession, bring the motorcycle to a safe stop in order to verify a street name or a trail number on the GPS, to check a gauge, or to read the number from which a text was sent to see if it’s necessary to reply right away; next de-glove; lift the helmet visor and remove sunglasses; don’t drop them; extract and put on reading glasses, do what you stopped to do; reverse all that before you get going again. It’s no fun, but that’s how I rolled until my first cataract surgery. After the treatment, it was easy and breezy to do the essentials without laborious stops.

Four years later, the cataract in my left eye had progressed to the point where I was back in hassle mode. I had had my right eye’s artificial lens set for distance (and it worked beautifully), but the cataract in my right was starkly affecting my long-range vision. Had I still been in the teaching profession, not such a biggie. The fields I help manage in Kansas, however, run 1/2 mile on an edge, which meant that my diminished capacities were a considerable hindrance to portions of that work. In 2022, winter approached and saw me ready for a second surgery.

I requested that the left lens be set for middle distance. It would be supportive to my right eye, but also suitable for reading most font sizes and enabling other closer vision. The surgery went very well, and recovery was smooth enough, if long. A part of my post-operative regime involved frequent application of three different drugs in eyedrop form. I was able to cease using two of them after a week. One required application t.i.d. (ter in diē, three times a day–there’s your daily Latin lesson) for 28 days. Consequent with that prolonged use, the name of this drug stuck with me.

Before long I was planning my next motorcycle adventure, which was slated a few months later in Puerto Rico. Happily, I would make it with 20-20 distance vision, and with near vision good enough that I did not nead reading glasses for any of the mid-trip ancillary tasks that make a great ride possible. For all that, it turned out that I had other hassles on the trip, though they were all of my making. These led me to make many stops at pharmacies where boxes and boxes of the drug from my long eyedrop regimen were on sale. The boxes contained the drug in gel form for topical use. (I don’t know why they first caught my eye in P.R., for the gel was and is available throughout the continental U.S., too.) But by then I had learned of the devastation that overuse of the drug had caused in India, and was caught by the paradox: the compound that allowed me to see and be in the world so with much greater ease and enjoyment had the effect of altering that world for the worse. It would be worse still, though, to be unaware of such cost-benefit paradoxes, or to wilfully ignore them. More on that tomorrow.

Look for part II of this story tomorrow! You’ll find out what drug helped me, but has also played a part in massive environmental damage by its overuse.

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