She was 28 years old, pretty and polished. As she walked elegantly into the room, I observed she wore a pair of fashionable glasses with gold rim. Trailing behind her was a good looking gentleman, a few years older who looked much like her.
“Doctor meet David, my fiancé,” she said, introducing him to me. I was taken aback. I thought I didn’t hear her properly so I asked, “Do you mean your brother?” She burst out laughing and said, “That was exactly the same thing dad and mum said when I took him home the first time.
“Anna, what’s up? I asked. “Shall we sit in the corridor and talk?” she requested. I have been Anna’s physician since she was five years old. She had had severe itching in both eyes off and on. She was, therefore, a frequent visitor to my office. Her father and my mum were distant relations, but I hardly saw other members of the family.
This time, she had come to see me at home and I was wondering if the discussions would be medical or social. We went to the balcony and sat down. “David, take off your glasses?” she ordered. Now my attention shifted to David’s glasses. In distinct contrast to Anna’s psychedelic frame, David’s was ugly, common place black plastic with very thick lenses which made his eyes look like big saucers.
As he removed them, David said ruefully, “I hate these damned glasses! I have worn them since I was four and this is my twenty-fourth pair! I am as blind as a bat if I take them off. I couldn’t do what other children of my age were doing; I couldn’t take part in physical sports; I couldn’t play football or swim or even run with other children for fear that my glasses would fall off. To make matters worse, everyone called me professor. I just hate these damned glasses!”
“What do you want from me?” I asked. “I’m told that there are other things that can be done. Anna talk now!” David said. Anna took off her glasses again. She had taken them off three times in the short period we had sat on the porch to mop her eyes. A quick look during that interval was enough to show me she was uncomfortable and perhaps had dry eye syndrome.
“Doc, I had laser refractive surgery to my eyes two months ago. Now I can see very well without glasses.” This was getting more interesting. “Why then are you still wearing these glasses? I asked.
“It’s because I suffer from severe glare and dryness of the eyes. Would you advise that David should follow me to London to have refractive surgery too?” she asked visibly worried. Anna had a small refractive error when last I saw her about five years earlier.
“Anna, I cannot answer this question because I haven’t examined David’s eyes to confirm the type and severity of David’s refractive error. Although from the look of his glasses I can make a fairly accurate guess.
“Secondly, I am not an expert in that field. Finally, I am very conservative and cautious about accepting new technology such as refractive surgery in people who can conveniently have non- invasive interventions such as glasses and contact lenses.” I wanted to ask her how satisfied she was with her new state. I decided against it. I already knew the answer.
“Please tell us then, the possible things that can be done for me. We are going to get married very soon and nothing will make me walk up to the altar with these damn glasses,” he said.
Without a comprehensive examination, I could only talk generally. “There are various alternatives to the use of glasses. The suitability of a patient for any of the procedures will be determined only after a thorough ocular and medical history and examination. I have already mentioned the use of contacts.
“An artificial intraocular lens can be placed inside the eye in front of the existing natural lens or the existing natural lens can be removed and replaced with the appropriate intraocular lens.”
Trying to avoid going into the frustrations of Anna which I could read on her face, I concluded, “Your fiancée can tell you all you need to know about the surgical remodelling of the cornea using laser because having had one such surgery, she is an expert in that field.”
and then