Which Costs More, Health Care or Blindness?

Hint: People With Vision Loss Never Miss This Question

Have you ever complained about the rising cost of health care?  Be honest.  If you’re living the visual lifestyle you’ve already had your physical, and addressed any problems it might have uncovered.  And you should already have had a thorough eye exam by an eye doctor you trust.  After these you probably had some work to do on your dietary, exercise, and visual habits.  So after the bills from your doctors roll in, you’re supposed to pony up for a gym membership, switch to whole food, and purchase personalized eyewear, right?  I get it: if the cost of healthcare in this country hasn’t gotten bad enough, prevention-minded doctors are suggesting lifestyle changes that aren’t cheap.  But before you lose perspective, consider the cost of the alternative.



Macular degeneration can cause severe distortion and vision loss


Two Different Perspectives

Yesterday I saw two patients with macular degeneration who had very different outlooks.  The first patient, Mrs. Green*, had relatively good vision.  It had been nearly a year since I had seen her, because she had canceled her previous testing appointments.  When I asked why, she said she canceled the visits because she didn’t want to pay her co-pay.  It was $40.

Mrs. Green went on to tell me that although she takes a multivitamin for her macular degeneration, she hasn’t bothered to stop smoking (smokers are 50% more likely to develop severe macular degeneration, and she knows this).  Nor has she changed her lifestyle to include a healthy diet rich in colorful fruits and vegetables.  She cited cost as the reason again, saying, “eating fruits and vegetables is just too expensive.”

It Pays to Be Healthy

Now allow me to be blunt.  No matter what you might spend on eye and health care, vision loss is more expensive.  I did not ask how much money per month she spends on cigarettes, but I know that a pack a day habit can cost over $2,500 a year.  I explained to Mrs. Green that if she would stop smoking she would dramatically improve both her finances and her health.  I do not say that lightly.  I understand that smokers find that quitting  is exceedingly difficult.  But so is living with vision loss.

Just ask the very next patient I saw.  Mrs. Smith* has severe macular degeneration and has lost most of her central vision.  She is totally dependent on others for her well-being.  She sees me often, and she regularly sees a retinal specialist who administers injections into her eye to preserve what vision she has left.  Most of her day involves trying to function in spite of her vision loss.  She can’t see to:

  • Drive
  • Watch TV
  • Read
  • Cook
  • Navigate her home

Mrs. Smith told me, “I will do anything to see just a little bit better.”  It was an unqualified statement, no strings attached.  She didn’t put a cap on the expense she was willing to undergo, because she is desperate to see better.  Sadly, there isn’t much I can do at this point but encourage her to continue her treatments, vitamin therapy, diet changes, and customized eyewear for magnification.  She didn’t mind.  She was happy to have any help at all.

Do you see the difference between the perspectives of Mrs. Green and Mrs. Smith?  Mrs. Green hasn’t been in Mrs. Smith’s shoes yet.  But she will be if she doesn’t look past the expenses of both health care and self care to see their value.  I have told her as much, several times.

And now I am telling you: place a high value on your health and vision.  Get and stay healthy.  Enduring personal health and a lifetime of clear vision are worth every penny.

And if you smoke, do whatever you can to stop.  Make a deal with yourself, replace old habits with new ones, or get help.  You will thank yourself years from now if you do.  And stay tuned for my next post, where I’ll introduce you to Marlene, someone who regrets ever taking that first puff.

Question:  Do you value your health and vision?  What steps have you taken to protect both?

*Names changed for anonymity

If You Were Losing Your Vision, What Would You Want to See First?

Check Your Answers and Ask Yourself, “Why Wait?”

Imagine this: you’ve just been told you are losing your vision, and you’d better see what you want to see right now, before it’s too late.  Where would you start?  Architectural wonders?  The beauty of nature?  Exquisite art?  Friends and family?  As a doctor of optometry for nearly two decades, I have met many people in just such a situation.  After the experiences I have shared with patients, my question is, “Why wait?”


Blurry Vision

If you were losing your vision, what sights would you want to see?


Roseanne Barr: I Just Try to Enjoy Vision as Much as Possible

In my last post I wrote about Roseanne Barr’s revelation that she is losing her sight to both macular degeneration and glaucoma.  Although I am disappointed in her treatment of choice, I was impressed by some other things she said.  The Daily Beast quoted her as saying, “I read a lot, and then I thought, ‘Well, I guess I could hire somebody to read for me and read to me.’ But I like words and I like looking. You do what you have to do. I just try and enjoy vision as much as possible—y’know, living it up.”

So How Do You “Live it Up” Visually?

I know this concept is hard to understand, because I have asked this question of myself (if not in those exact words).  My query was prompted by Mrs. Jones*, an older patient I met at the beginning of my career.  She was an elderly lady with a sweet and gentle disposition.  I liked talking with her because I got the sense she had lived a life of rich experiences, and had much to offer.  I was surprised when she took a particular liking to a file cabinet in my office, of all things.

I bought the old cabinet at a government surplus sale, so it was by no means a work of art.  I wouldn’t even have called it pretty.  But I needed a file cabinet and it fit the bill.  I spray painted it to match the office and that was that.  Or so I thought.

When Mrs. Jones saw the cabinet, she was immediately drawn to it.  She even took the time to run her hand up and down the side.  “Oh my,” she said with a Southern lilt, “what a beautiful enamel.”  She was with her grandson, and she repeated to him, “Don’t you think this is a beautiful enamel?”  Neither he nor I really appreciated the beauty of the thing.

Everything about what she did surprised me.  The way she talked.  Her caress of the file cabinet.  Her insistent questions about how I had accomplished such a beautiful paint job.  Even the amount of time she spent talking about it puzzled me.

And that’s where her grandson and I were both missing the boat: we hadn’t learned to practice (yes, practice) appreciation.  But she had both learned and practiced this art.  So she derived joy from something as pedestrian (in my mind) as an old file cabinet that I spray painted with questionable technique.

After she left, I looked at the cabinet more closely.  And wouldn’t you know it, she was right.  Once I took the time to really look at the color and texture of the thing, it really did look pretty nice.  I had chosen a glossy paint, and it had a bit of a shine to it.  I ran my hand over the paint job the way she had (I confess: after I made sure no one was looking).  It was satisfying, allowing the senses of sight and touch to coordinate with each other and to validate one another.

Visual Appreciation Shouldn’t Wait Until You Are Losing Your Sight

I believe we are the sum of our experiences both good and bad and for better or worse.  So I can’t say that day transformed my life.  But I remember it clearly two decades later, and that’s saying something.  That day, Mrs. Jones taught me something about appreciation.  If you know the fundamentals of living the visual lifestyle, you know that appreciation is one of the secondary pillars upon which the visual lifestyle rests.  This is because without visual appreciation, it can be easy to allow the major pillars (eye health and safety, bodily health) to fall from your priority list.  And when they do, you risk allowing habits and living a lifestyle that does not support (or even harms) your eyes, your vision, and your body.

I do not know Roseanne Barr, nor do I know the particulars of her case.  But I do know this: she said she is losing her vision.  She likes words, she likes looking, and she is trying to enjoy vision as much as possible.  Why not make visual appreciation a part of your life now, as a component of living the visual lifestyle?  As you learn to see and appreciate, you will grow in your understanding of how precious your vision really is, and you’ll be prompted to change habits, make a difference in your life, and protect your vision for the future.

Question: If you discovered you were losing your sight, what one thing would you want to see before that happened?  What’s keeping you from seeing it now?

*Name changed for anonymity

Roseanne Barr Reveals She Is Losing Her Eyesight

But She Highlights Questionable Treatment

In an interview earlier this week with The Daily Beast, Roseanne Barr revealed that she is losing her vision to both macular degeneration and glaucoma.  In the interview, she hails marijuana as good medicine, specifically for her sight: “I have macular degeneration and glaucoma, so it’s good for me for that because I have pressure in my eyes. It’s a good medicine for a lot of things.”

Guide Dog Sign

She said her eye diseases will eventually cause blindness.  When asked whether her doctors can give her a time frame for that, she replied, “No, they can’t. My vision is closing in now.” She continues, “It’s something weird. But there are other weird things. That one’s harsh, ’cause I read a lot, and then I thought, ‘Well, I guess I could hire somebody to read for me and read to me.’ But I like words and I like looking. You do what you have to do. I just try and enjoy vision as much as possible—y’know, living it up. My dad had it, too.”

Although the subject of her vision was just a small part of a larger interview, it still needs clarifying.  I realize Roseanne’s career is based on telling jokes and making fun, but she missed a golden opportunity to not only educate people about these serious eye diseases but also offer some encouragement.

I have been treating patients with macular degeneration and glaucoma for decades.  There are also a significant number of patients who are unfortunate enough to have both diseases.  So Roseanne Barr isn’t alone.  Plus, many other people share her fear of going blind.  I get asked often about blindness and eye diseases, and when I do it’s a wonderful opportunity to educate patients and provide them some peace of mind.  So I’d like to share some thoughts that may help you or any loved ones who either have eye diseases or want to protect themselves from them.

Marijuana Is Not A Sustainable Treatment For Eye Diseases

Marijuana is not good medicine for the eyes.  Numerous studies have proven that and there are many reputable institutions verifying it (the American Glaucoma Society is one of many, and you can read their statement on the subject here).  Most studies and institutions dispute the practical use of marijuana for the eyes because it must be smoked every 3-4 hours around the clock for maximum effectiveness.  Obviously, this regimen is unsustainable due to the physical and psychological effects of constant use.

Your Eye Doctor Can Help

Unfortunately, Roseanne’s statement about her doctors paints them in a poor light, as too inept to offer her either treatment (beyond weed) or professional advice.  But this is Roseanne Barr we’re talking about here; I’m certain her eye doctors are qualified individuals, whomever they may be.  I’m hoping that most doctors (Roseanne’s included) don’t respond with a flat “no” when asked whether anything can be done or whether they know the timeline of a disease.

I encourage most of my patients that not only should they not go blind due to a disease, but it may be possible to preserve vision well enough that they don’t even notice they have it.  This is more true for glaucoma than macular degeneration, and there are certainly cases where these diseases and others win out.  But no matter the disease, preserving vision requires great effort on the part of the patient.  Not only do they need to maintain all exam and testing visits, but also they must make lifestyle changes that protect and enhance the health and functions of the eyes.  Think of your eye doctor as a trusted advisor who can teach you how to manage your eye conditions, and not as a magician who can wave a wand (or prescribe marijuana) to save your sight.

An Automatic Sentence Of Blindness?

Another thing Roseanne failed to do is encourage those who also are struggling with macular degeneration or glaucoma.  She seems pretty resigned to losing her vision.  So if you already have an eye disease or two, take heart.  It may not be as bad as you think.  But also take note: you have work to do.  Your eyes and your health are your business, and it’s up to you to seek and maintain a relationship with a trusted eye care provider that will guide you through the process and help you preserve your sight and your visual lifestyle.

Stay Tuned

Surprisingly, there are a number of good lessons to be learned in Roseanne’s few thoughts about her failing vision.  I’ll highlight more of them in an upcoming post.

Question: Do you or someone you know have an eye disease or two? What treatments are being used to help?