[NAGDU] {Spam?} Cataracts, Surgery, and Having a Guide Dog -- LONG

[Jenine Stanley]

Oh Lizzy, I’m so sorry you even had those feelings that you were not really blind, etc. I pretty much grew up that way, though I was absolutely without a doubt legally blind and had 0 peripheral vision. I just didn’t see well. 

I had similar cataracts also when I was in my early teens and had them removed. I did gain some vision, for a time but another condition and another eye disease took that away by age 22. 

I was also told when I went through initial blindness rehab, locally to you btw, literally 33 years ago, that I had too much vision to get a guide dog and that I should focus on my cane. Fine but after that rehab, I went back to my home area of Ohio and never pulled that cane out again until I got to the point where I had no more reading vision and needed to move out of that area to grow as a person and have a life. It took about 3 months of using the cane in Columbus to know that I wanted a dog and I’d give it a shot. 

I would say that if your dog guides, and you feel safer working that dog, do so. Do so whenever you need to do so, and sometimes even when you don’t, to keep the skills sharp. 

I’m guessing very few people on this list would tell you that not having this surgery was selfish or that even keeping your degree of usable vision is selfish. It’s not at all and you are not faking anything. You have fallen thorugh some crack or other in whatever systems govern such things but at least you ahd the knowledge and forthought to go ahead and train the skills you need on your dog. Good for you and keep it up. 

Another aspect of surgery on these types of cataracts is secondary glaucoma risks. they significantly increase after such surgeries. This is what took my remaining vision and honestly, if I’d known, I probably would have still had the surgery but would have been much more proactive about the glaucoma and subsequent treatments. 

I say stay here, learn and share and know that if you can’t see, you are blind…and that’s OK. What more is there to say? 

> On Jul 16, 2016, at 8:43 PM, Lisie Foster via NAGDU <nagdu at nfbnet.org> wrote:
> 
> This is long. I'm sorry. I tried to make it shorter but I failed miserably. Please feel free to skip over it because it's long and probably whiny.
> 
> I know I don't post much but I really need help with figuring something out, so I hope it's OK I'm posting this to the list.
> 
> I have progressive/degenerative myopia, with only light perception vision at night and in dim light. My dog and I trained with and graduated from a service dog training program as a team a while ago. And, since I have trained working dogs before, and because I've studied guide dog training for years ( I originally wanted to become a guide dog mobility instructor, but continued studying when I was told my vision might progress to the point of legally blindness). So, I trained my dog's guide work and he's now been working beautifully for months. I can go out after dark again, and I've gained a lot of confidence and independence because of him.
> 
> My near-total loss of vision in dark conditions has always been attributed to the fact that I have a high-degree, progressive, not-fully-correctable form of myopia (it's considered an eye disease, different from simple nearsightedness, as it usually leads to other vision changes and loss, and it typically reaches a point where it can no longer be fully corrected).
> 
> Yesterday, I had my first appointment with an ophthalmologist in a different practice than my normal one; he was my second opinion because I never felt like the other doctor took me seriously. 
> 
> So, the new doctor found that, in addition to progressive/degenerative high-degree myopia, I also have two other things going on: one is something new, but minor, called "convergence...something", which can't be corrected but isn't a big deal. The second thing he found was that I've developed unusual forms of cataracts in both eyes. He said these cataracts are responsible for at least part of my near-total loss of night vision, my partial loss of color vision, the problems with severe glare, etc.
> 
> When I asked him if it was a matter of having a simple surgery (like almost everyone does at some point in their lives, at least in the U.S.), he paused, then said carefully that I wouldn't have the same outcome as most people do with cataract surgery. Most likely, I'd lose close & mid range vision to a low or mid partial level that may or may not be correctable. He doesn't know if the myopia would continue to progress; but, he said the surgery might help, at least for a while, with regard to my long distance visual acuity.
> 
> He told me having surgery would help eliminate some of the issues with glare, and would improve my night vision to an extent. He's not entirely sure that these cataracts will stay fully within the lens of the eye, because they're different from typical ones; they are a lot like cortical cataracts, but aren't age-related, (I'm in my early 30's), but they can form in or around the lens, and sometimes invade surrounding tissues. They're totally benign, thank goodness, but the dr said surgery may not be able to stop the later development of more of these in the area that would surround an artificial, implanted lens. He said my insurer wouldn't pay for surgery right now, anyway, since the cataracts need to be larger before they'd even consider it. My insurer's criteria for surgery isn't related to functioning, but by objective measurement.
> 
> Last night, I decided that since I only had cataracts, I had no reason to have my dog work as a guide anymore. I'd planned to simply stay at home at night, stop working my dog as a guide, and undergo surgery whenever that will be (it could be six months, or it could be a couple of years). I decided that, since cataracts are treatable, it was an insult to people with eye conditions that aren't treatable to ever consider letting my dog guide again, and that it would be wrong of me to stay on guide dog lists like this one.
> 
> I finally slept, after two days on two hours of sleep, and hope I'm thinking more clearly today. 
> 
> After what my doctor said, I don't even know that I want to have surgery, primarily because of the drawbacks and the likelihood that it would do as much harm as it would do good. He was clear that having surgery will destroy the vision I rely on most (near-to-mid range), which may not be able to be corrected at all.
> 
> So, do I sound like a horrible person for not jumping at the chance to wait and have cataract surgery? What if I decide not to have it? Do you think I'm almost obligated by social norms to have the surgery, no matter how it impacts my vision, and whether I want it or not?
> 
> I mean, would any of you -- people who are REAL guide dog handlers, people who have their dogs due to far more significant and much more valid reasons for vision loss than I have -- consider it selfish or wrong of me to choose against surgery under these circumstances? Would you personally be offended if I continued to allow my dog to work as a guide at night, and if I were to keep using my cane in dark/dim conditions, at least for the time being (until surgery was possible and I made a decision)? Would you think of me as abusing the system? Would I be abusing it? If I don't have the surgery, will I seem like an ungrateful idiot? 
> 
> I know that, without the surgery, I'd become legally blind both day and night sooner than I would from progressive myopia, alone. But, not having the surgery would mean I'd be able to retain a fair amount of the type of vision I use most -- close/mid-range vision, despite being legally blind. 
> (I only qualify for certain types of surgery due to the other conditions, so there is no way to get around the side-effects on my near vision). But if I allowed the cataracts to progress in order to preserve near vision, would you regard me as someone who should NOT ever be considered blind, and as someone who should NEVER be allowed to apply for a guide dog, because I didn't have the surgery?
> 
> I'm rambling. A lot. I hope maybe some of this made sense. If anyone might have any advice or thoughts here -- even if it's to say I'm a total idiot for ever thinking I had a reason to teach my dog to guide, that I had no reason to ever have had O&M training at all, or to say that I'm a complete jerk for using a cane to navigate at night before my dog was fully trained -- I'll be grateful to you. 
> 
> Having thought for years that my night vision, or lack of it, was due to one thing, it's really confusing to suddenly learn that oh, it's also probably because of something that surgery might help, but that same surgery would be done at the expense of other aspects of my vision that I value more.
> 
> Help? Please? Thank you if you made it this far! I didn't mean to re-write War and Peace on the listserv, but I just did, so I'm sorry if I broke the list in doing so. Haha!
> 
> Thank you!
> 
> 
> Lisie and her funny sweetheart of a dog (who keeps trying to get his mommy to stop typing and get his leash for a walk)
> 
> 
> Sent from my iPhone
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