Multifocals and the wisdom of Inside Out

by Brian on August 21, 2015

in A Parent in Israel,Health

20100105_MultifocalGlass“Let me take care of him. He’s very sensitive,” my optometrist Nadine whispered to her coworker in Hebrew behind the counter as she brought out my new glasses.

“I heard that!” I snapped back, indicating that, while my Hebrew is famously fragile, I had command of enough basics to know when I was being insulted.

Except that in my case, it was true. I am super sensitive, in all kinds of things, but especially when it comes to new glasses. And this was not going to be an easy change.

I’ve gotten to that point in the narrative arc of my eyesight’s life story where multifocals are my best option for maintaining acceptable vision in the greatest variety of situations. Multifocals – also called progressive lenses – are the bane of middle age sight: a brutal compromise pushed by well intentioned but nevertheless sadistic eye doctors that allows you to see both far and near with the same pair of glasses, but in a much-reduced area.

Wearing multifocals is like looking through a back fence pinhole at the coming train wreck. You see distance through the middle part of the top of the lenses; you read by looking down. But look to the sides and everything gets distorted like one of those funhouse mirrors where you’re alternately tall or fat but always befuddled. Turn your head left or right or up or down too fast and the floor gives way like a Norwegian car ferry making a sloppy landing. Dizziness is a common side effect in the beginning.

Multifocals are similar to bifocals except that, instead of dividing the lens into two discrete areas with an annoying line across the middle, the vision range in multifocals flows seamlessly from top to bottom. To reach that Faustian bargain, though, you get distortion on the sides.

The more expensive the lenses, the less the distortion. A good pair of multifocals will easily set you back more than $1,000 in Israel. The best of the best: $1,500. I have a friend in Jerusalem who orders his multifocals online from Hong Kong. He pays a fifth of what I do, but given my demonstrated sensitivity and the need to get the prescription and fitting just right, I’ve never considered that option.

Multifocals were first invented in 1907, but it wasn’t until 1953 that Bernard Maitenaz perfected them enough for commercial use. A further improvement in 1972 addressed some of the more frustrating peripheral vision limitations, though as I can attest, far from entirely.

Changes in vision at middle age happen to all of us, so if this column isn’t relevant to you now, don’t gloat…it will be. The condition is called presbyopia. It’s where the eye’s natural lens stiffens and loses the ability to focus on close objects. The term comes from the Greek presbys (old man) and ops (sight). So it literally means, “trying to see as old men do.”

I’ve worn glasses since I was about seven years old, but only for distance. When Nadine first told me I’d need a different prescription for reading, I resisted the multifocals and ordered a pair of separate reading glasses, which I wore around my neck on a chain. It was as geeky as it sounds, and I found myself constantly switching back and forth. At Friday night synagogue services, if I wanted to read from the prayer book, it was one pair of glasses. If I wanted to see what was going on at the bima, it was the other. But what would I do if I wanted to look around when we were supposed to be saying Shema – wouldn’t my choice of glasses give my mis-intentions away?

“Try these for a week or two and see if you can get used to them,” Nadine told me before sending me on my way. “If not, call me, and I’ll see what I can do.”

The brain eventually adjusts to the multifocals so that it can see clearly through the distortion areas. Or to be more accurate: the distortion is still there but it just doesn’t bother you anymore. Your brain ignores it. Smart brain. Just the same, it can take weeks – in some extreme cases even months – before everything settles down.

I knew cognitively that this was the case (Nadine and the Internet told me so). But as the days, then weeks stretched on, and the world was still woozy just the same, the voices in my head were not complying. By voices, I’m referring to the kind in the new Pixar movie Inside Out, which so wonderfully captures the dialogue between the different emotions that control us, portraying five feelings operating a cartoonified control room in a young teenager’s head.

In my case, when it came to adjusting to my new multifocals, to use the language of Inside Out, fear was taking the lead, playing the catastrophe fiddle with aplomb, while sadness was doing its best to provide back up. Sometimes I would veer into anger with occasional disgust that I had to go through this all in the first place. Joy seemed to be taking a very long powder break

“I will never get used to these new glasses,” I heard my Pixar voices pontificating. “This is a total disaster. What was I thinking? I’ll never see as well as before. I’m so stupid. What have I done to deserve this?”

Two weeks after receiving my new multifocals, my brain had not adjusted, not in the least. My peripheral vision was so limited, I found myself jerking my head around uncomfortably where I used to be able to just glance to the side. When I tried to cut vegetables for a salad, the cucumbers (and the knife) had melted into a dangerous blur. Shaving – forget about it. My new glasses were a guarantee towards a tasteful George Clooney look.

Maybe the voices running rampant in my hypothalamic control room were right?

I finally broke down and made an appointment with Nadine. “I tried to get used to them, I really have,” I said, defeated.

“Let me check them,” Nadine replied and she took the new glasses off my face and brought them over to some machine.

“Hmmm. There seems to be a mistake. The lens was cut too high. Your distance vision should be here,” she said, pointing to the middle of the lens. “But you’re only able to see from here.” She was now pointing to the very top of the glass. “So, anything to the side is even more distorted than I would expect. I’m going to have to send them back. I’ll order you a new pair.”

Two weeks later, my new pair arrived. I’ve been wearing them now for a month. The difference was immediate and profound. The distortion is still there, but this time I seem to be getting used to it. I can even cut vegetables and shave again.

Inside Out did a great job in helping me identify the emotional tug of war going on in my head. But sometimes, it seems, all you really need is the right prescription.

I first shared my fuzzy vision on multifocals in The Jerusalem Post.

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