Focus group

23rd February 2001 at 00:00
As a child (below) and for all his adult life, Gerald Haigh has worn glasses. But for younger people the arrival of laser surgery could mean that spectacles will one day disappear from view.

I clearly remember the first time I wore spectacles. I was seven, and I was looking out of the window of my mother's kitchen gazing at the houses at the top of the hill, when the fog miraculously lifted. It was the end to an agonising period of trying to find out from my increasingly impatient classmates in a silent Forties classroom what was written on the blackboard. I was now, officially, "Specky Four Eyes", the only bespectacled child - I have the photograph to prove it - in a little church school of 70. (I'm also the only one in the picture wearing a tie, but that's my aspirational mother for you.) Short sight - myopia - is a simple mismatch between the focusing action of the lens of the eye and the position of the retina, upon which the image is projected. Think of a film or slide projector showing a badly focused image on the screen.

The obvious solution for hundreds of years has been to give the eye's natural lens some help by putting a glass lens in front of it. For short sight you need a concave lens that diverges the light so the eye's lens focuses it further back, right on the retina.

For me, an only child whose companions were mostly to be found in fiction, spectacles were no more than a mild inconvenience. I was never interested in ball games, and the nickname didn't bother me much - when it resurfaced recently in a road rage incident, I felt quite nostalgic.

Swimming is the biggest problem. I couldn't take my daughters to the pool when they were little because I couldn't keep track of them in the water.

All through adult life I coped with spectacles because there was, then, no practical alternative. I remember just two emotional moments. One was when, aged 14, I had to face the fact that I never was going to achieve my dream of becoming an RAF pilot. The other was about three years later when a girl said to me: "You've got lovely eyes - it's a pity you have to wear glasses."

As time went on, I more or less forgot that I was a spectacle wearer. They're by the bed, last thing off, first thing on, and I confess to feeling absurdly superior to people who fuss about with their specs, taking them on and off, losing and forgetting them. "They're amateurs," I think. "I'm premier league."

But myopia can come with side-effects, and in 1968 I spent a day absent-mindedly brushing a hanging spider from the corner of my glasses until I realised it wasn't there. Within days I was in hospital having treatment on holes in my retina to prevent an imminent detachment.

There were no lasers in British ophtalmology then, and the treatment consisted of burning the retina with very bright non-laser light to seal the holes, followed by 10 days of lying flat on my hospital bed. Twenty years later I had a recurrence, but by then lasers had arrived and I was treated as an outpatient.

To this day, as the result of all that, I remain conscious of the fragility of the gift of sight.

All that we see of the world, after all, comes in through those small holes on the front of the eyeball and is focused as a beautiful and tiny inverted colour image on the retina - itself an insubstantial structure, like a thin layer of rice paper adhering pretty insecurely to the underlying tissue. Each morning, I marvel that I can still see clearly.

That I have to wear glasses to achieve this is a small price to pay. Younger people, though, have choices, and don't have to accept a spectacle-wearing future. Friday columnist and English teacher Gemma Warren, now 26 and severely myopic, never did get used to hers.

They were thick, heavy, and a barrier to most kinds of activity - she, too, found that swimming loses most of its attraction when you can't find the people you came in with.

"I hated glasses," she says. "When I was growing up it was a nightmare."

When Gemma was 13, she began to wear contact lenses, but they were never satisfactory. "Because they were so thick, they kept falling out. I also wore them too much - up to 17 hours a day." Ten years ago, her optician suggested that there would come a time when the new sight-correcting technique of cutting away some of the cornea with a laser would turn out to be the answer. She waited until last summer.

"It's a scary procedure," she says. "You're in an operating theatre, but wide awake. I was pretty shaky for a couple of days, and I wouldn't recommend it lightly." For her, though, it was life-changing, "a miracle".

Some people who have the procedure still need to wear glasses - though of much reduced power. "The results depend on how the patient heals - and there's no way of knowing that beforehand," says consultant ophthalmologist Keith Williams. Gemma Warren, in fact, was lucky. From being high myopic, she now has no need for glasses for her short sight. "I'm actually slightly long-sighted now and I need reading glasses," she says.

Keith Williams, a highly experienced surgeon in this field, believes refractive surgery will quickly reduce the number of people who wear glasses. "It's happening already," he says. "We can now treat most levels of short-sightedness, long-sightedness and astigmatism (a defect of the lens resulting in the formation of distorted images). They can see straight away and they are all very enthusiastic - it changes their lives."

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