I slept with a plastic shield over my eye for the first few nights after the procedure. The doctors billed it as an eyepatch, though it had neither the allure nor the convenience. Eyepatches are sleek, unobtrusive, user-friendly. This was an eye-shaped chunk of polycarbonate I affixed every night with medical tape and tore off in the morning, leaving a gluey trail of adhesive. Like a cone around the head of a freshly neutered dog, it was meant to protect me from myself: A doctor had scraped off the outermost layer of my cornea, the epithelium, which would take some time to regrow. Were I to rub my eye in my sleep, I could do serious damage, cause serious pain. The unspoken irony was that rubbing my eyes, that simple act that most commonly signifies exhaustion, was probably what got me here in the first place.
It’s called keratoconus and it’s not particularly dramatic. This is not a story of life-changing tragedy but life-changing inconvenience. Basically, as several ophthalmologists explained to me before I was able to explain it myself, it causes the corneas to thin, taking on a conical shape that distorts vision. The light from a streetlamp bleeds over the signs below it, my friends’ faces become indistinguishable in dimly lit rooms, there’s a certain level of dusk where everything — words on a page, cyclists streaking past — just sort of blurs. My father took me birdwatching back when activities were formative, and many of my treasured memories are of looking up at something else looking back down. I can’t see those things anymore, unless they come close. The interesting ones never do.
My vision deteriorated slowly enough, incrementally enough, that at no point did I realize anything was wrong, just figured the world looked that way to everyone. It wasn’t until I had an unrelated infection that anyone noticed my corneas were of subaverage quality. Whoops.
Keratoconus is poorly understood. It’s thought to be genetic; nobody else in my family has it. It’s associated with other conditions; I don’t have any. At an early appointment I rubbed my eyes, because my eyes itched and, well, that is how I learned to deal with such problems, and was promptly chastened.
So, here’s a shocker: On account of the laws of physics, when you rub your eyes, your eyes suffer the consequences of being rubbed. These consequences may include chronic corneal damage.
I was skeptical then and I’m skeptical now. If this were true, surely someone would have mentioned it. Rubbing your eyes when tired is as mundane, as commonplace, as instinctual as yawning. Babies do it. All my close friends and Hollywood role models do it. Even my dog, through some impressive maneuvering, does it.
And it’s also a pretty reasonable response to stimuli, as I confirmed with Douglas Lazzaro, an ophthalmologist and chairman of the Department of Ophthalmology at the SUNY Downstate Medical Center.
“Usually when we are tired, our eyes may be dry — usually toward the end of the day,” he explained. “Dry eyes produce similar symptoms as allergies do — itchiness of the ocular surface — and we tend to rub them.”
See? So it was natural for me to do what it was obviously natural for me to do. And yet, like using earbuds or devices that emit blue light, giving in to your itchy eyes has subtle but nefarious risks.
“Rubbing eyes can be problematic for a number of reasons,” said Lazzaro. “You can introduce bacteria and viruses onto the ocular surface, and this can contribute to the spread of diseases like viral conjunctivitis. If you rub hard enough, you can cause a corneal abrasion. If you rub your eyes, you also tend to incite some inflammation, which causes you to rub further. Rubbing the eyes chronically is also a well known factor in the development of keratoconus.” Guess I missed the memo.
The leading treatment for keratoconus is an experimental procedure called cross-linking, which is not yet approved by the FDA and thus only available in clinical trials. For me, it works like this: I lay in a chair with my eyes propped open, “Clockwork Orange”-style. One of the technicians, Steve, administered anesthetic eyedrops, then gave me a stuffed tiger to hold. I was 22 at the time. The doctor used a tiny blunted instrument to slowly, gently scrape off the epithelium, a feeling that registered as mild pressure. He placed a few drops of riboflavin into my exposed cornea, then turned on an ultraviolet lamp. This theoretically activated the riboflavin, which, again theoretically, strengthened the cornea, which — theoretically! — would not undo extant damage but would prevent further damage.
I lay there for eight minutes, unblinking. It was unpleasant. I’m not sure how to characterize the pain. It was too loud, metaphorically. It was too bright, literally. I wanted to blink. I couldn’t look away. I recited poems I’d memorized, mentally, to distract myself. “For The Last American Buffalo.” “Litany.” “Your Face Will Stick.” I recited them again. And again. And it was over. They took the tiger back. I went home with a plastic shield, a bottle of codeine and an arsenal of antibiotic eyedrops. I slept poorly. I couldn’t see. And then I could. Six months later we repeated it all with the other eye; I’m told it worked for one of them. I forget which.
It was a little more than two years ago they told me to stop rubbing my eyes. I mostly haven’t. It’s unconscious — by the time I remember not to, it’s too late. And what’s the alternative? Strenuous blinking? That's nothing but a half-measure.
Try not to rub your eyes. Try not to yawn. Try not to scratch an itch, look toward a sudden movement, laugh at a funny joke. These things happen and we let them. We have no choice, really. Even if we succeed — we stop rubbing our eyes, now and in time immemorial — this is scarcely half the battle. We spend one-third of our lives asleep; should we all wear plastic shields?
So my narrow eyes are my own damn fault. I’ll take it. I’ve put shittier things into this world than a pair of ill-functioning corneas. I mean, I wrote spoken-word poetry in college. I can get specialized contacts, but I can’t take down those YouTube videos.
And yet. I have this image. Suppose it was in the bloodline and no one knew. Suppose it skipped a generation. Or two. There’s an unsolved mystery in my father’s family — his grandfather disappeared without a trace. Here’s everything I know about the man: He was a World War I vet. He was a Freemason. He didn’t come home one night in 1941. It’s tempting to imagine him as some Grand Vizier of the Shadow World Hegemony, whisked away at the height of World War II to solve matters of grand importance.
What’s more likely is that he walked down to the shore one evening in the cold Long Island winter, a little disoriented by the way snow falls backwards on updrafts, a low wind raking the slow but formidable current, his wife and daughters soundly asleep. Maybe he found he couldn’t quite focus, couldn’t quite distinguish sea from sand, had to close his eyes, for a second, a minute, until things put themselves back in the proper order, so he did, he closed his eyes, took a step to steady himself, and the world just slipped silently away beneath him. Maybe things happened as they were always going to happen. It wasn’t anyone’s fault.