It isn't nice to hear that your tears aren't good enough, but that is what I was told some years ago. What follows is the true account of how, why by whom that statement was made. Of course, it could have another meaning altogether, but that's for another occasion.
“It isn’t the quantity of tears that matters; it’s the quality,” he said, “and I’m afraid your tears just aren’t good enough.”
At least, as an ophthalmologist, he was speaking in a literal sense, not metaphorically, allegorically or figuratively.
I had arrived in the Kimberley area of South Africa the previous day, following an uneventful journey from London by way of Johannesburg. I had been well looked after by my host, and spent the night in his guest room. I awoke at about 4am with the distinct sensation of something in my left eye. I tried various movements and manipulations to clear it, but they only seemed to make it worse. I arose as soon as I heard my host moving about, dressed, and asked him if he could try to clear my eye. He politely declined, saying that was the kind of thing at which his wife excelled, but at which he was, in his words, rubbish. As the pain was becoming difficult to deal with, we skipped breakfast, and he took me to see a doctor friend of his. By this time, the pain was severe, my eye was watering like never before, and I couldn’t stand the light.
The doctor took a look, and put two drops of liquid in my eye. As soon as the drops hit, the pain stopped. Completely. Gone. No more. I thanked him profusely, effusively even, and prepared to leave.
“Not so fast,” he said, “that was just an anaesthetic.” He scribbled a note. “Take this to the address on the envelope,” he continued, “the ophthalmologist will be expecting you by the time you arrive.”
We set off once again, through the streets of Kimberley. By the time we arrived at our destination, the pain in my eye had returned with a vengeance. As promised, when we handed the note to the receptionist, she showed us through to the ophthalmologist’s consulting room. He approached me in the same way that opticians do; very closely. I appreciate that if anyone is examining one’s eyes, they need to approach closely. Too close for my liking; I mean, exactly how far from the surface of my eye does my personal space extend? Seriously. I forgave him, though, because he hit me with another couple of drops of the magic juice and took my pain away.
He started asking questions, “Have you had this problem before?”
“Any eye injuries?”
“When I was about eighteen, I was playing with an Alsatian pup; she put her paw out before I could pull back, and made a scratch on the white of my eye.” At the time of telling him, it would have been more accurate to describe it as the red of my eye, but I think he understood.
“Ah yes,” he said, “I can see a very faint scar there.”
“Is this related?” I asked.
“Possibly, but probably not. You are suffering from RCE – recurrent corneal erosion,” he explained. “Your eyes become dry whilst you are asleep, and your tears don’t have the right composition to keep the cornea moist enough to prevent the eyelid rubbing on it. When you open your eyes, some of the corneal surface sticks to the lid and is pulled off.” Pain or no pain, that made me feel queasy. That, and his casual use of the word recurrent.
He then proceeded to attack me with a needle, as if practising pointillism on my eye.
“I’m making a number of small puncture wounds,” he explained, “these will give the repairing tissue something to bind to.” I felt no pain, so let him carry on with his artwork.”
He put ointment into the eye, covered it with a patch, gave me a prescription and said, “You should spend the next few days in a darkened room. Keep your eye covered and closed; apply ointment at regular intervals and especially at night. The symptoms will improve, but you might find bright light uncomfortable for a week or so. Keep using the ointment and artificial tears to manage your dry-eye syndrome”
I had travelled to South Africa to do some field work, which I couldn’t do. After three or four days, I could go outside during the day, with the darkest sunglasses I could find. It was still uncomfortable, and the dry wind (relative humidity was only about 14%) passing across the eye was painful, causing me to walk away and seek shelter on a couple of occasions, when I would rather have stayed around.
A week or so after returning home, in the much more humid air of southern England in mid-October when I thought I had put the episode behind me, the other eye decided to join the party. The local hospital had a supply of magic drops, but repeated what the South African ophthalmologist had told me; more than a very few applications of these drops would damage the eye. No pointillism this time, just ointments and artificial tears. A couple of days later I was back to work, although I was wearing sunglasses in the office, and two pairs when driving to work and home again, to deal with the photophobia that was still plaguing me.
Almost a decade later, I still keep a supply of ointments and artificial tears at my bedside and in my study, together with a bottle of dry eye spray. Thus armed, I haven’t suffered a full-blown recurrence of the problem, although I have learned to recognise warning signs, and have used the preparations preventively on several occasions.
Nine months after the first occurrence, we moved to France. Things didn’t change, except the artificial tears are probably cheaper and the mist more expensive — but doesn’t sécheresse oculaire sound so much more refined than dry eye?