How a patient experienced surprising improvement in his acuity through meditation

About 30 years ago, fairly early in my practice life, I had a 52-year-old Japanese patient we will call “Al.” He was well educated, an engineer and a very high myope.

He presented to me as a monocular cataract patient; the first eye’s vision having been lost to a pseudophakic retinal detachment complicated by proliferative vitreoretinopathy, despite state-of-the-art repair at the University of Iowa 50 miles from my practice.

A dense milky nuclear sclerosis in his only sighted eye progressed, and, despite compensating for progressive myopic shift, his vision no longer met his daily needs.

WEIGHING THE OPTIONS

After serial visits — much chair time and deliberation, full counseling, preoperative treatment by me for a superior atrophic hole in lattice and an immersion A-scan predicting the need for a -2.00 D IOL — Al opted for phacoemulsification without an implant. This would keep incisions small (foldable lenses were not then routine), and he would require presbyopia-correcting safety glasses regardless (multifocal IOLs were not yet FDA approved). Additionally, we agreed on general anesthesia to avoid injection risk and emotional distress (this was prior to modern topical anesthesia).

The surgery was successful. He was 20/25 uncorrected from day one and we were both delighted.

SEEKING ANOTHER ALTERNATIVE

Despite my penchant for meticulous lens removal, within 2 years, Al began to proliferate Elschnig pearls, which slowly marched across the posterior capsule into the visual axis and threatened to become visually debilitating.

Given his risk factors, I convinced Al to allow me to present him at the bi-monthly University Clinical Conference. I felt it wise to gain consensus regarding the relative risks of Nd:YAG laser posterior capsulotomy vs observation. If the latter, I would offer dilation to see around the progressive opacity until total disability required action. Another option was to reoperate to polish the capsule clear, prolonging the integrity of his anterior hyaloid face (though this wasn’t likely to be a permanent solution). Faculty consensus leaned towards Nd:YAG capsulotomy.

At our follow-up visit, Al asked me to explain exactly what I would do were I to enter the eye and polish away the cells. I complied, describing the Terry squeegee that I would use to clear the cells with gentle friction.

Al asked for some time to think about it. I prescribed Mydriacyl p.r.n. for vision, and he made a 3-month return appointment.

A SHOCKING IMPROVEMENT

I certainly wish I’d had a slit lamp camera or an iPhone at the time, though I did make a careful chart drawing of his PC opacity in the undulated pupil.

Upon his return, to my shock and amazement, his acuity had improved, and his plaque had regressed about 10-20%, thereby clearing a portion of his visual axis!

Al told me that he was a life-long meditator. He spent an hour every day visualizing squeegeeing cells away and seeing more clearly. He no longer needed the Mydriacyl.

Somewhat skeptical but not one to be close minded, I congratulated him and we made an appointment for another 3 months with the understanding that he could return sooner if necessary.

Within 6 months, Al’s capsule was clear and remained so for the several years I saw him before he transferred to a job in California. He maintained 20/20 vision until I lost him to follow up.

There is such a thing as spontaneous apoptosis and regression of lens epithelial cells, but I had never seen it before nor have I since. Is this a case of mind over matter? I have been closer to believing anything is possible ever since. OM