I had an aunt who had an eye disorder called keratoconus. Her symptoms included deteriorating vision and a sensitivity to bright light. The condition was diagnosed early in her life. As a young woman she traveled from Montana to Chicago where she was fitted with large, hard contact lenses that put pressure on the centers of her corneas in an attempt to slow the change in the shape of the surface of her eyes. The contacts were corrective lenses as well that improved her vision. As an adult she was an early recipient of corneal transplants. Each of those procedures required a multi-month trip out of state to a medical center where the surgery was performed and post operative care was provided. I remember stories of how her head was kept from moving by being surrounded by sand bags during and after the surgery.

I have a very mild form of the same condition. The misshaping of my corneas, however, stabilized when I was in my early 40’s and I haven’t had further issues. For a while I wore corrective hard contact lenses, but when those became too uncomfortable I returned to wearing glasses and so far doctors have been able to correct my vision with regular glasses. I’ve been fortunate to live in a time of plastic lenses, which makes my glasses lightweight and less awkward than those available years ago.

I was advised by an ophthalmologist that there was good cause to wait for any possible surgical correction to my condition because of the rate of advance in ocular surgical techniques. As time passes, doctors become better and better at making ocular corrections and procedures become less invasive. The doctor said the delay of a year or more would bring advances in technique. As it turned out, my condition has stabilized and I have not required any surgery.

I was thinking about my aunt and the challenges of having my own vision corrected 30 years ago yesterday. Susan went to her ophthalmologist for a routine check up yesterday. She had procedures to remove cataracts a few years ago and she receives regular check ups to make sure that all is well. During her examination the doctor observed a slight film on one of her eyes. This can be corrected with a laser surgical procedure and the doctor recommended that the procedure be performed. As it turned out, she was the first patient of the day and there was no backup of patients waiting for appointments so the procedure could be done after her examination. The procedure took about 5 minutes and she was given no restrictions on activities post procedure. Her eyes were dilated for the procedure, so she was very light sensitive for a while after it and it was a good think I was available to drive for the trip home from the visit. After a few hours her pupils were contracting normally and she enjoyed her regular activities for the rest of the day.

I realize that the procedures were very different, but the contrast between my aunt’s experience with eye surgery and Susan’s experience yesterday was dramatic. One patient traveled out of state to get to a research hospital, was an inpatient in restraints following the surgery, then had to remain nearby for follow-up care for a couple of months. The other’s surgery was a 5-minute outpatient procedure with no need for follow up care or restrictions.

What a difference a few decades have made in eye surgeries!

I haven’t seen the medicare explanation of benefits in regards to Susan’s procedure yet, but I’m fairly confident that the cost of that 5-minute procedure was well beyond the charges that came from my aunt’s corneal transplant surgeries. A few decades has also affected the cost of medical procedures.

Still, I think that the advance in patient care can definitely be labeled progress. As we were walking last evening we talked about how fortunate we are to live in this time and place, where access to such convenient vision enhancing procedures is so convenient. A few generation ago, people our age frequently saw their vision blur and fail due to cataracts. We live in a time when those are easily corrected, where lens implants are common, and where office procedures continue to make good vision available to aging patients. Had we lived in our grandparent’s time, our experience of aging would be much different.

So much of our quality of life is due to things that are beyond our control such as the time in which we are born and live. We have a tendency to think of our situation in life as the product of planning and hard work, but we haven’t worked any harder than those who have less fortunate outcomes. Where we are is the product of luck as well as of dedication. We were lucky to have met each other at young ages. We were lucky that our parents chose churches that shared the camp where we met. We were lucky that we lived in a time of relatively low tuition and easy student loan terms. We completed our undergraduate and graduate educations together and emerged with minimal debt that was repaid in just a few years. A similar educational pathway does not exist for couples married these days.

Sure, we have worked. And we have been blessed with meaningful work and benevolent employers. We have also benefited from the time and place of our births. Who we are and what we have experienced in life has been the result of unearned privilege. Others who have worked just as hard have not received the benefits that we have taken for granted.

Comparing our experience yesterday with that of my aunt and uncle makes us aware of how much different life will be for our children and grandchildren as they age. Some things will continue to improve. Other things will present challenges we aren’t able to imagine. It will be different. We cannot control the circumstances of their lives. What we can do is to be as generous as possible, sharing the love we have found and pray that they too will find love and care as they travel the journeys of this life.