Four years ago Joe Hernandez was told he had cataracts and his vision would get worse. It did.
Eventually, he could see nothing but light and shadow out of one eye. The vision in the other started to fail, too. A simple surgery would fix him, but he was uninsured and couldn’t afford it.
Cataract surgeries are one of the most common surgical procedures in the US. But for many, like Hernandez, treating the cataracts is unaffordable. Left untreated, the clouding of the eye lens means a slow descent to impaired vision and eventual blindness.
Hernandez says his wife called doctor after doctor for him, but everywhere she called, a surgery was too expensive.
“We don’t have no money,” Hernandez said. “Everything I make just goes on bills, so it was impossible.”
The 58-year-old says one of the hardest things about losing his vision was not being able to read his Bible. Driving, though, was the scariest. He had to keep driving, he says to get to his job stocking shelves at a big box store in Fort Worth. His family couldn’t afford the extra gas for his wife or son to drop him off and pick him up. The future looked bleak.
“My wife would cry,” Hernandez said, crying himself as he remembered. “’She would say Joe, you can’t go blind on us. Joe you can’t go blind. What are we going to do?’”
But his wife kept trying, and was ultimately referred to the Cornerstone Clinic, a free clinic in Fort Worth that performs the surgeries for free every month or so for people who can’t afford them. Palestine-based ophthalmologist Daniel Gold volunteers there.
“People are falling through the cracks,” he said. “Cornerstone sees those people, and they help us to see them. And when we come into contact with them, we can actually do something to help fix them.”
Removing the cataract is pretty quick work. Gold cuts a tiny incision – 2.6 millimeters in Hernandez’s case – and uses a fancy machine that makes a kind of weird noise as ultrasonic waves to break up the bad lens. Then, an artificial lens goes in and Hernandez is off to a recovery room. The whole thing takes about 30 minutes.
Cataracts are incredibly common, especially in older people. The Centers for Disease Control estimates more than 20 million people in the US have them. The National Eye Institute says that number will more than double by 2050 as the population ages. Cataracts are also incredibly treatable, but the surgeries can cost several thousand dollars. Not everyone who can’t afford the surgery are uninsured.
“There’s a large number of our patients who have been able to access insurance, but we call them underinsured because they have very high deductibles or co-pays and so they end up going without care,” said Jennifer Deakins, an optometrist who runs the Community Eye Clinic in Fort Worth.
The Community Eye Clinic does the pre-and post-op care, and other eye health services, for patients at the Cornerstone cataract clinic. Deakins says Fort Worth has a robust safety net for patients like Joe Hernandez, funded in party by donors like eye-care company Alcon. An annual eye exam can find early indications of treatable systemic diseases like diabetes. But many , Deakins said, don't seek services until their vision has been effected, which can have huge impacts on their life and livelihood.
“I’d say we have probably three to five cataracts per week where people are having to stop driving or stop working because they’re unable to see through that cataract,” Deakins said. “And a couple of times a month we have people who are literally feeling their way through their life because they can’t see motion or light because of the cataract.”
The morning after his surgery, Hernandez is sitting in an exam room, reading an eye chart for Deakins. He breezes through the first few rows. He’s less confident about the smaller letters at the bottom of the chart.
Still, Deakins tells him he’s got 20/20 vision in that eye. “How cool is that?”
Hernandez still doesn’t see well out of the other eye; there’s a cataract in that one too that he’ll get taken out later. But now, he can see well enough to pass a driver’s test and read his Bible again. Watching a Rangers game on TV with his wife after his surgery, Hernandez said, was unreal.
“I was freaking out,” Hernandez told Deakins, beaming. “I was like look at the colors on this TV again. My god, look at the colors. Man it was so beautiful man. It’s still beautiful, I was looking at it this morning.”