I have always had slightly dry eyes. This has made wearing contacts difficult. During the pandemic, I gradually became inexcusably annoyed at having to choose foggy glasses or blurry vision when wearing a mask in public. Independently, it occurred to me in The Year of Isolation that this would be an ideal time for some long at-home recovery surgery. Sadly, there are no elective procedures I really needed or wanted, not even cosmetic. I even researched getting an elective tonsil or appendix removal, but the risk-reward payoff was not there. In 10-20 years there will probably be cool cyber body mods available, but I’m just not at the right time in history yet. Anyway, the fogginess and spare time led me to get laser eye surgery, PRK as opposed to the more popular LASIK, as this was slightly better for the shape of my corneas. A known side effect is that one’s eyes may get slightly drier, but it was worth it.

My PRK surgery was in December 2020. My vision is 20:20 now, and I love it. In addition to dry eyes, I’ve historically had “shy eyes”; my eyes overreact when anything is near them. This is yet another reason why contacts sucked. Any time I’d try out eye shadow or eyeliner, it was tediously time-consuming to get right. For the PRK surgery, they put me on Valium. This was interesting metaphysical experience because I just…did not care about my body any more. They put a laser tip right next to my eye ball and told me to look in a specific spot and not to look elsewhere. I don’t know what safety mechanisms there are in case I did not obey. I smelled my cornea burning during the operation, just like burning hair, yet still held fast. No mustering of willpower needed on my part; I just didn’t care about what was happening to my body.

These days, I put in 1-2 eye drops daily, and they’re the first thing I must reach for whenever I wake up. The dryness is particularly annoying in winter months. One surprising feature about eye dryness is that there’s a lag where they are too dry a few hours before you interpret the symptoms as “dryness”. Your vision worsens, and your eyes will feel tired long before you realize they are dry. I put up a vision chart in my kitchen as a sanity check that would help me know when to get eye drops. At a regular optometrist checkup I complained again about my eye dryness and they checked out my tear glands. They are atrophied (cause unknown, irrelevant) and operating at 50% capacity. This is called Meibomian Gland Dysfunction (MGD).

One treatment for this is Intense Pulsed Light Therapy, which is the actual preamble to the real subject of this post. My glands being atrophied means my oil content is low. There’s another pharmaceutical solution to dry eyes due to low water, but this wouldn’t help me much.

IPL is a new thing…initially for cosmetic skin care treatment. As far as I can tell, its function to improve eye drop gland function was discovered entirely by accident (link to paper by Craig, Chen and Turnbull) thanks to improvement in eye glands in patients getting cosmetic treatments.

Here’s a quote on the purported mechanism of action from this paper by Toyos, McGill and Briscoe:

Potentially, IPL near the lid should cause closing of the abnormal blood vessels secreting inflammatory mediators and decrease bacterial overgrowth; an eventuality we began to observe early in our practice when some of our patients treated with IPL showed improvement in their MGD and DED.

So, now I’m in a once/month regimen where I sit in an optometrist’s office and have intense pulsed light directed around my eyes. This is through custom hardware, that looks like this:

I wear this HMD for 15 full minutes. The word “pulsed” is in the treatment, but the pulsing isn’t really noticeable. I have difficulty describing the effect of experiencing a constant red, more red than you can handle or conceive, unending, as your only stimulus. My eyes are closed the entire time, and yet the brightness I perceive is more than when I look directly at the sun with my eyes closed. My entire existence and the universe is red. I go on journeys in the world of red and converse with the red. Red and I plan trips, picnics and projects together, and we make after-dinner arrangements. All I’ve ever known is red and we are for each other. The only thing I need is red. This is as involved as any hallucinogen.

Have we, perhaps, considered that the problem with VR is that we’ve been pursuing many pixels, rendered very quickly and accurately, and yet this is the wrong approach? What if we simply made 1 pixel, but made it very, very good?