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MASON OPTOMETRY
Date: 12/12/04
Patient
Record: #14844
Visit Type: Remote Screening
Session ID: TV-19
UB15
I
ntake Status: In Progress

Test 7 of 8

After about a fifteen-minute or so wait, I called his name. Peter stood up and dazedly walked over to me. For a second, the thought that he was on drugs or he was hungover crossed my mind. You never knew nowadays what the kids were up to. Back in the day, young people were more respectable. They’d never think to walk into a public establishment under the influence, but nowadays you could never be certain. I brushed the thought aside as I led Peter into the exam room to the right.

    “Okay, Peter…I am going to run two little tests ahead of your appointment with Dr. Mason. There are two machines I’m going to have you hop on, okay? The first one is called a tonometer.”

    I motioned for the young man to take a seat on the white stool in front of him and place his chin on the chin rest. His face was so gaunt and bony that his chin didn’t seem to fully rest flush. He looked at me hesitantly, and I quickly maneuvered over to the other side of the tonometer and pressed the remote control so the machine would lower and set his chin at a more comfortable position.

    “So what this machine is doing is basically measuring the pressure of the fluid in your eyes. Your optic nerve is very sensitive, and it is important to make sure the pressure is not too much. A little bit of pressure is normal, but anything over a certain amount puts you at risk for glaucoma.”

    “Glaucoma? I think my grandma has that,” Peter whispered.

    “Us elderly ladies tend to suffer from it most,” I laughed. “Thank goodness it hasn’t come to me yet, but it’s entirely possible. Don’t get old!”

    He didn’t react to my joke. He didn’t loosen up at all. Again, I thought it strange but went right back to my tonometer spiel. I felt it best to describe to patients the purpose of these machines and the constant rituals performed at the eye doctor—too many assistants don’t go into the nitty-gritty of why we do what we do; it’s a disservice to our patients.

    “What I’m going to have you do is look into the tonometer at the little green light. Do you see it?”

    “Yes.”

    “Good! We are going to start with the right eye, and then we will do the left after. This tonometer is going to blow a light puff of air into your eye. We used to have to actually touch the eye with a tonometer, and that required numbing and whatnot, but now that the technology is getting so advanced, we’ve taken the discomfort level down to a minor puff. Your eyes are going to water a little bit, but it’s only a brief second. Are you ready?”

    “Yes.”

    “Okay. Look into the green.”

    The tonometer whirred for ten seconds or so, and when it located the exact spot of Peter’s eye it needed to hit, the machine sent out a burst of air with a light puff.

    Peter jolted slightly (all the patients do), but he relaxed in an instant. I clicked the remote and the tonometer whirred until it maneuvered over to his other eye. Another fifteen seconds of looking into the green light, another bit of whirring and clicking, another puff, and another recoil from Peter, and then he was done!

    “Excellent! Dr. Mason will take a look at these when he meets with you, but we should be golden. Next to the tonometer is another machine we like to test each visit called the autorefractor. The autorefractor is similar to the tonometer in that you also need to place your chin on the chin rest and look into the machine for a couple of seconds. This machine is used to measure the refractive error of your eyes. That’s just a fancy way of saying how light is reflected through your eyes. I’m going to put an image up in the autorefractor and have you look at it with each eye. All you need to do is focus on the image, and the machine will move the picture in and out of focus in order to get a proper reading. Sound good?”

    “Yes.”

    Peter lowered his chin onto the rest and looked into autorefractor.

    “Wow!”

    I jumped. This was the first moment since I’d met him that his voice had any inflection whatsoever. Every word till then was a whisper. This was actually loud.

    “Wow!” he repeated, pressing his eye deeper into the viewer. “What picture is that?”

    “What picture? Umm…it’s a farm.”

    “I know it’s a farm!” he scoffed, not looking up from the machine. “What picture exactly though? It’s a beautiful picture…I want the name.”

    “Um…”

    That struck me as very strange. No patient in all my years with Dr. Mason had ever requested the name of the silly farm picture inside the autorefractor. It was just a farm. I had no idea what exactly it was called. The image was of a farm. A bright red farmhouse off in the distance, and leading your eyes to that farm in the exact center of the image were two white picket fences on either side of a gray dirt road. Vibrant green grassy hills surrounded the white picket fence and red barn like a sea. It was a simple and common image in optometry offices all across the country.

    “I don’t think it has a name. There are these pictures everywhere. Some are hot air balloons, some are pinwheels, and some places have this farm picture. Do you live on a farm, Peter?”

    He ignored me, switching to his left eye now to look at the farm.

    “Wow. I…I really like this picture, miss.”

    “It’s—it’s a good picture.” I smiled. “But you got to focus on the middle, right on the barn, so I can get a good reading real quick.”

    “But…but there is so much to look at. Look at all that green.”

    He was pressing his face so hard into the lens I felt an immediate urge to grab his shoulders and pull him back. It looked like it had to hurt. For a second I even reached out to tap him on the shoulder, but I hesitated.

    “Peter…um…hah…can you focus on the middle part for just a second?”

    “Yes…yes,  I just…wow. Do you know how I can find this picture?”

    “Do you have a home computer with access to the Internet?”

    “No. I have a phone though.”

    “Good. I…I think you can find it on a phone. Just go on Google and search for ‘autorefractor farm’ or something like that. I think that would do the trick. Now, please…focus on the…”

    “I think I see someone!”

    I jumped. Peter was on his feet now, his face off the lens, pointing wildly at the machine in front of him, his mouth agape.

    “Peter, I—”

    “There’s a man! There’s a man at the farm!”

    “Peter, there isn’t a man in—”

    “Just look!” he said, practically leaping over the stool as he reached out for my hand. “Just look. Trust me! Look! That’s amazing. He wasn’t there before! He wasn’t!”

    Reluctantly, I sighed and made my way to the other side of the table to the viewfinder. I figured I’d at least humor him. I’d say I didn’t see anything and it must be a smudge or something, and then we’d move on from this bizarre side plot.

    “Look! Right at the center of the barn!”

    I pressed my face to the lens.

    The same familiar picture was before me. Solid, grainy black space surrounded the outer edges of the image, the kind of black you’d see in the microscope your parents got when you were a child. Offsetting the black, in the center of the lens, was the most vibrant green you could imagine. Rolling grassy hills detailed down to the single blade and extending far beyond the house in the foreground. On either side of the dirt road of the farm were the two long, white picket fences leading my eyes to the red-and-white barn in the center. For how long I had worked here it had been a long time since I had been on this side of the image, and one thing Peter was right about was the beauty of it. It looked like an image as crisp as something out of a Pixar movie. I placed my hand on the top of the autorefractor and maneuvered until I found the power button. I pressed it, the machine whirled to life, and the crisp green image became even crisper as the machine measured the reflection in my eyes. The image became so clear I could see the rivets in the wood of the barn door, the slight mounds of dirt right in front, and a small bottle of milk, presumably from a cow owned by the autorefractor farmer.

    But no man.

    “Nope. I don’t see a man, Peter,” I said, looking up from the lens and back at him. “Must’ve been a smudge is all. Now…please return to the—”

    “He was there. I saw him. I know I did. Here!”

    He shoved me aside (yet another sign my hypothesis on the youth and their manners was correct) and pressed his face back to the autorefractor.

    I made my way again to the other side of the desk at a snail’s pace, my brain completely frozen in indecision as I contemplated the odd situation developing before me.

    It was a silly farm. A silly, tiny, insignificant little farm that meant nothing. It was an image chosen by some optometry school decades ago that was never replaced or refined because it didn’t need to be. It served its purpose, just like its companion the hot air balloon or the pinwheel. It calculated the reflection in your eyes. That was it. No hidden meaning, nothing.

    What was his deal?

    “There!” he shouted, his voice loud enough to carry into the waiting room. “He’s right there! He’s smiling at me. Like a sinister smile. Like he’s bad. He’s standing right in front, next to the barn door. He’s really pale and bald and smiling. How can you not see him?”

    “I didn’t see anyone, Peter. Now, please…this is taking up an awful amount of time, and Dr. Mason is very busy. I need to finish this test so we can get you prepped for Dr. Mason. Please…just focus on the image for just a moment, and then we can move on.”

    Peter crossed his arms and shook his head. He was insistent. He was untamable. I knew right then and there he wasn’t budging unless I went for the big guns. I cut him off right before he was about to protest.

    “Okay, Peter…listen. I can tell you are really agitated about this image. If you can’t get past it, I’m afraid you are going to have to come back another day. That means all this waiting for your appointment, setting it up, driving here, and all of our time has been wasted. Is that what you want? Do you really want to miss out on this appointment because of the picture in the autorefractor?”

    I was in full disappointed-grandma mode now—my hands on my hips, my lips pursed, and my head cocked in a “don’t be stupid” angle that worked so well with Trinity when I babysat. To my surprise, he agreed.

    “Yes.. That’s fine. I really don’t think I can continue today anyway I need to get to the bottom of this picture. Can you write down on a notepad or something the name of this so I can look it up when I get home?”

    “You’re joking?”

    “No,” he said, shaking his head. “I’m not joking! I see a man there. This is the most beautiful picture I’ve ever seen, and I see a man standing there, smiling at me. I have to get to the bottom of it. I’ll reschedule my appointment, I promise.”

    “Peter, this is ridiculous!” I said, my hands leaving my hips, and I raised them in the air as he turned to leave. “You can’t be serious.”

    “Could you write it down?” he asked, ignoring my incredulity. He was holding the notepad he had picked up from my desk outside the exam room.

    “Like I said, it doesn’t have a name.”

    “Then give me something.”

    I shook my head repeatedly, just beyond frustrated, and wrote:
 

    Autorefractor image—farm scene in green valley
 

    “Thanks!” he said, snatching the paper out of my hand before I had even finished writing. “And what’s your name?”

    “Gerry. Gerry Manning, but I don’t see how that is really that relevant—”

    “And your email, Gerry?” Peter asked, now writing on the pad himself with a mechanical pencil he had pulled out of his pocket.

    “Uh…gmanning@masonoptometry.com.”

    “Thank you! I’ll reschedule my appointment, I promise. Thanks for all your help today.”

    And with that, the most peculiar patient who had ever stepped foot into Dr. Ronny Mason’s Crystal City Optometry Clinic left the office as quickly as he had entered, leaving me confused and alone with the autorefractor.

Disclaimer: This online experience is a work of fiction and is not a medical device, diagnostic tool, or source of medical advice.

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