It’s easy to underestimate the brutality of boredom, but people in prison will tell you that keeping your mind occupied is essential to survival. Paulette Fiedler, a 69-year-old prisoner at Logan Correctional Center in Illinois, keeps her mind alive by reading — she plows through book after book.

So, Fiedler said, when she got cataracts in both eyes, she wanted them fixed as soon as possible. But the prison doctor told her that she’d have to make a choice. Which eye did she want fixed, the right one or the left one?

Multiple Illinois prisoners say they have been denied eye surgery because of a “one good eye” policy that only entitles them to have one functioning eye.

James Cox said he entered Illinois’ prison system with perfect eyesight. But in 2015 he got in a fight with another inmate at Pinckneyville Correctional Center who knocked him upside the head with a hardcover book, hitting his eyeball. The pupil dilated so wide, it looked as if one of his blue eyes had changed color.

“I get constant headaches, like my eyes are going to pop out,” he said.

Even now, four years later, at age 45, Cox said his vision is blurry and so sensitive to light that he avoids going into the prison yard. But he said the doctor won’t fix it, as long as he can see out of the other eye.

“They say if you got one good eye, that’s it. That’s good enough.”

The Illinois Department of Corrections and Wexford Health Sources, the private company that provides health services in the state’s prisons, both refused to answer questions about the allegations raised by Cox, Fiedler and other prisoners about a “one good eye” policy. Both the department and the company refused to provide a copy of the eye surgery policy stating it is a “trade secret.”

But court documents from a 2014 lawsuit filed by a different prisoner give some insight into the trade secret: The documents include affidavits from doctors working for Wexford that say they denied a prisoner’s eye surgery because one functioning eye is sufficient for the daily activities of a prisoner. Those court filings also include a copy of a Wexford eye policy from that time that says cataract surgery can be denied so long as the prisoner has sufficient vision in their dominant eye.

“Although Wexford takes issue with [the] designation of this policy as the ‘one good eye’ policy, this description is not unfounded,” federal Judge Nancy Rosenstengel wrote in one ruling in the case.

Wexford Health Sources

Wexford Health Sources has an 10-year, over $1.4 billion contract with the Illinois Department of Corrections. Alan Mills, a lawyer for Uptown People’s Law Center in Chicago, said for the most part, Wexford is paid a flat fee instead of being paid based on the amount of medical care it provides.

“Every time they actually provide care, it takes off their bottom line, takes away from their profits. So therefore, they have a clear profit motive to provide as little care as they can get away with,” said Mills.

Mills has spent much of the last decade fighting legal battles over prison healthcare on behalf of inmates. He fought a lawsuit on behalf of deaf and hard of hearing prisoners. Before that lawsuit, he said Wexford denied people hearing aids for both ears, a kind of one ear policy.

Mills also worked on a lawsuit, filed with the ACLU of Illinois, that accused Illinois prisons of providing such poor care that it violated the U.S. Constitution. As part of that lawsuit, an independent court expert wrote a 2018 report that said prisoners were dying from preventable causes. The state settled that lawsuit in 2019 and agreed to federal oversight. The legal agreement is still new enough that Mills said it’s unclear if it will lead to an end of the so-called “one good eye” policy.

A fight for an eye

Faced with a choice between her left eye and her right, Paulette Fiedler chose the right one but has been fighting to get surgery on the other eye as well. She filed a complaint with the prison known as a grievance and in response, the prison said it would submit an appeal to Wexford to have surgery on her second eye.

James Cox is also still fighting for his eye to be fixed. He filed a lawsuit that said the 45-day wait to see an eye doctor may have contributed to his eye damage. He said his lawsuit is about eyesight, but it’s also about the humiliation of feeling like he’s not worthy of having his eye fixed — as if his loss meant nothing.

Cox said he’s been drawing since he was 15 and he continued when he was sent to prison, sometimes trading his drawings for soap or deodorant. But even more important, it was a therapy for him.

“It takes me out of this place,” said Cox. But since the eye injury, it’s harder to enjoy making detailed drawings. “I’m locked in a cell 22 hours a day, what else do I have to do?”

Shannon Heffernan is a criminal justice reporter for WBEZ. Follow her at shannon_h.