I started my ophthalmology training at Wills Eye Institute two years ago. We had a month-long crash course in ophthalmology, including how to examine the eye and how to prescribe glasses for patients. Several nationally renowned Wills doctors then lectured on the basics of the retina, cornea, and other parts of the eye.

These essentials sent us off to the clinics well-grounded. We learned more as we went along. One thing we'll never stop learning: How do you help patients who are losing their vision, despite your best efforts?

Our last session, with a man named Nino Pesce, now 74, of Bensalem, remains with me.

Pesce remembers the exact moment when he lost his sight: 2:20 p.m. Aug. 28, 1988. He was putting in a floor in a sunroom when he saw a tear drop come into his sight. He rubbed his eye, hoping it would go away, but it didn't. It was blood.

At that moment, Pesce was having a hemorrhage in his eye, causing his vision to go from 20/25 to 20/200. (That's the difference between being able to see nearly all the way down the eye chart to just being able to see the line below the big E.)

This blow was particularly bad because he had been born blind in his left eye, and now his right eye's vision had deteriorated from complications related to the same congenital problem.

Pesce, a short man with a raspy voice, came into our auditorium with his guide dog Raphael and introduced himself. Then, he asked us the hardest question of all: "What would you do if you lost your sight today?" Well, try it, he said.

We each took turns closing our eyes and maneuvering through the building without any vision. We had partners to help guide us. Life suddenly seemed dark and empty, as if the world had collapsed onto itself. I felt dizzy and lost.

Pesce also taught us simple maneuvers to help our patients in the clinics. Let the blind person hold on to you. Offer up your arm. Don't grab his or her elbow, because if you trip, then you'll take them down with you.

And don't make the faux pas that blind people are also deaf. He tells the story about the waitress who asked his wife, "Does he want cream in his coffee?"

It took Pesce six months for it to hit him. He cried when he handed over his car keys. That was the sign he had really lost his independence. Several years later, his vision worsened until he couldn't even see light. At that point, he sat on his recliner for three days and lived, what he calls, "the poor-me situation."

On the third day, he got up and said, "That's it, no more for me." He told his wife he was going for a walk. He recalls that she responded: "You can't do that, you can't see."

"Watch me," he said.

"You reach a point where you have to make a decision. You can either become a couch potato and say poor me, or dust yourself off and get up."

Pesce said he became the second blind real estate agent in the country and sold 15 houses using assistance from a voice-synthesized computer. Now, he bags groceries for Giant supermarket five days a week and loves the job. He also is a motivational speaker for children and at senior citizens' homes, as well as an educator to medical students and residents in Philadelphia.

Though he doesn't drive, his wife, Elizabeth, and her children joke that he does drive them crazy.

I think of Pesce often. Two of my patients recently suffered severe eye injuries. One man was assaulted in a bar and had to have his eye removed. He is having a tough time coming to terms with losing that eye.

Another woman injured her eye while changing a window pane and ended up with a retinal detachment. We don't know what her vision will be, but she is terribly anxious about it.

Unlike Pesce, they have a second eye, a second chance. I want them to protect their good eye with shatterproof glasses, but most of all, I hope that they will find the strength, as Pesce did, to take life's blows and bounce back.