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Seeing is believing: Cataracts are treatable Cataracts are a common problem, comprising the No. 1 surgical procedure in this country and being the No. 1 cause of curable blindness in the world. With 50 percent of people over age 65 having a cataract, 1.4 million Americans this year will have cataract surgery. A cataract occurs when the eye's lens turns yellow and cloudy, through the normal aging process. At age 75, almost everyone will have a cataract to some degree. While some cataract problems are congenital, or can stem from an eye injury or metabolic disease such as diabetes, most problems are age-related. The early signs of cataract development are a change in eyeglass prescription. As the lens becomes cloudy, vision becomes blurred and colors are washed out. Difficulty with reading, glare, and trouble driving at night are also symptoms. Having a cataract has been compared to looking through a foggy or dirty window. The good news about cataracts is that they're very treatable. Microsurgery to replace the cataract lens with an implant has so evolved over the past 10 years that today the procedure takes less than an hour with local anesthesia and minimal discomfort. Years ago, the surgery involved a week-long hospital stay. One misconception about the surgery that still remains, however, is that it's done with a laser. State-of-the-art cataract surgery involves a technique called phacoemulsification. Small incisions are made into the eye into which an ultrasound probe is inserted. This ultrasound device breaks up the cataract, or phacoemulsifies it, and then it's suctioned out. Once the cataract is removed, an artificial intraocular lens made of special plastic is implanted into the eye. Cataract surgery is effective in 95 percent of cases, and most patients see well in one to six weeks. While the eye heals, some redness and sensitivity to light may be present, and drops are required during the healing process. I'm often asked how does one know whether a cataract is ready -- or "ripe" -- for removal. The patient, not the doctor, often is the best judge. The time for surgery is when the cataract is affecting one's daily life. If you're not comfortable driving at night, or not reading or knitting any more, than it's time to consider surgery. Patients may have a cataract in one eye or both, and surgery is done on each eye separately after a few months or so. Many patients over the age of 60 have come to see me for a laser vision correction consultation, wishing to reduce the need for eyeglasses. Often, they're not a candidate because of cataracts and are disappointed. The encouraging news is that after cataract surgery, these people can often enjoy the same benefits as laser vision correction -- the reduction or elimination of eyeglasses or contact lenses. This is because the lens implant is customized to the patient's eye to compensate for any previous nearsightedness or farsightedness. This does not always work perfectly, and patients who have already had cataract surgery but still need glasses may subsequently undergo laser vision correction. Prevention is important in many diseases, but we're waiting for more answers with cataracts. Studies show that ultraviolet rays from the sun have been tied to cataracts, so it's always best to wear sunglasses with 100 percent UV protection. Antioxidants may slow progression of cataracts, but this theory is unproved. If you're not enjoying life as much as you could because of vision problems, talk to your doctor. Cataracts are very common, easily corrected, and the right time is up to you. Copyright ©2000, 2001 Greenwich Hospital. All rights reserved. |
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