By Ernst Lamothe Jr.
As you get older your eyes age as well.
The most common eye ailment is cataracts, a vision-related issue which is the clouding of the eye’s lens.
In an eye without cataracts, the lens of the eye is clear, allowing light to pass through to reach the retina, facilitating clear vision. However, with age and various other factors, the lens becomes cloudy and opaque. The World Health Organization estimated 95 million people worldwide were affected by cataracts.
“All people if they live long enough will eventually develop cataracts which will interfere with all their daily functions, including reading, driving and other activities. It could lead to issues such as occludable angles and secondary glaucoma, and even blindness,” said Asher Weiner, physician and glaucoma and cataract specialist and surgeon at the University at Buffalo Medical Department Ophthalmology at the Ross Eye Institute.
“There are various comorbidities that tend to accompany any vision loss such as dependency on others, depression, falls and fractures and dementia acceleration.”
While symptoms of cataracts can vary, they often include blurry or cloudy vision, light sensitivity, difficulty seeing in dim or low-light conditions, seeing halos around lights, and changes in one’s perception of color. It is important to remember that symptoms of cataracts can occur gradually.
Weiner discusses five things you need to know about cataracts.
1 — Causes
Age is a primary factor in the development of cataracts. As individuals age, the proteins in the lens of the eye clump together, causing cloudiness. In many cases, this cloudiness starts small and gradually increases over time, significantly impacting visual quality.
Other factors that contribute to the development of cataracts include prolonged exposure to ultraviolet radiation from the sun, certain medical conditions such as diabetes, medication usage, smoking and excessive alcohol consumption.
Treatment for cataracts typically involves surgical removal of the cloudy lens, replacing it with an artificial lens. Cataract surgery is a very common and successful surgical procedure that is performed worldwide. In fact, advancements in cataract surgery techniques have greatly improved outcomes and recovery times.
“For many people, especially those who are very near-sighted or far-sighted, cataract surgery can be a life-changing procedure,” said Weiner, a clinical associate professor of ophthalmology at the Jacobs School of Medicine & Biomedical Sciences.
“As a cataract surgeon, I’m always impressed and rewarded to hear my patients describe how their surgery changed their life and made them much happier, independent, safer and healthier.”
2 — Misconceptions
Patients are often surprised to hear they have early signs of cataract when they are in their 50s, but this is usually when cataracts begin. Cataracts progress over time but this change occurs slowly. It takes years, sometimes even decades, between when we first identify early signs of cataract and when they become visually bothersome. Some people think that cataracts are hereditary, but the truth is that all people develop cataracts eventually.
“Some people feel they won’t be able to undergo cataract surgery and that they are likely to lose their vision in surgery,” said Weiner. “They also sometimes believe they can do fine without cataract surgery forever, which is not the case.”
3 — Cataract surgery
The process of cataract surgery begins with a pre-operative visit done in the office a few weeks prior to surgery in order to take measurements, review cataract surgery instructions and finalize the surgical plan with your surgeon. The surgery itself is performed as an outpatient at an ambulatory surgery center. When surgery is needed for both eyes, we always operate on the two eyes on separate days for safety purposes and these two surgeries are usually spaced apart by about two to four weeks. The surgery itself is a painless procedure done under mild IV sedation. Except in rare cases, general anesthesia is not needed.
“Cataract surgery is usually performed as an outpatient procedure not requiring general anesthesia or any injections, takes about 15-20 minutes if uncomplicated, and requires several post-op visits,” said Weiner. “Pre-op and post-op eye drop installation is the current standard of care to prevent infection and other complications.”
4 — Recovery
Fortunately, the recovery period after surgery is usually a very comfortable one and the vision often improves rapidly. While there are some exceptions, most patients notice within one or two days of surgery that the vision is already a little bit better than before surgery. The vision tends to improve each day from there until it reaches its final clarity.
“Immediately after surgery, people can experience possible blurry vision, some discomfort and need for activity restrictions for a short time,” he added. “Later they will experience much improved vision and freedom from glasses for at least some of their daily tasks.”
In addition, there are a series of post op visits performed in the office after surgery, including one day after surgery for each eye. If a new prescription for glasses is needed after surgery, this will be provided about one month after surgery.
5 — Surgery side effects
Possible side effects immediately after surgery include blurred vision, halos in the vision, light sensitivity, eye redness and mild eye irritation or foreign body sensation. Some patients experience none of these and others experience multiple of them. In most cases these side effects are mild and improve over the course of the first few days after surgery.
The most common complication after surgery is development of an “after cataract” which is a cloudiness occurring on a natural structure called the capsule which remains in the eye after surgery. When this occurs, it may cause a return of blurred vision months or years after your surgery.
“Fairly rare side effects and risks include loss of vision, infection and need for a second surgery,” he said. “Uncommon side effects and risks include retinal detachment, secondary glaucoma and corneal failure.”