A cataract is a clouding, opacity, yellowing, or accumulation of fluid in the lens of the eye that results in a loss of vision and interferes with your lifestyle. Most cataracts are related to aging, and by the time you reach the age of 70 most people will show some signs of cataracts. Age related cataract may occur in one eye first but with time will usually be present in both. The lens is a clear part of the eye that helps to focus light, or an image, on the tissue lining the back of the eye called the retina. The retina is lined with the receptor cells that transform light particles into electrical impulses. A healthy lens is transparent due to the special proteins that help the layers repeat in a regular pattern that causes the least interference and passes the most light through.
The lens does some filtering of the ultraviolet radiation from the sun preventing UV from reaching high levels in the retina. While the lens filters out UV in both the A and B bands, it filters virtually all of the UV radiation between 320 to 400 nan meters and the proteins responsible oxidize over time. Free radicals also increase and the lens yellows and loses transparency as water starts accumulating in-between the layers.
Eye surgery for glaucoma and other conditions can lead to cataract formation. Certain health conditions like diabetes can also cause cataracts, occasionally very rapidly and in some instances also rapidly reversible. Unfortunately, they are usually permanent. Prescription steroid medications used long term can result in cataract development. Traumatic cataracts result after serious eye injuries but usually will not progress over time like age related cataracts. Infants occasionally are born with cataracts or develop them in early childhood, These cataracts may be so small and enough off the line of sight that they do not affect vision. While technically a cataract, I feel an opacity needs to cause lifestyle interruptions before they should be labeled as a cataract. Cataracts are best described by function rather than form. If they do interfere with your daily life, the lenses may need to be removed. Radiation exposure can result in cataracts if the dose is high enough or accumulates over repeated exposure.
The lens lies behind the colored iris and the pupil, the black opening you see in the eye. The lens adjusts the eye’s focus like the diaphragm adjustable metal shutters on a camera, allowing us to see things clearly both up close and far away. The lens is made of mostly water with small amounts of protein and other substances. Vitamin C and Glutathione have both been thought to delay cataract formation. Now there are questions if pigments that also keep the retina healthy may play a role in keeping the lens clear.
Smoking is the best thing you can do if you want to develop cataracts at a young age. Smoking also is associated with the other leading causes of blindness, glaucoma and central retinal degeneration. Reducing your UV sun exposure by wearing quality sun glasses that meet A.N.S.I. standards is helpful. Sun wear that wraps and blocks sun exposure from the side is even more helpful. Although research studies have given mixed results, time will probably bear out a protective effect of antioxidants on the lens tissue. Supplementation with vitamin C, vitamin E, and special plant pigments likely will be shown to reduce cataract development. Eating foods that are complex carbohydrates such as whole grains and less refined foods with a lower tendency to cause sharp rises and falls in blood sugar are associated with a decreased risk of cataract formation. Leafy green leafy vegetables, fruit, and other foods with antioxidants are always the best source of supplements.
Annual comprehensive dilated eye health exams are vital to monitor for cataracts and allow your optometrist to check for signs of retina degeneration, glaucoma, and other eye diseases. Early treatment and detection of eye disease may save your sight and life! The most common symptoms of a cataract are cloudy or blurry vision and problems driving at night due to halos and glare. Frequently, after years of minor changes, patients developing cataracts will start to have rapid changes in their eye glass prescription as they become more nearsighted from the changes in the lens.
Cataracts do not require surgery until they interfere with your lifestyle. In rare cases, the lens can rupture causing serious problems. This is almost unheard of today as eye doctors are widely accessible in all areas of the United States. A new eyeglasses prescription, brighter lighting, anti-glare sunglasses, or magnifying lenses can all be used to help in the interim period. Cataract surgery has a success rate over 95% today and replaces the lens with an artificial implant. Frequently your prescription for distance will be significantly reduced after surgery. Many patients find they have only occasional need for glasses for distance. Some lens implants available today provide some reading capacity also. Most of the time delaying cataract surgery will not cause long-term damage to your eye so you should not feel a need to rush into surgery. Cataract removal may become essential when other eye diseases in the eye are present. Retina degeneration or diabetic related complications need to be visualized well to be followed for complications that might night be seen with a cataract obstructing vision. . Even if your eye doctor tells you have a cataract, your cataract may never develop to the point where surgery is required.
If you have cataracts in both eyes, the surgery may be necessary on one eye only for good vision. If surgery is required on both eyes it will be done at separate times several months apart. This is a much safer approach should complications occur, and allows for refinement of procedure if the first outcome is slightly off. As with any surgery, cataract surgery does have some risks. Infection inside the eye is the most serious, but rare complication. Lenses may be displaced, cause damage to other tissues in the eye, and the retina tissue in the back of the eye may have swelling or detach.
Some prescription medications predispose you to problems during surgery so be sure to discuss all of your prescriptions with your eye doctor well in advance of eye surgery. Flow-max, a prescription used to treat benign prostate growth has been associated with Floppy Iris Syndrome during surgery. Floppy Iris Syndrome can cause problems during cataract surgery so you should be sure to inform your eye doctor if you are any prostate medications. Before cataract surgery, your doctor may ask you to temporarily stop taking certain medications that increase the risk of bleeding during surgery. Over the counter drugs like aspirin and Advil may fall in this category. After surgery, you must keep your eye clean, wash your hands before touching your eye, and use the prescribed medications to help minimize the risk of infection. Serious infection can result in loss of vision. Cataract surgery slightly increases your risk of retinal detachment. Other eye disorders, such as high myopia (nearsightedness), can further increase your risk of retinal detachment after cataract surgery. Retinal detachments usually announce their onset with a sudden increase in flashes (like brief lightening to the side) or floaters. Floaters are little “cobwebs” or black spots that seem to float about in your field of vision. If you notice a sudden increase in floaters or flashes, call your optometrist immediately. A retinal detachment is a medical emergency. If necessary, go to an emergency service or hospital. Early treatment for retinal detachment often can prevent permanent loss of vision.
For a short period of time after surgery, your eye doctor may ask you to use several eye drops to help healing and decrease the risk of infection. You will need to wear an eye shield or eyeglasses to help protect your eye. Avoid rubbing or pressing on your eye. Sun glasses will be needed to protect your eyes from the bright glare we have in Fort Collins and Northern Colorado. When you are home, try to avoid bending over and lifting. You can walk and do light household chores. In most cases, healing will be complete within eight weeks. Most of the time you can fill your new glasses prescription 2-3 weeks after surgery. Your doctor will schedule exams to check on your progress. Problems after surgery are rare, but they can occur. These problems can include infection, bleeding, inflammation, leakage of the incision, swelling in the back of the eye, and high pressure, With prompt medical attention, these problems can usually be treated successfully.
Months or years after cataract surgery cell growth can occur on the artificial lens obscuring vision. This is frequently referred to as after cataracts. A simple, brief laser procedure done in the office quickly resolves this problem. Cataracts surgery is one of the most successful procedures done today. While you don’t want to rush into any surgery you can rest assured knowing if your vision does become problematic you have a good treatment option available. Medicare will cover cataract surgery when your eyesight has degraded to a designated level. Many types of vision insurance, including Vision Service Plan, provide coverage of cataract surgery under some of their policies. You will need to check with your provider to find out what is covered under your plan. Some types of lens implants are usually excluded.