Cataracts - Cause and Treatment
Cataracts are a common eye disease seen in ophthalmology practices. Cataracts occur in all sorts patients, but are usually found in patients beginning their 50’s. Fortunately, cataracts are treatable, and the surgery is getting better all the time. A cataract develops when the lens in the eye becomes cloudy. There are many reasons cataracts occur, the most common being aging. Blunt force (being hit by a fist, paint ball or rock), can trigger clouding of the lens, sometimes years after the injury. Medical conditions like diabetes, and medications such as Prednisone cause earlier development of cataracts. Cataracts occur in patients who work or spend a lot of time outside (remember those sunglasses!). Finally, genetics can predispose patients to cataracts earlier in life (it’s your parent’s fault).
Cataracts have different personalities. Some cataracts grow slowly, such as (the poorly named “senile” cataract). These cataracts yellow gradually over the years, causing symptoms slowly. Other cataracts progress more rapidly, typically occurring in diabetics, people on Prednisone, or after trauma. These cataracts are often frosty white. They tend to cause glare, a phenomenon in which vision worsens when light is shining at the eye (driving at night or facing the sun). Either type can make it harder to get glasses “right”, and keep the patient from seeing 20/20. It is not uncommonto have a 20/40 cataract bother one patient terribly, while the next patient who sees 20/80 may not even notice how blurry things have become. Deciding with the patient when it is time for cataract surgery is the art of practicing ophthalmology. Not all patients need surgery at the same level of vision. Factors such as how their vision affects their daily activities (driving, playing golf, etc.) have to be weighed when helping a patient decide whether surgery is appropriate. The old days, when the doctor told the patient that thecataract is “ripe”, are gone.
Patients need to be aware of their options, be involved, and make an informed decision when to have surgery. The goal of surgery is to make the patient’s vision better. Although surgery is better than it used to be, it still involves risk. Risks with cataract surgery include infection, inflammation, worsening of vision, exacerbation of underlying retina disease, and needing more surgery. Cataract surgery is done in the operating room with the eye numb, and the patient under minimalsedation. It involves making a small incision into the cornea (the clear part in the front of the eye), vacuuming out the cloudy lens and then replacing it with a clear acrylic or silicone lens. The surgery can take as little as ten minutes. Patients rarely experience any pain during or after the procedure, and are not bedridden afterward (like the good old days). For some patients, the decision to have cataract surgery is difficult. After all, it is the eye, and God only gives us two of them. Technical improvements in the operating room and better medicines before and after surgery have greatly improved the predictability of the procedure. When the time for surgery is chosen appropriately, the reward can be wonderful.
For more information, contact Dr. Ramirez orDr. Poulos at 407-847-2020 for an appointment.