By Dr. James P. Tweeten
Cataracts affect an estimated 20.5 million people-about one in six Americans. If you are over seventy you have a greater then fifty percent chance you have cataracts, the leading cause of vision loss in people over age forty.
If you think of the eye as a camera the lens of eye is usually crystal clear. A cataract is a clouding of the eye’s lens. The lens is made up mostly of protein and water. Over time, the proteins that are arranged in a precise crystalline pattern break down creating cloudiness in the lens. This can happen very slowly and the blurriness it causes can be undetected, especially when it affects both eyes. Eventually, it becomes dense enough or the opacities become more central, preventing light from passing clearly through the eye and leading to noticeable symptoms. These symptoms include cloudy, blurry or dim vision. Other symptoms include sensitivity to light, glare and halos around lights. Less commonly double vision in one eye can occur.
Aging is the most common cause of cataracts. Others include, congenital or developmental cataracts, which may be hereditary or associated with birth defects. Other non-age related cataracts maybe related to trauma, medications, chronic disease and other eye disease or surgeries.
Cataracts are observed until the symptoms affect a patient’s lifestyle. A common misconception is that a cataract has to be “ripe” to be removed. In many cases, changing an eyeglass prescription may improve vision enough to postpone surgery. However, once diagnosed it is important for patients to be followed for vision changes. A detailed eye exam is necessary to determine if other eye diseases are present. Once a cataract is diagnosed it is important to protect your eyes from UV light by wearing sunglasses and broad rimmed hat. Work with your primary care doctor to take care of health problems, especially diabetes, obesity and hypertension. These measures may retard the progression of your cataract. Unfortunately, there are no medications or eye drops that can reverse cataracts-surgery is the only treatment. Once, the vision interferes with daily living activities surgery is considered.
Cataract surgery is one of the most common procedures performed in the United States. Through a small incision the natural cloudy lens is removed and replaced with a clear intraocular lens implant (IOL) made of acrylic, silicone or plastic. The type of IOL selected will determine how you see without glasses. This is a complicated decision that requires a discussion regarding the pros and cons of each type of IOL. Once this decision is made the surgery is usually performed with topical anesthesia and a wound that requires no suture. The recovery is usually rapid with excellent results. Many patients wish they would have the surgery sooner.
The American Academy of Ophthalmology recommends that adults with no signs or risk factors for eye disease get a baseline eye disease screening at age forty. Anyone with a strong family history of eye disease, diabetes or high blood pressure should be seen sooner.