Vision fuzzy? Feellike your glasses always need cleaning? You may be among more than 100,000 Australians and 7500 New Zealanders slated for cataract surgery this year. Thanks to new surgical procedures, your eyesight will soon be as good as new.
What is happening
Hanging suspended in a transparent capsule, just behind the pupil of your eye, is a clear lens. It's functions to make your vision sharp. But justabout the time you cross the midpoint of life and head for your sixties and seventies, the lens often starts to become unreliable. Its protein fibers gradually
begin to clump together, like sugar congealing in a container of honey, causing a cloudiness that's known as a cataract.
Ordinarily, when you look at something, light rays reflected from the object enter your eye through the cornea and the lens. The lens then focuses the light onto the retina at the back of your eye, which sends the image to your brain. When a cataract develops, the light rays are no longer precisely focused but instead scatter before reaching the retina. Generally a cataract forms on the lens of both eyes but not necessairly at the same time. And in its earliest stages it may not cause a vision problem.
But eventually, as the protein fibres begin to clump further and then break down, images dim, colours fade and distinctions between light and dark turn fuzzy. Doubts vision may also occur.
LIKELY FIRST STEPS
Although cataracts can form at any age--babies are occasionally born with them--most occur in later life. In fact, by the time you reach age 75 or so, your risk of having a cataract is equivalent to coming up 'tails' with the flip of a coin--about one in two. A number of factors increase that risk even more, including smoking, lots of exposure to bright sunlight and long-term oral corticosteroid use (especially at high doses). And you are more likely to develop cataracts if you have a related health problem, such as glaucoma, diabetes, high blood pressure (hypertension) or an immune-system disease such as rheumatoid arthritis. Genetics, too, can play a role. By far, the most dominant risk factor is ageing.
What is happening
begin to clump together, like sugar congealing in a container of honey, causing a cloudiness that's known as a cataract.
Ordinarily, when you look at something, light rays reflected from the object enter your eye through the cornea and the lens. The lens then focuses the light onto the retina at the back of your eye, which sends the image to your brain. When a cataract develops, the light rays are no longer precisely focused but instead scatter before reaching the retina. Generally a cataract forms on the lens of both eyes but not necessairly at the same time. And in its earliest stages it may not cause a vision problem.
But eventually, as the protein fibres begin to clump further and then break down, images dim, colours fade and distinctions between light and dark turn fuzzy. Doubts vision may also occur.
LIKELY FIRST STEPS
- A specialised eye examination by an ophthlamologist to determine where the cataracts are located,if they're in one or both eyes and how far the condition has advanced.
- An assessment of your vision impairment to find out whether you need surgery soon, or just a follow-up appointment.
- Discussion with your doctor about possible procedures for eye surgery and how much time you should reserve for recovery.
QUESTIONS TO ASK
The speed and extent of your vision impairment depends not only on the size and density of the cataract but also what type it is. There are several variations, and more than one type can be present in the same eye. Most common is a nuclear cataract, which occurs inside the core or nucleus of the lens. If it forms on the rear of the lens capsule, it's labelled a posterior sub-capsular cataract. And when it affects the outer part of the lens nearest the dome of the cornea, doctors call it a cortical cataract. A cataract in the periphery of the cornea has little effect on vision because it doesn't interfere with the passage of light through the center of the lens, while a dense nuclear cataract causes severe blurring.- Are there ways I can protect my eyes so my cataracts won't get worse?
- With other eye problems I have affect the outcome of my cataract surgery?
- Will I go blind if I don't have surgery?
- Will I need glasses or contacts even though I've had a lens implant?
- Will my children develop cataracts because I have them?
Although cataracts can form at any age--babies are occasionally born with them--most occur in later life. In fact, by the time you reach age 75 or so, your risk of having a cataract is equivalent to coming up 'tails' with the flip of a coin--about one in two. A number of factors increase that risk even more, including smoking, lots of exposure to bright sunlight and long-term oral corticosteroid use (especially at high doses). And you are more likely to develop cataracts if you have a related health problem, such as glaucoma, diabetes, high blood pressure (hypertension) or an immune-system disease such as rheumatoid arthritis. Genetics, too, can play a role. By far, the most dominant risk factor is ageing.
Treatment Options
Procedures------------------------------------------------------------------------------------------------------------------------------
Phacoemulsification Most common surgery; no stitches needed.
------------------------------------------------------------------------------------------------------------------------------
ECCE Same success as phaco; stitches needed.
------------------------------------------------------------------------------------------------------------------------------
ICCE Done very rarely, for special situations.
LIFESTYLE CHANGES
--------------------------------------------------------------------------------------------------------------------------------
Quit smoking Reduces incidence; may improve sight.
-------------------------------------------------------------------------------------------------------------------------------
Avoid too much sun More than doubles cataract risk; harms lens.
-------------------------------------------------------------------------------------------------------------------------------
Improve lighting To reduce glare when doing close work.
-------------------------------------------------------------------------------------------------------------------------------
Antioxidant foods Fresh fruit and vegetables protect lens.
TAKING CONTROL
Procedures------------------------------------------------------------------------------------------------------------------------------
Phacoemulsification Most common surgery; no stitches needed.
------------------------------------------------------------------------------------------------------------------------------
ECCE Same success as phaco; stitches needed.
------------------------------------------------------------------------------------------------------------------------------
ICCE Done very rarely, for special situations.
LIFESTYLE CHANGES
--------------------------------------------------------------------------------------------------------------------------------
Quit smoking Reduces incidence; may improve sight.
-------------------------------------------------------------------------------------------------------------------------------
Avoid too much sun More than doubles cataract risk; harms lens.
-------------------------------------------------------------------------------------------------------------------------------
Improve lighting To reduce glare when doing close work.
-------------------------------------------------------------------------------------------------------------------------------
Antioxidant foods Fresh fruit and vegetables protect lens.
TAKING CONTROL
- If you smoke, give it up. Smoking doesn't cause cataracts, but research has shown that this eye condition develops much more rapidly and more frequently in those who do smoke. In fact, some of the damage done by smoking may be reversed if you stop right away.
- Shield your eyes from bright sunlight. A mild cataract condition is likely to get worse if your eyes are exposed to ultraviolet (UV) rays. Wear a wide-brimmed hat and sunglasses to protect your eyes from both UVA and UVB rays.
- Ask someone to help you after surgery. Although the outpatient cataract procedure is simple and painless, you will need someone to drive you home from the clinic or hospital afterwards. For the next few days, while your eyes are adjusting, you will continue to need a person to drive and help you with household chores, especially those that require exertion.
- If a second eye needs surgery, don't wait too long. In a study of cataract patients in England, doctors found that those patients who had the second eye treated within 6 months and the best results. Those who waited 7 to 12 months often reported difficulties with depth perception, especially when walking and driving. Discuss your particular situation with your doctor.
No comments:
Post a Comment