By R. Thomas Barowsky, MD Contributing columnist
March 17, 2014
This will conclude our month long look at cataracts in recognition of March as National Cataract Awareness Month.
There is a common misconception that cataracts must be ripe before they should be operated on. This was a good idea in the past but with today’s technology it is an unnecessary consideration.
First of all, who is at risk of developing cataracts? By far the largest population of cataract sufferers is the elderly. However, I have removed cataracts from patients as old as 104 years to as young as 3 months old. Patients tend to develop cataracts from many different causes. These include aging, long term, unprotected exposure to sunlight and ultraviolet light, cigarette smoking, high cholesterol and triglycerides, diabetes, certain medications including cortisone, trauma to the eye, and even certain medical eye conditions such as myopia, retinitis pigmentosa and retinopathy of prematurity.
Certainly there is no proven way to prevent cataracts from forming but there are ways a person can reduce the risk of developing cataracts. If you have diabetes, high cholesterol or other medical conditions, keeping them under control is a good way to slow down the progression of cataracts. Wearing eyewear with ultraviolet protection and taking antioxidant supplements like beta carotene, vitamins C and E and omega 3 fatty acids like you find in fish oil or flax oil capsules may assist in reducing the risk of developing cataracts or slowing their progression. Before beginning any of these supplements, be sure to check with your health care provider to ensure they don’t interfere with other medications or treatments you may be taking.
The only way to get rid of cataracts is by surgery. Cataract surgery is an elective operation. Remember that just because a cataract is present, it does not necessarily need to be removed. I usually recommend that cataracts not be removed until they start interfering with your ability to do the things you like to do, want to do or need to do. Typically in the early stages of cataract development a change in glasses is all that is needed. At some point you will notice changes in your vision such as glare from headlights and overhead lights, difficulty reading road signs, printed pages or colors appear faded and print may be more difficult to read in dim light.
There are several different techniques for removing a cataract. Because of changes in technology and surgical technique it is no longer necessary to wait until a cataract is “ripe.” In Sampson County we are fortunate to have a state-of-the-art cataract surgery suite staffed by well-trained nurses and technicians. This allows me to offer the latest technology in small incision surgery to patients in the area who require cataract surgery to improve their vision without traveling out of town. Typically, my patients who are having cataract surgery reports to the hospital’s outpatient surgery center early in the morning and are usually home before lunch without having to travel long distances or spend a long time away from home.
I perform cataract surgery under a topical anesthesia. That means no risky general anesthesia and no painful needles to numb the eye. The incision is specially designed and only 1/8 inch in length. As a result, patients rarely require sutures and never require bulky bandages after surgery. During surgery, the cataract is broken-up into little pieces using ultrasound vibrations. By using eye drops to numb the eye instead of an injection with a needle, the patient’s vision returns more quickly. Usually after cataract surgery, patients can return to most of their normal activities the next day. Many people mistakenly think that a laser can be used to remove their cataract. Even though a laser has been developed for this purpose, it is very inefficient and poorly effective in removing many kinds of cataract.
The important thing to remember is that even though cataracts are a nuisance they can be safely removed and allow patients to enjoy their lives through improved sight.
Hope you have a Happy St Patty’s Day.
(Editor’s note: If you have questions about your eye health e-mail Dr. Barowsky at firstname.lastname@example.org and we’ll try to answer your questions here at Eye-Q.)