Important Questions about Cataracts

[Anthony S.]

Hello to everyone, I feel guilty because I know people have
probably written similar questions before, but here goes...
I'm 25 and I recently went to get a new pair of glasses, and
the technician told me that I was in the beginning stages of
having cataracts. It really, really disturbed me, mainly
because the only thing I knew about it was the fact that
eventually it can cause blindness which frankly terrifies
me. I am pretty ignorant on the whole issue of cataracts,
and unfortunatly the optomtrist (sp?) didn't care to answer
the questions I had because he was in such a rush. He was
like, "Oh, everything's fine, you just have the start of a
cataract on your eye." I've been searching the web, but I
end up getting some fairly technical information about how
cataracts come about, and things, but not a great deal of
info on treatment, prevention, and when (or if) surgury is
necessary. In other words, I'm lost and don't know how to
handle the problem. Anyway, my point is just that I'd really
like to hear from anyone with problems like this, as I have
a lot of questions about the problem and don't know if
there's anything to prevent the cataracts from growing, or
get rid of them, etc. I just am scared and probably sound
paranoid by worrying about it, but the thought of blindless
has always scared me very, very much. Thank you _so_ much in
advance for any information or thoughts you could offer. My
e-mail is [email protected] , and anyone can feel
free to message me. Thanks.

Best wishes, Anthony

 

[Repeating Rifle]

in article [email protected], Anthony S. at
[email protected] wrote on 3/15/04 12:18 PM:

> I feel guilty because I know people have probably
> written similar questions before, but here goes... I'm
> 25 and I recently went to get a new pair of glasses, and
> the technician told me that I was in the beginning
> stages of having cataracts. It really, really disturbed
> me, mainly because the only thing I knew about it was
> the fact that eventually it can cause blindness which
> frankly terrifies me.

Do not rely upon a technician for such advice. See an
ophthalmologixt or at least an optometrist for that kind of
professional advice

Bill.

 

[The Real Bev]

Repeating Rifle wrote:
>
> in article
> [email protected], Anthony
> S. at [email protected] wrote on 3/15/04
> 12:18 PM:
>
> > I feel guilty because I know people have probably
> > written similar questions before, but here goes... I'm
> > 25 and I recently went to get a new pair of glasses, and
> > the technician told me that I was in the beginning
> > stages of having cataracts. It really, really disturbed
> > me, mainly because the only thing I knew about it was
> > the fact that eventually it can cause blindness which
> > frankly terrifies me.
>
> Do not rely upon a technician for such advice. See an
> ophthalmologixt or at least an optometrist for that kind
> of professional advice

The diagnosis was made by an optometrist who was too busy to
provide further information:

> I am pretty ignorant on the whole issue of
> cataracts, and unfortunatly the optomtrist (sp?)
> didn't care to answer the questions I had because
> he was in such a rush. He was like, "Oh,
> everything's fine, you just have the start of a
> cataract on your eye."

An excellent reason to seek out a different optometrist next
time he needs glasses. Professionals who are too busy to
explain but have plenty of time to take your money shouldn't
be encouraged.

--
Cheers, Bev
=================================================================

"The federal government has taken too much tax money from
the people, too much authority from the states, and too much
liberty with the Constitution." -- Ronald Reagan

 

[merle]

On 15 Mar 2004 12:18:12 -0800, [email protected] (Anthony
S.) wrote:

>Hello to everyone, I feel guilty because I know people have
>probably written similar questions before, but here goes...
>I'm 25 and I recently went to get a new pair of glasses,
>and the technician told me that I was in the beginning
>stages of having cataracts. It really, really disturbed me,
>mainly because the only thing I knew about it was the fact
>that eventually it can cause blindness which frankly
>terrifies me. I am pretty ignorant on the whole issue of
>cataracts, and unfortunatly the optomtrist (sp?) didn't
>care to answer the questions I had because he was in such a
>rush. He was like, "Oh, everything's fine, you just have
>the start of a cataract on your eye." I've been searching
>the web, but I end up getting some fairly technical
>information about how cataracts come about, and things, but
>not a great deal of info on treatment, prevention, and when
>(or if) surgury is necessary. In other words, I'm lost and
>don't know how to handle the problem. Anyway, my point is
>just that I'd really like to hear from anyone with problems
>like this, as I have a lot of questions about the problem
>and don't know if there's anything to prevent the cataracts
>from growing, or get rid of them, etc. I just am scared and
>probably sound paranoid by worrying about it, but the
>thought of blindless has always scared me very, very much.
>Thank you _so_ much in advance for any information or
>thoughts you could offer. My e-mail is
>[email protected] , and anyone can feel free to
>message me. Thanks.
>
>Best wishes, Anthony

If you just have the beginning of a cataract, then it's too
early to do surgery. If you start having vision problems and
they worsen quickly, go back to your optometrist and ask to
have the cataract re-measured. They take them out when
they've either grown to a certain size or are growing.

It's a simple surgery. Takes about an hour and is most often
done with laser now. They lift the cornea and remove the
cataract. In my case, they implanted a lens in each eye and
the moment I got off the table, my eyesight was improved.
You have to put antibiotic drops in the eye several times a
day for about a week to prevent infection. After six weeks,
you can be measured for new eyeglass lenses. In some cases,
vision will be improved enough that you won't need glasses.

 

[Dr Judy]

"Anthony S." <[email protected]> wrote in message
news:[email protected]...
> Hello to everyone, I feel guilty because I know people
> have probably written similar questions before, but here
> goes... I'm 25 and I recently went to get a new pair of
> glasses, and the technician told me that I was in the
> beginning stages of having cataracts. It really, really
> disturbed me, mainly because the only thing I knew about
> it was the fact that eventually it can cause blindness
> which frankly terrifies me.

Cataracts will not cause blindness. As it develops it will
interfere with your vision to some degree and there is a
good, safe and effective surgical cure when the vision
declines to the point where you notice it. It take years,
often decades, before vision is affected.

> I am pretty ignorant on the whole issue of
> cataracts, and unfortunatly the optomtrist (sp?)
> didn't care to answer the questions I had because
> he was in such a rush. He was like, "Oh,
> everything's fine, you just have the start of a
> cataract on your eye." I've been searching the
> web, but I end up getting some fairly technical
> information about how cataracts come about, and
> things, but not a great deal of info on treatment,
> prevention, and when (or if) surgury is necessary.
> In other words, I'm lost and don't know how to
> handle the problem.

It is unfortunate that your optometrist did not discuss this
with you. Make another appointment and tell them in advance
that you are terrified of going blind from cataract and want
to talk about catarct. Your doctor has an obligation to
reassure you. If nothing else, from your reaction he will
learn to instruct his techs to not mention cataract, he will
learn to not mention it himself unless it is advanced enough
to cause symptoms and he will learn that he needs to provide
information to his patients when he does mention cataract.

Surgery is done when the cataract affects your vision enough
to justify the (small) risk of surgery. There is no known
prevention or non surgical treatment. We do know that
exposure to ultraviolet light is a cause: wear sunglasses
always when outdoors. Trama and some medications can also
cause cataract. You are relatively young to be developing
cataract, it is possible you have a congenital problem.

> Anyway, my point is just that I'd really like to hear
> from anyone with problems like this, as I have a lot
> of questions about the problem and don't know if
> there's anything to prevent the cataracts from
> growing, or get rid of them, etc. I just am scared
> and probably sound paranoid by worrying about it, but
> the thought of blindless has always scared me very,
> very much.

Please relax. It usually takes years before there is any
vision loss and cataract surgery is one of the safest and
most effective types of surgery there is.

Dr Judy

> Thank you _so_ much in advance for any information
> or thoughts you could offer. My e-mail is
> [email protected] , and anyone can feel
> free to message me. Thanks.
>
> Best wishes, Anthony

 

[taurusrc]

I would go to an opthamologist and have an examination. A
technician at the optometrist's office might be quite
unqualified to give that diagnosis.

I have had cataract surgery twice and it was almost a snap.
Both of them required a minor procedure several months later
but nothing to get upset about.

Ora

On 15 Mar 2004 12:18:12 -0800, [email protected]
(Anthony S.) wrote:

>Hello to everyone, I feel guilty because I know people have
>probably written similar questions before, but here goes...
>I'm 25 and I recently went to get a new pair of glasses,
>and the technician told me that I was in the beginning
>stages of having cataracts. It really, really disturbed me,
>mainly because the only thing I knew about it was the fact
>that eventually it can cause blindness which frankly
>terrifies me. I am pretty ignorant on the whole issue of
>cataracts, and unfortunatly the optomtrist (sp?) didn't
>care to answer the questions I had because he was in such a
>rush. He was like, "Oh, everything's fine, you just have
>the start of a cataract on your eye." I've been searching
>the web, but I end up getting some fairly technical
>information about how cataracts come about, and things, but
>not a great deal of info on treatment, prevention, and when
>(or if) surgury is necessary. In other words, I'm lost and
>don't know how to handle the problem. Anyway, my point is
>just that I'd really like to hear from anyone with problems
>like this, as I have a lot of questions about the problem
>and don't know if there's anything to prevent the cataracts
>from growing, or get rid of them, etc. I just am scared and
>probably sound paranoid by worrying about it, but the
>thought of blindless has always scared me very, very much.
>Thank you _so_ much in advance for any information or
>thoughts you could offer. My e-mail is
>[email protected] , and anyone can feel free to
>message me. Thanks.
>
>Best wishes, Anthony

 

[David Robins]

Blindness means permanent eye damage that is irreversible.

Cataracts do not cause blindness. They are easily removed,
and having them in the eye in general causes no damage to
the eye, just gradully increasing blurry vision and/or
glare and fog.

Surgery is low risk (but never zero risk).

If you have cataracts at age 25, either you have a family
history of early age cataracts, or you have a medical
condition that can cause catracts, or, more likely, you have
some lens opacity from infancy that is being incorrectly
interpreted as cataracts.

I'd see an ophthalmologist (eye surgeon) to help try to put
this to rest.

David Robins, MD Board certified Ophthalmologist Pediatric
and strabismus subspecialty Member of AAPOS (American
Academy of Pediatric Ophthalmology and Strabismus)

> On 15 Mar 2004 12:18:12 -0800,
> [email protected] (Anthony S.) wrote:
>
>> Hello to everyone, I feel guilty because I know people
>> have probably written similar questions before, but here
>> goes... I'm 25 and I recently went to get a new pair of
>> glasses, and the technician told me that I was in the
>> beginning stages of having cataracts. It really, really
>> disturbed me, mainly because the only thing I knew about
>> it was the fact that eventually it can cause blindness
>> which frankly terrifies me.

 

[Dan Abel]

In article <[email protected]>,
[email protected] (Anthony S.) wrote:

> Anyway, my point is just that I'd really like to hear
> from anyone with problems like this, as I have a lot
> of questions about the problem and don't know if
> there's anything to prevent the cataracts from
> growing, or get rid of them, etc. I just am scared
> and probably sound paranoid by worrying about it, but
> the thought of blindless has always scared me very,
> very much.

YOU WON'T GO BLIND!!!

Now that that is out of the way, you should go visit an
opthamologist and get examined for this. There's nothing you
can do for it, other than to have it removed. The doctor
won't remove it until your vision gets worse than a certain
point (but you'll still be able to see pretty well). You
might well get one eye fixed, and the other later (if you
have it in both eyes).

I've had the surgery done in both eyes, and I'm 54. The
surgery is very minor, and the last time I was in and out in
a little over 2 hours. The surgery was done in the eye
clinic (a mini-operating room) under local anaesthetic.

About a million of these surgeries are done every year in
the US. Many people get these as they get older.

--
Dan Abel Sonoma State University AIS [email protected]

 

[Richard Schumac]

First thing: relax. Cataract is not a big deal these days.
Almost no one with access to health care goes blind from it,
and you probably have months or years to consider the
options. Second thing: consult an ophthalmologist and get
all our questions answered. In the meantime...

Boilerplate about cataracts, IOLs, and surgery

I write as a near-sighted layman (not a doctor) who has had
cataract surgery in both eyes with intra-ocular lenses (IOL)
implanted in both eyes, and vision corrected with glasses to
better than
20/20. What follows are my own opinions. Always consult and
rely upon medical professionals for diagnosis,
advice, and treatment.

I. Preventing cataracts
II. Reversing cataracts
III. Cataract removal and IOL implant surgery
IV. What type, brand and diameter of IOL?
V. What's the best focus distance?

VI. Preventing cataracts

There is evidence that the following can slow the
development of cataracts:

1. Avoid exposure to UV and IR light: wear a brimmed hat,
visor or protective glasses when in Sunlight for more
than a few minutes, and if you work around furnaces or
kilns always wear protective glasses.
2. Lose weight.
3. Stop smoking.
4. Reduce consumption of diuretics (e.g., caffeine).
5. Stay well hydrated (drink plenty of water).
6. Get a full MDA ("Minimum Daily Amount", previously called
RDA, "Recommended Daily Amount") of anti-oxidants
(vitamins C and E, and the mineral zinc). It's best to
get these from food. Getting them in supplements is
better than not getting enough, but don't take much more
than an MDA of any of these as supplements without the
advice of a doctor.
7. Eat lots of strongly-colored vegetables (eg., spinach)
and fruits (eg., blueberries). Extracts of these may be
of some help. This should also help reduce the chances of
macular degeneration, a serious disease of retinas which
can cause blindness.
8. Wear protective goggles during sports or labor, to help
prevent eye injuries. Mechanical trauma to the lens can
initiate a cataract or accelerate the development of a
pre-existing cataract. (Eye surgeries can also do this,
but often it is a necessary risk and cannot be avoided.)

II. Reversing cataracts

There is no known way to reverse or clear up a cataract
using ultrasound, lasers, medicines, etc. Doing that would
be like un-cooking a hard-boiled egg.

III. Cataract removal and IOL implant surgery

A. Get opinions from two or three ophthalmological
surgeons early, before the cataract advances very far.
See whether they largely agree on the diagnosis,
compare their recommended course of treatment, and
compare their manner of dealing with you as a patient.
Have the surgeons measure your eye for fitting an IOL.
Accurate measurements are needed to select the right
IOL to get the desired focal distance. (As the
cataract progresses it can get more difficult to
accurately measure the length of your eye, so the
earlier this measurement is done, the better.)

B. Choose a surgeon who comes well-recommended and who
does a lot of these surgeries. There's no subsitiute
for practice. But also avoid anyone who appears to be
a "cataract mill", pumping patients through as fast as
they can without much explanation of the procedure and
its side-effects or without answering all questions to
the patients' satisfaction. In other words:

C. Get all of your questions answered. Press the surgeon
on possible side effects such as retinal detachment
(which is more likely if you are very nearsighted),
capsule opacification, floaters, astigmatism, "photic
phenomena" (for example, momentary flickering arcs of
light caused by reflections inside the IOL, haloes,
and unclear vision at night); post-operative care and
medications; and so on. Especially, discuss the type
and diameter of IOL to be used and what focal distance
you want from the IOL. More on these below.

CI. Taking into account your surgeon's advice for your own
case, consider waiting as long as possible before
actually having the surgery. This will make the
limitations of IOLs less objectionable and their
benefits more welcome. (That may sound like some goofy
mind game, but studies show it does help to improve
satisfaction with the result. My own experience
supports this.) But don't wait so long that you start
giving up routine activities, and expecially not that
you become a danger to yourself or others. For
example, if you can't see well enough to drive, then
it's time for surgery. Also, waiting a long time
allows the cataract to become "ripe", which can make
it more difficult to remove and more difficult to
correctly fit the IOL. (There is some variation in how
the term "ripe" is used. Some use it to mean "it's now
time to remove the cataract". Others use it to mean
"completely opaque and hard", which would usually be
long past the best time to remove the cataract.)

CII. What type, brand and diameter of IOL?

This is important because some are much less likely to
cause "capsule opacification" than are others. Capsule
opacification is a sort of secondary cataract that may
appear within a year of IOL surgery. It can usually be
burned away with a laser as an in-office (non surgical)
procedure, but it's probably better to avoid it if you
can. If your surgeon insists that all types of IOL have
the same risk of causing capsule opacification, get
another surgeon.

The diameter of the IOL can affect your final vision. Your
natural lens is larger (up to 12mm) than your largest
dilated pupil (up to 8mm in young eyes, decreasing to as
little as 4mm in old eyes), so that no out-of-focus light
"sneaks" around your lens in very dim light. Ideally, the
IOL would be just as large as your natural lens, but
unfortunately IOLs have to be smaller than your natural
lens. There are two reasons for this: the IOL includes
support structures ("haptics") which must also fit into
the same capsule which held your natural lens; this leaves
less room for the actual lens portion of the IOL, which
therefore must be smaller than your natural lens. Also, a
smaller IOL can be inserted through a smaller surgical
incision; a smaller incision usually heals faster and
leaves you with less astigmatism than would a larger
incision. Be sure to discuss the trade-offs of larger
versus smaller IOLs with your surgeon in advance. If you
are relatively young (under 40) and if you need better
night vision, ask about getting a larger diameter IOL.

CIII. What's the best focus distance?

Most existing IOLs will give you one fixed focus distance.
Some existing IOLs are "multifocus" in the sense that they
give you one fixed focus distance for one part of your
field of view, and another fixed focus distance in another
part of your field of view. For both types, the fixed
focus distance does not change as you look around, and you
cannot "will" the focus distance to change. Most people
choose an IOL with a single focus distance. From what I've
read some people who get "multifocus" IOLs are not very
happy with them. True adaptive-focus IOLs which work like
the lens you were born with may be available in the
future, but they are probably years away.

Some surgeons will assume that your "dominant" eye should
be fixed at "infinity" (more than about 6 feet) and that
your "non-dominant" eye should be fixed at reading
distance (about 18 inches). If you have been very
nearsighted or farsighted all of our life that may not be
the best choice, especially if you get an IOL in only one
eye at a time or if you do not have one strongly dominant
eye. If possible work with an optometrist to simulate the
effect of a particular choice of focal distance (or
distances, one for each eye) before surgery. This can
often be done with disposable soft contacts, which are
very comfortable. You may find that you don't like or
can't tolerate the first choice of focus distance. Or, you
may find that you can't tolerate having different focus
distances in each eye, because this causes the image sizes
in each eye to differ. (When I had only one IOL I found
that I could not tolerate any image size difference, but
that was easily corrected by using a contact lens in the
non-IOL eye. When I got the IOL in my other eye it was
targetted for the same focus distance as my first IOL to
give the same image size and focus distance, and so
obviate the need for the contact lens.)

Because of unavoidable uncertainties in measuring eyes, it
is hard to predict the exact actual focus distance that
will result from an IOL. If the intended focus distance is
roughly reading distance (anything from one to three
feet), that uncertainty will cause at most a few inches
shift away from the desired focus distance. You will be
slightly nearsighted, but you will be in focus at some
particular distance in that range without glasses (unless
you need glasses anyway to correct astigmatism). If,
however, the intended focus distance is infinity
("emmetropia") the uncertainty amounts to about plus-or-
minus three feet. That leaves about one chance in two that
you will be made farsighted, and in that case you will
always need glasses to see clearly at *any* distance.