A part of aging
With one eye covered, every patient at the optometrist hopes to read that last line of small print correctly. Is it a number or maybe a letter?
As the years go on and the lines become less clear, it might just be cataracts. Cataracts are often described as a fog or cloudiness over the lens of an eye and, over time, can become worse if not treated. With so many factors contributing to today’s health concerns, what’s the No. 1 cause to cataracts?
“Birthdays,” said Dr. Sam Silverblatt. “If you live long enough, you’ll get cataracts; it’s going to get cloudy. The cloudiness may not affect your day-to-day life to where you won’t need surgery, but I can promise you, if you’re 65 or 70 years old, that lens does not look like it did when you were 35.”
There are some cases in which people are born with congenital cataracts, but according to Silverblatt, they don’t typically notice them and they do not affect their vision. The cataracts that are due to aging are likely caused by oxidative stress, which is de ned by the National Center for Biotechnology Information as the result of an imbalance of antioxidants and pro-oxidants.
A factor which can cause cataracts to progress faster is exposure to ultraviolet light. It’s important to protect your eyes and wear sunglasses, but Silverblatt also credits total health in combating the process as well. “You’re going to get them [eventually], but it can be a matter of protection – like UV block for your skin,” he said. “I believe that all other [health aspects] go with it, too. If you eat right, don’t smoke … overall general health can delay that process, too.”
When it comes to eyewear, however, there’s the good and then there’s the best.
“You can’t beat polarized lenses,” Silverblatt said. “When you’re sitting in your car and you see all those re ections on your dashboard off the inside windshield, with tinted lenses they’re still there, but with polarized lenses they’re gone. They block horizontal glare, like re ections coming off water, the street and the hood of your car. It helps with ultraviolet because it blocks just that much more.”
There is only one treatment to cataracts: surgery. Silverblatt said if a patient sees worse than 20/40, which is the driver’s license rule of thumb, it might be time for surgery.
“A lot of the time we ask the patient, ‘Is your vision keeping you from doing anything you want to do?’” he said. “‘You like to sew. Can you thread the needle?’ When your vision is affecting your daily life and updating your glasses isn’t going to improve anything, it’s time to have surgery.”
The surgery itself has evolved to a manageable, out-patient procedure that offers high results and little downtime.
“It’s an outpatient surgery, and in the hands of a good surgeon, it should take about 20 minutes,” Silverblatt said. “Recovery time is easy; you go home to sleep with a plastic covering over your eye for about ve nights and use antibiotic drops to prevent infection. You can have cataract surgery on Friday and go to work on Monday – with better vision. And if everything goes according to plan, there’s a good chance you won’t need any distance vision glasses [after surgery]. A lot of patients only wear reading glasses.”
The surgery involves replacing the clouded lens with a lens implant by using an ultrasound probe.
“The power of the lens, on average, is about 15, which is a strong lens,” Silverblatt said. “So when you take it out, you’re missing that much power. They take an ultrasound and measure the length of your eye [needed for implant size]. Then they take an ultrasound probe that breaks up the lens, I call it an ultrasound vacuum, that has uid going in and out of it. As it breaks up the pieces, it sucks it out and they clean it all out.” The lens implants have evolved as well with astigmatism-corrective implants and multi-focal implants. In some cases, patients can recover from surgery able to see both near and far with no corrective eyewear or contacts.
It’s important to visit your optometrist regularly to monitor your eye health as cataracts only get worse when left untreated.
“Eventually, if it goes untreated, it can cause total blindness,” he said. “You hardly see that these days, but there can be the patient that doesn’t take care of it and when they come in, their lens isn’t just a little cloudy – you basically can’t get any light through it.”
The moderate surgery provides relief to cloudy vision with little downtime, but maintaining overall health and wearing eye protection remains crucial in delaying the onset of cataracts.
