|
Cataracts are a clouding of the normally clear lens of the eye. Vision is impaired when the blurring occurs directly in the line of sight or as the cataract slowly enlarges and blocks vision. Cataracts are not a growth or film over the eye, and are not painful. They affect only the lens of one or both eyes, and can make the pupil look white or grey.
The prevalence of cataract rises from about 2.5 per cent for people in their forties to 99 per cent of people in their 90s. Nearly half of people in their 90s have had cataract surgery. Cataract surgery is the most commonly performed ophthalmic surgery in Australia and is becoming more common as people live longer. In 1999, approximately 120,000 cataract operations were performed. Although most commonly associated with older age, cataracts can occur in children and adults. FACTORS CAUSING CATARACTS INCLUDE: - age (the most common cause)
- heredity
- birth defects
- German measles
- eye injury
- diabetes
- smoking
- lifelong exposure to ultraviolet light (usually sunlight)
- diet
- certain medications (such as corticosteroids)
- some types of arthritis
- short-sightedness
SYMPTOMS OF CATARACTS MAY INCLUDE: - cloudy, foggy, or filmy vision, not corrected with eyeglasses or contact lenses
- glare from lamps, sunlight, or snow
- blurred or double vision
- decreased night vision
- light sensitivity
- dulling of colours
- frequent eyeglass prescription changes and
- stronger glasses failing to improve sight
TREATMENT: Small cataracts require periodic monitoring only. Larger ones may require glasses or other treatment. When vision problems caused by cataracts become serious enough to disrupt a person's life, a surgical procedure called cataract extraction may be recommended to correct the loss of vision. This procedure involves the removal of the cloudy lens of the eye which is usually performed under a local anaesthetic. A tiny incision is made and the lens is removed and replaced with an intraocular lens implant to restore the focusing power of the eye. The cut is sometimes sutured closed, and a patch may be placed over the eye. PREPARING FOR SURGERY Before surgery, the eye specialist will discuss any changes that should be made regarding any medications normally taken. They will probably advise the patient to avoid aspirin and other aspirin products for at least a week before surgery, as these can cause excessive bleeding during or after the operation. Also, the patient may need to begin using antibiotic eye drops a few days before the surgery. Some testing may be required before surgery is scheduled, such as: - routine blood tests and
- an electrocardiogram or ECG test
12 hours before surgery the patient may be required to avoid eating or drinking anything. A sedative will be given just before surgery to relax the patient. A topical or local anaesthetic will be given to numb the eye so no pain will be felt during the surgery. Cataract extraction surgery is rarely performed under general anaesthesia. AFTER THE SURGERY Most cataract surgery is done as a day procedure and does not require an overnight stay in hospital. After the surgery, the patient's blood pressure and other vital signs will be monitored in a recovery room. Eye drops will be given and some mild pain medication may be required. Within a few hours, they should be allowed to go home, but will require someone to drive them as they will not be allowed to drive immediately after the surgery. Following the operation daily activity will be limited for a few days and assistance may be required for personal care and household duties, such as: - dressing
- toileting
- bathing
- bending
- lifting
- errands and
- transportation
The specialist may also advise the patient not to rub or press on the eye nor shampoo hair until advised. No driving may also be stipulated, until permitted by the specialist. HOME CARE Home care instruction will be given to the patient for the affected eye. This usually includes using prescription eye drops (to promote healing) and wearing glasses or an eye shield (to protect the eye). The eye may be red and sensitive for the first few days after surgery. However, these symptoms will gradually fade. Complete recovery may be expected in 4 to 8 weeks. During this time, vision will continue to change and improve until it finally stabilises. Colours may look brighter and have a bluish tint. Wear dark glasses to block the brightness of the sun. Once vision has stabilised, a prescription will be given for new eyeglasses. During recovery, especially during the first 4 weeks, watch for certain symptoms that may signal a complication or developing problem. These symptoms may include: - eye pain
- decreased vision
- swollen eyelids or
- seeing flashes of light
IF YOU HAVE ANY OF THESE SYMPTOMS AFTER CATARACT SURGERY, CONTACT YOUR DOCTOR IMMEDIATELY. After cataract surgery 85 per cent of people have vision good enough to drive a car. Complications are rare, but as with any surgery, a perfect result cannot be guaranteed. Cataracts do not recur after surgery however, in approximately 25 per cent of people, the capsule that supports the lens in the eye becomes cloudy some time after cataract surgery. Laser is then used to clear this cloudy capsule and restore clear vision. It is done under local anaesthesia or topical anaesthesia and takes about an hour. Currently, we do not know how to prevent cataract, but sun protection (use of a brimmed hat and sunglasses when outside) and quitting smoking may help. Research is currently being conducted to determine if antioxidants may help prevent or delay the onset of cataracts. Article #4511 Copyright (c) 2002 McKesson. All Rights Reserved. |
