Historical June 1989 health article, reprinted from Community HouseCalls, published by the Visiting Nurse Association of Greater St. Louis, Vol. V, No. 1. It preserves period information and is not current medical guidance.
What it is and how it is treated. Cataract is a leading cause of blindness among adults in the United States, accounting for one out of every seven cases of blindness among persons 45 years of age or over.
Although most prevalent among older persons, a cataract can occur in young people, and can sometimes be found in a baby’s eyes at birth.
As medical advances have succeeded in lengthening the human lifespan, more and more Americans are—and will be— entering the age group associated with the development of a cataract.
It has been said that if we live long enough, most of us will develop a cataract.
The treatment for a cataract is surgery, which offers a safe and successful means to restore vision in more that 95 out of 100 cases!
For the cataract patient this means that he no longer has to accept cataract blindness as the price of aging.
A highly effective and proven means exists to return the patient to a world of vision.
What is a cataract?
A cataract is an opacity, or clouding, of the eye’s lens which blocks or changes the passage of light needed for vision.
The lens of the eye is located behind the pupil and the colored iris, and normally is transparent. Its role is to help focus images onto the retina at the back of the eye, which transmits the images to the brain.
The underlying cause of cataract formation has not yet been determined, although it is known that a cataract is associated with chemical changes within the lens.
Most often a cataract is related to the normal aging of the person—and the eye. Other factors that play a role are infection; hereditary influences and congenital events, such as German measles in the mother; physical or chemical injury to the eye; and exposure to intense heat or radiation. Eye diseases and certain general diseases, such as diabetes, can also lead to cataract development.
Are there symptoms?
Cataract formation is not associated with “signals” such as pain, redness or tearing.
The symptoms of a cataract all revolve around the interference with vision; blurred vision, double vision, spots, ghost images, the impression of a “skin” over the eyes; problems with light, such as finding lights not bright enough for reading or near work, or being “dazzled” by intense light—as one eye physician has described it, “You need more light on your work, but less light near your eyes.” The need for frequent changes of eyeglass prescriptions—which don’t seem to help—is another symptom.
As a cataract develops it may be noticeable to others as a milky or yellowish spot in the normally black pupil.
When the area of clouding is small and away from the center of the lens, there may be little interference with vision except for the annoyance of corresponding loss of detail in the visual image.
If such a cataract progresses a great deal, however, or if the cataract began in the center of the lens, visual difficulty may be marked and may even interfere with everyday activities.
The eye physician, or ophthalmologist, usually advises surgery when this point of “life-interference” is reached.
A cataract is not contagious, is not a kind of infection, is not a “skim” growing over the eye.
It will not be made worse by using the eyes; nor can it be made better by medicines.
There are no treatments, eye drops or other medications which will dissolve a cataract or slow down its progression.
A cataract may develop rapidly over a period of a few months, or it may progress very slowly over a period of years.
In other instances it may progress so far and then stay the same—and many people never experience visual difficulty to the point that the ophthalmologist will advise surgery.
What can be done?
The only effective treatment of cataract is surgery; and although it is a delicate operation, it is one of the safest operations done today. Cataract surgery has been perfected to the point where successful recovery of vision is attained in more than 95 out of 100 cases!
The determination of when and if surgery is advised will be made by the ophthalmologist, in accordance with the patient’s degree of vision loss and other important factors. Regular eye examinations, once the diagnosis of a cataract has been made, are important.
They permit the ophthalmologist to evaluate the cataract’s progress, treat other eye problems if they exist, and elect the best time for surgery—with knowledge of his patient and the patient’s medical history.
In cataract surgery, the clouded lens is removed.
There are varying techniques for the surgical procedure itself; and the ophthalmologist will select the method best suited to his patient, considering such factors as the degree of “ripeness” of the cataract, the age of the patient, the patient’s general health and any other important influences.
The patient who feels hesitant about surgery should bear in mind that advances in this field extend to all areas involved, including presurgery medication, drugs used to ease the removal process, the technique and instruments used, the anesthesia, and the recovery process— most patients now go home in a few days.
After cataract surgery, a replacement is needed to provide the eye with a focusing agent to take the place of the removed lens.
The -replacement” may be special cataract eyeglasses, contact lenses, or lenses placed inside the eye at the time of surgery. Temporary glasses are usually prescribed until the recovery process is complete—usually about six weeks.
Will vision be normal?
The patient will notice that his new vision is different: Objects are larger, colors are altered, the feel for distances must be adjusted.
If only one eye has been operated on, the patient will rely for the time on, either one eye or the other alone, since the image the two eyes will receive will be too different and confusing.
After both eyes have been operated on, this problem no longer exists.
In instances where only one eye is to be operated on, a contact lens is often prescribed because the “image difference” between the two eyes is small and the patient can usually adjust quite well.
If “best vision” is the only consideration, contact lenses or intraocular lenses do provide less distortion than cataract eyeglasses and more complete side vision.
However, other considerations, including the patient’s ability and desire to adjust to contact lens handling, or the ability of the eye to adapt to lenses within the eye, are important and decisive.
If you have questions…
The prospective cataract patient who needs referral to an ophthalmologist should ask his family physician, contact his local medical society, or write to the National Society to Prevent Blindness (79 Madison Avenue, New York, NY 10016).
Various sources of aid are available to those with limited income: Medicare and other governmental or insurance resources may apply; social service departments of medical centers or hospitals can help; and many eye clinics offer fees adjusted to income.
The eye physician should be told of such considerations, so that he can offer advice. Local family service agencies, the Visiting Nurse Association, the public welfare department, or public health department can also provide guidance. Reprinted from Community HouseCalls, published by The Visiting Nurse Association of Greater St. Louis, Vol. V, No. 1.
Originally published in The Times of Skinker-DeBaliviere, June 1989.
Read this article in the original newspaper issue.
Original source: SD_Times1989_06.pdf, printed page(s) 7; PDF page(s) 7.
