Q: I just had my annual eye exam and was told I am developing cataracts. I am 59 years-old and in very good health. Is there anything I can do or could have done that would make a difference in my getting cataracts? I take a hormone called Activella and also take Atenolol and Maxzide for blood pressure. I walk four miles almost every day in about an hour and eat pretty healthy. My glasses have a coating for UV protection. The eye doctor said the only treatment was to change my glasses as my eyes worsen until the point I will need surgery to replace the lenses. Thank you.
A: It is difficult for me to determine what, if anything, you could have done to prevent cataracts. You may have been what is called a “sun worshiper” and spent hours out of doors without eye protection when you were younger. You may have been on a steroid medication long-term at some stage in your life, or experienced eye trauma. You may have a family history of developing cataracts, have had exposure to ionizing radiation through X-rays or sunlight, have hypertension, or be a smoker. The data on hypertension as a cause of cataracts is not strong, but may be a remote possibility. Most cataracts develop slowly and with age so they aren’t disabling early on. Your ophthalmologist is correct, stronger eye glasses will help for a period of time. However, the cataracts will eventually interfere sufficiently with your vision so that the benefits outweigh any risks of having them removed.
The lens of your eye where a cataract forms is located behind the iris, the colored part of the eye. The lens focuses light that produces a clear image on the retina, the membrane on the inside wall of the eyeball that works in a similar fashion to that of a camera. With age, the lenses of our eyes thicken, become less transparent and cloudy, and less flexible. When a cataract develops, the clouding becomes more dense and covers a larger portion of the lens. It becomes more difficult to see and a person may have difficulties with oncoming headlights when driving at night. Stronger eyeglasses don’t improve vision and quality of life is affected. A person may have difficulties reading a book, watching television, or performing tasks taken for granted in the past.
Cataracts may develop in one eye only; however, they commonly develop in both. Your eye physician will likely take a wait and watch approach, declining to perform surgery until he or she determines the timing is correct. This may take an extended period of time that is difficult to understand but the eyes are precious things that must be protected for as long as possible before anything is done. Then, one eye may be worse than the other and an ophthalmologist may choose to repair one before the other.
Repair involves removing the clouded lens and replacing it with an intraocular lens that is positioned in the same place as your natural lens. This will require local anesthesia to numb the eye; however, you will remain awake throughout the relatively brief procedure. The lens will remain in place as a permanent part of your eye. If a second eye is to be repaired, it will likely be accomplished in a month or so following the first procedure. There are some individuals with other eye problems who cannot have lens implants. For those, the cataract will be removed and the individual will wear eyeglasses or contact lenses for improved vision. Or, phacoemulsification a/k/a small incision surgery may be considered in which the lens is fragmented using ultrasound energy and aspirated from the eye through a smaller 2 to 4 mm incision.
You should continue with regular eye examinations, wear sun glasses with proper UV coating when out of doors to protect your eyes from ultraviolet light, discontinue smoking if appropriate, eat a healthful diet that includes fruits and vegetables and manage any health problems you may have.
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