You may have cataracts?

Courtesy of entirelysubjective on Flickr

Courtesy of entirelysubjective on Flickr

Cataracts are common

Not a day goes by in the office when I don’t tell a patient that he or she has a cataract, which is any kind of clouding in the crystalline lens of our eye. Some patients have heard of the term and understand that it’s a common occurrence as one ages. Other patients are terrified of the term and think it’s a disease that will make them blind. But the patients I relate to are the ones who hear the word cataract, and think “I’m old.”

Cataracts can affect your vision

If it helps, most cataracts develop over decades, from young adulthood onward. As early as 40 years old, we can start to notice the effects of this change over time. The crystalline lens in our eye, which is responsible for focusing light onto our retinas, begins to change shape and chemical structure over time. These changes result in more light scatter and dimming of vision. Usually, a patient will begin noticing glare from car headlights, double or ghost images around letters and lights or that night vision is not as clear or bright.

These are often initial symptoms and do not require treatment. As the cataracts continue to develop, patients’ eyeglass prescriptions may begin to change and they will also experience blurry or cloudy vision with worsening of the above symptoms. When they reach this point, which is about half of patients over the age of 65, cataract surgery may be indicated.

Cataract surgery – not as bad as you’d think

Cataract surgery is the most common surgery performed in the world. Nowadays, it can be a 15 minute out-patient procedure. The cataract is removed from the eye and replaced with an artificial lens implant, called an intraocular lens. With many advancements in this field, the lens implant can also have specialty optics which can correct for astigmatism or for both distance and reading.

What many don’t know is that cataract surgery is an optional procedure. A cataract is not malignant and does not always have to be removed. However, a patient’s vision will improve significantly with a successful cataract surgery. They will notice a much brighter and clearer environment. Some patients who have glaucoma or have a crowding of the internal structures of the eye would benefit from having cataract surgery.

Image

Photo courtesy of Community Eye Health on Flickr

Types of cataracts

There are many different forms of cataracts. In fact, I found a cataract in a 9-month old baby when his mom brought him in for a well-visit eye examination. In such a case where the eye is still developing, clouding of the lens can interfere with visual development and needs to be removed. Other congenital form of cataracts may simply be a cloudy spot on the lens which doesn’t interfere with vision. In this case, there is no need for cataract surgery.

Cataracts can also develop from trauma, use of certain medications and diabetes. Depending on the type, a cataract can slowly worsen over years, or change rapidly requiring surgical intervention within months. For patients whose vision is changing rapidly, I often like to follow them every few months to monitor for vision and cataract changes.

People often ask what can be done to prevent cataracts. Unfortunately, genetics plays a factor so if your parents required cataract surgery, you will most likely need one also. If you’re outdoors, wear a good quality pair of sunglasses that block UVA/UVB rays. This goes for kids as well since exposure to ultraviolet radiation is cumulative. If you’re outdoors for long periods of time, throw on a hat for added protection. Smoking has been shown to cause cataracts also, so limit your exposure to cigarette smoke. If you are currently being treated for diabetes or using steroid medications, be sure to see your internist regularly.

Why wait for your vision to blur? See your optometrist every year!

Most importantly, see your optometrist annually for an eye examination. They can check for cataracts but also determine if there are other factors that may be contributing to a reduction in your vision. It’s not just the lens that helps you to see but a whole network of related structures that work as a team to provide you with optimal vision.  If you require a new pair of glasses, always opt for an anti-glare coat on the lenses, which would further reduce disabling glare symptoms.

~Cindy P. Wang, OD, FAAO
http://eyehelp.org
http://www.coavision.org

 

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Anatomy of the Eye 101

Courtesy of DVIDSHUB on Flickr

Courtesy of DVIDSHUB on Flickr

As a teacher and a doctor, I talk about the eye on a daily basis to my optometry students and patients alike.  I often use examples that my optometry students and patients can relate to.  The eye is like a high definition video camera that captures images of the visual world in real time.  If any part of your eye, that is, your “human video camera,” is affected or broken you may experience varying degrees of blurry vision, discomfort, or other common symptoms.  If you seek professional evaluation by your optometrist at the first inkling that something is out of sync, he or she can “fix or repair” your eye and get you back on a healthy track.

So let’s talk about the eye from front to back.

To start, the eyelids and lashes are the first visible structures to the outside observer.  Not only are the eyelids and lashes beautiful, but they also serve to protect the eye.  The eyelids spread lubricating tears like that of a windshield wiper across the surface of the eye with just a single blink, and the lashes act like specialized antennae sensing the smallest incoming offending particles.

Next, the conjunctiva is known to us as the “white” part of the eye.  This too is visible to the outside observer.  There are times that the conjunctiva may get inflamed or infected which results in that unwanted “pink eye” or conjunctivitis.

Much respect and attention has been given to the 5-layer-thick cornea as the clear window of the eye.  This is the layer where contact lenses are applied to correct nearsightedness or farsightedness.  Many successful surgeries like LASIK and corneal transplants have been performed on this tissue.

The anterior chamber and the vitreous are two compartments that give form to the eye and serve as conduits for circulating important fluids from one part of the eye to another.

Courtesy of entirelysubjective on Flickr

Courtesy of entirelysubjective on Flickr

The color part of the eye is called the iris.  It comes in many different colors and hues including brown, hazel, green, blue, and even violet.  The purpose of the iris is to regulate the amount of light that enters the eye.  Like that of a camera shutter, the iris controls the size of the pupil thus preventing under or over exposure of the picture of the visual world that is being seen.

The crystalline lens sits right behind the iris.  And similar to a camera lens, the human lens helps focus the things we see.

The retina, optic nerve, and macula can all be found way back in the eye.  The retina is the nervous tissue of the eye and is made up of 10 important layers. It gathers nervous signals and funnels it to the optic nerve.  As the name implies, the optic nerve is the nervous cable that connects the eye to the sight center in the back of the brain.  The macula allows you to see the finest details in vision.

This sums up the crash course on the Anatomy of the Eye 101.  Next time you are at your friendly optometrist’s office, just imagine the different parts of your eye being systematically looked at.

~By Judy Tong, OD