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Blurred vision and increased glare could mean cataracts

HIGHLIGHTS:

  • If you experience any of the following symptoms, it could be a sign of cataracts: blurred vision, lack of vision clarity, increased glare, distorted vision and a change in eyesight that may include becoming increasingly short sighted, or for those who were previously long sighted and required glasses to see at a distance their vision has returned to normal when not wearing glasses.
  • The most common causes of cataracts are aging, some forms of medication, prolonged exposure to sunlight, smoking, alcohol consumption and some types of diseases such as diabetes.
  • There are currently no drugs or eye drops available that can effectively cure or reduce symptoms associated with cataracts. Surgery is the standard form of treatment most widely used.

 

The lens of the eye focuses light onto the retina in order to transmit signals to the brain that result in an image being formed. A lens which becomes cloudy, referred to as a cataract, results in a decrease in vision clarity. Cataracts are categorized into the following types: nuclear sclerosis, cortical, posterior subcapsular, anterior subcapsular and polar.

How to find out if you are suffering from a cataract

There are a large number of symptoms associated with cataracts, including:

  1. Vision deterioration. Patients usually experience blurring of vision that can significantly affect their daily lives, for example when driving, reading signs, reading in general, or even performing daily tasks such as walking up and down stairs, working or outdoor walking. Patients who undergo a visual acuity assessment will see a deterioration in vision quality. Each type of cataract can have a unique effect on a person’s vision, depending on the available light and pupil size. For instance, despite being rather small in size, posterior subcapsular cataracts (PSCs) can have a significant impact on short sightedness, such as when reading, while long sightedness and color perception may be relatively or completely unaffected. Nuclear cataracts, on the other hand, tend to affect long sightedness more than short sightedness and may also impact a person’s color perception.
  2. Increased glare. Patients with cataracts will experience more glare than usual, particularly in direct sunlight or car lights while driving, with posterior subcapsular cataracts (PSCs) especially culpable in this regard.
  3. A lack of, or deterioration of, vision clarity.
  4. Changes to vision in the form of increased short sightedness, especially in patients suffering from nuclear sclerosis who may previously have had normal sight – neither long nor short – and would not have required glasses to see clearly at a distance. However, cataracts can cause a deterioration in vision and lead to short sightedness. Patients who suffered from long sightedness and required glasses to see clearly at a distance will find that their vision has returned to normal and that they no longer require glasses.
  5. Distorted vision. Cataracts sometimes cause distorted or double vision. However, distorted vision can also be a signifier of other more dangerous health disorders such as cranial nerve paralysis. If you experience such symptoms, you should consult an ophthalmologist at your earliest opportunity.

Causes and prevention of cataracts

Prevention is preferable to treatment for any illness, so it is important to understand the most common causes of cataracts, including:

  1. Aging. Our lenses deteriorate with age, becoming thicker and harder due to chemical changes affecting proteins contained within.
  2. Some forms of medication, such as:
    • Steroidal drugs, decoction drugs, traditional medicines, bolus drugs and herbal medicines containing steroids
    • Psychotropic drugs of the phenothiazine class
    • Atropine blockers
    • Beta blockers
    • Statin drugs (aimed at reducing blood vessel lipid levels) when consumed in large amounts
    • Tamoxifen

For this reason, we should take good care of our bodies to avoid illnesses requiring medication that may place us at risk of developing cataracts.

  1. Ultraviolet light. Prolonged exposure to ultraviolet rays leads to an increase in cortical cataracts. Wearing sunglasses and a wide-brimmed hat will help to reduce this risk.
  2. Smoking.
  3. Excessive consumption of alcohol.
  4. Physical disorders that have been found to be associated with cataracts, including:
    • Diabetes – high blood sugar levels and mismanagement of diabetes increases the risk of cataracts
    • Galactosemia disease
    • Wilson disease
    • Calcium deficiency
    • Myotonic dystrophy
    • Atopic dermatitis
    • Takayasu arteritis
  1. Accidents, including eye injuries. Getting stone or metal particles in the eye not only increases the risk of cataracts but can also severely damage the eye, permanently affecting sight.
  2. Exposure to radiation. People with certain illnesses such as cancer who receive radiotherapy aimed at the head have an increased risk of developing cataracts.
  3. Chemicals, especially alkaline chemicals, entering the eyes can penetrate the eyeball and lens, potentially resulting in the formation of a cataract.
  4. Electric shock.
  5. Some eye disorders, including:
    • Uveitis
    • Exfoliation syndrome
    • Eyes that have undergone vitreous or retinal surgery
    • Anterior segment ischemia
    • Retinitis pigmentosa
    • Low eye pressure (less than 6 mm/Hg for an extended time)

Now that you understand a little more about the causes and risk factors of cataracts, we can see that age is the only factor out of our control. However, you are able to mitigate many other risk factors, such as not smoking, avoiding regular consumption of alcohol, keeping your eyes safe from ultraviolet rays by wearing sunglasses and a wide-brimmed hat, and taking good care of your health at all times to ensure you do not develop a potentially dangerous health disorder. If you are diabetic, make sure you are always paying attention to your blood glucose levels and avoid the use of unnecessary medication. Additionally, if you suffer from any existing eye disorders be sure to consult an ophthalmologist regularly regarding the proper care for your condition.

Diagnosing cataracts

Accurate diagnosis of cataracts must be carried out by a qualified ophthalmologist who can then plan any subsequent treatment that may be necessary.

Treating cataracts

There are currently no drugs or eye drops available that can effectively cure or reduce the symptoms associated with cataracts. Cataract surgery is the main form of treatment used to treat this condition.

The following factors should be apparent before surgery is considered:

  • The cataract is so severe that it is affecting the daily life of the sufferer.
  • The cataract is severe enough that it places the patient at an increased risk of related illnesses such as glaucoma.
  • The cataract is prohibiting effective eye screening from taking place, for example in cases of diabetes that require screening of the retina in order to assess whether the disease has spread to that area. If the lens is particularly cloudy it will interfere with proper screening, meaning that surgery must be carried out to remove the cataract.

Steps involved with cataract surgery

Minimally invasive cataract surgery, a form of surgery that utilizes a device to remove the cataract completely, is currently the industry standard. The device is inserted into the corneal region and then replaces the damaged lens with an intraocular lens. The procedure usually takes from 30 minutes to one hour, during which time the recipients have their head covered with a cloth but are able to hear the sound of the device as it is removing their cataracts. It is essential that patients undergo thorough optical screening prior to surgery, with the following tests generally carried out by an ophthalmologist: eye test, pupil dilation test, eye pressure test, corneal curvature screening, eye length measurement, and intraocular lens measurement. Some cases may require an endothelial cell count and corneal thickness analysis.

Cataract surgery preparation

Preparation for cataract surgery includes avoiding taking drugs that impact blood coagulation for seven days prior to surgery, although such decisions are at the discretion of the doctor in charge. It is advisable that patients bathe, wash their hair and ensure high levels of personal hygiene on the day of the procedure. They should be sure not to apply any makeup.

Post-surgery advice

The eye that has been operated on will be covered with an eye patch, and water must not be allowed to enter that eye for at least 7 days. The eye should be covered completely for the first night, although eyedrop treatment can begin the following morning. Use a clean cloth to wipe your face to prevent water from accidentally entering the eye. Swimming is not allowed for at least one month. Be careful not to allow dust, dirt or smoke to enter the eyes, and avoid strenuous exercise, coughing, sneezing, squeezing with force, and rubbing the eye. Use a patch to protect the eye for at least 7 days, especially when sleeping. Sunglasses are advisable during daylight hours. Patients may carry out their daily activities as normal but should stringently adhere to the use of eyedrops and medication as advised by their doctor, and should bring those drugs with them to all follow-up appointments. If irregularities occur, such as an increase in blurred vision, eye pain, and/or increased eye redness, schedule an appointment with your doctor at the earliest available opportunity.

Many of the risk factors associated with cataracts are unavoidable, including the aging process and some health disorders that can increase the risk of cataracts. Nevertheless, there are numerous risk factors which can be managed to ensure protection against cataracts, including taking good care of your physical health and being sure to consult your doctor regularly or when you experience issues with your eyes.

If you are already suffering from cataracts or vision irregularities be sure to seek diagnosis and treatment, and adhere to the recommendations of your doctor before and after any treatment takes place. This will ensure treatment is as effective as possible, while also protecting you against potentially dangerous complications.


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Yonrawee Piyacomn, M.d., Fico, M.D. Summary: Ophthalmology Ophthalmology