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DIFFICULT TO PREVENT ONSET OF CATARACTS

By Dr. George V. Roberson/FOR YOUR HEALTH
Sunday, April 19, 2009 11:24 PM CDT

Q: Dear Dr. Roberson, I am about to have cataract surgery and I was wondering what causes a cataract and is there anything you can do to prevent them? I am having surgery on the left eye.

A: Having a cataract can be frustrating as our eyes are a camera on the world and let us know what's going on around us. Cataracts may result in blurred or dimmed vision, and increased difficulty with night vision, having halos around lights, double vision, and sensitivity to bright lights. Fortunately it can be corrected by a skillful Ophthalmologist. It is one of the more common outpatient procedures. The success rate of the procedure is greater than 95%.

Our eyes are somewhat like a camera. Light passes through the rounded outer surface of the eye called the cornea. It then passes through the aperture or pupil, in the middle of the eye, and is gathered by the lens. Like a lens in a camera, it focuses the light on the membrane called the “retina” or the “film” on the back of the eyeball. This is transmitted, by nerve endings, to the brain which forms an image. Cataracts develop in the lens. The lens is formed by crystal clear proteins that with time may break down, losing their transparency. As the breakdown spreads, clouding develops over the lens scattering the light which enters the eye, preventing a sharp focus from reaching the retina.

It is hard to prevent the development of a cataract because by the age of 80 more than _ of all Americans either have a cataract or have undergone cataract surgery. Age is the single greatest risk factor for cataracts.

There may be some things which can be done to limit the possibility of developing a cataract. The first step should be to stop smoking. Then if you are an outside parson, wearing sunglasses and/or a wide brimmed hat, to reduce the exposure of ultraviolet light, is beneficial. Ultraviolet light produces some unstable molecules, called free radicals, in the lens which can damage some of the protein and cells of the lens. Ordinary sunglasses may not be acceptable. They should block 99% of ultraviolet A&B.

There is no evidence that a healthy diet has any effect on the development of cataracts. Anti-oxidant containing foods may be beneficial.

If you have other health problems, such as diabetes, a good treatment plan will control or reduce the risk of eye problems. Prolonged corticosteroid treatments for conditions such as arthritis may increase the risk of cataracts.

In early stages of the disease Optometrists or Ophthalmologists will frequently recommend wearing magnifying lenses or use of stronger lighting while working. This may delay surgical corrections. Cataracts develop slowly and do not cause any damage to other parts of the eye. When the cataract begins to affect your quality of life or you ability to read or drive, then it is time to consider surgical correction.

The most common method of cataract surgery is phacoemulsification. The name is longer than the incision (1/8 '') for replacing the lens. A tiny needle is placed in the lens and a vibrating probe softens and breaks up the clouded lens which is then removed. When the lens pieces are removed, a clear outer capsule is left behind to help support an implanted lens. These are generally flexible and soft, similar to a contact lens. The new lens is folded up and inserted into the capsule. A larger or more advanced cataract may have to be replaced with a different outpatient procedure. Vision is improved over a period of a few days, to a week.

Although this surgery is very successful, resulting in improved vision, you may have to have prescription glasses either for reading or distance.

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