Endocrinology

What Are Cataracts? What Causes Cataracts?

to have no problem with daily function, while others who may do well insist that their eyesight is poor and does interfere with ordinary activities. Treatment for cataracts If the patient is found to be only mildly affected surgical treatment may not be needed. During its early stages, stronger glasses and brighter lights may help improve vision. The following simple approaches may assist people who are not ready yet to have surgery: *Make sure your glasses are the most accurate prescription possible. *Use a magnifying glass for reading. *Get brighter lamps for your house. Halogen lights may help a lot. *Wear sunglasses to reduce glare on sunny days. *Try to refrain from driving at night. Surgery However, these are only temporary measures - the cataracts will continue developing and gradually impair eyesight more. Patients who take alpha-blockers or are considering taking alpha-blockers should be aware that the drugs may increase the difficulty of cataract surgery. While Flomax (an alpha-blocker) is largely prescribed to men to treat prostate enlargement, some women also take the drug to treat urinary retention problems. Other alpha-blockers are used to treat hypertension. The American Academy of Ophthalmology and the American Society of Cataract and Refractive Surgery issued an advisory telling patients and GPs to inform their surgeon if they are taking alpha-blockers, or took them in the past. Once informed, the ophthalmologist can anticipate certain problems and employ different surgical techniques that help to achieve excellent outcomes. When the cataracts are severe the only effective treatment is surgery. The specialist will recommend surgery if the patient: *Is having trouble looking after himself/herself. *Is having difficulties looking after someone else. *Cannot drive, or finds driving difficult. *Has problems leaving the house. *Finds it hard to see or recognize people"s faces. *Has problems doing his/her job. *Cannot read properly. *Can no longer watch television properly. The cloudy lens is removed from the eye and an artificial clear plastic one is put in its place - an intraocular implant (intraocular lens). In most developed countries, and a growing number of developing countries, cataract operations are performed as keyhole surgery. The patient will be given a local anesthetic. He/she will not usually have to spend the night in hospital. The operation is commonly known as phacoemulsification or phaco extracapsular extraction. Laser surgery is not used for cataract procedures. (There are more details about the operation further down this page) Pre-operative assessment (assessment before surgery) The specialist will assess the patient"s eyes and general health. During the pre-operative assessment the eye will be measured so that the replacement artificial lens can be prepared. The day of the operation - before it begins Eye drops that dilate (widen) the pupils will be administered just before the procedure. Sometimes the eye drops will also have anesthetic in them, or the doctor may inject the tissue around the eye for a local anesthetic. As soon as the anesthetic starts working the area will be numbed and the patient will feel nothing. During the operation he/she will be aware of a bright light, but will not be able to see what is happening. Various types of replacement lenses may be used: *Monofocal lens - this is a fixed-strength lens which is set for one level of vision - usually distance vision. *Multifocal lens - this type of lens may have two or more different strengths; near and distance vision. *Accommodating lens - this type of lens is the most similar to the natural human lens. It allows the eye to focus on near and distant objects. The operation The eye surgeon makes a tiny cut in the cornea at the front. He/she then inserts a minute probe through the cut. The probe uses ultrasound and breaks up the cloudy lens into very small pieces which are sucked out. The artificial lens is then inserted through the cut. The lens sits in the lens capsule to keep it in place - the lens capsule is like a little pocket. When it is first inserted the lens is folded - it unfolds when in position. The whole procedure should not take more than about 30 minutes. Most patients will wear an eye pad for protection for a short while. Other procedures *Manual extracapsular extraction - the lens is removed in one piece. No ultrasound is used to break it up. The surgeon will make a slightly larger cut in the eye. *Intracapsular extraction - the lens capsule as well as the lens is removed. The artificial lens is sewn into the eye. This type of procedure is much less common. After the operation Most patients will experience vision improvement virtually immediately. It may take a while for the eye to settle down completely. The cut in the eye may occasionally need a stitch - in most cases, however, it is so small that it heals by itself. Patients should avoid vigorous activities for a while. Most individuals find they can go about their daily activities as soon as they get home. An appointment will be made to test the patient"s vision. Most patients will need different glasses after their operation. The new glasses can only be determined after his/her vision has settled down - this can take several weeks. There is no other way to cure cataracts. Medications, dietary supplements, exercise or optical devices are not effective. As mentioned earlier, during the early stages there are some things the patient can do to help see things better - but they are only temporary. Prevention of cataracts To prevent suffering the complications of cataracts it is advisable to have regular eye exams, especially as you get older. The following steps are advisable to lower your risk of developing cataracts - some of them have convincing circumstantial evidence of their worth, while others (smoking, diet) are proven measures: *Give up smoking - several studies have indicated that a higher percentage of smokers develop cataracts, compared to non-smokers. There are also indications that smokers are likely to experience cataract symptoms earlier. Smoking also increases the risk of other eye disease/conditions. *Nutrition - eat plenty of fruits and vegetables, whole grains, unrefined carbohydrates, good quality fats (avocado, olive oil, omega oils), and either plant d proteins or lean animal d proteins. The findings by researchers at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, USA suggest that vitamins and polyunsaturated fatty acids - two categories of nutrients believed to have health benefits - may both affect cataract development, although not necessarily in beneficial ways. Women who consume plenty of dark leafy vegetables which are rich in lutein and zeaxanthin, as well as sufficient vitamin E from supplements/foods seem to have better protection against developing cataracts, scientists from the Brigham & Women"s Hospital and Harvard Medical School, Boston found. *Sunlight - wear sunglasses that block ultraviolet B rays (UV radiation). Many people are not aware of the damage UV radiation can cause to the eyes - a study found that only 49% of Americans said UV protection was the most important factor when purchasing sunglasses. *Sleep - make sure you get at least 7 hours of good quality, continuous sleep every night. *Obesity - obesity significantly raises the risk of developing diabetes type 2, which in turn is an important cataract risk factor. Keeping your weight within the recommended limits will help prevent your risk from increasing. *Diabetes - be careful to have your diabetes under control; follow your treatment plan assiduously. *Exercise - Researchers from the U.S. Department of Energy"s Lawrence Berkeley National Laboratory reported that running reduces the risk of both cataracts and age-related macular degeneration. Complications *Blindness - If the cataracts are left untreated, they may lead to blindness. *Higher mortality rates - people aged 49 and older with cataract and those aged 49 to 74 years with age-related macular degeneration appear to have higher mortality rates over an 11-year period than those without such visual impairments, according to a study carried out by researchers at the University of Sydney, Australia. Written by Christian Nordqvist Copyright: Medical News Today Not to be reproduced without permission of Medical News Today

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