A Family Doctor's Tale - CATARACT

DOC I HAVE A CATARACT

Every one will have cataract sooner or later because the eye's  natural lens degenerates over time. I have a patient who is a avid golfer who develop a cataract on his left eye due due to exposure to the sun. Any way he asks me to send him to an eye specialist for removal after I confirm that it was ripe for removal.
His operation was a big success and he was very happy with result so much so that he wanted the eye surgeon to remove the normal right lens for him so that he does need to wear spectacles.
 The eye surgeon was reluctant but go along with his wishes after he signed that he will take all the responsibility. Unfortunately the right lens could be removed totally because it was still stuck to the tissue behind the lens. He had to resort to another eye specialist to remove the lens from the back of the eye. That costs him another $9000 for the operation. He finally got his wish for not wearing spectacles.

A cataract is a clouding of the eye's natural transparent lens, which helps us to focus on the objects we see.
The lens is mostly made of water and protein.
Due to age, some of the protein may clump together and start to cloud a small area of the lens. This is a cataract, and over time, it may grow larger and cloud more of the lens, making it harder to see.


Cataracts ( A Simple Guide to Cataract)are classified as one of three types:
1.A nuclear cataract is most commonly seen as it forms.
This cataract forms in the nucleus, the center of the lens, and is due to natural aging changes.


2.A cortical cataract, which forms in the outer lens cortex, gradually extends its spokes from the outside of the lens to the center. Many diabetics develop cortical cataracts.


3.A subcapsular cataract begins at the back of the lens. People with diabetes, high farsightedness, retinitis pigmentosa or those taking high doses of steroids may develop a subcapsular cataract.


A cataract begins slowly and at first has little effect on your vision.
There may some blurring of vision .
Light from the sun or a lamp may seem too bright or glaring.
Colors may not appear as bright as they once did.


The eye's lens changes as we age, forming cataracts.
1. exposure to ultraviolet light may be a cause of cataract development, so eye specialist recommend wearing sunglasses and a wide-brimmed hat.


2.Other types of radiation such as from TV or PC monitors may also be causes.
Airline pilots may be exposed to cosmic radiation.


3.People with diabetes are at risk for developing a cataract.
The same goes for users of steroids and diuretics.


4.Other risk factors include cigarette smoke, air pollution and heavy alcohol consumption


Symptomatic treatment:
When symptoms begin to appear, you may be able to improve your vision for a while using new glasses, strong bifocals, magnification, appropriate lighting or other visual aids.

Some eye care practitioners believe that a diet high in antioxidants, such as beta-carotene (vitamin A), selenium and vitamins C may slow down cataract development.


Eye drops such as Catalin and Quinax has been prescribed to slow down the development of cataract.


Surgical treatment:
An intraocular lens (IOL) is implanted in the eye in place of the patient's clouded natural lens.
During surgery, the surgeon will remove your clouded lens, and in most cases replace it with a clear, plastic intraocular lens (IOL).


Cataract surgery is very successful in restoring vision.

I have a Malay patient who have advanced cataracts in both eyes. However I persuaded him he will refused any operation and rather depend on his grandchildren to bring him to the clinic because of his poor eyesight. One day he had a fall and landed in hospital. There the eye surgeon was able to convince him to have an operation.After the operation he could see perfectly and was so pleased that he came to tell me about it.


The most important prevention for cataracts is to avoid direct sun rays and other forms of radiation from TV or PC monitors, polluted air and smoking.