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Cataracts

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Cataracts are a sign of growing older, but they do not have to cramp your lifestyle. A cataract is a cloudiness of the crystalline lens inside your eye. As your lens gets cloudier, your vision will gradually become more blurred. The human eye may best be compared to a camera. When you take a picture, the lens in the front of the camera allows light through and focuses that light on the film. When the light hits the film, a picture is taken. The eye works in much the same way. The lens of your eye is clear and allows light to pass through. Light is focused by your cornea and lens onto a thin layer of tissue called the retina. Your retina works like the film in a camera. When the focused light hits the retina, a picture is taken, and sent to your brain. While a dirty camera lens blurs a picture, any significant cataract in your lens will blur what you see. If the cataract blurs your vision severely enough to interfere with your daily routine, it is crucial that you speak with your eye care professional immediately.

"Cataract" means literally a loss of transparency of the lens of the eye, or it's capsule. Unfortunately, we all have this ocular condition to look forward too, as we get older. Normally it's not a problem until our late 70's or early 80's. What causes this is that the internal lens of the eye is always growing, throughout our whole lives, just like your fingernails and hair (hopefully!). As the lens gets thicker, it loses some transparency, and also becomes less elastic. Lens thickening also produces a yellowish discoloration, so a person with cataracts freshly removed will often remark on how Blue everything is - they have been looking through a yellow filter for the previous few years.

Pre-disposing Factors

Family history is, as with so many other things, a reliable indicator. If your relatives developed cataracts sooner than most people, your chance of doing the same increases. We can't control our genes as yet, so there's not much we can do about this, short of cataract surgery.

Diabetes can cause early cataracts, as a direct result of varying blood sugar levels. When the blood sugar is high, the internal lens swells up in response to this, changing the person's glasses prescription. Conversely, low blood sugar leads to lens thinning. This constant swelling and shrinking of the lens disrupts it internally somewhat, causing cloudiness, and clefts of the internal fibres.

Cataract Surgery

Thankfully, this has become a very much less invasive procedure than say 30 years ago. Today it is normally an outpatient surgery, done under local, not general anaesthesia. Briefly, a small incision is made, 3-4 mm long, under the top lid at the 12 o'clock position on the eye. A small tunnel and flap are created in the sclera (the white of the eye), and a probe is inserted internally into the lens. The lens is broken up into small chunks (by laser, ultrasound or freezing), and removed bit by bit with a vacuum cleaner like instrument. Then, an artificial intra-ocular lens is implanted in place of the cloudy one. This new IOL can be made to whatever power necessary, so the idea is to get people as close to zero for the distance as possible - often distance glasses are much less necessary after a cataract operation. Reading glasses are still required.

UV and Cataracts

Once the natural UV protection of the body's normal lens is removed, there must be some sort of UV filter incorporated after cataract operations. Now, this is usually put into the lens implant itself, but >15 years ago may not have been. If this is the case, and your IOL does NOT have UV protection built-in, you MUST incorporate this in your eyeware, either glasses or contact lenses.

There is some speculation that the increased UV levels we have today due to the hole in the ozone will cause accelerated cataract development in future generations is still unproven. However, UV filters are cheap ($10 to coat your glasses) and the case may be made that "better safe than sorry".

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