I’ve gotten a lot of feedback and more than a few well-wishers from my auricle on getting my tired old eye fixed up here in the Philippines, with or without medical insurance.  Thanks to all who have been commenting/mailing.

But I’ve noticed more than a few people haven’t grasped the concept of what was wrong with my eyes and what’s been done to fix them, permanently.

I’ve worn glasses for years because my eyes have not had sufficient visual acuity.  That is, at their best focus, things that should have been easy to see were not, lines did not have sharp edges, fine details were indistinct and tiny objects that a person with normal acuity (sharpness or focus) should have been able to see.

But a few years ago I went for a routine eye exam/new glasses prescription and my ophthalmologist told me I was showing signs of cataracts.  Shocked me a little because of my age, but explained a lot about why it was much harder to see at night and why oncoming traffic at night seemed to cause so much extra glare.

Cataract Defined

What is a cataract?

A cataract is a clouding of the lens in the eye that affects vision. Most cataracts are related to aging. Cataracts are very common in older people. By age 80, more than half of all Americans either have a cataract or have had cataract surgery.

A cataract can occur in either or both eyes. It cannot spread from one eye to the other.

What is the lens?

The lens is a clear part of the eye that helps to focus light, or an image, on the retina. The retina is the light-sensitive tissue at the back of the eye.

In a normal eye, light passes through the transparent lens to the retina. Once it reaches the retina, light is changed into nerve signals that are sent to the brain.

The lens must be clear for the retina to receive a sharp image. If the lens is cloudy from a cataract, the image you see will be blurred.

Are there other types of cataract?

Yes. Although most cataracts are related to aging, there are other types of cataract:

1. Secondary cataract. Cataracts can form after surgery for other eye problems, such as glaucoma. Cataracts also can develop in people who have other health problems, such as diabetes. Cataracts are sometimes linked to steroid use.
2. Traumatic cataract. Cataracts can develop after an eye injury, sometimes years later.
3. Congenital cataract. Some babies are born with cataracts or develop them in childhood, often in both eyes. These cataracts may be so small that they do not affect vision. If they do, the lenses may need to be removed.

Radiation cataract. Cataracts can develop after exposure to some types of radiation. It’s likely (at least to me) that radiation certainly related at least in part in my cataract problem.  I worked for years with high power microwave transmitters, extreme long range radar and my favorite … dozens of very bright radar display consoles we had in Cheyenne Mountain.  These fellows were ‘oldies but goodies’, they worked really well if you could keep them working, but they were old and not easy to fix.  They had come to the Air Force as a ;gift; from the FAA.  After I worked there several years I found out why the FAA got rid of the screens … the air traffic controller’s union had proved the radiation they emitted was above national health standards, and this illegal to expose FAA civil service employees to.  The Air Force, however, didn’t care so much for their active duty and civilian employees ,,, they scarfed these babies up in a heart beat and used them for years.  Thanks General xxxx. “Nothing is too good for my people, see that that is what they get.>

Anyway, moving on, what treatment is available?

Treatment

How is a cataract treated?

The symptoms of early cataract may be improved with new eyeglasses, brighter lighting, anti-glare sunglasses, or magnifying lenses. If these measures do not help, surgery is the only effective treatment. Surgery involves removing the cloudy lens and replacing it with an artificial lens.

A cataract needs to be removed only when vision loss interferes with your everyday activities, such as driving, reading, or watching TV. You and your eye care professional can make this decision together. Once you understand the benefits and risks of surgery, you can make an informed decision about whether cataract surgery is right for you. In most cases, delaying cataract surgery will not cause long-term damage to your eye or make the surgery more difficult. You do not have to rush into surgery.

Sometimes a cataract should be removed even if it does not cause problems with your vision. For example, a cataract should be removed if it prevents examination or treatment of another eye problem, such as age-related macular degeneration or diabetic retinopathy. If your eye care professional finds a cataract, you may not need cataract surgery for several years. In fact, you might never need cataract surgery. By having your vision tested regularly, you and your eye care professional can discuss if and when you might need treatment.

If you choose surgery, your eye care professional may refer you to a specialist to remove the cataract.

If you have cataracts in both eyes that require surgery, the surgery will be performed on each eye at separate times, usually four to eight weeks apart.

Many people who need cataract surgery also have other eye conditions, such as age-related macular degeneration or glaucoma. If you have other eye conditions in addition to cataract, talk with your doctor. Learn about the risks, benefits, alternatives, and expected results of cataract surgery.

What are the different types of cataract surgery?

There are two types of cataract surgery. Your doctor can explain the differences and help determine which is better for you:

1. Phacoemulsification, or phaco. A small incision is made on the side of the cornea, the clear, dome-shaped surface that covers the front of the eye. Your doctor inserts a tiny probe into the eye. This device emits ultrasound waves that soften and break up the lens so that it can be removed by suction. Most cataract surgery today is done by phacoemulsification, also called "small incision cataract surgery."  (this is the one you want!  Recommended)
2. Extracapsular surgery. Your doctor makes a longer incision on the side of the cornea and removes the cloudy core of the lens in one piece. The rest of the lens is removed by suction.  (My father-in-law had this procedure last year.  NOT recommended.  Significant pain and a long recovery/adaptation time.)

After the natural lens has been removed, it often is replaced by an artificial lens, called an intraocular lens (IOL). An IOL is a clear, plastic lens that requires no care and becomes a permanent part of your eye. Light is focused clearly by the IOL onto the retina, improving your vision. You will not feel or see the new lens.

Phaco is the procedure I had.  Highly recommended.  The entire procedure on my worst (left) eye was don
e in 30 minutes from the time I laid down on the sort of operating couch until I was in a wheel chair being taken to the changing room to get back in my street clothes.  Most painful part of the entire procedure was getting the ;stick; of the IV needle for the mild sedative the anesthesiologist gave me.  Actual pain in the eye is covered with a local anesthetic that is dripped into the eye. 

This is nor ‘laser’, ‘Lasik’, ‘RK’ or ‘Radial keratotomy’ which are procedures that shape the outside of the lenses to correct acuity problems.  In my case, the net result should be that I don’t need glasses (the left eye was exactly at 20/20 yesterday when I had my checkup and scheduled the second eye (a week from today).  But if the new lenses are not 20/20 after the several weeks it will take the eyes to fully adapt, ‘touch up’ RK could be performed or I might need a pair of ‘reading only’ glasses.  Only about one third of the far/close distance adaptation the eyes need to make come from the lenses, so it’s still possible for a guy my age to suffers from ‘short arms;,  Time will tell, but my point is, Lasik or RK only deals with the outside of the eye’s lenses, my Phaco cataract surgery completely replaces the lenses from the inside … and boy am I loving it.

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