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Cataracts

By Carine Nadel

CATARACTS

I was 38 when I received the shocking news from my optometrist.  "Carine, you have a cataract forming in both eyes, one isn't much, but I want you to go see an ophthalmologist".  

No pain did I feel.  Since I was legally blind (my good eye was 20/850) I truly didn't see what the big deal was about.  At the time, even with my contact lens, I was only able to see 20/150. Barely able to pass the driver's test.   So I went.  I met with Dr. Coral Smith-a doctor within my HMO who also taught ground-breaking surgical procedures for cataracts at University of California, Irvine.

He told me that, indeed, I did have a significant cataract forming on one eye and a very tiny one in the other.  I had developed a "sub capsular" type-beginning on the back of my lens due to the amount of prednisone injections and tablets I had be given prior to my diagnosis of rheumatoid arthritis and the ensuing use of the steroid until the disease was under control.

There are two other types: nuclear (naturally formed in the aging process) and cortical (the type many diabetics develop)

cataracts

A cataract is a clouding of the eyes natural lens, which is right behind the iris (the color part of your eye) and the pupil.  Because of this growing "cloud", vision deteriorates.  A cataract just doesn't appear one day; they start out small and go from there.  In the beginning there was little to any effect to my already horrible vision.  Then somewhere down the line I felt as if I had begun looking through a pair of glasses in desperate need of cleaning.  At some point during the growth, light became irritating-whether it was from the sun or a lamp.  At this point driving at night became a hazard since the blurred vision and irritation from the lights affected my depth perception.  Colors did not seem very, well, colorful.

I noticed a feeling of dread if I had to get behind the wheel of my car at night.  I didn't feel "safe"-so I took myself off the road for several years once the sun started to set.  Fortunately at this time in my life, I worked at home.

What causes cataracts besides age, certain diseases and drugs?  Even after all the surgical advancements-no one really knows why there is such a thing.  Some studies suggest it could be the exposure to ultraviolet light.  Many, if not most optometrists/ophthalmologists urge their patients to always wear sunglasses and visors.  Newer studies have shown that a way to prevent or slow their growth is to eat a diet high in anti-oxidants and lowering salt intake.  Other risk factors?  Smog, drinking too much alcohol and smoking to name a few.

Once I was diagnosed my treatment was on hold until the cataract is "ripened".  Most people usually know when their cataract is "ripe" because it impairs their vision enough that their daily life is affected.  For me, besides not being able to drive at night, I found that my ability to read my beloved mysteries and work crossword puzzles became a chore instead of a pleasure.

What comes next, once the coating on your eyes drives you nuts?  Surgery.  Once you and your doctor decide that you can wait no longer, the date will be set.  I had my surgeries done within 4 months of each other.  In the almost 7 years since then, procedures now give you more of a choice-you may have an implant with single vision or a multifocal lens. The later makes it possible to not have to wear reading glasses!  When I had mine done, my very deft surgeon gave me the best there was at the time:  one far-sighted, one near-sighted.  I do not need to wear glasses a good portion of my day.  I can read without reading glasses, but prefer to when trying to enjoy a novel or, again, work puzzles.  For driving, while I see quite well, to sharpen the image I wear distance lenses.  Fortunately, I have all the goodies in one set of gorgeous glasses that are even equipped with transitions so I don't even need a separate pair of sunglasses.

As for the surgery itself-it's strictly outpatient.  Upon being brought into the prep room, I had to live through a series of drops and medications to help me to both relax and numb my eye.  Having a "state of the art" surgeon meant he didn't have to use a needle to do this!  Once I was wheeled into the operating room a gizmo was put onto my eye to make sure I that I couldn't/wouldn't blink.  I was up the entire time.   Unless it's decided that a bit more of the "relaxant" is necessary to make it less stressful for you and the doctor, there is no reason to be given a general anesthetic.  I was so nervous during the first surgery I wouldn't fall asleep, but it only lasted a grand total of a half hour and I survived.  Once the initial first "cut" is made and the lens is removed, you can't see until the implant is secured.  After the surgery is complete a protective cup was put over my eye for the first 24 hours.  A lot of fluid leaked out during this time.  I felt as if I had scratched my corneas severely for the rest of the day.  

The attendants sent me home with a big set of sun shades that I was told I had to wear for the next 6 weeks and to stay out of bright light.  I also wasn't allowed to do any strenuous activities, left anything over 25 pounds, bend over or sleep on the side my surgery was done on.  There was to be no putting myself in areas that had a lot of dust.  Antibiotic drops had to be used several times a day for several weeks.

After 24 hours, I had a post-op appointment.  But I could see the difference before I even got out of bed the next morning.  Even with the shield on my eye (it had pin holes in it), I was able to see!  I opened my eyes, looked across the bedroom to the digital clock about 15 feet away and saw the time-CLEARLY AND WITHOUT ANY ASSISTED HELP!!!

I was absolutely amazed.  I screamed for my husband and read the clock.  Tears started falling.  I had not seen that far away without the aid of coke bottle glasses or contact lenses since I was 10 years old-I was 42.

When I saw my doctor, I was so excited-I kept thanking him over and over again.  He kept telling me it was his pleasure and to please calm down, he didn't want me to cause any complications!  I read the chart-I was seeing 20/40 in the just done eye.  Even my husband started to cry.  He couldn't thank the doctor enough.

Four months later, I eagerly anticipated the second surgery.  Fortunately, I had the same success with it.  According to a Swedish study published in the British Journal of Ophthalmology in November 1999 (this was before my surgeries in late 2001 and early 2002) found that the younger the patient was when they had undergone the surgery the happier they were with the outcome.  

I can certainly attest to that-I consider my implants to be the best thing, health wise, that has ever happened to me.

Carine Nadel is a contributing writer for Fabulously40






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