More than one in two people aged 65-70 and seven in ten over 70s have a cataract – the age-related clouding of the lens of the eye that is the most common cause of vision loss after 40 and the leading cause of blindness in the world.
Although it used to be a common belief that cataracts should not be operated on unless they are mature, this view has now been disproved.
“Cataract cannot be avoided because in the vast majority of cases it is a result of aging, but it can be treated and the only treatment for it is to remove the cloudy lens and replace it with a new one,” says ophthalmologist Dr. Ioannis I. Datseris, vice-president of the Vitreous-Retina Society. “More than 90% of patients who undergo surgery regain some useful vision, improving their quality of life.”
Four key questions. But when should the operation be done? The American Academy of Ophthalmology has compiled a mini-list of four questions to ask when deciding on surgery:
- Does cataract affect daily activities? Its symptoms include loss of contrast and clarity that can be difficult for those who need to see clearly to work, drive, write, cook, sew, etc.
- Do cataracts affect the ability to drive safely at night? Cataracts can create a halo (halo) around lights and block vision in low light or darkness, making night driving difficult. If he is indeed advanced, the driver may fail the exams for the renewal of his license.
- Are cataracts preventing you from engaging in outdoor activities? Cataracts can also increase sensitivity to glare, which can be especially difficult for those involved in outdoor activities (eg fishing, surfing, snow or water skiing, etc.). It can also cause differences in vision between the two eyes, which can affect those who need to see clearly at a distance (eg hunters, golfers).
- Can it be treated in other ways? Many patients manage to improve their vision for some time using various means (eg, brighter lighting at home, a magnifying glass when reading, sunglasses with polarized lenses, and a wide-brimmed hat during outdoor activities), but at some point the means these may cease to help.
“If the cataract does not yet affect daily life, the operation can probably be delayed, but not indefinitely. We usually recommend surgery on a patient when the lens clouding has reduced their vision by 50%,” says Dr. Datseris. “The earlier the operation is performed, the lower the risk of complications and the greater the benefits.”
Indeed, many studies have shown that the operation is associated with a better quality of life, a lower risk of falls and fewer traffic accidents, while especially in diabetic retinopathy patients, the removal of the clouded lens allows proper monitoring of the progression of the disease.
The operation is performed by removing the clouded lens with the phacoemulsification method and replacing it with a permanent artificial intraocular lens, through a tiny incision, without the placement of sutures. The opening of the incisions from where the lens will be replaced can be done in a classic way or with a laser, explains Dr. Datseris.
The new lens lasts a lifetime, is well tolerated and requires no maintenance or replacement. Cataracts cannot reappear once the eye’s natural lens has been removed. However, the natural membrane of the eye behind the intraocular lens may become cloudy at some point, so a laser correction is required that immediately corrects the clarity of vision.
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