Cataracts

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• QHow common are cataracts in people with diabetes?

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  A Healthy Humans answered

  In adult-onset diabetes mellitus, cataracts are very common. The two reasons for this increased prevalence is the fact that high blood sugars affect the health of the lens of the eye, and diabetics are evaluated more often than the rest of the population.

  High levels of blood sugar eventually get into the fluid in the eye-raising the level of the sugar in the crystalline lens. This will draw water into the lens and the lens will swell. Also, sugar will form alcohol in the lens creating lens opacities, which we call cataracts. The cataract is actually a break down of the protein structure in the lens, and high sugar and alcohol content will increase this phenomenon. The same is true for people who indulge in excess alcohol.

  For this reason, all diabetics should try to maintain a normal blood sugar. Furthermore, the UV portion of sunlight creates cataracts. Many medications such as steroids accelerate cataract formation. So always ask your pharmacist whether you are taking a photosensitizing medication. The good news is that sunglasses will block sun related cataract formation. Look for sunglasses that block UVA and UVB.

  Insurance companies and family practitioners request an annual eye exam for all diabetics. Therefore, it is far more likely that early cataract formation is detected in this group of people.Remember through nutrition and specific supplementation cataracts can be stopped in many cases.

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• QHow is surgery used to treat cataracts?

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  A Dr. Daniel R. Spogen, MD , Family Medicine, answered on behalf of Univ. of Nev. School of Medicine, Family Medicine

  The preferred method of cataract surgery is lens replacement with a synthetic intraocular lens. Cataract surgery is generally indicated when cataract symptoms interfere with a person's ability to perform independent daily living needs.

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• QHow do medications treat cataracts?

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  A Sigma Nursing answered

  Unfortunately, there are no medications that can help treat cataracts. At least for awhile, eyeglasses and contacts can help with some of the vision problems that result from a cataract. However, surgery is the only successful treatment option to successfully get rid of a cataract and restore a person's vision

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• QWhat happens after a cataract surgery?

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  A Sigma Nursing answered

  Itching and mild discomfort are normal after a cataract surgery. Some fluid discharge is also common. Your eye may be sensitive to light and touch. If you have discomfort, your doctor can suggest treatment. After one or two days, moderate discomfort should disappear.

  For a few days after surgery, your doctor may ask you to use eyedrops to help healing and decrease the risk of infection. Ask your doctor about how to use your eyedrops, how often to use them, and what effects they can have. You will need to wear an eye shield or eyeglasses to help protect your eye. Avoid rubbing or pressing on your eye.

  When you are home, try not to bend from the waist to pick up objects on the floor. Do not lift any heavy objects. You can walk, climb stairs and do light household chores.

  In most cases, healing will be complete within eight weeks. Your doctor will schedule exams to check on your progress.

  This answer is based is based on source information from the National Institute of Diabetes and Digestive and Kidney Diseases.

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• QWhat is the prognosis for cataracts?

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  A Dr. Daniel R. Spogen, MD , Family Medicine, answered on behalf of Univ. of Nev. School of Medicine, Family Medicine

  The prognosis for cataracts is quite good. Cataracts are not known to cause death. They are generally easily treated via lens replacement surgery. This surgery is well tolerated and generally leads to substantial improvment in people's lives.

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• QCan a cataract come back after cataract surgery?

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  A Dr. Manvi P. Maker , Ophthalmology, answered on behalf of NorthShore University HealthSystem

  During cataract surgery, the actual structure that forms the cataract is removed, and an implant is put in its place. That cataract cannot come back. However, after cataract surgery, sometimes the thin layer that sits behind the implant can become cloudy, and some people refer to this as a "second cataract." This thin cloudy layer can be addressed in the office with a laser procedure.

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• QWhat is cataract surgery?

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  A Dr. Daniel R. Spogen, MD , Family Medicine, answered on behalf of Univ. of Nev. School of Medicine, Family Medicine

  Cataract surgery is an elective, outpatient surgery in which a clouded lens in the front portion of the eye is surgically removed and replaced by an artificial lens. It is typically performed under light sedation and not general anesthesia.

  In the eye the lens helps to focus eyesight. A cataract is the clouding of this lens, which is normally clear. The clouding of the lens is a result of aging and can be accelerated by sun exposure over time. This progressively blurs and clouds vision.

• QIs there any danger in postponing cataract surgery?

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  A Dr. Wayne Bizer , Ophthalmology, answered on behalf of American Academy of Ophthalmology's EyeSmart

  The time for cataract surgery is when the visual impairment reaches the point of altering your life activities (like driving at night or seeing street signs), or interferes with your ability to read, watch TV, or do other activities that are important in your daily life. Cataract surgery is one of the safest major surgeries that can be performed, with a success rate of greater than 98%, but complications and risks can be associated with every operation. Cataract surgery is rarely an emergency and can often be delayed, but remember, the longer one delays cataract surgery, the more dense (hard) the cataract will become, and this will make the operation more difficult for your eye doctor to perform in a safe manner.
  
• QHow will my doctor decide if I'm ready for cataract surgery?

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  A Dr. James J. Salz, MD , Ophthalmology, answered on behalf of American Academy of Ophthalmology's EyeSmart

  It is not the doctor who knows when you are ready for cataract surgery. It is primarily the patient, and it is based on how satisfied you are with your vision. Some patients have mild cataracts but major problems with glare and halos that make it difficult to drive a car at night or fly a plane, for example. If it is determined that these complaints are due to the cataract, surgery can be considered. Other patients may have more advanced cataracts but few complaints. For example, a patient who no longer drives and only needs to watch a little TV and read with a bright light may have little difficulty, and so surgery is not indicated. The concept that the cataract is ripe or ready is no longer valid as an indication for surgery. It is rare that a cataract must be removed for medical reasons. The final decision is up to the patient, not the surgeon, in most cases.
• QHow fast does a cataract develop?

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  A Dr. Wayne Bizer , Ophthalmology, answered on behalf of American Academy of Ophthalmology's EyeSmart

  There is no way to predict how rapidly a cataract will develop. There are  many kinds of cataracts, and they can develop very slowly or progress rapidly. Usually, if one can determine their speed of development in the past few years, an educated guess can be made as to how rapidly they will develop over the next few years. There is no guarantee that the speed of cataract development will not increase or decrease in the future.
  
  Your ophthalmologist, Eye M.D., will be happy to provide you with his best estimate during your comprehensive eye examination.

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