August 4, 2003
Lift the fog of age-related cataracts
U-M Health System expert advises early consultation and treatment for this common but debilitating condition
Video available upon request
Newswise — Betty Markwardt's vision was failing. Over time, the 77-year-old began having difficulty with everyday activities such as reading signs in grocery stores and seeing traffic signals on the road. But her real 'eye opener' came when she went in to renew her driver's license.
"When I failed their simple eye test, I knew it was time to get something done," she says.
Markwardt underwent a comprehensive eye exam at the University of Michigan Kellogg Eye Center and was diagnosed with cataracts in both eyes.
Age-related cataracts " the most common type of cataract " affect about 50 percent of all Americans by the age of 65, and the number grows to approximately three-quarters of all 75-year-olds. Around that age, about half of the men and women suffering from cataracts will have significant enough changes in their vision to warrant treatment to restore their vision.
According to Jerome Finkelstein, M.D., F.A.C.S., an ophthalmologist and medical director of the W.K. Kellogg Eye Center-Canton, a cataract is simply a clouding of your eyes' natural lens. The lens is the part of the eye that helps focus light on the retina, which then sends visual signals to the brain.
"Cataracts can happen by a variety of means and for a variety of reasons, but the end result is that the lens is no longer clear, it doesn't transmit light properly and then you can't see well," he explains.
Like Markwardt, most people have a range of painless symptoms for quite a long time before they seek treatment. Either they don't recognize the problem, or they're not bothered enough by it. Finkelstein says the most common symptom of cataracts is simply poor vision.
"You feel like something's in front of your vision but you can't clear it, and you just cannot make things out at a distance like you used to," he says. "But there are other symptoms, and those include colors that seem faded, halos around lights, glare in bright lights or headlights at night, or difficulty seeing at night."
Cataracts are diagnosed through a comprehensive eye exam that typically includes three components. A visual acuity test, or eye chart test, measures how well a person sees at various distances. A pupil dilation test allows a more thorough examination of the lens and retina by widening the pupil with eye drops. Another standard test called tonometry measures fluid pressure inside the eye. Increased pressure may be a sign of glaucoma, another serious eye disorder.
"Individuals who experience cataract symptoms should seek attention promptly " within a week or two of developing them " because the symptoms may be related to something else that might needs treatment a little sooner. And also, it may effect the course of treatment," advises Finkelstein.
For early cataracts that don't interfere with everyday activities, vision can often be improved with different eyeglasses, magnifying lenses or stronger lighting. However, if these approaches don't help or the cataracts grow larger, Finkelstein says surgery is the only long-term solution.
After getting a diagnosis, Betty Markwardt chose to do something about her troubling symptoms. She underwent surgery first to remove the cataract in her right eye, which was more serious, and then later, her left eye was corrected.
"To put in the IV and get me prepared for surgery took longer than the surgery itself," remarks Markwardt. "With my right eye, the surgery itself took maybe 10 minutes, and with my left, the cataract was very hard but took 15 or 20 minutes at the very most to remove."
According to Finkelstein, surgery for cataracts has made tremendous strides in recent years, and is among the most successful and safe surgeries performed today.
"Cataracts used to be removed with a very large incision. These days we've progressed to smaller incisions with smaller instruments that allow us to more efficiently extract the cataract from the eye and replace it with an intraocular lens, a crystal-clear artificial lens that needs no care and restores vision to its previous state," he says.
"The smaller wound means shorter surgeries and recoveries " patients find they're back to many of their daily activities within 24 to 48 hours, although their vision may be a bit blurry for a while," Finkelstein continues.
Markwardt says having the surgeries is one of the best decisions she's ever made. "It's opened up a new world for me. I never knew colors were so bright. I can read better, and I can do grocery shopping now.
"I just never realized what I was missing until the cataracts were removed. And that is really the gospel truth," she says.
Types of cataracts:-Age-related: Most cataracts develop as part of the normal aging process and can begin in someone as young as 40-Congenital: A very small number of babies are born with cataracts or develop them in childhood. If they affect vision, they must be removed.-Secondary: People who have other health problems such as diabetes may develop cataracts.-Traumatic: Cataracts can develop following an eye injury.
Symptoms of cataracts:-Blurry or cloudy vision-Frequent changes in vision prescriptions-Changes in color vision-Glare from or halos around bright lights-Difficulty with night vision-Double or multiple vision
For more information, visit the following Web sites:
U-M Health Topics A to Z: Cataracthttp://www.med.umich.edu/1libr/aha/aha_catar_crs.htm
University of Michigan Kellogg Eye Centerhttp://www.kellogg.umich.edu
National Eye Institute: Cataract Factshttp://www.nei.nih.gov/health/cataract/cataract_facts.htm
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