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Don't delay cataract surgery

Published March 27, 2007 at midnight

With some trepidation, my husband, Richard, who is 73 and otherwise healthy, finally decided it was time to have the cataract removed from his left eye, which had a visual acuity rating of worse than 2 0/200 (being able to read 2 0/20 on the eye chart is "normal").

Poor vision affected nearly everything Richard did. In anything less than perfect light, he needed a magnifying glass to read, despite wearing prescription glasses. He could no longer drive at night - the glare was blinding, and not being able to see the road clearly was terrifying. During the day on unfamiliar roads, he relied on me to read road signs, because he didn't see them soon enough to follow them.

So he decided to go ahead with the surgery, with encouragement from me and his 89-year-old bridge partner, who had had cataracts removed from both eyes and could abandon the thick glasses he'd used for distance vision in favor of reading lenses.

After a health checkup and eye exam by the ophthalmologic surgeon, Richard entered a free-standing eye clinic at 8 o'clock one morning and walked out an hour and a half later with a "new" eye, able to walk the streets, drive and even read without glasses. The morning after surgery, the acuity in his left eye was already 2 0/25, and further improvement was expected as it healed.

It's nothing short of amazing. I can only hope he'll soon decide to have the cataract removed from his right eye, which would result in more balanced vision. This deceptively simple surgery, which, like any operation, has its risks, can be life-changing.

While in the past people waited until a cataract was fully "ripe" and nearly blinding before having it removed, the current recommendation is to have the surgery as soon as a cataract interferes with normal activities, including driving, watching television, climbing stairs, playing tennis, cooking and reading.

In fact, the more advanced a cataract becomes, the more difficult - and risky - the surgery.

Today, cataract surgery is nearly always performed under local anesthesia as an outpatient procedure that takes less than two hours. The clouded lens that's removed is replaced with an individually fitted artificial lens that can result in near- perfect visual acuity - the ability to see distance. Or, for those who prefer a correction of near vision for reading, an artificial lens can do that instead. For some people, even a multifocal lens can be fitted, to improve both near and far vision.

Cataract facts

A cataract is a clouding of the natural lens, the part of the eye responsible for focusing light on the retina and producing clear, sharp images. Old cells in the lens die and become trapped in the sealed lens capsule, accumulating until light passing through the lens scatters, resulting in a blurry or fuzzy image.

Contrast sensitivity is reduced, as if you were always trying to see in dim light.

Cataracts are often a result of natural aging and are the leading cause of vision loss in people older than 55. By 80, more than half of Americans have a cataract or have already had cataract surgery.

Factors that increase the risk of developing cataracts include unprotected exposure to sunlight, smoking, drinking alcohol, diabetes and prolonged use of steroids. Sometimes, cataracts develop years after an eye injury or surgery for other eye problems like glaucoma. And sometimes babies are born with cataracts or develop them in childhood, often in both eyes.

People can reduce the risk of developing cataracts by not smoking or abusing alcohol and by always wearing sunglasses and a hat with a brim when outside on bright days. Good nutrition might help, as well, especially regular consumption of green leafy vegetables, fruit and other foods rich in antioxidants.

People older than 60 are also advised to have a complete eye exam at least every two years, more often if a problem is detected. Other age-related vision problems include glaucoma and macular degeneration, which, if detected and treated early, won't not mean a loss of sight.

Be sure to see an ophthalmologist without delay if you develop any of the following symptoms: cloudy or blurry vision; colors seem to be faded; headlights, lamps or sunlight seem too bright and glaring, or a halo appears around lights; poor night vision; double vision; a frequent need to change prescriptions for glasses or contact lenses.

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