Cataracts are the leading cause of blindness. But a relatively simple outpatient procedure can restore the sight of even the most severely afflicted cataract patients, safely and virtually without complications.
For information on cataracts, and what can be done for them, I consulted Dr. Sheila West, an associate professor of ophthalmology at the Johns Hopkins School of Medicine.
Q: What are cataracts?
A: Located behind the cornea and the pupil, the lens of the eye focuses incoming light. In order for it to do this effectively, the lens must be perfectly transparent. If the lens starts to "cloud," or become opaque, to the point of visual loss, then a cataract is said to exist.
Even in the worst cases, some perception of motion and color usually remains.
Q: What are the symptoms?
A: The cataract affects the lens' protein composition, causing it to "clump" and lose transparency. Instead of light being refracted properly, it is scattered throughout the eye.
Cataract sufferers may experience severe glare problems, especially in night driving. Many liken worsening cataracts to trying to see through an increasingly opaque shower curtain.
Sharpness of vision and color acuity, especially perception of blues and violets, can decline markedly.
Q: Who is vulnerable?
A: The incidence of cataracts increases with age; it basically remains a condition affecting people in their 60s and above. Not everyone approaching their senior years develops cataracts, however. Some people have elevated risk, including diabetics, steroid users, smokers and people with prolonged ultraviolet (sunlight) exposure. In rare cases, cataracts can be congenital. Sometimes, they can be induced by trauma, such as a blow to the eye.
Q: How does surgery work?
A: Over the last several decades, cataract surgery has evolved into a highly effective, nearly risk-free outpatient procedure. The damaged lens is removed, then a tiny bag holding a replacement plastic lens is substituted, with the lens then unfolding into position. Occasionally, the lens is directly sutured onto the iris of the eye. In most cases, patients are sent home the same day. The eye remains patched for a day or two.
Q: Is the operation permanent?
A: The replacement lens should last indefinitely.
Lenses now feature ultraviolet-absorbing coatings, mimicking the natural lens' ability to protect the rest of the eye.
Q: What about the cost?
A: Cataract surgery remains one of the most cost-effective procedures performed, with Medicare covering the cost for older patients.
Dr. Matanoski is a physician and epidemiologist at the Johns Hopkins School of Hygiene and Public Health. She is founding XTC director of its Institute for Women's Health Research and Policy.