Cataracts

What is a Cataract?

It is a common myth that everyone, if they live long enough, will get a cataract. This doesn’t have to be the case. In fact, the deterioration of the lens of the eye can be prevented with a few simple measures.

But first, what exactly is a cataract. The eyeball is a bag of water with an outer coat consisting of the clear cornea (like the crystal of a watch) and the white sclera. Next are the iris and its central opening, the pupil.

Behind the pupil sits the biconvex crystalline lens of the eye, which focuses incoming light onto the retina in the back of the eye.  The retinal receptors cells absorb the light rays and send an electrical response on to the brain.  Any clouding of the lens is called a cataract.

Cataracts: Inevitable or Avoidable?

The lens of the eye focuses light from objects onto the retina. The lens pushes the old focusing fibers into the center, causing haziness or a film. Because the lens has neither nerves nor blood vessels, it depends on the internal flow of fluid inside the eye (aqueous humor) to provide oxygen and nutrients, and to remove toxic products.

The lens focuses light constantly, from distant objects to near objects. Some of the light wavelengths, such as ultraviolet light, are especially toxic. UV light creates more free radicals, which will accelerate the clouding of the lens over the years. Any clouding of the lens is a cataract.

A cataract may be central (called nuclear); peripheral ( younger  cortical fibers near the outer edge of the lens); or sub-capsular (at the very front or very back of the lens).

Symptoms of cataracts include hazy vision, glare, difficulty focusing on the printed page, eye fatigue, even double vision. Some people will develop second sight, meaning, that as they grow older, they may see better without their glasses, because the cataract is actually changing the prescription of the eye. Always check to see if your glasses can be improved.

Blocking UV Light

Ultraviolet and certain high energy wavelengths of blue light slowly fry the lens over the years. Furthermore, there are hundreds of medications (antibiotics, antihypertensives,etc) which are photosensitizers and accelerate the process. So WEAR GOOD UV-Blocking SUNGLASSES…your best protection against many eye disorders. Have your eye doctor or optical shop measure the protective quality of your sunglasses; this should be 100% and is available even in inexpensive glasses.

Transition lenses which change under different lighting conditions are 92% to 97% effective. Outdoor solar exposure deserves the best protection. Since pilots and astronauts have a greater chance of getting cataracts at an early age, many are wearing Silhouette sunglasses for the ideal solar protection; the company can be contacted at www.silhouette.com.

Some important causes of cataracts

Heredity and age are also factors, but ones that we cannot do much about, except to focus on other lifestyle changes.

Diabetes, heart disease, hypertension, arthritis (and the medications that go with them) can contribute to the formation of cataracts. For example, cholesterol-lowering drugs frequently speed up the formation of cataracts by virtue of their effect on the liver. Cortisone, used in arthritis and lung disease treatment, will also create cataracts with long-term use. Ask your doctor if your dose can be decreased or eliminated, or if there are any other natural means of controlling or treating these conditions.

There are more than 300 commonly prescribed medications that speed up cataract formation when coupled with sunlight exposure. Ask your pharmacist about your medication. Wear your sunglasses to eliminate this possibility so you don’t have to discontinue necessary medications.

Estrogen apparently has a protective effect. Studies show women are almost twice as likely as men to develop cataracts after the age of 50. We are still waiting for a better designer estrogen that can give us the good effects without increasing the chance of breast or uterine cancer.

Protect against injuries, at home, play or in the workplace. Remember children’s safety, and select their toys wisely.

Other preventive measures are the following:

* Vitamin C 1000mg daily

* MSM 1000mg or other glutathione booster daily. Glutathione and Vitamin C are  the main antioxidants in the    lens

* Drink lots of water to increase the intraocular fluid circulation; limit artificial sweeteners

* Omega-3 fatty acids play a minor role in the lens but are good for the rest of the eye

* Lutein 6-10mg daily

* Wear protective lenses for racquet sports

* Stop smoking and avoid second hand smoke

* Control diabetes

* Moderate alcohol consumption

* Maintain body weight

* Limit saturated and trans fats

L-Carnosine

The next frontier for cataract prevention is the use of L-acyl carnosine eye drops. The Russian scientist Dr. Marc Babizhayev has published many articles demonstrating this combination of two amino acids can stop and even reverse cataract development. Several products are on the market including Oclumed, Brite Eyes and Can-C. I have seen several patients have dramatic visual effects and know that many more are trying the three times a day regimen. However in a short study other patents cataracts stopped but did not significantly reverse.

We’re led to believe that everyone will develop cataracts. That is not true. We also are told that once you have them they get worse. That is usually true, but only because people continue the same lifestyle and habits which lead to the formation of cataracts in the first place. However, you can use nutrition and lifestyle changes to stop and even reverse cataracts.

Ask your eye doctor if he or she has ever seen a patient whose cataracts have stopped. I know they have. Yet doctors often tell people nothing will stop cataracts. This is often not true.

Cataract Surgery and new options

Symptoms should determine whether cataract surgery is necessary and not just the physician’s judgment alone. You need a good examination with a refraction. Remember that the refraction is not paid for under many medical insurance policies, but a refraction is the only way to learn if glasses will improve your vision. I have found nine out of 10 people can be improved at distance or near. Sometimes that is not enough and surgery is necessary.

If you do have to have surgery, modern cataract surgical procedures are excellent. Eye drops are used as anesthetics, and rarely are any stitches needed. It is performed with high-speed sound. We do not do surgery yet with a laser, but we do use a laser to open an after-cataract membrane. In 20 to 30 percent of cases this membrane will develop over the years (this is not a serious problem).  Modern cataract surgery is fast and highly effective for most people.

There are premium intraocular lenses available for patients undergoing cataract surgery.  The toric IOL will reduce moderate levels of astigmatism (as will corneal relaxing incisions). The Crystal lens is said to move back and forth in order to provide a return of a limited amount of focus power.  Lastly, the multifocal IOL has concentric rings for distance and near vision so as to provide focus both near and far.  Each of these implants has benefits and detractions and will require out of pocket expenses, since these are not covered under the insurance plans.

The traditional IOL has a focal power for either near or far vision.  Most people select the option of excellent distance vision and are willing to wear computer and reading glasses, which they have done for years.  Some patients have already been accustomed to wearing monovision contact lenses; in this situation, one eye wears a distance lens and the other wears a near lens.  This is yet another option in selecting  IOL power.  Your doctor should go over all of the options and you should decide on which is your preference, and what is cost-effective.