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Cataracts

Cataracts

 

Class
Eye
Description
People often mistakenly think a cataract is a skin that grows over the eye. In fact, it is a clouding of the lens in the eye that focuses the image onto the retina - the back of the eye - and enables one to see. When a person has a cataract, the lens clouds over and vision becomes blurred or dim because light cannot pass through the lens. The size of the cataract determines how badly vision is affected. If only a small part of the lens is clouded vision may become blurred, but if the whole lens is affected the person may become blind.
Causes
It is not known why cataracts develop in some people and not in others. In most cases, cataracts are age-related, they begin to develop in the over 50s, gradually getting worse as the years go by. It is estimated that over half of those over the age of 65 have a cataract affecting one or both eyes. Women and men are affected equally.

Although cataracts are commonly age-related, the young can get cataracts too as a result of injury, certain drugs, long-term inflammation, illnesses such as diabetes, or poor diet. Smoking and excess exposure to sunlight also increase the risk of cataracts. Some babies are born with cataracts as a result of a rare genetic problem or because the mother has been exposed to German Measles (Rubella) during her pregnancy and she was not immune to the disease.

A cataract is not an infection so it cannot be spread from one person to another nor can it be spread from one eye to another by rubbing the eyes.
Symptoms
As a cataract develops the person may not notice the difference at first and may attribute any changes in the ability to read or see the television simply to getting older. As the cataract continues to develop, vision gets progressively worse. The person affected may notice blurring round the edges of objects, halos around lights, or may get the impression that their glasses are dirty or scratched. Other symptoms may include double vision and a yellow tinge to everything seen. The person may also have difficulty seeing in bright light or on very sunny days.
Treatment
The most effective treatment for cataracts is surgery to remove the cloudy lens. The operation can be carried out at any stage of the cataract, particularly if it starts to interfere with everyday activities, such as reading or working. The operation is usually done as a day case, using a local anaesthetic. A plastic lens is used to replace the cloudy lens, although in some cases the eye specialist my recommend contact lenses or special glasses instead. After the operation, the person will need someone to look after them at home until the eyes recover. This normally takes a few days, although complete healing may take several months.

Laser treatment is sometimes needed afterwards to remove any parts of the original lens case remaining which may have turned cloudy.
When to consult your pharmacist
If you are worried about cataracts, talk to your pharmacist. It is recognised that the anti-oxidant vitamins A, C and E and zinc are essential for the maintenance of the healthy tissues of the eye and may prevent the development of cataracts and age-related macular degeneration. These vitamins are available to those who eat a balanced healthy diet full of fresh fruit and vegetables, particularly leafy green vegetables such as spinach and broccoli, but if you cannot change your diet, a supplement may be preferred. Your pharmacist will be able to talk to you about vitamin and nutritional supplements.

Talk to your pharmacist if you have problems with your eyes or your vision and if you are worried that you may have cataracts. Some medicines known as anticholinergics that are used for the treatment of urinary incontinence or diarrhoea may affect vision and cause similar symptoms to those of cataracts. Your pharmacist will be able to reassure you if this is the case or will suggest that you visit your optician or doctor.

After a cataract operation it is likely that you will be prescribed eye drops to reduce any inflammation and to prevent infection. Your pharmacist will be able to advise you on the correct way to use the drops, how to store them and when they should no longer be used.
When to consult your doctor
If you have diabetes you must visit your doctor or optician as soon as you notice changes in your vision. If you do not have diabetes and your vision has changed also check with your doctor or optician, particularly if you are experiencing double vision, blurring or a yellow tinge to your vision.
Living with cataracts
As cataracts develop gradually it is important that you visit an optician regularly, particularly when over the age of 40, especially if you do notice a change in your vision, or if you have diabetes. Your optician will examine your eyes and will be able to see if you are developing cataracts or any other eye problems and will be able to advise you on the best action to take.

If it is decided that you require treatment for cataracts, do not be concerned. Cataract surgery is now a routine procedure and is one of the most successful operations. The operation takes about 20 minutes and is performed under a local anaesthetic. Most people who have the operation go home on the same day and are soon able to carry on normally.

After the operation most people notice an instant improvement in sight, although complete healing may take several months. It is important during this time, especially soon after the operation, to take care not to damage your eye. You should avoid rubbing your eye and should take care to avoid getting soap or shampoo in your eye when washing. Do not go swimming, wear sunglasses on sunny or windy days, and avoid strenuous exercise or lifting heavy weights.

If you wore glasses before the operation, you will probably need to have your eyes tested for new glasses and you may also require glasses for reading. The eye specialist will be able to advise you when to have an eye check to get new glasses.

You will be given eye drops to use for up to two months after your operation. Carry the drops with if you go out so that you can use them at the prescribed intervals and according to the dosage instructions. Discard any eye drops remaining two weeks after first opening and get another prescription if your treatment is to continue. Do not keep opened drops for future use as it is highly likely that the drops have become contaminated and further use risks causing severe eye infections.
Advice for carers
If you care for someone who has had cataract surgery who needs help putting drops or ointment in the eye, learn to apply the preparations properly. Your pharmacist is always available to provide advice if you need it.

When putting drops in someone else's eye, it is easier if the person lies on their back or, if capable, tilts the head back. Pull the lower eye lid down with the index finger of one hand to create a pocket below the eye. With the other hand, bring the eye dropper close to the eye over the eye pocket. Place the other fingers of this hand on the nose, for balance and to avoid touching the eye with the dropper. Squeeze the eye dropper gently allowing a drop to fall into the eye pocket. Count out the required number of drops. Release the lower eye lid and ask the person to close their eye gently. If necessary, gentle pressure can be placed in the corner of the eye near the nose to prevent the drops from running out of the eye. Repeat the procedure for the other eye, if both eyes are affected. If you need to administer more than 1 type of eye drop, wait 10 minutes between giving each type.

When putting ointment in someone else's eye, it is usually best to do it at bed time to avoid disturbing the person's vision. Pull the lower eye lid down with the index finger of one hand to create a pocket below the eye. With the other hand, bring the tube of eye ointment close to the eye over the eye pocket. Point the tube towards the corner of the eye near the nose. While gently squeezing the tube move it to allow about a centimetre of ointment to emerge as a thin line along the inside of the lower eye lid. Release the lower eye lid and ask the person to close their eye gently. Repeat the procedure for the other eye, if both eyes are affected. Avoid touching the eyes or eye lids with the tip of the tube.
Useful Tips
  • Diets or drugs have not been shown to slow or stop the development of cataracts, but anti-oxidant vitamins A, C and E and zinc have been shown to reduce age-related macular degeneration.
  • Sunglasses that cut down UV light may help to reduce the likelihood of developing cataracts
  • After surgery
    • Avoid rubbing your eye
    • Avoid strenuous activity e.g. heavy lifting or exercise
    • Try to avoid anything blowing into your eyes, such as on a windy day
    • Make sure you don't get anything in your eyes when washing your hair
    • Avoid eye make-up for six weeks
    • Avoid driving until your doctor gives you the go-ahead
Further information
Royal National Institute of Blind People (RNIB) is the UK's leading charity offering information, support and advice to almost blind and partially sighted people.

Helpline: 0303 123 9999

www.rnib.org.uk

Reviewed on 22 November 2010


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