If you live long enough, you WILL get cataracts. While cataracts can occur much earlier in life as a result of disease, trauma, radiation, or certain medications, the condition known more specifically as senile cataracts is the subject of this (hopefully) short series of diaries.
What is a cataract?
Right behind the pupil of the eye is the lens. Normally, the lens is perfectly transparent. It helps focus light rays for clear vision. A loss of transparency of the lens is known as a cataract. As a result, the light from an object, which normally passes directly through the lens to produce a sharp image, produces only a degraded image. If the cataract is severe enough, no image at all is produced.
Cataract formation is the most prevalent disorder resulting in blindness.
This is a personal story. Every case of cataract formation is slightly different, but mine is typical enough that those of you who don't have cataracts yet can come along with me as I get my vision restored and have some idea of what you'll face when it's your turn. I have no doubt that those who have already had the surgery will add their experiences to the comments.
In November of 2007 I went to see my optometrist for my annual eye exam. I have worn glasses or contacts since the age of ten for nearsightedness and astigmatism, and my vision has always been correctable to at least 20/20. When I turned forty and had to hold reading material at arms' length to focus on it, changing to progressive lenses once again gave me fantastic vision. There was a slight change in my prescription every two years or so, but my eyes were otherwise very healthy: no increased pressure, no retinal disease, no floaters.
In that November visit I did not require a new prescription and I scarcely recall the doc's observation that I was developing cataracts. By the following November, however, I fully expected a new prescription because my near vision (reading distance) was no longer crisp. "Do you remember my mentioning last year that you're forming cataracts?" the doc said. "Your corrected vision is as good as it will ever be with cataracts." He went on to tell me that I could have cataract surgery whenever my vision degraded to the point it was interfering with my quality of life.
At that time (November, 2008) I was a long way from wanting eye surgery. It was possible that my cataracts would remain stable, i.e., the cloudiness in my lenses would not get worse, for a long time. Perhaps years. In fact, I was able to report no appreciable change as recently as six months ago. Over the winter, unfortunately, I reached a "tipping point" with my vision. My near vision is even worse, and my middle vision - call it monitor vision - became impaired. By January I found myself closing my left eye, the eye with the greater cloudiness, to read Daily Kos. Horrors! Nurse Kelley will put up with a lot, but not that!
And so I have scheduled my cataract surgery. Last Tuesday I went to the Wright Eye Center for a thorough exam and meeting with the ophthalmologist who will replace my natural lenses with artificial ones. The nice thing about today's artificial lenses is their ability to correct common vision problems, such as my nearsightedness, reducing the need for glasses or contacts. An option called monovision corrects one eye for distance vision and the other for near vision, often eliminating the need for any further prescription correction in people who can adapt to it.
I was intrigued. "How can you determine who's a good candidate for monovision?" I asked. "It sounds good in theory, but what if I do it and don't like it?" Dr. Wright said he would send me home with contacts giving me monovision; that is, one contact would correct my distance vision and one would correct my near vision. He said in his experience people can tell very quickly if their brain is likely to adapt to monovision. As it turns out, he seems to be correct. Once I put the contacts in I thought I'd adapt fairly quickly to monovision except for one small problem: my middle distance vision, my monitor vision, was dreadful with monovision.
I've chosen to have both eyes corrected for distance vision. I'll need glasses for reading and computer work, but I'll be best where I need it most ~ behind the steering wheel.
The greatest risk with cataract surgery is infection. For this reason the surgery is done in two stages. I will have my right eye done on May 26 and the left a week later. Part 2 of this series will discuss the surgical process in greater detail, along with preoperative preparations and expectations.
Questions or comments? Talk to Nurse Kelley.♥