Guide To Diagnosing And Treating Cataracts
A cataract is a progressive eye condition, which can occur in one or both eyes, where the lens of the eye, which is normally clear, gradually clouds over. Symptoms of cataracts include blurry vision, sensitivity to light, seeing spots or halos around lights in the visual field, and difficulty seeing at night. Patients who have cataracts may also find colors appear less vivid than usual and they need extra light for reading and other close-up tasks. If left untreated, cataracts can significantly impair an individual's ability to drive safely. Cataracts most often occur in those over sixty years old, and more than 200,000 cases are diagnosed in the United States every year. By the age of eighty, more than fifty percent of individuals will experience a cataract in one or both eyes.
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Prescription Glasses
Prescription glasses can help ease the blurry vision patients typically experience with cataracts. Often, blurry vision is accompanied by other eye problems such as nearsightedness, also known as myopia. This condition makes it harder to see objects in the distance. Since cataracts often occur with other eye concerns, it is especially important for patients to attend regular eye exams with an optometrist. In general, patients are advised to have screening exams at least every one to two years, and patients who have diabetes or who have active cataracts may need screening more frequently. As cataracts advance, many patients will often need multiple adjustments to their existing glasses due to vision changes. Eye health professionals can work with each patient to find the prescription that provides the best symptom relief for them. For example, they may suggest the use of an anti-glare coating on the lenses of the glasses to decrease sensitivity to light and help with driving. High-strength lenses may help patients whose cataracts are particularly advanced.
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Cataract Surgery
Surgery is the only way to remove cataracts and restore normal vision. The surgery is normally recommended when a patient's cataracts impact their quality of life, making it difficult for them to enjoy daily activities such as watching TV, reading, and driving. For patients who have additional eye problems such as diabetic retinopathy or macular degeneration, cataract removal may be necessary to properly examine and treat these issues. Surgery for cataracts has an estimated ninety percent success rate. For patients with cataracts in both eyes, one cataract is removed in a single surgery, and a second operation is usually scheduled for the following month to remove the remaining cataract. Typically, the operation lasts one hour, and most patients can remain awake for the entire procedure, which can be done using local anesthetic and numbing drops for the eye. During the operation, the cloudy lens with the cataract is removed, and an artificial lens is placed. Patients can leave the same day of the surgery, and most will make a complete recovery within two months. Eye drops may be used following cataract surgery to heal the eye and prevent infection.
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Improve Lighting In The Home
Cataracts can cause particularly dim vision, and objects may appear faded and shadowy. Some patients may feel an increasing sense of frustration as common activities such as reading the morning paper, pouring coffee, and watching the evening news become challenging or impossible. Making lighting changes in the home environment can help patients who have cataracts enjoy their home environment more, improving their wellbeing and quality of life. Reading tasks can be made easier through the use of special magnification lamps. These magnification lamps are placed on the floor and include a strong light and a magnifying glass mounted on an adjustable arm. Patients can move the arm to bring the light and magnifying glass very close to their reading materials, enabling them to see much more accurately. In the kitchen, the installation of bright under-cabinet lighting can help illuminate work surfaces and improve lighting in the home overall, making chopping and other meal preparation tasks safer. While lighting options are available through home decor stores, specific devices designed for patients with low vision are often available through local government resources.
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Wear Sunglasses Outside
Optometrists and ophthalmologists routinely advise all patients to wear sunglasses outside throughout the year. Exposure to the sun's rays can increase the risk of getting first-time cataracts, and patients who have already had cataract surgery may have an increased risk of getting a second cataract if they do not wear sunglasses outside. The most important factor when using sunglasses for cataract prevention is to choose sunglasses that block one hundred percent of the sun's ultraviolet rays (both UV-A and UV-B rays). If possible, patients should wear sunglasses with large frames that cover most of the eye area, including the sides of the eyes. Do not buy any sunglasses that appear scratched on the outside. To further protect eyes from the sun, eye health professionals recommend wearing both sunglasses and hats or visors. They also suggest that patients stay indoors during the time of day when the sun is strongest, usually between 11 am to 4 pm.
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Limit Driving At Night
Patients with cataracts may need to limit driving at night, particularly as their cataracts become more advanced. The nearsightedness and blurred, low vision cataract patients typically an increased risk of having an accident while driving, potentially endangering their lives and the lives of others. Patients who have concerns about their eye health or cataracts should see an optometrist regularly and follow their doctor's suggestions about whether or not they should drive. Patients who are fit to drive may wish to do so only during the day, and doctors may suggest they only drive on roads with low-speed limits or only around town. Patients who cannot drive because of cataracts can usually find help with transportation through local taxi companies, public transportation, as well as family or friends.
So how are they diagnosed anyway? Find out next.
Slit-Lamp Examination
Cataracts can be diagnosed with the use of a test referred to as a slit-lamp examination. A slit-lamp exam is usually performed by an ophthalmologist or optometrist. A slit-lamp examination is also commonly referred to as biomicroscopy in the medical community. Before a slit-lamp examination, eye drops are used to help the specialist identify any abnormalities in the patient's eyes during the exam. The eye drops used during this diagnostic test contain fluorescein, a yellow dye. This dye washes the tears away and helps make the pupils larger. A slit lamp or high-intensity light is used in conjunction with a low-powered microscope to examine the eyes. A patient's eyelids, iris, sclera, retina, conjunctiva, lens, cornea, and optic nerve can be examined. Because cataracts are an abnormal clouding of the lens, the slit-lamp examination can identify their presence.
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Retinal Exam
A patient's cataracts can be detected and diagnosed with a retinal exam or retinal imaging. A retinal exam allows an ophthalmologist or optometrist to see a patient's retina, blood vessels, and optic disk. The digital retinal imaging technique commonly used to carry out a retinal exam in modern-day medicine enables specialists to take a digital photo of the inside of a patient's eye. This photograph contains the macula, blood vessels, optic nerve, and retina. If signs of cataracts are present on a digital retinal imaging test, the ophthalmologist or optometrist will carry out the same test with the use of higher resolution and higher quality imaging referred to as fundus photography. Some characteristics of diseases that affect the eye may not be able to be seen with the use of a comprehensive eye exam with dilation. Certain subtle changes in the characteristics of a patient's eye can be seen better with the use of a digital retinal exam.
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Visual Acuity Test
Optometrists will regularly employ visual acuity tests to determine the accuracy of a patient's vision using an eye chart with a series of letters of varying sizes printed on it. They will test the patient's eyes one at a time, often asking the patient to either close one eye or using a viewing device to block out one eye. This can help them determine if the patient has 20/20 vision or if their vision is exhibiting any indicators of impairment. If the patient's vision does show some decline, it can help optometrists determine what tests may be required from there, including further testing for cataracts.
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Comprehensive Eye Exam With Dilation
A comprehensive eye exam with dilation is a series of diagnostic tests that measure an individual's ability to see and identify any potential problems that can adversely affect the health and functionality of their eye. An optometrist assesses a patient's eye muscle movement and function, how light waves pass through the lens and cornea of the eye, color vision, the health of the retina, how clearly they can see, the degree to which an individual can see on both sides of them without changing the position of their eye, physical health of the eyelids and eyelashes, and a patient's risk of glaucoma. Because cataracts develop in individuals over forty years old, adults between forty and fifty-four years old are advised to have a comprehensive eye exam every two to four years. When an individual reaches between fifty-five and sixty-four years old, they are advised to have a comprehensive eye exam every one to three years. Individuals over sixty-five years old are advised to have yearly comprehensive eye exams.
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Visual Field Test
Cataracts can be detected with the use of a visual field test. As discussed, the width of an area that can be seen by the eye when it is focused on a central point is considered the visual field. A confrontation visual field test is the manual method used to test the accuracy of the patient's peripheral visual field. An automated perimetry test is a visual field test performed with the use of a machine called a perimeter that can show the provider a detailed map of where a patient can and cannot see. Cataracts can compromise a patient's ability to see clearly and accurately in certain parts of the eye. The peripheral vision is commonly affected by the development of cataracts in the eye, and a visual field test can pick up this type of compromised functionality.