Eye-atollah
Like a desert sheik stealing through the night in search of a fertile bed, a welcome crumb, and a drop to quench his thirst, cataracts stealthily infiltrate the tranquility of our aging population. But where do they come from, and what is their grand design?
Simply put, a cataract is nothing more than a painless, cloudy area in the lens of the eye, which blocks the passage of light from the lens to the nerve layer of the retina. Unlike a sultan’s harem, which at the least has vigilant, muscularly well-endowed eunuchs to halt the march of an unholy infidel, the retina is defenseless to the onslaught. In fact, some cataracts grow larger or denser over time, causing severe vision changes leading to blindness, glaucoma, or a loss of independence in older adults.
While aging, ultraviolet radiation from sunlight, eye injury, poorly controlled diabetes mellitus, glaucoma, steroid medications, and frequent radiation treatments of the head all contribute to the clouding effect of cataracts, some degree of lens opacity is expected in everyone over the age of 70.
Risk factors for cataracts are as multivariegated as the colors of a Persian rug, and some of them can literally represent straws to break a camel’s back. There are those, for example, that one cannot change, such as age 65-74, Native American and African American race, female sex, and family history. Others, like life-long, chronic diseases (diabetes, glaucoma, and high blood pressure), when kept in check, can be temporarily thwarted in the inexorable march toward cataract. Still other risk factors, for example chickenpox during pregnancy, smoking, exposure to ultraviolet light, long-term use of steroid medications, and even alcohol, should not be underestimated.
So, when does cataract warrant the same concern demonstrated by the head of a clan, unable to find a suitable husband for the eldest of his eight daughters? Severe eye pain, sudden change in vision or eyeglass prescription, and blurred or double vision all mandate recourse to the healing arts. Surgery becomes necessary when vision loss caused by a cataract affects the patient’s quality of life. Until then, not smoking, wearing sunglasses in the sun, eating a diet rich in vitamins C and E, limiting alcohol intake, avoiding steroid medications, keeping high blood pressure and diabetes under control, taking estrogen for menopause, and using mydriatic eyedrops to dilate the pupil do as much to prevent or postpone surgery, as a “toke” on a water pipe and a good cup of Turkish coffee do to make a reluctant suitor more malleable to the manipulative whims of a prospective father-in-law.
When standard extracapsular surgery, in which the lens and its anterior membrane are removed, or extracapsular surgery using phacoemulsification, in which sound waves are used to break the lens up into small pieces, becomes necessary, subsequent placement in the eye of a new intraocular lens will usually guarantee most adults 20/40 vision or better within 3 weeks to 2 months after surgery.
It therefore goes without saying that, dollar for dollar, an ounce of prevention and informed consent do far more than smart bombs and cruise missiles to halt unwanted incursions of the “Eye-atollah.” Remember, cataracts are no fun, and belly dances are performed at night!
Simply put, a cataract is nothing more than a painless, cloudy area in the lens of the eye, which blocks the passage of light from the lens to the nerve layer of the retina. Unlike a sultan’s harem, which at the least has vigilant, muscularly well-endowed eunuchs to halt the march of an unholy infidel, the retina is defenseless to the onslaught. In fact, some cataracts grow larger or denser over time, causing severe vision changes leading to blindness, glaucoma, or a loss of independence in older adults.
While aging, ultraviolet radiation from sunlight, eye injury, poorly controlled diabetes mellitus, glaucoma, steroid medications, and frequent radiation treatments of the head all contribute to the clouding effect of cataracts, some degree of lens opacity is expected in everyone over the age of 70.
Risk factors for cataracts are as multivariegated as the colors of a Persian rug, and some of them can literally represent straws to break a camel’s back. There are those, for example, that one cannot change, such as age 65-74, Native American and African American race, female sex, and family history. Others, like life-long, chronic diseases (diabetes, glaucoma, and high blood pressure), when kept in check, can be temporarily thwarted in the inexorable march toward cataract. Still other risk factors, for example chickenpox during pregnancy, smoking, exposure to ultraviolet light, long-term use of steroid medications, and even alcohol, should not be underestimated.
So, when does cataract warrant the same concern demonstrated by the head of a clan, unable to find a suitable husband for the eldest of his eight daughters? Severe eye pain, sudden change in vision or eyeglass prescription, and blurred or double vision all mandate recourse to the healing arts. Surgery becomes necessary when vision loss caused by a cataract affects the patient’s quality of life. Until then, not smoking, wearing sunglasses in the sun, eating a diet rich in vitamins C and E, limiting alcohol intake, avoiding steroid medications, keeping high blood pressure and diabetes under control, taking estrogen for menopause, and using mydriatic eyedrops to dilate the pupil do as much to prevent or postpone surgery, as a “toke” on a water pipe and a good cup of Turkish coffee do to make a reluctant suitor more malleable to the manipulative whims of a prospective father-in-law.
When standard extracapsular surgery, in which the lens and its anterior membrane are removed, or extracapsular surgery using phacoemulsification, in which sound waves are used to break the lens up into small pieces, becomes necessary, subsequent placement in the eye of a new intraocular lens will usually guarantee most adults 20/40 vision or better within 3 weeks to 2 months after surgery.
It therefore goes without saying that, dollar for dollar, an ounce of prevention and informed consent do far more than smart bombs and cruise missiles to halt unwanted incursions of the “Eye-atollah.” Remember, cataracts are no fun, and belly dances are performed at night!
Copyright 2003, Albert M. Balesh, M.D. All rights reserved.
posted by Dr. Al at
7/18/2006 09:47:00 PM
2 Comments:
This site is one of the best I have ever seen, wish I had one like this.
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