cataracts

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Cataracts – what are Cataracts and why shoudl you be concerned?

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[Original article on NHS Choices website]

Cataracts occur when changes in the lens of the eye cause it to become less transparent (clear). This results in cloudy or misty vision.

The lens is the crystalline structure that sits just behind your pupil (the black circle in the centre of your eye).

When light enters your eye, it passes through the cornea (the transparent layer of tissue at the front of the eye) and the lens, which focuses it on the light-sensitive layer of cells at the back of your eye (the retina).

Cataracts sometimes start to develop in a person’s lens as they get older, stopping some of the light from reaching the back of the eye.

Over time, cataracts become worse and start to affect vision. Eventually, surgery will be needed to remove and replace the affected lens.

Symptoms of cataracts

As cataracts develop over many years, problems may be unnoticeable at first. Cataracts often develop in both eyes, although each eye may be affected differently.

You’ll usually have blurred, cloudy or misty vision, or you may have small spots or patches where your vision is less clear.

Cataracts may also affect your sight in the following ways:

  • you may find it more difficult to see in dim or very bright light
  • the glare from bright lights may be dazzling or uncomfortable to look at
  • colours may look faded or less clear
  • everything may have a yellow or brown tinge
  • you may have double vision
  • you may see a halo (a circle of light) around bright lights, such as car headlights or street lights
  • if you wear glasses, you may find that they become less effective over time

Cataracts aren’t painful and don’t irritate your eyes or make them red.

When to see an optician

If you have problems with your vision, make an appointment to see your optician (also known as an optometrist). They can examine your eyes and test your sight.

The optician may look at your eyes with a slit lamp or ophthalmoscope. These instruments magnify your eye and have a bright light at one end that allows the optician to look inside and check for cataracts.

If your optician thinks you have cataracts, they may refer you to an ophthalmologist or an ophthalmic surgeon, who can confirm the diagnosis and plan your treatment. These doctors specialise in eye conditions, such as cataracts, and their treatment.

Who’s affected

Cataracts are very common and they’re the main cause of impaired vision worldwide.

In the UK, most people who are aged 65 or older have some degree of visual impairment caused by cataracts. Men and women are equally affected.

Even though cataracts tend to affect older people (known as age-related cataracts), they can also sometimes affect babies and young children (known as childhood cataracts).

What causes age-related cataracts?

The reasons why age-related cataracts develop aren’t fully understood. Like grey hair, cataracts are an inevitable part of ageing that affect different people at different ages.

Cataracts are the result of changes in the structure of the lens over time. It’s thought that the cloudy areas in the lens may be caused by changes in the proteins that make up the lens. However, it’s not clear how or why getting older cause these changes to occur.

As well as your age, there are a number of other factors that may increase your risk of developing cataracts. These include:

Other factors that may possibly be linked to the development of cataracts include:

  • smoking
  • regularly drinking excessive amounts of alcohol
  • a poor diet lacking in vitamins
  • lifelong exposure to sunlight

As the exact cause of age-related cataracts isn’t clear, there’s no known way to prevent them.

Treating age-related cataracts

If your cataracts aren’t too bad, stronger glasses and brighter reading lights may help. However, as cataracts get worse over time, it’s likely that you’ll eventually need treatment.

Surgery is the only type of treatment that’s proven to be effective for cataracts. It’s usually recommended if loss of vision has a significant effect on your daily activities, such as driving or reading.

Cataract surgery involves removing the cloudy lens through a small incision in your eye and replacing it with a clear, plastic one. In most cases, the procedure is carried out under local anaesthetic (where you’re conscious, but the eye is numbed) and you can usually go home the same day.

Almost everyone who has cataract surgery experiences an improvement in their vision, although it can sometimes take a few days or weeks for your vision to settle. You should be able to return to most of your normal activities within about two weeks.

After the operation, your plastic lens will be set up for a certain level of vision, so you may need to wear glasses to see objects that are either far away or close by. If you wore glasses previously, your prescription will probably change. However, your optician will need to wait until your vision has settled before they can give you a new prescription.

Read more about recovering from cataract surgery.

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Living with low vision

Cataracts - what it is like to have cataracts

Cataracts – what it is like to have cataracts

Nearly 2 million people in the UK are affected by low vision, but you can maximise poor eyesight if it’s dealt with properly.

Sonal Rughani is an optometrist and senior adviser at the RNIB (Royal National Institute of Blind People). She explains what low vision is, and how it can be managed properly.

What is low vision?

Low vision is when a person’s sight can’t necessarily be corrected with glasses or contact lenses.

Low vision doesn’t develop just because of old age. Your vision can get worse as a result of cataracts, age-related macular degeneration or diabetic retinopathy.

According to the RNIB, around 2 million people have significant sight loss in the UK.

Very few people have complete ‘black’ blindness, so any remaining eyesight needs to be maximised. People often go to a clinic hoping that a pair of glasses will fix their vision, but this may not always be possible. Low vision is treated by maximising the patient’s eyesight beyond what glasses or contact lenses can achieve.

When should you visit the optician?

Any decline in your sight should be checked by an optician. Signs that you need to seek help include:

colours look a bit washed out

you’re finding it difficult to judge the depth of steps

straight lines look wobbly

you find it hard to read

you’re struggling to see road signs when you’re driving

It’s important not to simply wait for these signs to appear. They’re not just a part of getting older, they’re telling you that something is wrong.

Everyone should visit their optician every two years. Lots of people are entitled to free eye tests, so find out if you’re eligible for free eye care.

What NHS support is available for low vision?

A visit to your optician is a good place to start. If a problem is detected, you’ll be referred to the hospital to see an ophthalmologist (eye doctor). Your GP will be kept informed, and will give you extra support and advice if you need it.

If the eye doctor finds that your vision can’t be improved by medical or surgical treatment, you may be referred to a low-vision clinic. At the clinic, an optometrist can advise you about lighting and low-vision aids. They will also assess you to see if you are eligible to be certified as partially sighted or blind.

Read more about the criteria for certification.

Being told you can’t see (and that glasses or surgery can’t improve your vision) can be a shock. It can be difficult to get used to that level of sight loss, but support is available from your clinic, GP and organisations like the RNIB.

What is a low-vision aid?

A low-vision aid can be one of the following:

An optical low-vision aid, such as illuminated magnifiers, hand-held magnifiers or flat magnifiers. Aids for viewing faraway objects include monoculars and binoculars.

A non-optical low-vision aid, which includes everything from an anglepoise lamp, to bold-print books or liquid level indicators – which beep to stop you burning yourself when using hot water.

During a low-vision assessment, your optometrist will try different magnifiers to see what works for you. For example, they will work out if you need help for sewing, reading music, doing a crossword or reading the headlines in a newspaper.

How do I become registered as partially sighted?

If your vision can’t be improved beyond a certain point, you can register as partially sighted or blind. Your eye doctor will fill out a certificate for you. In England and Wales this is called a Certificate of Visual Impairment (CVI). In Scotland it’s called a BP1, while in Northern Ireland it’s an AP655.

This certificate documents your eye condition and the extent of your vision loss. It will also state whether you need additional support if, for example, because you are living alone.

After you and your doctor sign the form, copies of it will be sent to you, your GP, social services and the National Census. One copy will also be kept in your medical records. Social services can then register you before getting in touch to offer support.

The benefits of registering as partially sighted may include a 50% reduction on your TV licence fee and an extra personal tax allowance.

What can the RNIB do?

The RNIB can support you in lots of different ways. These include offering advice about your eye condition, advice about daily living skills, and information about welfare rights and benefits. The charity also has information about leisure activities, holidays, befriending services and emotional support services, as well as advice on low-vision aids and where you can get them.

The RNIB’s helpline number is 0303 123 9999. Calls cost no more than a standard rate call to an 01 or 02 number. If you need to speak to someone in a language other than English, there are 80 languages available.

 

Video: cataract animation

This animation explains what cataracts are, and how they affect the eye.

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Vision for Zambia – how you can help children in Africa see again this holiday season.

Orbis, the sight-saving charity that transforms lives by preventing and treating avoidable blindness and visual impairment, is appealing for support. For the next two months, the UK government will be doubling all public donations made to their Vision for Zambia appeal, helping the charity prevent blindness in twice as many children.

Orbis - Vision for Zambia

Orbis – Vision for Zambia

Ophthalmic Nurse, Ann-Marie Ablett (interviewed below) , is the winner of the Royal College of Nursing in Wales 2014 Humanitarian Relief Award, which recognises her amazing contribution and commitment to improving health services in areas of need around the world. She has volunteered with Orbis since 2003, using her annual leave to take part in 29 training programmes, including 7 in Zambia, sharing her skills with nurses and treating over 1000 patients.

Zambian children are four times more likely to suffer from blinding conditions, such as cataract, than those in countries such as the UK. Here the condition is thankfully rare, affecting 3 out of every 10,000. It has one of the highest rates of paediatric blindness globally however there are few ophthalmologists – 15 vs 3,000 here in the UK, and only one paediatric ophthalmologist in the entire country.

With the right access to treatment, half of paediatric vision loss can be avoided or cured. Orbis relies on its amazing medical volunteers, like Ann-Marie, to train eye care specialists, including nurses, surgeons and anaesthetists, who transform lives. Ninety percent of blind children do not attending school and 60% of die within a year of becoming blind; this appeal can make a real difference.


In order to save the sight of over 105,000 children, Vision for Zambia will raise funds to improve outreach work and train over 750 eye care professionals, including nurses. The UK public can help save a child’s sight for free – when they visit www.visionforzambia.org and sign up to find out more, a generous supporter will give £1. Until the 3rd February the UK government is matching all donations, so this simple act will generate £2.

Patient Talk – Who is Orbis and what do they do?

Ann-Marie Ablett – Orbis is a an eye charity focusing on blindness in developing countries, we focus on particularly on children, 90% of children in Zambia do not attend schools so that means there is no door open for them for the future and also shockingly 60% of children die within a year of becoming blind, that’s 3 in every 5 children because they haven’t had the opportunity or the means where they can be screened for avoidable or untreatable blindness.

Patient Talk – Ok and what does the training consist of?

Ann-Marie Ablett – Well we have Doctors, Nurses and biomedical engineers so my role as a volunteer nurse is I will work very closely with the local nurses, I will scrub with them and go through the practises and the principles of safe side surgery, reducing the risk of infection and the easiest way to do that is to make sure you wish your hands properly, there is a specific way when you are scrubbing for cases and so we are there to expose the patient to best practise and we teach the nursing staff because once we go in the door that’s all they say is ‘ help me, please help me to learn ‘ so that they can support their patients and help them to lead a productive life.

Patient Talk – Ok and can you tell us a bit more about the Vision for Zambia campaign?

Ann-Marie Ablett – It’s focusing on Vision for Zambia , focusing on screening and treating up to a 100,000 patients and we are going to do that by working in out of reach areas, we have already been working in Zambia since 2011 and now what we need to do to reach out to reach the patients in outreach areas is to train primary nurses so that they are in a position where they can focus and have a look at the patients eye and determine how early the treatment is required because the earlier you treat the condition, such as cataracts, the sooner the patients vision will be restored. The great thing about this appeal is the UK government is matching the donations which we will have from the public.

Patient Talk – What does being a volunteer involve?

Ann-Marie Ablett – Well it’s one of the easiest things that I have ever done, so what we do is work closely with the nurse, we will present the speciality they have us for ahead of time so that they can learn how to treat the patient so that they can teach their colleagues who are looking after the patients on the wards, so to do that they have got to have an understanding of the problem and the possible complications, nothing is 100% guaranteed and there is always a possibility of a complication so if they know what to look for they can then tell the patient like in cataracts surgery a pain that is not controlled by pain killers than that’s an indication that you need to contact the surgeon.

Patient Talk – Ok who should become a volunteer and how would someone apply to do the types of things that you do?

Ann-Marie Ablett – Well the easiest thing to do is ring up Orbis it’s the most amazing charity, it’s very supportive and I am lucky enough to go to all those countries where the need is greatest, 60% of children die within 1 year of becoming blind and that’s 3 out of 5 children so if you have the opportunity to go there and work with the local nurses to prevent that you would certainly take it up and once you go once you are going to be addicted as I have been addicted for 13 years now and I carry on going so if you were to contact Orbis.org.uk they will take it further and before you know where you are you will be on the plane to an interesting developing country and meeting new colleagues.

Patient Talk – Ok and I just wanted to ask, why did you volunteer?

Ann-Marie Ablett – There are 2 doctors at the hospital who volunteered at Orbis and I asked if I can go and they said ‘no orbis has got their own personal staff ‘ so I wasn’t going to take no for an answer so with further investigation and a bit of determination I found myself going to Zambia And once I got there I realised my practises were no different, we go there to exchange our skills and knowledge and the reception we had from the nurses, really nurses are nurses the world over and all we want to do is care for our patients but I would like to say that once you do it once you won’t ever want to stop just if you don’t do it it’s as though there is a piece if the jigsaw missing and to complete that part of your life you have to go and do something, it’s very addictive.

Patient Talk – Well I was going to say, what is the best thing you have got out of the experience?

Ann-Marie Ablett – Well the opportunity to change the lives of children and their family as well as to do the job I do and exchange the information I have got to make sure my skills are up to date and evidence based but when you think that just by going there for a week or maybe two week you can change the life of the patient and their family and the community, it’s such a warm feeling that you can’t get anywhere else, you can’t buy it and its really quite a selfish feeling because when you go home you think I did something that not many are doing, how lucky am I but then that’s because I work with Orbis and that focuses on education so it boils down to education.

Patient Talk – Ok and what other resources are out there for patients and for people who wish to donate?

Ann-Marie Ablett– Well if they sign up to VisionforZambia.org then we will receive a £1 from generous donors and that will be matched by the UK government so please just sign up to that.

Patient Talk – Ok thank you very much Ann-Marie.

Ann-Marie Ablett – Thank you.

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Some Amazing Facts about the History of Cataracts from Hayley Irvin


Cataracts - what it is like to have cataracts

Cataracts – what it is like to have cataracts

Cataracts, a natural result of the aging process, are the world’s leading cause of blindness. Although humans have known about cataracts for thousands of years, treatment options for most of our history were limited to painful and dangerous procedures that offered little in the way of visual improvement. Check out these interesting and little-known facts to learn more about the history of cataracts!

Cataract surgery has been performed for thousands of years.

The earliest artistic representation of a cataract is a small wooden statue of an Egyptian priest from approximately 2457-2467 B.C.E. A white patch, believed to represent a cataract, is carved into the priest’s left eye. The earliest known representation of a cataract removal procedure appeared on the walls of Egyptian temples and tombs centuries later. The word “Cataract” come from the Greek word used for “waterfall” because prior to the 1700s, people believed that cataracts were “opaque material flowing like a waterfall, into the eye”.

500 B.C a procedure, known as couching, could only be performed on people with advanced cataracts. As cataracts worsen, the lens becomes opaque and rigid and the lens capsule and zonules that hold it in place weaken. Early couching procedures involved hitting the patient’s eye with a blunt object in order to displace the lens so it could be absorbed into the vitreous humor in the back of the eye. Because contact lenses hadn’t been invented yet, patients were often left slightly improved but extremely blurry vision.


Early cataract surgery involved a needle, a steady hand, and no anesthetics.

Though cataract removal procedures remained relatively unchanged for centuries, by 29 AD Western physicians had started using a needle break to break up cataractous lens into smaller pieces that would be more easily absorbed into the back of the eye. Because topical anesthetics wouldn’t be more invented for a few hundred more years, doctors required the help of a strong-armed assistant to hold the patient down while they jabbed their eye with a needle. Ouch.

Cataracts - couching procedure

Cataracts – couching procedure

The advent of “needling” meant that patients did not have to wait until they had advanced cataracts to have them removed. However, as antibiotics and sterile surgical equipment were still a few centuries in the making, the procedure had a high mortality rate, a long recovery period, and still left patients with incredibly blurry vision.

Parisian Jacques Daviel performed the first cataract extraction procedure in 1748.

In couching and needling procedures, the lens was not actually removed from the eye – just displaced and reabsorbed. In Daviel’s procedure, an incision was made to the outer layer of the eye in order to completely remove the lens, leaving part of the lens capsule behind. Londoner Samuel Sharpe introduced a new variation of this surgery in 1753, in which he used his thumb to apply pressure and pop the lens out of the eye. Thankfully, by 1902, doctors were using small suction cups and forceps – you know, actual medical equipment – to remove the lens from the eye.

Intraocular lenses were first developed in 1940 by Englishman Harold Ridley.

Up until the invention of the intraocular lens, cataract surgery left patients with poor visual acuity. Although patients were no longer experiencing cloudy, yellowed, or distorted vision, the lack of lens made it impossible for their eyes to focus light. IOLS changed everything for cataract patients.

Made of plastic, early IOLs provided a permanent solution to vision loss associated with cataracts by giving the eye another lens through which to focus. This improved visual acuity in addition to getting rid of a patient’s cataracts. Since then, IOLs have received numerous upgrades to make them safer and more comfortable for wearers. Now, IOLs are made out of flexible material that respond to your eye muscle’s natural movements and can treat a number of eye problems, including presbyopia and astigmatisms.

In 1967, New Yorker Charles Kelman introduced the phacoemulsification technique for cataract surgeries.

Unlike previous procedures that required a large incision in the cornea to remove cataracts, this technique uses ultrasonic vibrations to break up the lens into incredibly small pieces that could be sucked out through a tiny incision in the eye. Kelman’s innovation, which was less painful and had a shorter recovery time than other cataract removal procedures, further improved the patient experience during and after the surgery.

Claude Monet, the father of French Impressionism, developed cataracts in his old age.

 A product of the aging process, no one is immune to cataracts – even artists. French Impressionist painter Claude Monet developed cataracts during his later years, though he would eventually have them removed.

Cataracts and Monet

Cataracts and Monet

This series of images illustrates how Monet’s cataracts affected his work. Image A, from Waterlilies, was painted while Monet had cataracts. Put through a filter, image B shows what this piece looked like to Monet through his cataracts.Image C, Morning with Weeping Willows, was painted after his cataracts were removed. Notice the differences in color and detail before and after undergoing cataract surgery. The first image really speaks to Monet’s talent as a painter, considering what it looked like to him!

With a 98% success rate modern cataract surgery is one of the safest and most effective surgical procedures performed today. There are more than 3 million cataract surgeries performed in the U.S. every year, and most patients experience greatly improved vision after the surgery. Thanks to computer-assisted technology and the femtosecond laser, it is safer than ever to undergo cataract surgery. If you’re experiencing vision loss due to cataracts, speak with your ophthalmologist today about the best treatment options available to you. Enjoy incredible sight for life!

 

BIO: Hayley Irvin is a graduate of the University of Oklahoma. When she’s not creating awesome content for Marketing Zen Group & Eyecare2020 , she’s writing about basketball, learning about space, and thwarting her cats’ attempts to take over the world. Catch up with her on Twitter @HayleyNIrvin.

 

 

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Optometrists notice increase in young people suffering from potentially serious eye conditions


  • Going to the opticians

    Going to the opticians

    A Survey of Optometrists shows two thirds have seen an increase in the number of younger patients presenting symptoms of eye conditions

  • Almost half are concerned that people will start losing their sight, or suffering from conditions such as glaucoma and cataracts at a younger age
  • Increased use of screens is considered one of the major reasons for deterioration in eye health
  • Consumer survey shows one in 10 people would only have an eye test if they were experiencing problems
  • Around 45% wouldn’t get their eyes tested if they were struggling to read road signs and one in ten have even got behind the wheel of a car with blurred vision.

The number of young people who are being diagnosed with serious eye conditions is thought to be growing, according to a survey of Optometrists released today. The study saw two thirds of Optometrists say they have seen an increase in conditions such as Dry Eye disease and Blepharitis, while almost half are concerned that people will start losing their sight or suffering from conditions such as glaucoma, cataracts and age-related macular degeneration at a younger age. The Optometrists surveyed say the increased use of screens in our daily lives is one of the major factors in the deterioration of the nation’s eye health (63%).


Also the increasing prevalence of diabetes in the UK (72%), poor diets (70%), smoking (74%), not wearing sunglasses (75%) and not following a proper hygiene routine for contact lenses (62%) all contribute to the worsening of our eyes.

Three quarters of Optometrists say that they are concerned generally about the eye health of their patients, while more than 90% say they don’t think people take their eye health seriously or look after their eyes as much as they should.

Furthermore, consumer research also released today by Spectrum Thea shows one in 10 people would only have an eye test if they are experiencing problems, with less than half saying they would get checked out if they had blurred vision from screen-time, while a third wouldn’t even if they were unable to read small print.

Worryingly, for road users, around 45% wouldn’t get their eyes tested if they were struggling to read road signs from a distance and one in 10 have even sat behind the wheel of a car with blurred vision. Watch the following video for more details of the report.

Readers may also be interested in our recent blog post to celebrate National Eye Exam Month which gave five great reasons to have an eye test.