Looking Into Cataracts
Oct 17, 2011
By Barret Procyshyn, Pharmacist at the Dauphin Clinic Pharmacy
In the pharmacy we constantly see prescriptions for eye drops given to patients who are going for Cataract Surgery. It seems to be a common and a very routine surgery. I decided to look into cataracts and see what exactly the procedure is all about.
A cataract is a clouding in the lens of the eye, which impedes the passing of light. Early in the cataracts development the power of the lens is increased, which causes near sightedness. Cataracts will progress from a clouding appearance, to a yellowing of the lens. Eventually it will cause vision to lose the perception of the color blue. Color contrast fades and shadows, contours, color vision all become less vivid. If left untreated the lens will become opaque and it will result in vision loss. Both eyes can be affected, but in almost all cases one eye is affected earlier than the other.
The majority of cataracts are related to aging, although they may develop due to an eye injury, inflammation of the eye or disease. Age related cataracts are responsible for almost 50% of blindness in the world, which amounts to about 18 million people. In 2007 nearly 2.5 million Canadians had cataracts and over 250 000 surgeries were performed in that year. With an aging population in Canada, the news does not get any better. In the next 25 years the prevalence of cataracts is expected to increase by 90%.
There is not a lot we can do to prevent cataracts. Reduction of cigarette smoke, sunlight exposure and alcohol consumption may prevent or delay cataracts. Uncontrolled diabetes, high blood pressure and obesity are also tied to cataract formation. There is no medical treatment to stop the formation of cataracts or slow their progression. Theoretically vitamins should help prevent or slow cataract development; however this has not been shown in clinical trials.
Surgery is the only option to fix cataracts and is indicated in those who have difficulty doing daily activities due to their vision impairment. The procedure involves removing the old lens and replacing it with an artificial intraocular lens. It is performed as day surgery, which makes it quite convenient. The success rate of an uncomplicated cataract procedure is approximately 95%.
Many patients scheduled for cataract surgery often ask if they should stop any of their medications. The answer is that they should discuss their medications with the cataract surgeon. The surgeon will inform you if any medications need to be stopped. Studies have not shown blood thinners, including aspirin affect cataract surgery or increase the risk of an ocular bleed.
Cataract surgery does cause inflammation in the eye, which can lead to complications. This is why eye drops are given to reduce inflammation. Eye drops used include corticosteroids and NSAIDS. Both of these help bring down the swelling and prevent future complications. Although infections developing from surgery are extremely rare Antibiotic eye drops are usually used to prevent infection.
It is very important you instil eye drops into the eye correctly. Your pharmacist will show you proper technique for instilling eye drops and provide counselling on them. If you have difficulty doing it on your own you may need assistance from someone else or may need an eye drop dispenser. These eye drops do not need to be stored in the refrigerator. However if they are kept cool it is easier to feel the drop hit the eyeball. The Canadian pharmacists association recommends different eye drops be administered 15 minutes apart, although 5-10 minutes may be sufficient. Most often eye drops are started 3 days before eye surgery. The antibiotic continues for 7 days post-surgery, while the anti-inflammatory and steroid continue for 4 weeks post-surgery. If after cataract surgery you notice worsening vision, floaters, flashes, eye discomfort or increasing eye redness an ophthalmologist should be consulted.
The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.
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