Coping With Cataract Surgery

Shivani, a 58-year-old banking professional living in Oregon, was experiencing blurred vision. She has been diabetic for many years. Upon consulting her ophthalmologist, she was told that while she does not have diabetic retinopathy, she has cataracts in both her eyes and needs cataract surgery.  She heard that cataracts develop after 80 years of age and was worried about the diagnosis and the upcoming surgery. She approached us for advice.

*Name changed upon request.

Q: What is a cataract? 

Dr. Sharma: A cataract is a clouding of the lens of one’s eye. The lens is typically the clear part of the eye that helps to focus light. The development of cataracts can make vision blurry, leading to visual disability and eventually, blindness. 

There are about 53 million people globally with blindness due to cataracts. Ageing is the primary risk factor for cataracts, with about two-thirds of people over 80  years affected. 

Q: Can I get it in my 50s?

Risk factors for cataracts include genetic predisposition, certain medications (e.g., corticosteroids), eye injuries, UV exposure, radiation therapy, and uncontrolled diabetes. So, yes, one can get it in the 50s. 

Early surgery of cataracts can improve not only vision but also quality of life by enhancing general physical health due to decreasing falls, improving cognitive abilities, and improving emotional well-being by decreasing depression. 

Q: Is surgery the only option for me?

Dr. Sharma: Cataract surgery is one of the most common surgeries performed, with approximately  4 million per year in the United States and over 20 million globally. It is one of the most successful interventions in modern medicine.

As such, cataract surgery is a viable option for the treatment of cataracts. Though you can delay, It is better to get it done early if recommended while one is healthy. It is a safe, outpatient procedure where the clouded natural lens of the eye is removed by ultrasound waves and suction. It is then replaced with a clear artificial intraocular lens (IOL).  The procedure takes just 10–15 minutes, and it is performed using numbing drops and mild sedation. Most patients experience improved vision within a few days. 

Q: How can I prepare for this surgery?

Dr. Sharma: Typically, a cataract removal is done one eye at a time with at least two weeks between surgeries. Before the surgery, your ophthalmologist will take measurements of the size and shape of your eye and order IOLs for you. 

There are five types of IOLs: (a) monofocal IOLs (standard and covered by insurance), which correct one visual field, typically distant vision, (b) Toric IOLs, which also correct astigmatism (irregular cornea), (c) multifocal IOLs, which correct near, intermediate, and distant vision (generally frees one from the use of glasses), (d) Extended depth of focus (EDOF) IOLs, which stretch a single focal point into a long, continuous field of vision; (e) Light adjustable IOLs, in which the lens material is made of light-sensitive macromers. 

You and your ophthalmologist will choose which is best for you. Before the surgery, you will begin using prescription eye drops that will prevent infection and inflammation.  You may be asked to stop some medications that may cause bleeding during surgery. You will be asked to stop taking food and drink for at least six hours before the surgery.  On the day of surgery, you should bring someone who can drive you back home. 

Q: What happens after the surgery? 

Dr. Sharma: After the surgery, continue to administer eye drops prescribed by your ophthalmologist, typically for at least two weeks. You may need to wear a shield on the eye to prevent accidentally scratching it.  Avoid heavy exercise, touching your eye, swimming, wetting your eye, air travel, and lifting heavy things. 

Q: What complications should I be aware of?

Dr Sharma: You should watch for vision loss, bad pain in the operated eye, very red eyes, or seeing a lot of small dark spots in your vision. Some complications can be eye infection, eye bleeding, detached retina, dislocation of the IOL, etc. (though their chances have been reduced over the years). Sometimes weeks, months, or years after the surgery, the membrane behind the lens may scar, which is easily corrected through YAG laser capsulotomy.

Q: Can yoga and meditation help with cataract surgery?

Dr. Sharma: Yoga should not be seen as a treatment for cataracts. However, meditation (dhyana) and gentle deep breathing (pranayama) are excellent tools for pre-surgical stress reduction and post-surgical relaxation. Because physical strain and bending can spike eye pressure, one must strictly avoid intense postures (asanas) and intense pranayama during recovery for at least two months.

Q: Can you share some additional resources in this area?

Dr. Sharma: Here are some additional resources from which you can find more information:      

• American Academy of Ophthalmology’s website on Cataract Surgery 
• American Society of Cataract and Refractive Surgery (ASCRS)’s  website on Operation Sight to help those who cannot afford the costs of cataract surgery  
• Cleveland Clinic’s website on Cataract Surgery   
• Mayo Clinic’s website on Cataract Surgery 
• National Eye Institute’s Guide for Cataract Surgery    

If you have questions, reach out to Dr. Manoj Sharma at editor@indiacurrents.com.