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Seeing is Believing: Time for Cataract Surgery

I cleaned my glasses again: Not much improvement. When I got into my car I spray cleaned them—only to find that the road and signs still weren’t much clearer. I went back to a pair of older glasses, no better! Time to book an appointment with the ophthalmologist.

By Dr. Michael Gordon

“You have posterior cataracts in both eyes,” he told me. He knew that I had been exposed to very high doses of corticosteroids for more than a year for another medical condition and, based on the speed of progression, he felt that
was the likely cause. “You need cataract surgery.” I wasn’t surprised.

Hurry up and wait an appointment was made with another ophthalmologist for the surgery. He confirmed the assessment and booked
me a first date to operate on one eye, and then another a few weeks later for the second eye. I’d joined the approximately four million people who have cataract surgery each year in North America, with a 95 per cent success rate. While waiting for my surgery, I continued working with older glasses that marginally improved my long-distance vision and a pair of so-called “cheaters” (fixed magnifying glasses) that improved my reading.

What are cataracts?

Being a doctor, I thought I should refresh my memory and understanding about cataracts before the operation. After all, more than 2.5 million Canadians have cataracts. I was reminded that they are painless, develop within the existing lenses in your eyes and are usually detected during routine eye exams. Simply put—as you age, your lenses naturally harden and can also turn cloudy. A cloudy lens blocks light from reaching the retina and interferes with vision.

Cataracts can form in one or both eyes, and at the same time or at different times. In my practice over the years, I have seen many older patients who might have benefited from cataract surgery. Sadly, some have rejected the procedure out of fear of any type of surgery—despite the usual scenario of knowing friends and family who have benefited from it. Occasionally, of course, they have heard of someone for who the operation failed.

For those with medical comorbidities, the surgery can be riskier—however, current techniques mean there is almost no one who can’t benefit. I recall an elderly man with moderate dementia who sat in front of the elevator at the nursing home in which he lived, and was always calling out “Hello, hello!” He was found to have two cataracts and, despite initial hesitation on the part of the family, the operation went without a hitch. Afterwards, instead of repeating his random “Hellos,” he began to address people and speak to them in
his mother tongue.

The right decision my surgery also went without a hitch and, with recalibrated glasses, I can see near and far without constantly and ineffectively trying to clean them—truly a miracle of modern medicine.v

Dr. Michael Gordon is Medical Program Director of Palliative Care at Baycrest Geriatric Health Care System.

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