I was 38 years old when I received the shocking news from my optometrist. “Carine, you have a cataract forming in both eyes, one isn’t much, but I want you to see an ophthalmologist.”
I felt no pain. Since I was legally blind (my good eye was 20/850), I didn’t really understand what the problem was. At the time, even with my contact lens, I could only see 20/150. Barely able to pass the driving test. So I went. I met with Dr. Coral Smith, a doctor within my HMO who also taught innovative cataract surgical procedures at the University of California, Irvine.
He told me that, indeed, I was developing a large cataract in one eye and a very small one in the other. I had developed a “subcapsular” type starting at the back of my lens due to the number of injections and prednisone tablets I had been given prior to my rheumatoid arthritis diagnosis and subsequent use of the steroid until the disease was under control . .
There are two other types: nuclear (formed naturally in the aging process) and cortical (the type many diabetics develop)
A cataract is a clouding of the lens of the eye, which is just behind the iris (the colored part of the eye) and the pupil. Due to this growing “cloud”, vision deteriorates. A cataract just doesn’t appear one day; they start small and go from there. At first there was little to no effect on my already horrible vision. Then at some point I felt as if I had started looking through a pair of glasses that desperately needed cleaning. At some point during growth, light became irritating, whether it was from the sun or from a lamp. At this point, driving at night became dangerous as the blurred vision and irritation from the headlights affected my depth perception. The colors didn’t seem very, well, colorful.
I noticed a sense of dread if I had to get behind the wheel of my car at night. I didn’t feel “safe” so I stayed off the road for several years once the sun started to go down. Fortunately at this point in my life, I worked from home.
What causes cataracts besides age, certain diseases and medications? Even after all the surgical advances, no one really knows why such a thing exists. Some studies suggest it could be exposure to ultraviolet light. Many if not most optometrists/ophthalmologists urge their patients to always wear sunglasses and visors. More recent studies have shown that one way to prevent or slow their growth is to follow a diet rich in antioxidants and reduce salt intake. Other risk factors? Smog, drinking too much alcohol, and smoking to name a few.
Once I was diagnosed, my treatment was stopped until the cataract “matured”. Most people usually know when their cataract is “mature” because it affects their vision enough to affect their daily life. For me, in addition to not being able to drive at night, I found that my ability to read my beloved mysteries and solve crossword puzzles became a chore rather than a pleasure.
What comes next, once the cape of your eyes drives you crazy? Surgery. Once you and your doctor decide you can’t wait any longer, a date will be set. I had my surgeries 4 months apart. In the almost 7 years since then, the procedures now give you more options: you can have an implant with monofocal or multifocal lenses. The latter makes it possible not to have to wear reading glasses! When I had mine done, my very skilled surgeon gave me the best there was at the time: one farsighted, one nearsighted. I don’t need to wear glasses a good part of my day. I can read without reading glasses, but I prefer to do so when I’m trying to enjoy a novel or, again, solve puzzles. To drive, while I see quite well, to sharpen the image I use distance lenses. Fortunately, I have all the advantages in a set of beautiful glasses that are even equipped with transitions, so I don’t even need a separate pair of sunglasses.
As for the surgery itself, it is strictly outpatient. When I was taken to the prep room, I had to go through a series of drops and medications to help me relax and numb my eye. Having a “state of the art” surgeon meant I didn’t have to use a needle to do this! Once I was taken to the operating room, they put a device on my eye to make sure I couldn’t/wouldn’t blink. I was awake the whole time. Unless it is decided that a little more “relaxation” is needed to make it less stressful for you and the doctor, there is no reason to give you a general anesthetic. I was so nervous during the first surgery that I couldn’t fall asleep, but it only lasted a full half hour and I survived. Once the first initial “cut” is made and the lens is removed, you will not be able to see until the implant is secured. After the surgery, a protective cup was placed over my eye for the first 24 hours. A large amount of fluids leaked out during this time. I felt like I had severely scratched my corneas for the rest of the day.
The attendants sent me home with a large set of sunglasses that I was told to wear for the next 6 weeks and to stay out of bright light. I was also not allowed to do any strenuous activity, drop anything over 25 pounds, bend over, or sleep on the side the surgery was performed on. I was not to put myself in areas that had a lot of dust. The antibiotic drops were to be used several times a day for several weeks.
After 24 hours, I had a post-op appointment. But I could see the difference even before I got out of bed the next morning. Even with the shield on my eye (it had holes), I could see! I opened my eyes, looked across the room at the digital clock about 15 feet away and saw the time: CLEARLY AND WITH NO AID!
I was absolutely amazed. I yelled for my husband and read the clock. Tears began to fall. I hadn’t seen this far without the help of contacts or contact lenses since I was 10 years old, I was 42.
When I saw my doctor, I was so excited that I kept thanking him over and over again. She kept telling me that it was her pleasure and to please calm down, she didn’t want me to cause any complications! I read the chart: I was seeing 20/40 in the fresh eye. Even my husband started crying. I couldn’t thank the doctor enough.
Four months later, I was anxiously awaiting the second surgery. Fortunately, I had the same success with him. According to a Swedish study published in the British Journal of Ophthalmology in November 1999 (this was before my surgeries in late 2001 and early 2002) it was found that the younger the patient was when they had the surgery, the happier they were with the result.
I can certainly attest to that: I consider my implants to be the best health-wise thing that has ever happened to me.