American Medical Association Family Medical Guide - American Medical Association [736]
Q. Recently my eye doctor told me that I have cataracts. Do I need to have them removed?
A. Not necessarily. The decision is yours, and will probably depend on whether the cataracts are impairing your vision enough to prevent you from doing the things you like or need to do every day. Your eye doctor will work with you to determine the best course of treatment. If your cataracts are at an early stage, you may need only eyeglasses or a stronger correction for your glasses. You might also try improving the lighting in your home and at work and using a magnifying glass for close-up activities such as reading. If these measures are not helpful, your doctor will probably recommend cataract surgery.
Although the exact cause of cataracts is unknown, doctors think that factors such as smoking, excessive exposure to sunlight, uncontrolled diabetes, and long-term use of corticosteroid drugs (medications used to reduce inflammation from chronic diseases such as rheumatoid arthritis) may increase a person’s risk of developing cataracts. If you are over age 60, you can help ensure early detection of cataracts by having your eyes examined by an ophthalmologist at least every 2 years (or as often as your doctor recommends).
Symptoms
The most common symptoms of cataracts include blurred, distorted, or multiple vision; sensitivity to glare from sunlight, lamps, or headlights; halos or rainbows around lights; poor night vision; and colors that look dull and faded. Gradual deterioration of vision makes everyday activities such as reading, watching TV, and driving more and more difficult. A person’s eyeglass or contact lens prescription must be changed frequently to correct the progressive nearsightedness that may be associated with cataract formation.
Diagnosis
To diagnose cataracts, an ophthalmologist asks about your symptoms and your health history and performs a thorough eye examination. He or she will dilate (widen) your pupils with eyedrops and look inside your eyes with an ophthalmoscope (a viewing instrument that projects a bright light onto the back of the eye). The doctor uses a special microscope called a slit lamp to examine the lenses and look for any clouding. If the doctor detects a cataract, he or she will determine its type, size, and location.
Treatment
If you have a cataract, the doctor will work with you to determine the best course of treatment. In the early stages of a cataract, prescription glasses (bifocals), a magnifying glass for reading or other activities that require you to see things close up, or stronger lighting at home or at work may help you see better. However, when such measures are no longer helpful, your doctor probably will recommend surgery to remove the clouded lens and implant a substitute lens. If cataract surgery (see above) is an option, the doctor will explain the risks and benefits of the surgery.
Glaucoma
Glaucoma is a group of eye diseases in which damage to the optic nerve leads to loss of vision. A leading cause of blindness in the United States, glaucoma is about three to four times more likely to occur in blacks than in whites, and the disease causes blindness in blacks about six times as often.
The most common type of glaucoma, called chronic open-angle glaucoma, usually develops gradually over a number of years. A clear, watery liquid called aqueous fluid flows in and out of a small space at the front of each