Aug 4, 2015 — Fifty years ago, cataract surgery was a big deal. Even if you could afford it, it was a painful operation that took a week or more of bed rest recovery afterward. Today, cataract surgery can be performed in 10 minutes and you can go back to work the next day. Dr. Tom Miller and ophthalmologist Dr. Bala Ambati talk about the first signs of cataracts—an eye condition that, sooner or later, effects everybody.

Interview

Dr. Miller: Your vision is hazy in bright sunlight. Could you have cataract?

Announcer: Access to our experts with in depth information about the biggest health issues facing you today, The Specialists with Dr. Tom Miller is on The Scope.

Dr. Miller: I'm here with Bala Ambati today. He's a professor of ophthalmology. We're going to talk about the symptoms of cataract today. Thanks for being here, Bala. Can you tell us a little bit about what to look for if someone thinks they might have cataract? What are the symptoms?

Dr. Ambati: Cataract is when the natural lens that you're born with inside the eye gets cloudy and if you live long enough, you will get a cataract. It pretty much happens to everybody and the age of cataract onset is usually between 55 and 70. The vast majority of patients present... some people present a little younger than that or older than that. But in general, I'd say most people present between 55 and 70.

Initial symptoms include difficulty driving at night, difficulty reading fine print, haze especially in colors or open bright light or even looking at paintings people notice their colors are off.

Dr. Miller: Somebody thought Picasso, or not Picasso but Van Gogh actually may have had cataracts.

Dr. Ambati: There's actually two interesting artists, Matisse and Monet and if you look at the career of their art in their youth, their artwork was very bright and vivid and then as they got their cataracts, their paintings turned very maroon and red and brown because they had lost the blues and yellows

Dr. Miller: These are the water lilies that Monet did...

Dr. Ambati: That's right. And then, once they had their cataracts removed, again, their vividity and vivaciousness of their art returned so it definitely affects color perception. And that interesting historical tidbit really correlates nicely or fits nicely within the context of the evolution of cataract surgery where a hundred years ago or even 50 years ago, cataract surgery operations were a big deal.

You would have a very large incision in the eye, often a lot of stitches. You would need to be in the hospital for a week on bed rest and until about maybe 40-50 years ago, there really weren't lenses to replace the cataract and so now in the last 50 years, so many evolutions have occurred in cataract surgery to where we have incisions that are now smaller than two and a half millimeters in width. That enables patients to drive and return to work the next day.

Dr. Miller: And the whole procedure takes 20 minutes.

Dr. Ambati: Ten to 15 minutes on average, almost no pain. The new lenses that we have can give both distance and near vision so patients now have a lot of options where they can get rid of distance glasses, reading glasses or both at the time of cataract surgery as well as correct their astigmatism. So the field of cataract surgery has been very dynamic and innovative over the last three to four decades and our patients have benefitted tremendously as a result.

Dr. Miller: I've heard that ultraviolet radiation may speed the progress of cataract. Is that true?

Dr. Ambati: Absolutely.

Dr. Miller: And if that's true, is there any information about the use of sunglasses or eye protection in preventing the onset of cataract? I know you mentioned that everyone will get cataracts at some point if they live long enough.

Dr. Ambati: Sure, I would recommend in general to wear sunglasses or transition glasses as I do when you're outside whether it's just going for a walk or water skiing or skiing or landscaping or anything else. UV radiation is bad for almost every structure of the eye, the cornea, can cause a taridium in the lens. It can cause a cataract. In the retina, it can contribute to macular degeneration and so, in general, I would say sunglasses are a good idea for almost everybody.

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