Cataract development becomes more likely with age

I have been blessed with the greatest set of in-laws a woman can have (actually, two sets—my husband’s parents were divorced when he was little.) When Jeffry’s mother and stepfather were staying with us one spring a while back, I was happy to refer Ferne to one of Spokane’s wonderful ophthalmologists. She has diabetes, and her vision was slowly deteriorating. There was some retinal damage due to her diabetes, but the bigger problem at that time was cataracts—cloudy, opaque areas in the lenses of her eyes.

The lens of the eye is an elliptical, elastic structure that sits behind the pupil of the eye. Its purpose is to focus light waves that enter our eyes on the retina, or back part, of the eye. As we age, the lenses become less elastic—all us middle-agers know this phenomenon—our arms become too short and we need reading glasses.

Also as we age, the proteins in the lens can clump together—these are called cataracts. Generally, cataracts develop slowly over several years. Depending on where the cataracts are, and how dense they are, they can interfere with the passage of light through the lens and hinder the formation of images on the retina, causing blurred or cloudy vision. Sometimes those with cataracts can experience loss of contrast sensitivity, change of refraction at the eye exam, or even double vision. Glare around bright lights can make night driving difficult.

We don’t know exactly what causes garden variety cataracts, but we know that age is a factor. (Remember, aging is not for sissies.) Researchers have surmised that free radicals, or oxidants, may be involved, as they are in so many aging processes.

The eye produces its own antioxidant, and one theory is that in the aging eye this anti-oxidant can’t get to where it needs to be to control the damage to the lens.

Another factor is UVB radiation from sunlight. UVB rays are the same ones that cause sunburn and damage to the skin. UVA radiation, also from sunlight, may increase the production of free radicals.

Ferne doesn’t smoke, but if any of you need another reason to quit smoking, those nasty cigarettes can encourage the formation of cataracts. Once again, free radicals are probably involved.

Certain medications can cause cataracts. One common class of drugs implicated is oral corticosteroids, often used in autoimmune diseases like rheumatoid arthritis. Data on inhaled steroids, used in asthma, is conflicting. As always, a risk versus benefit dialogue should take place with your health care provider.

Women are more likely than men to get cataracts, and diabetes is a risk factor as well. Heavy alcohol consumption can also increase the risk of cataracts.

It doesn’t seem that cataracts can be prevented, but they can be delayed. Avoiding cigarettes and heavy alcohol use is a good place to start. Wearing sunglasses that block at least 95 percent of UVB rays and up to 60 percent of UVA rays is always a good idea.

Look for glasses that are labeled “Meets ANSI Z80.3 General Purpose UV Requirements.” Get your kids used to wearing sunglasses early. It doesn’t look like anti-oxidants help here, and large doses might be harmful.

If cataracts begin to have a significant effect on vision, then surgery may be indicated. Cataract surgery is now the most common surgery performed on Americans older than 65.

Cataract surgery improves vision in up to 95 percent of patients treated and saves millions of Americans from blindness. The most common surgery involves removing the lens and replacing it with an artificial one. As with any surgery, there are risks, but mostly minor.

One risk, I’m sure, Ferne’s doctor did not warn her about. After surgery, when she looked at her husband of thirty years, she remarked, “When did you get old?” Then, looking in the mirror she said, “When did I get old?”