Fear of cataract

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Hi,

I had my eyes tested yesterday and my optometrist said there was slight yellowing in my left eye which is a sign that a cataract is forming in my left eye. I also have problems with colour and blurred vision.She told me not to worry and come back in a year for a routine eye check up but I'm really scared now of having to have cataract surgery. The thought of having an incision in my eye and all the repercussions terrify me.How long can I leave it and what happens if I don't have any surgery. As you can see I have a bad helath anxiety too. Help.

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  • Posted

    Hi

    I can understand your concern and apprehension. It's very hard not to worry but I found the best way was simply not to think about the actual procedure. Even when I was having mine done, it seemed to me that I was sort of 'outside' my body and kind of observing but not being present - if that makes any sense. 

    Like you I had the early stages of a cataract and I could see its effect if I looked at a light bulb in a certain way. The thought of that getting worse and worse across the whole eye went a long way to convincing me to have it done.  That plus the fact that the lens would correct my long-distance vision and so I would no longer need conact lenses - which would save me £300 or so a year. 

    I know that for some people their accomodation for short-range vision wasn't sufficient and that they needed reading glasses.  You need to discuss this with your optometrist/optician/surgeon. Becuse of my age, I already used reading glasses and so this was not an issue.

    I don't know what country you are in but I am in the UK and have two routes - NHS or private. I happen to have private health cover at the moment and persuaded them that I could have both eyes done - even though the right eye shows very little presence of a cataract. But it will come almost certainly.  If you go down the NHS route then you have to wait a very very very long time and your eyesight has to get really bad.  Think of that red line partway up the eye chart...your eyesight has to be bad enough that you can see nothing below that line. And that is just sharpness.  Factor in glare etc and for me that was unacceptable.

    I read up on the complications.  And you can frighten yourself silly.  But what swung it for me was my optician telling me that (a) the cataracts will get graudally worse (b) but over what timeframe it is impossible to say but (c) as the cataract develops the lens also hardens and so what is a relatively simple operation to liquefy the cataract lens and suck it out, becomes a major task as NHS Gloucestershire have found out to their cost.

    They had a policy of postponing cataract operations for as long as possible.  The trouble is that when patients were finally presenting themselves for surgery, in many cases the lens had hardened to the point that the surgeon had to make a much larger incision and use a scalpel to shave bits of the lens to get it out.  Much longer operation...more risk of complications.

    Not sure if that helps or hinders!

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    • Posted

      When I had mine done by the NHS two years ago they were not too bad but when asked if I wanted them done then or to wait I opted to have them done.

      Now they are tightening up and using a points system and you need to score over 10 to get it done right away. My wife was asked if she was a driver as she is not she lost five points.

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  • Posted

    It is a simple procedure that takes about 15 minutes. Much better than a visit to the dentist. What repercussions ? The next day you see the world as it is. My only problem after the first one was dryness in my eye from the first eye drops.The only other problem was coping with different vision from each eye until I had the second one done. 
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    In most cases even once a doctor spots a cataract, it can take serveral years for it to be enough of a problem for them to be operated on.  The best corrected visual acuity gradually decreases, and people wait  to get it operated on until their  visual quality has been reduced enough that it is interfering with their life. Usually insurance or government healthcare programs don't cover the operation until the cataract impairs their vision in an eye below the standard for driving (which in most, perhaps all, of the US is 20/40), though some are becoming more flexible and will cover surgery based on other tests the doctor can do for things like contrast sensitivity & glare that interfere with night vision, or when the cataract may be interfering with work. 

    The fact that you are already noticing issues with colour vision suggests that either you are very sensitive to such things, or that it may perhaps be developing faster than usual, though in my cases that still means it'll be years since treatment is needed. In my case my eye developed a problem cataract that degraded vision within a few months rather than several years, though that isn't common. If your vision gets worse, you can go in earlier for another check. Sometimes cataracts can alter people's refractive error, make them more or less myopic, farsighted or astigmatic, meaning they may need to have their glasses/contacts adjusted  more often (or get correction if they don't wear it now).

    re: "thought of having an incision in my eye"

     I didn't feel a  thing, except when they rinsed the eye at first which was just a sense of water rinsing over.  In addition to the local anesthetic, most places these days give you a sedative to help you relax and just zone out. Someone else already noted they found it better than a trip to the dentist, and I'd agree that to me the actual procedure itself was easier to go through than even a filling  (actually it was also easier to me I'd say a cleaning where they pick at your teeth), even if it might take a few minutes longer than a filling to go through. There was no pain nor things that aren't painful but are still irritating like the vibration like you get with a dental drill or the need to keep a mouth wide open while they pick below the gums in a cleaning.

    In terms of the "repercussions", if you are talking about complications, cataract surgery is the most common and safest surgery done and the vast majority of people are happy with the results. Of course out of the millions of people that go through it, if even a small minorty have problems, they are the ones likely to post to health websites about them so it is too easy to get a skewed perspective of how concerned to be. 

    In terms of the "repurcussions" on your life due to getting an artificial lens, for many people that can leave them better off than they were since many people who needed correction for distance vision all their lives no longer need it.

    The major "repurcussion" is the impact on near vision, and how much of a big deal that is partly depends on how presbyopic you are. You don't mention your age, most people who get cataracts are old enough to have lost some or all of their near vision to presbyopia and need reading glasses or wear progressive glasses or bifocals to deal with near vision (or deal with it specially using contacts).  I don't know if you are old enough to be familiar with that issue. Cataract surgery with the standard lens, a monofocal, is sort of like the end stage of presbyopia since your eye loses the ability to change focus to see at near. There are various "premium" lenses that can provide more near vision that usually insurance/government don't pay for, they are out of pocket extras. It is also   possible to use "monovision" to adjust one eye to see near and one eye to see far to compensate for that. 

    If your cataract isn't too bad yet, then your optometrist can help you try out some possibilities now that'll help you decide what to do when you have cataract surgery. Even if you don't usually wear contact lenses, if you can stand to try them out for a short while  then you can try some options (the contacts these days are more comfortable than ones they had a few decades ago, if you are one of those people that tried them and didn't like them in the past).  They can have you try monovision with contact lenses to see how well you adapt, and how much of a difference you are comfortable with.  Most people adapt well to monovision after cataract surgery, but how much of a difference between the two eyes they can adapt to, how much near vision they can get and be comfortable with, varies. It isn't exactly the same as what will happen after cataract surgery, since you likely have more near vision with your distance eye still (unless you are fully presbyopic and have lost all your accommodation), but it can help decide what you are comfortable with.

    You can also try multifocal contacts which will give some idea if you could tolerate a multifocal IOL (though that isn't as useful to test if you aren't presbyopic yet, it can at least give you an idea if its a problem for you).  There are other forms of premium lenses they have, but there isn't a good way yet to test those options out with contacts. 

    It is useful for people to consider cataract surgery options well in advance if they can in order to decide for instance if they are going to wish to pay out of pocket for extras like premium lenses, so you can budget for that if finances are a concern. Premium lenses aren't required, they have pros and cons, but most people who get them are happy with them (again, those who aren't are the ones who post so that can be misleading),  and the available options get better all the time so there may be something new by the time you need surgery.  

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  • Posted

    I have had the operation done on my left eye (-10.25 diaptres) 4 weeks ago. I can't tell you how frightened I was, I really didn'twant anyone touching my eyes. So I thought, OK if it all goes wrong, at least one other eye. I had been seeing two images in each eye and my opticians ahd fully corrected my contact lenses. I had got so worried I kept going back and they rlented - I would have to have a second opinion before I went to the NHS - so they (Boots in Baildon) sent me to Grays where I sat in front of n number of machines for almost 2 hours - they declared that both my eyes were healthy, I could read the chart albeit with difficulty. So they sent m to Orett eye clinic (part of Southend hosp.). Within 5 minutes the consultant declared I had advanced cataracts and put me on the urgent list and the operation was done within 4 weeks (left eye only). I can't say how angry I am with Boots, I should have it done over 10 years ago - so much for private medicine !!!! I don't drive, but if I did I would have killed somebody by now. Cycling for the past 15 years or so, I've dreaded going down hills, now I understand why. But I repeat I dreaded the procedure. Goodlig cataract operation did put my mind at rest tho' - IT IS THE MOST COMMONLY PERFORMED OPERATION IN THE WORLD AND THE MOST SUCCESSFUL. That's your first worry answered, Lucas. It alleviated my worry somewhat, altho' my wife said I was like a cat on a hot tin roof prior to the op..Secondly the criteria for whom they allow to have the operation is very simple: if you are having difficulty carrying out certain everyday activities, they will put you on the list straight away and it's then usually a wait of no longer than 2 months. I suggest you go back really stressed and say something like you almost had an accident driving your car the other day and can't read the signs even with your strong specs or lenses, that you have difficulty recognising people. Don't wait for a year, they are just putting you off. As it is you will have to wait  bit for the first NHS appt.. I can't tell you, Lucas, what it has done to my left eye: I have not been able to see like this since I was 9 years old! My other eye, even with contact lens in it, is murky has a yellow tinge compared to the sharp, clean vision of the operated eye which at th check-up was found to have better than 20:20 vision! I can read the bottom line with ease. And I can tear down those slopes  on my bike now - and that's with only one eye. I am "on short notice" for my other eye (waiting for someone to cancel), so I can't wear my contact lens in it (has to be out for 48 hours prior to op. and I may have only 2 hours notice), not that wearing a lens there would make much difference. I am so angry with my optician, I was thinking of taking thm to court, but it's such a contentious issue that it's not worth it. I am just so impatient to have the other eye  done. One of the symptoms of cataracts is that you can read better - I suddenly found 10 years ago that I didn't need reading glasses which made my wife very jealous, I could read the smallest writing at the opticians without glasses. But after this operation I do again - a small price in my view. Lucas, I would make an appt. with your opticians as soon as possible, it is one of the most wonderful thing to happen to me. Read about on google (start with the NHS site), any complications that do arise (very rare) and they are easily corrected. And do it with the NHS, the private consultants work in the NHS anyway. The operation takes just over 5 minutes, you lie down facing up, no need to change into op.theatre clothing, there is no pain, afterwards it's misty, but that clears from after 2 hours to 2 days and even misty, it's better than your sight beforehand. A real life changer, warmly recommended. Go for it.
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    • Posted

      If you read someof my posts on this Forum my wife and I have each had problems with poor care from Boots. Twice I have had a problem discovered just a few days after a Boots eye test.
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      D & A and were often featured on TV due to their selling practices and poor eye care. Actually all opticians are selling overpriced frames that cost little to produce and do hard switch type selling from reasonable to a highly priced product.

      I have great difficulty finding a traditional type of frame in a sea of strangley coloured oddly shaped designer frames. At one time people wanted a discreet frame now you notice their specs rather than their other facial features.  

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      Sorry to hear what you went through, it is really surprising and unfortunate  that in a modern country they went that long before spotting "advanced cataracts". 

      I just thought I'd note that unfortunately  it is only in some places that this comment you made is true, even in the UK:  "Secondly the criteria for whom they allow to have the operation is very simple: if you are having difficulty carrying out certain everyday activities, they will put you on the list straight away and"

      This is a global site and the many people are from the US and other countries where its most common  for insurance&government to only cover surgery if  is vision worse than 20/40, or whatever the driving visual acuity requirements are in a country. Some are making the criteria more flexible and allowing other tests  like somehting showing glare issues, or merely reporting interference with daily activities, but at least in the US that isn't yet common.

      I was curious since I didn't realize the UK  was now better about that, and did a google search for "NHS cataract surgery" and you'll see articles  on the first page of hits dated 2013 noting that a large fraction of the country cataract surgeries were being rationed and they hade a high bar for getting on the list.  (this site sends a link to a moderator if you include links, so just search if curious). One article said "Sir Bruce’s comments come months after a report by the Royal National Institute for Blind People (RNIB) found that 57 per cent of England’s 157 primary care trusts used eye test thresholds to determine who qualified for surgery."

      It may have improved/changed since then, but it could be that even within the UK you are lucky. The NHS page  currently does say  the standards vary: "There are no national guidelines stating what your level of vision needs to be before cataract surgery is carried out, although individual NHSclinical commissioning groups (CCGs) may have their own criteria outlining when cataract surgery should be offered." 

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    • Posted

      The NHS is cutting back on cataract surgery. Two years ago I was asked if I wanted mine done now or to wait a couple of years. I said now and had the operation within six weeks.

      This year my wife found that they now have a points scoring system. She was asked if she was a driver and by saying no did not get an extra five points to take her over ten. I do not drive and was not asked before mine.

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      Boots is appalling. They have those in-store machines that, in addition to weight and height, will tell you your body fat content.  The accuracy is so poor that many people will go away worried when they need not be.  I contacted Boots who couldn't care less.
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      They are cutting back because of a lack of manpower, this government has put little money into taiing (same with teachers) - hence the shortages. Really sad.By the way I was not asked, but since my cataracts were so advanced and my degree of myopia so bad, they did not need to. Thanks for the response ....
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    • Posted

      Boots offered lenses and frames from £69. I said that I just wanted the new lenses put in my present frames that were just a year old. They said that would be £85 plus the cost of the lens!

      I went to an independent optician who said £20 plus the cost of the lens. Vision Express said £10 plus the cost of the lens.  Specsavers were puzzled and said we dont charge for doing that you just pay for the lens.

       

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