Cataracts are the leading cause of blindness in the world, and more than 22 million Americans have them, according to the National Institutes of Health. Vision decreases as the lens at the front of the eye becomes clouded. But there is good news.
“Cataracts are also the most treatable form of vision loss,” says Dr. Sean Breit, a cataract specialist with Eye Care Associates of St. Louis. In fact, Breit notes that cataract surgery is the most common type of surgery performed in the U.S., with eye surgeons performing more than 1 million cataract surgeries each year.
By removing the clouded lens and replacing it with a clear lens implant, vision is restored. “In years past, it was necessary to wait for the cataract to get to a fairly advanced stage before surgery could be done,” says Dr. Michael Donahoe with Ophthalmology Consultants Ltd. “But I would like people to know that if their vision is not adequate for the things they enjoy doing and they’ve been diagnosed with a cataract, then it’s time to consider cataract surgery.” Symptoms include cloudy vision, glare at night and muted color vision.
Most cataract surgeries are outpatient procedures, and complications, such as infection or bleeding, are rare. “Improvements in cataract surgery technique now allow surgeons to use ever smaller incisions. This allows for a very rapid recovery. Most of my patients return to work in one to two days,” Breit says. The latest generation of implantable lenses also can correct the patient’s near and distance vision, including astigmatism. Patients who are candidates for these lenses and choose to pay for them may be free of glasses or contact lenses for the first time in decades.
“Insurance companies do not pay for these premium, advanced technology intraocular lenses. That’s an outof pocket expense,” Donahoe notes. Cataract surgery and basic lens implants are usually covered, but lenses that correct for astigmatism, nearsightedness and/or farsightedness may cost as much as $3,000 per lens.
If we live long enough, everyone develops a cataract, notes Dr. Jay Pepose, founder and medical director of the Pepose Vision Institute. Scientists have studied preventive strategies, but evidence is scant.
“Ultraviolet light exposure can accelerate cataract,” Pepose says. “With every 10 degrees of latitude closer to the equator, the cataract rate goes up. Wearing sunglasses that protect from ultraviolet light along with a brimmed hat can reduce harmful exposure of the eyes to UV light.”
Observational studies suggest certain nutrients may have a protective effect. “Some epidemiological studies suggest that oral intake of carotenoids, such as lutein and zeaxanthin, can slow down the rate of cataract progression,” Pepose says. “The best natural food sources of lutein and zeaxanthin are green, leafy vegetables and other green or yellow vegetables. Among these, cooked kale and cooked spinach top the list, according to the U.S. Department of Agriculture.”
Most ophthalmologists recommend a healthy diet but are reluctant to suggest special supplements promoted for eye health. “Avoid the highest dose vitamins, especially vitamin A, unless told by a physician to use them as excessive amounts of vitamin A can cause liver damage,” Breit says.
The American Academy of Ophthalmology recommends a baseline screening for all adults with no signs or risk of eye disease at age 40 and annual exams for everyone age 65 and older. “The onset of cataract is often gradual and may be hard to notice,” Breit says. “Getting a comprehensive eye exam with an experienced eye professional is the best way to be certain.”