Five myths about cataracts and cataract surgery

The word “cataract” is derived from the Latin word cataracta, meaning waterfall. Similar to the white appearance of rapidly descending water, the term was used metaphorically to describe the white opacities that form in a mature human lens. A cloudy lens leads to blurring of vision, decrease in contrast sensitivity, yellowed vision with dulled colours, and difficulties with night vision and glare.

Cataracts are the leading cause of treatable blindness globally — in Canada, more than 2.5 million people have them. And even though cataracts develop slowly, and cataract surgery is one of the most successful surgeries, understanding the signs and symptoms is the best way to protect your eyes. There are many myths around cataracts and cataract surgery, but here are the top five.

Myth: Cataract is only age-related!

Fact: It is a common misconception that cataracts only affect the elderly. Though ageing is the one of the primary causes of cataract formation, it is certainly not the only cause. In fact, cataracts can occur at any age and even be present at birth (congenital cataract).  Other causes of cataract formation include uncontrolled diabetes, trauma, ocular inflammation, steroid intake, drug toxicity and other medical conditions. Therefore, it is important to know the warning signs and talk to your eye doctor about any changes in your vision, so they can diagnose and initiate appropriate management. 

Myth: Eye exercises, diet modifications and drops can treat cataracts.

Fact: Exercise, healthy diet rich in anti-oxidants, smoking cessation and wearing sunglasses have shown to slow the progression of cataracts. In the initial stages, mild symptoms can be managed with non-surgical options including anti-glare eyeglasses and magnifying lenses. However, once a cataract begins interfering with your everyday activities such as driving, reading or playing sports, surgery is the most effective treatment option. For instance, in my practice, I provide personalized recommendations based on a detailed interview of each of my patient’s lifestyle. If you are having trouble with your vision and suspect you may have cataracts, I suggest that you speak with your ophthalmologist to confirm the diagnosis and explore your options.  

Myth: A cataract need to be “ripe” before I have surgery. 

Fact: Back in the late 1970s, cataract surgery shifted to small incision suture-less technique. Prior to that, cataract had to be manually removed through a large incision in the eye. The old technique imposed high risk of potential complications due to infection or inflammation and an overall poorer prognosis for visual recovery. The story of “ripening” was used to explain the necessity to put off surgery for as long as possible to offset the risks of surgery. With significant advances in surgical technique and technology, a natural lens with any degree of dysfunction can be safely removed and replaced with a lens implant with a high success rate. For my patients, I therefore emphasize that the decision to perform surgery is based on risks versus benefits balanced against the interference with personal lifestyle. I also caution my patients on not waiting until the cataract is hyper mature, which potentially makes the surgery more difficult and introduces higher risk. 

Myth: Cataract will grow back.

Fact: During cataract surgery, the cloudy lens will completely removed from your eye and replaced with a clear artificial lens implant. Once removed, cataract will not grow back. What can sometimes occur is a gradual clouding of the container (capsule) that supports the lens implant in place after surgery. This cloudy membrane is called posterior capsular opacity (PCO), also known as an “after cataract”. This cloudy membrane is easily removed with a low risk, quick, painless laser procedure in the office. Once the laser is performed, the opacities will not grow back.

Myth: Cataract surgery is painful.

Fact: There is little or no discomfort during cataract surgery. The surgery is done under mild sedation with local anesthesia. Patients are comfortable throughout the procedure that usually takes about 10 minutes. Most of my patients find their overall experience pleasant and they often report seeing a light show with several gradation of beautiful colors throughout the various steps during the surgery. After surgery, your surgeon will provide you instructions on how to care for your operated eye and review your post-operative drops and follow-up appointment. 

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