WebMD Live Events Transcript
Cataracts are one of the leading causes of vision loss in the United States. As part of Cataract Awareness Month, ophthalmologist Guy Knolle, MD, joined us to answer your questions about cataracts -- symptoms, prevention, and the latest treatments -- on Aug. 3, 2004.
The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.
Of course, the first thing that has to be determined is whether or not there are any other causes for their reduced vision. If a diagnosis of significant cataract is established by examination, this can be treated surgically and often, even if they have a small amount of macular degeneration, removal of significantly dense cataracts can result in improved vision.
It's hard to remember sometimes what good vision is like compared with the gradual loss of definition that occurs with a cataract. This is especially true when the cataracts develop at about the same rate in each eye, so that there's no good standard of comparison.
We do have a way to roughly evaluate glare with an examination called the brightness acuity test, abbreviated BAT. This can give the examining surgeon a good idea of the patient's ability to see in bright daylight and when looking into oncoming headlights at night.
The examining doctor can help the patient evaluate their gradually deteriorating vision when this is occurring, and more objectively than the patients can sometimes evaluate their own vision. The average age for cataract surgery is approximately 73 to 75 years old. But cataracts can occur in the 30s, 40s, and 50s. Of course the older the patient gets the more common the cataracts. But again, the presence of a cataract is not significant in itself. The associated loss of vision, if present, is significant.
Many years ago, patients were told that the cataract should not be removed until it was "ripe." This was because prior to the 1970s, the entire crystalline lens was usually removed and it was easier to remove the lens if its attachment's zonules were weak. The analogy was that it's easier to pull a pear off a tree if it's ripe than if it's green. If it's green you could pull the tree down trying to pull the pear off. When the entire lens was removed through a large 180-degree incision, the surgeons preferred that the lens could be easily removed so that the fluid behind the lens would not be disturbed.
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