Why more boomers are getting cataract surgery at a younger age

 

On the morning I got cataract surgery, my ophthalmologist joked it was his “young day,” since all his surgical patients were under 70.

I’m 43. I first noticed the haziness in my left eye about this time last year and thought it was a dirty contact. A few months later, I went to my doctor and got a huge shock.

My doctor appeared just as surprised – partly because of my age at the time, 42, and partly because I showed no sign of a cataract at an exam just six months earlier.

Only one percent of all cataract surgery patients are as young as me, according to Dr. David Chang, clinical spokesman for the American Academy of Ophthalmology. But many more people in their 40s probably have cataracts already forming in one or both eyes and just don’t know it yet.

A cataract is a clouding of the eye’s lens. It’s the most common cause of blindness in the world — and it’s also a normal part of aging. More than 3.3 million such surgeries are performed in the country each year, said Chang, who described it as “the most common operation performed anywhere on the body.” And a recent study by the Mayo Clinic indicates an increasing number of people are having cataract surgery — and are doing so at “younger” ages. The study, which examined cataract surgeries done from 2005 to 2011 in Minnesota’s Olmsted County, found that about 20 percent of those surgeries were in patients younger than 65.

By age 80, more than half of all Americans either have a cataract or have had cataract surgery, according to the National Institutes of Health’s National Eye Institute.

“When does it happen? Well, we could say it’s pretty common in our 50s, but there are plenty of people who have a full head of hair in their 70s. There are also a lot of people who get bald spots or start to see their hairlines recede in their 30s,” said Chang, chairman of the cataract guidelines committee for the AAO.

It took about a year from the time I first noticed hazy vision to when I finally scheduled my surgery. In between, I often felt my left eye was looking through a dirty, Vaseline-smudged window. Since it is most notable in bright light, the cataract was a nuisance when I played with my kids outdoors or drove them around on sunny days. While at the beach last summer, I felt like I was looking through a sand storm.

Shortly afterward, I had reached my annoyance threshold. That’s a similar trait doctors see among their “younger” patients, whose active lifestyles make them less willing to put up with a cataract’s inconvenience, said Dr. Rosa Braga-Mele, who chairs the cataract clinical committee of the American Society of Cataract and Refractive Surgery.

While the majority of cataract patients are in their 70s and 80s, Braga-Mele said she recently noticed an increase in patients between 50-65 – a range reflecting the heart of the baby boomer population, a generation living longer and less tolerant of any hurdle to their independence.

“Whereas my grandmother or even my mother might have waited until she was in her 80s because she didn’t really need her vision for what she was doing … the baby boomer population, the minute their vision starts to drop, says, ‘Well, this isn’t normal, I can’t do my job. There has to be a solution to help me function at the level I’m used to functioning at,” she said.

That was the case for Katie Roberts. At 37, she is far younger than any Boomer, but she understands why many of them would elect to have surgery as early as possible. The Morgan Hill, Calif., firefighter has had cataract surgery on both of her eyes; she was 32 when she had the first procedure.

Unlike my cataract — which had no physical cause or genetic disposition — the ones Roberts developed were a side effect from steroid medication she received in her 20s for an eye disease, pars planitis. When she first showed signs of a cataract, she initially thought she was experiencing a flare-up. Once she got the correct diagnosis, she ended up getting surgery about a month later.

“Because I have to drive a fire engine and drive at night, with lots of lights and everything going on, I got it done as soon as it was bothering me, just enough to where I was aware of it,” she said.

Dr. Bonnie An Henderson, a clinical professor of ophthalmology at Tufts University School of Medicine, hasn’t seen the average age of her patients dip, but she believes several factors may explain why more people are having surgery. One reason is the proliferation of cell phones, computers and tablets over recent years.

“Patients may detect even a small decrease in their visual function earlier than before,” Henderson said.

In addition, diagnostic tools are more sophisticated than they were a generation ago, making it easier for ophthalmologists to evaluate and diagnose cataract severity, she said.

All doctors agree there isn’t a specific time when surgery is needed to remove cataracts. One person may not find it a bother, while someone else with the same rate of progression may find it completely disruptive.

I clearly remember the advice my doctor gave me about when to give him the green light for surgery.

“There’s no magic number when you have to get it done,” he said. “It’s whenever you’re ready to cry ‘Uncle.’”

Source: Today health


Risk of falls increases between cataract surgeries

Older adults with cataracts appear to double their risk of falling after surgery on their first eye and before surgery on the second, suggests a new study.

The finding that corrective eye surgery may – at least temporarily – be linked to an increase in falls comes after years of conflicting study results on the subject, researchers write in the journal Age and Ageing.

But the topic remains important as the global population ages and demand for cataract surgery increases. In Australia, where the study was conducted, cataract surgeries tripled over the past two decades.

“This study tells us that timing of cataract surgeries is very important,” Dr. Ediriweera Desapriya of the University of British Columbia in Vancouver, Canada, told Reuters Health.

Desapriya has researched falls in older adults at the Center for Clinical Epidemiological and Evaluation Research, but wasn’t involved in the new study.

“In the past, you didn’t really want to get both eye surgeries done at the same time,” Desapriya said. That was in case of problems like infection or swelling. “But now the technology has improved and complications occur less often,” he said.

For their study, Lynn Meuleners of Curtin University and her team in Perth looked back through detailed electronic health records from Western Australia’s hospitals and its death registry.

Between 2001 and 2008, nearly 28,400 older adults in the region had cataract surgery on both eyes. The researchers found 1,094 of them also took a fall serious enough to warrant a hospital visit during that period.

People waited an average of 10 months between eye surgeries. Compared to the two-year period before any cataract surgery, their chance of falling doubled between procedures.

In the two years after surgery on their second eye, people’s fall risk was 34 percent higher than before their first surgery. The risk of falling also rose with age.

Most people who fell were older than 80, women, city dwellers and were not married.

“It’s a well-conducted study,” said Stephen Lord, a senior principal research fellow with Neuroscience Research Australia in Sydney. Lord was not involved with the current study, but researches balance and falls among older adults.

“In the intervening time between surgeries, you have a person with two eyes that are no longer equal and this can lead to various effects,” Lord said – like on visual sharpness and depth of field.

“For these things, we need two eyes working together,” he told Reuters Health.

However, at least one previous randomized controlled trial – medicine’s gold standard for research – found people had fewer falls after cataract surgery, Lord said.

Based on this study, doctors could warn patients to be extra cautious after having surgery on their first eye, Desapriya said.

“It is also important to encourage patients to have a second eye cataract surgery early,” Desapriya said. “Otherwise, eyes continue to function monocularly (with just one eye) and patients lose their depth perception.”

The new research cannot point to cataract surgery as the primary cause of the falls – it only suggests they are linked.

The researchers said a limitation of their study is a lack of knowledge about people’s lifestyles, including their living situations, and co-existing eye conditions, both of which could strongly influence fall risk.

They also did not look at falls among people who had not undergone cataract surgery. Such comparisons are helpful when considering changes in risk.

“The aging population is growing rapidly in the U.S. and Canada,” Desapriya said. “And this surgery is becoming a very common clinical procedure.”

According to the National Eye Institute, more than half of all Americans have a cataract or have had cataract surgery by the time they’re 80.

Lord compared cataract surgery to a major change in prescription eyeglasses: in both cases, the brain needs time to adjust to the changes in vision.

But patients and doctors should not shy away from cataract operations, Lord said.

“The last thing we want to have happen is to prevent people from receiving cataract surgery,” Lord said. “This surgery has many benefits, such as improving quality of life, increasing a person’s participation in the community and even preventing falls in the longer term.”

“It just seems that, in the short term, there may be a problem while people adjust to their new vision,” he said.

Source: Khaleej times


Cataract surgery linked to longer life

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354 persons aged 49 years diagnosed with cataract-related vision impairment – some of whom had undergone surgery and others who had not – were assessed between 1992 and 2007.

People who have had cataract surgery to improve their sight live longer than those who choose not to undergo the procedure, according to a new study.

The research is drawn from data gathered in the Blue Mountains Eye Study, a population-based cohort study of vision and common eye diseases in an older Australian population.

A total of 354 persons aged 49 years and older and diagnosed with cataract-related vision impairment – some of whom had undergone surgery and others who had not – were assessed between 1992 and 2007.

Adjustments were made for age and gender as well as a number of mortality risk factors, including hypertension, diabetes, smoking, cardiovascular disease, body mass index and measures of frailty and comorbid disease. Follow-up visits took place after five and ten years since the baseline exam.

Jie Jin Wang, Ph.D., of the Westmead Millennium Institute and one of lead researchers of the study, said that their fiodnings suggested that correcting cataract patients` visual impairment in their daily practice results in improved outcomes beyond that of the eye and vision, and has important impacts on general health.

Wang noted one limitation of the study is that participants with cataract-related visual impairment who did not have cataract surgery could have had other health problems that prevented them from undergoing surgery, and that these other health problems could partly explain the poorer survival among non-surgical participants.

The study has been published in the journal of the American Academy of Ophthalmology.