Cataracts - LPNI

    

A cataract is a clouding of part of the eye known as the lens, through which light enters the eye.  When normal, the lens is clear and is located just behind the iris.  The lens helps to focus the light on to the retina at the back of the eye.  

Most people develop a cataract in both eyes although its onset may be earlier in one eye than the other.  They can occur at any age; the most common type is associated with aging and contributing factors include smoking, sunlight, diabetes, arthritis, short-sightedness and some medications.  Cataract surgery is the most commonly performed ophthalmic surgery, and because we don’t know how to prevent them, it can be expected that the longer one lives, the more likely one will need this surgery.  Statistics show that the prevalence of cataract rises from 42.5% for people in their 40s to 99% for people in their 90s.  We are an aging society and it is predicted that a child born today will probably live to the age of 120!  The demand for cataract surgery will always be there.

Many people first find out that they have a cataract when they have their eyes examined for glasses.  Unless the cataract is removed, vision is progressively impaired to the extent that the loss of a driving license is inevitable.  Symptoms include a painless blurring of vision; glare or light sensitivity; double vision in one eye; frequent spectacle prescription changes; needing brighter light to read; fading or yellowing of colours; poor night vision and, as the cataract worsens, halos around lights.  Failure to get timely cataract surgery may lead to people having more falls and fractures, greater isolation, depression and an increase in dependency.  

Years ago, patients were in hospital for a week after cataract surgery, resting in bed with patches over both eyes and sandbags each side of the head to stop movement.  Nursing care was intense as the patient required feeding, bed pans and/or urinals as well as bed washes.  Today, with the advances in technology, the patient can be admitted, operated on and discharged in one and a half hours.  Although technology has reduced the length of time the operation is performed these days, cataract surgery is not simpler; it is more technically challenging than before.  It requires skill and is unforgiving of the slightest error in judgment or technique.

Ninety-five per cent of cataract surgery is successful, but if the patient happens to be in the five per cent that is not they may suffer from tearing of the structure behind the lens, which may result in damaged vision.  Other complications include loss of the cataract into the back of the eye, requiring another operation, or clouding of the lens capsule, which begins about two years after the operation and can be fixed by relatively simple laser surgery.

Thankfully these complications are relatively infrequent but must be considered in the knowledge that not having the operation will lead to eventual blindness.  With the advances in technology, vision can rise to the best standard.  People can be restored to full vision and functioning in a few days.  The recovery time has been lessened to a minimum so, with a few days rest, full eyesight can be restored, which leads to an improvement in the quality of life.

Sylvia Hutt RN

Lutheran Nurses Association of Australia