Information About Cataract
MEANING
Cataract is a condition in which the clear and transparent lens in the eye becomes cloudy and opaque resulting to gradual loss of vision and later blindness. A cataract appears like a round whitish ball in the centre (pupil) of the black part of the eyeball.
CAUSES
– Ageing or old age
– Congenital (the person is born with it)
– Eye injuries
– Prolonged use of eye drugs containing steroids
– Diabetes mellitus (suga disease) especially if poorly controlled.
IDENTIFICATION
Someone who has cataract will initially experience smoky or cloudy vision. Later, the person finds it difficult to identify far objects and much later even near ones. However, the occurring period may be shorter in case of eye injury.
This process is painless and occurs gradually over a period of years (especially if it is as a result of old age). The only thing that will be noticed in the affected eye is a round whitish sport inside the centre of the dark portion of the eye. This whitish sport is different from the one that may be seen on the glass-like cover (cornea) of the black part of the eye, which is a corneal scar.
TREATMENT
The only treatment for cataract is by surgery (operation) in which the cataract (opaque lens) is removed. An artificial lens called intra ocular lens, popularly referred to as IOL is inserted during the operation to replace the removed lens.
IOL implantation is a technology that gives better visual rehabilitation, avoiding the use of thick heavy glasses. The implanted artificial lens is expected to remain permanently in the eye.
It is to be noted that treatment with drugs is not yet possible and prevention of age-related cataract is also not possible.
PREPARATION FOR THE OPERATION
– Examination and blood test will be carried out to ascertain the general fitness of the individual.
– People who have hypertension or diabetes will need to have them under control before they are operated upon.
– The date for the operation will be decided by the doctor and the patient, who is then admitted a day before the operation.
– The person will sign a consent that he / she has agreed to the operation.
– It is normal for the nurse to trim the eyelashes of the eye to be operated and place a piece of plaster on the side for the purpose of identification.
– Food will not be taken 6 hours before the operation
– On the morning of the operation, the person will have a clean bath and will be given the hospital’s clothes to wear before going into the theatre.
IN THE THEATRE
– An injection that kills pain will be given around the eyeball to be operated.
– The patient will lie down on the operation bed quietly, avoiding all forms of movement or talking throughout the period of operation.
After the Operation
– Avoid bending down, especially with head down, touching the operated eye, lifting or any form of strain or vigorous exercise for a period of six weeks.
– Do not lie on the operated side to avoid problem on the operated eye for a period of two weeks.
ON DISCHARGE
– Ensure you understand all instructions regarding use of drugs and others
– Comply with treatment orders and regiments.
– Ensure good personal hygiene and continue to have your bath and wash your face normally with caution around the operated eye.
– Honour the next and subsequent appointments
– Report to your doctor immediately if you have serious pain, discharge or reduced vision in the operated eye. Do Not wait until your appointment date.
– Generally, your doctor and the nurse will provide you with more information before and after the operation. Find out from them any area you are not clear with.
Please know that
Patients with cataract may have other eye problems in which case the result of the operation will depend on the health status of the eye. For example, Glaucoma might have damaged the nerve of the eye before the operation. Similarly, an eye injury that caused cataract may have also damaged other parts of the eye, hence, could contribute to poor vision even after the cataract have been removed.
SAY NO TO TRADITIONAL TREATMENT
This is because the traditional or native treatment of cataract called COUCHING does not remove the lens, rather, it dislodges it to float within the eyeball. Though there may be an improvement of vision, this is often uncertain and short-lived as the process is unsterilized and the dislodgement may result to severe complications that may lead to irreversible blindness.
You can help someone with cataract blindness to see again by
– Promoting awareness about cataract by sharing your knowledge on it with other people or sponsoring its campaign in the radio, television, newspapers, posters, stickers, pamphlets, etc.
– Encouraging and directing people with cataract and other eye problems to the appropriate eye care providing institutions e.g. the National Eye Centre, Kaduna.
– Contributing or paying for the treatment of poor patients, sponsoring an eye camp where specialists will operate many cataract patients in the Centre or in a health facility within the community.
– If you have had cataract surgery, encourage and bring someone with cataract for treatment next time you go the eye hospital / unit for your follow-up and review.
INFORMATION ABOUT GLAUCOMA
Meaning
Glaucoma is a disease of the eye which results in gradual loss of vision due to damage to some vital structures inside the eye, especially the optic nerve which carries information from the eye to the brain. In some of the eyes with glaucoma, the pressure inside the eye have been found to be higher than what the eye could tolerate; the higher the pressure the greater the likelihood of more damage.
Visual loss is often gradual and unnoticed until much damage has taken place. The death of optic nerve cells is like losing strands of hair from the head gradually until baldness becomes evident to all. The rate of loss differ in individuals, the end result is blindness.
HOW DOES GLAUCOMA PRESENT?
Many people who have glaucoma do not have initial symptoms such as headache, eye pain or decreased vision, however, with progression of the disease decreased vision is experienced in the affected eye. The areas seen by the eye starts to get narrower or some dark areas start appearing; while in the very late stages even straight vision is lost until total blindness sets in.
The absence of symptoms is the reason many patients delay coming to the hospital until it is already too late to intervene.
WHAT CAUSES GLAUCOMA?
The eye like a balloon or inflatable tyre maintains its shape by a stable pressure. This pressure comes from a transparent fluid called aqueous. It is produced in the eye continuously while almost equal quantity escapes gradually and unnoticed through a special drainage system in the eye. The balance is necessary to maintain a stable pressure but if the pressure builds up too high, the optic nerve which is like a special relay cable to the brain, gets damaged.
WHO IS AT RISK?
No one is exempted! Anyone can suffer from the disease, but some people are more at risk, such as older people, (it is also seen in young adults in black people). In some families, those who have high blood pressure (Hypertension) or uncontrolled high blood sugar level (Diabetes mellitus); past eye injury, those with near-sightedness (myopia) and a history of severe anaemia or shock or some people on drugs called steroids especially when taken for than a few weeks are also at risk.
IS GLAUCOMA ALWAYS PAINLESS?
The type of glaucoma common around here is often painless, and it is possible to detect it during a routine eye check up. Sometimes, there may be symptoms with some other types of glaucoma; these symptoms include blurred or smoky vision, sudden and severe eye pain; headache; vomiting or nausea and seeing haloes or rainbow colours around light. These symptoms can occur if the pressure build-up becomes sudden and very high especially when the drainage area of the eye becomes too narrow or blocked. If any of these symptoms occur, it is an emergency! You will have to see your doctor called ophthalmologist urgently.
HOW DO I KNOW IF I HAVE GLAUCOMA?
A regular eye test which is painless and lasts for a fraction of an hour is often enough for your eye doctor (ophthalmologist) to decide if you have the disease, or likely to have it in which case some more detailed tests will be carried out for confirmation.
Such tests could also detect any other eye problems you may have assumed to be normal.
This few minutes test can save your eye from going blind. Ensure you have your eyes tested today!
Why treat this disease?
Though, damage caused by glaucoma cannot be reversed, treatment will help to halt or reduce the progression to blindness. If not treated, the eye may go blind within a few years.
HOW IS IT TREATED?
After testing your eye thoroughly, the ophthalmologist will lay open to you all the options available, including the cost, effectiveness and availability of the type of treatment.
Glaucoma can be treated with some special eye drops, pills or sometimes injections; it can also be treated with special operations that help slow down further damage. You will need to always have a check up at regular intervals to monitor the effect of treatment. It is also important that you adhere to the drugs strictly as prescribed by your doctor.
WHY THE CHOICE OF AN OPERATION?
Your doctor and you will decide on an operation if the drugs used for treatment are not lowering the pressure sufficiently or when compliance with the drugs becomes difficult to achieve due to cost or prolonged usage.
BEFORE THE OPERATION
You will be given an explanation on what it entails and can ask questions on areas you don’t understand. Later you will sign a consent form for the operation. You will be admitted at least a day to the operation and will be expected to have a clean bath in the morning before going to the operation theatre. Your doctor, anaesthetist and you will discuss whether the operation will be performed while you are put to sleep throughout the duration or while you are awake but the pain is killed by an injection around the eye.
DURING THE OPERATION
You are expected to lie down quietly if you are not put to sleep
After the Operation
– Sleep using your glaucoma eye drops in the operated eye, you may continue with them in the other eye if it is also affected by glaucoma
– Detailed instructions on the use of your drugs will be given to you, try to abide by those instructions
– On discharge you will be given an appointment to be seen in the clinic after one or two weeks and then every four to six months thereafter.
Please
– Avoid heavy lifting and straining for the first four weeks after operation.
– If you feel pain in the eye, have discharge or the vision deteriorates after discharge, report immediately to the clinic. DO NOT wait until your appointment date please.