Medical student and patient coordinator Sunny Li and surgeon James McKelvie. Photo / Ken Downie
Medical student and patient coordinator Sunny Li and surgeon James McKelvie. Photo / Ken Downie
From the archives: Surgeon James McKelvie is a cornea and anterior segment specialist who’s done thousands of cataract operations. Here, he busts the common concerns and myths around cataract treatment and provides some top tips to maintain your eye health.
How do cataracts form?
The cells in your eye lensdevelop before you are born, and jettison much of the usual cellular machinery, including the organelles and mitochondria, in preparation for being as transparent as possible. In cataracts, somewhat similar to other degenerative disorders such as Alzheimer’s and Parkinson’s (but not related), proteins in the fire cells of your eye’s lens clump together.
Where cataracts form. Photo / Getty Images
The proteins, called crystallins, are particularly susceptible to damage. Unlike in most other cells, the crystallins lose the ability to make new proteins or dump old ones. The crystallins you’re born with are those you have as an adult. They stay healthy with the help of other proteins, called, not entirely surprisingly, chaperones.
What are the symptoms of cataracts?
Blurred or clouded eyesight. Sensitivity to daylight. Double vision. Lights at night becoming flared or haloed. Frequent changes to your prescription and glasses or contacts can’t completely fix your vision.
How do I confirm that I have them?
Your optician will be checking for things such as glaucoma and macular degeneration. Ask them explicitly to check for cataracts.
What are the risks of cataract surgery?
Risks include infection, capsule rupture, bleeding behind the eye and even loss of vision. But major complications are rare, perhaps one in a thousand. You do need to be able to lie on your back for half an hour, which you might not be able to do if you have a chronic cough, bad reflux or a crocked back.
Are there injections?
Generally, the operation is done under a local anaesthetic because it means a faster recovery time and fewer complications. Mine was done using a sub-Tenon’s block, an injection in the gap between the eye capsule and the eye itself, though occasionally people have a general or just topical eyedrops. Patients might have a general - or a sedative plus local - if they are extremely anxious or unlikely to remain still (you are not tied down).
Are there stitches?
The cuts are generally self-sealing. Most people take two lots of drops to help the healing, one for a week and one for a month.
Perhaps, though you have to meet criteria that assess your total vision. Going private will undoubtedly be faster and offer more choice, though you - or your insurer - will have to pay.
Why is the vision with my new lens brighter ant slightly bluer?
That is the colour your eyesight was when you were a child. With age, it goes more yellow.
How long will my new lens last?
Longer than you are likely to.
Eye Care
Eat healthily, including lots of green leafy vegetables (which contain lutein and zeaxanthin), oily fish, vitamins C, E and B3 (promising for glaucoma), and non-meat protein.
Stay at a healthy weight. To reduce the risk of macular degeneration, eat fish two to three times a week, as well as lots of fresh fruit daily and a handful of nuts a week.
If you smoke, quit.
In the sun, wear a hat and sun- glasses that block UVA and UVB.
If you read or view screens a lot, take frequent breaks.
Protect your eyes when doing hazardous activities or racquet sports.
Have your eyes checked regularly.
This story was first published in the New Zealand Listener’s April 1-7 2017 issue. You can read more about cataract surgery here.
