Cataracts - Medical Malpractice Lawyers

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Cataracts - Medical Malpractice

A cataract is a cloudiness of the lens of the eye that usually occurs gradually and affects the ability to see. The lens sits behind the coloured part of the eye, which is called the iris. It cannot be seen with the naked eye unless it is extremely cloudy. The lens helps focus light onto the retina and, if it clouds, you cannot see properly. The light is distorted so that you have visual complaints and visual symptoms.

Cataract development is a normal process of aging and usually comes on gradually. Most people do not know they have cataracts because the change in vision has come on so slowly. Cataracts usually affect both eyes but it is common for one eye to progress more rapidly than the other eye. Cataracts are a common condition, affecting 60 percent of people over the age of 60 years of age. In the US, more than 1.5 million cataract surgeries are performed per year. As more people reach the age of sixty and beyond, there is expected to be more cases of cataracts to be treated yearly.

The cause of cataracts is protein build ups over time in the normally clear lens. The lens is made up of mostly water and protein and, over time, the structure of these proteins is changed so that the effect is a cloudier lens. They can be present at birth due to a congenital enzyme defect and can occur when there is severe trauma to the lens. Eye surgery or inflammation of the intraocular portion of the eye can cause a cataract to form at earlier ages. Excessive UV ray exposure, smoking, diabetes and steroid use can contribute to getting cataracts. Phenothiazines and statins are weakly associated with getting cataracts.

The major symptoms of cataracts include foggy vision that can affect the periphery of the eye or the total lens area. Blurry vision and problems with glare can contribute to the inability to see clearly. There can be a dullness of coloured vision and an increase in nearsightedness so that your prescription changes in your glasses or contacts. One's reading vision can actually improve slightly so you can read easier for a while when having the progression of cataracts. This lasts only a short while, however, and eventually the reading vision worsens, too. Cataracts are not painful and come on gradually. The eye is usually not red unless the problem is severe. It can take many years from the time a cataract is uncovered until surgery is necessary.

The detection of a cataract is simple if you have the right equipment. Eye care professionals can see a cataract when they examine the lens through a slit lamp. A visual acuity at reading distances and at far distances can be determined and the doctor can find out if you need glasses for near or far vision, or both. The doctor can also see how you see things under conditions of glare and the doctor determines how much improvement in vision you would get if the cataract is removed. This is called potential acuity testing. Contrast sensitivity testing is done which helps the doctor know how well you can differentiate between varying shades of gray. This is hard to do if you have a severe cataract. Fluid pressure in the eye is determined and the pupil is dilated so that the cataract and retina can be evaluated as fully as possible.

The major treatment for cataracts is to do cataract surgery. It is done under local anaesthesia at a hospital or ambulatory care surgery center. The clouded lens is removed using ultrasound vibrations that emulsify the cloudy cataract. This is a process known as phacoemulsification. The fragments of lens remaining are vacuumed up and an artificial lens is placed into the place where the old lens used to be. The new lens helps you focus and you can immediately see better.

If the lens is too dense to dissolve into fragments via phacoemulsification, the cataract is removed in a single portion using a larger incision. The artificial lens is placed where the cloudy lens was removed. During intracapsular cataract surgery, the entire lens and capsule is removed in one piece. The intraocular lens used to replace the old one is placed in front of the iris after the old lens is removed. This is not an often used procedure.

The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here