Cataracts

 

 

 

A cataract is an eye disorder that is caused by the clear lens of the eye becoming cloudy. Looking through a cloudy lens has been compared to trying to see through a frosted or fogged up window. Cataracts cause opaqueness to affect the normally crystalline clear eye lens. This can lead to reduced vision, and if left untreated, eventually to blindness. In fact, cataracts are the leading cause of impaired vision and blindness in the United States today. However, the majority of cataracts are very treatable and the prognosis for recovery is excellent for most patients.

Cataracts are so common in elderly folks, that many consider it a normal part of the aging process. Approximately 50% of Americans over the age of 65 have some degree of lens clouding, and after the age of 70, the percentage goes up to about 70%.

Perhaps a little knowledge of how the eye operates will help to understand cataracts better. The human eye is composed of several different parts. The outermost layer of the eyeball includes the dome-shaped cornea, and the sclera. Both of these structures serve to protect the eye. Next comes a layer that consists of the iris (the colored part of the eye), pupil (the dark round spot in the middle of the iris), and ciliary body (location of the muscles that help the eye to focus). The pupil and iris are responsible for controlling the amount of light that comes into the eye. The lens, where cataracts form, is found behind the pupil and the iris.

The lens is normally transparent and somewhat elastic. This flexibility of the lens makes it possible for it focus on both close and far away objects. The muscles in the ciliary body are attached to the lens by ligament-like fibers called the "zonules of Zinn." As the zonules are expanded and contracted, the lens is able to focus and provide clarity of vision. This process is known as "accommodation." As we age, the lens progressively loses its elasticity, and initially leads to troubles with close-up vision. This occurs in most folks at about the age of 40, and is called "presbyopia."

The lens of the eye is basically composed of about 35% protein and 65% water. As we age, the proteins of the lens begin to deteriorate, and this is the main reason for the cloudiness that results in cataracts. It is similar to what happens to the clear proteins of an egg white when it is cooked. They change from transparent to an opaque white as the proteins are broken down. The structure of the lens may be thought of as a piece of fruit. The nucleus is like the pit. The cortex is the fleshy part of the fruit. The outer layer of the lens is like the skin of the fruit, and is called the capsule.

Cataracts occur in three distinct types, classified by which part of the lens they form in:

Nuclear: This type of cataract forms in the center of the lens. Some folks with nuclear cataracts experience a phenomenon called "second sight" whereby they experience a temporary improvement in their reading vision, and may even be able to read without their glasses. However, this does not last, and as the cataract advances, the lens turns progressively more yellow, and eventually may turn brown. Nuclear cataracts cause problems with night driving, seeing in dim light, and distinguishing between colors, especially blues and purples.

Cortical: Cortical cataracts start on the outer edge of the cortex. They usually begin as whitish streaks that spread towards the center of the lens and progressively impede the amount of light that is able to pass through the lens. Both near and far vision can be affected, and many patients with cortical cataracts have trouble with focusing and experience distorted vision.

Subcapsular: These typically form just under the capsule, near the rear of the lens, directly in line with the path the light takes to reach the retina. Subcapsular cataracts tend to cause problems with reading, vision in bright light, and glare or halos associated with night vision.

Symptoms

In most cases cataract causes some visual disturbances, such as:

- Blurred vision, slow, confusing

- Photophobia (hate the light) or the natural or artificial. Driving is also difficult due to visual discomfort caused by light traffic lights

- Need relatively frequent change of glasses lenses

- Double vision

- Difficulties in carrying out daily activities due to visual disturbances

It is important for parents to observe various visual disorders in children for early identification of cataract (juvenile cataracts) or other eye diseases

What Causes Cataracts?

The exact reason why the lens of the eye changes as we age is not known. Initially thought of as an inevitable part of aging, scientists are beginning to rethink this assumption. There are several theories that researchers are exploring:

Free radical damage: Free radicals are substances that cause oxidative damage to tissues throughout the body. Antioxidants are naturally occurring substances found in many foods that are responsible for negating the effects of free radicals. When levels of antioxidants in the body are insufficient, cataracts are allowed to form. The good news is that many nutritionists and alternative health care providers believe that a diet high in antioxidant nutrients can prevent cataracts and even reverse the damage of existing cataracts if they are not too far advanced. Beta-carotene, found in carrots and other vegetables, is one of the best sources of antioxidants. Mom was right when she told us to eat our carrots so we could see better! Like the old joke says, You never saw a rabbit with glasses, did you? Some other suggested foods are:

• Leafy-green vegetables
• Yams, squash, and other yellow, deeply colored vegetables
• Broccoli
• Citrus fruits and a variety of dark-colored berries, such as blueberries and blackberries. These are high in vitamin C, a wonderful source of antioxidants.
• Wheat germ oil is excellent for its vitamin E content.
• Avoid fried, fatty or rancid foods, as they contain high amounts of free radicals
• Smoking: Statistics show that smoking or exposure to second hand smoke will increase an individual's risk for developing cataracts. The reasons for this are not fully understood, but it is known that tobacco smoke is a source of free radicals.
• Excessive UV light: UV light is also recognized as a source of free radicals. A lifelong habit of wearing quality sunglasses that protect against UV light (especially UV-A and UV-B) is a great preventative step to reduce the chances of developing cataracts later in life.
• Alcohol: Some researchers believe that alcohol may increase the exposure to antioxidants as well, and thus increase risk for cataracts. However, the evidence for this is scant.

Other risk factors that may make it more likely for you to get a cataract are:

• Diabetes
• Previous eye surgery
• Previous eye injury or inflammation
• Extended use of corticosteroid medications

  Treatment

The symptoms of early cataract may be improved with new eyeglasses, brighter lighting, anti-glare sunglasses, or magnifying lenses. If these measures do not help, surgery is the only effective treatment. Surgery involves removing the cloudy lens and replacing it with an artificial lens.

A cataract needs to be removed only when vision loss interferes with your everyday activities, such as driving, reading, or watching TV. You and your eye care professional can make this decision together. Once you understand the benefits and risks of surgery, you can make an informed decision about whether cataract surgery is right for you. In most cases, delaying cataract surgery will not cause long-term damage to your eye or make the surgery more difficult. You do not have to rush into surgery.

Sometimes a cataract should be removed even if it does not cause problems with your vision. For example, a cataract should be removed if it prevents examination or treatment of another eye problem, such as age-related macular degeneration or diabetic retinopathy.

If you choose surgery, your eye care professional may refer you to a specialist to remove the cataract.

If you have cataracts in both eyes that require surgery, the surgery will be performed on each eye at separate times, usually four to eight weeks apart.

There are two types of cataract surgery. Your doctor can explain the differences and help determine which is better for you:

·  Phacoemulsification, or phaco

A small incision is made on the side of the cornea, the clear, dome-shaped surface that covers the front of the eye. Your doctor inserts a tiny probe into the eye. This device emits ultrasound waves that soften and break up the lens so that it can be removed by suction. Most cataract surgery today is done by phacoemulsification, also called "small incision cataract surgery."

·  Extracapsular surgery

Your doctor makes a longer incision on the side of the cornea and removes the cloudy core of the lens in one piece. The rest of the lens is removed by suction.

After the natural lens has been removed, it often is replaced by an artificial lens, called an intraocular lens (IOL). An IOL is a clear, plastic lens that requires no care and becomes a permanent part of your eye. Light is focused clearly by the IOL onto the retina, improving your vision. You will not feel or see the new lens.

Some people cannot have an IOL. They may have another eye disease or have problems during surgery. For these patients, a soft contact lens, or glasses that provide high magnification, may be suggested.

Cataracts Natural Treatment Remedy

"Mainstream"' medical treatment for cataract is doing nothing until the cataract is "ready" and then removing it surgically, usually replacing the lens of the eye with an artificial one.

If you have cataract you needn't just wait until it's time for surgery. Especially if it's an early cataract, it's often possible to slow it down or even stop it. One research study shows that cataract may even be reversible.

As is often the case in nutritional medicine and health care, the same nutrients that can slow or stop cataract are the ones -which can help prevent it in the first place! If you have cataract in your family, or are at higher risk because of diabetes or other health problems, you might consider using some of these diet changes and nutritional supplements.

Galactose, a sugar found in cow milk and unfermented dairy products, has been implicated in the development of some cataracts. If you have cataract or are at risk, it's probably wisest to avoid galactose.

If you have diabetes yourself, or if it's in your family, eliminating or reducing refined sugar and refined carbohydrates is also best, both for preventing possible cataract, and slowing or stopping it, if it's already present.

One research study has shown that an herbal, bilberry (European blueberry) can help to reverse cataract in some cases. Although it's too early to say how many of us bilberry will help, it can't hurt to try. I usually recommend 80 milligrams of a standardized extract (25%), twice daily. Like most herbal remedies, it can take months to tell if it's making any difference.

All of the individual nutrients useful in the prevention and treatment of cataracts are classified as "antioxidants", substances capable of slowing or stopping "oxidative damage" to the cells of our bodies. There are so many antioxidants that might be useful that many people I know prefer to find a "multiple" supplement, rather than using them individually. However, I'll list them individually next. If you select a multiple, try to find one that matches or comes close to these individual quantities.

The ones I usually recommend at present as most useful in treatment start with vitamin C, 1000 milligrams two or three times daily.

Vitamin E is next on the list, 400 to 800 units daily. A few people think their blood pressure has gone up when they've taken extra vitamin E. It's certainly easy to keep track.

Riboflavin, vitamin B2, isn't known for having many specific uses, but cataract prevention and treatment appears to be one. 25 to 50 milligrams daily is a good range.

Vitamin A and beta-carotene are both useful for cataract prevention and treatment: Vitamin A, 25,000 units daily and beta-carotene, 50,000 units daily.

The antioxidant minerals I recommend include selenium, 200 micrograms daily and zinc. Selenium works with a very important enzyme in the lens of the eye that protects against oxidative damage.

I usually end zinc picolinate 30 milligrams daily and sometimes more, but only after checking zinccopper balance. It's wisest not to use greater quantities of zinc without checking this balance with a doctor knowledgeable and skilled in nutritional therapy.

Quercitin is a flavonoid and an antioxidant. For diabetics and likely in those at risk for diabetes, quercitin has been shown to slow the activity of an enzyme that leads directly to cataract formation! I recommend 500 milligram, two or three times daily, especially in diabetics and pre-diabetics. For "preventive" purposes, smaller quantities are usually adequate.

Remember, if you don't want to take all of these nutrients, individually, there are several "multiple antioxidant" formulas combining them and usually several more, available in almost all natural food stores.

The individual nutrients, or the "antioxidant multiple", should be used along with a general multiple vitamin-mineral combination.

Because of differences in age, sex, metabolism or potential allergy, these diet and supplement therapies may not be suitable for you. Consult a health care professional skilled in nutritional and natural therapies.