Seeing clearly

Cataract is one of the leading causes of blindness in older adults, but there is still a lack of awareness surrounding the condition

An almost routine part of growing older is having to cope with not having our senses as tip-top as they were in our younger days. When it comes to sight, cataracts are relatively common among older adults — if it is not you, someone you know has probably had to deal with that cloudy gauze over their eye.

Despite this, it appears that we may not be as informed as we should regarding the condition. According to the Alcon More to See Survey, released in conjunction with World Sight Day in October, many of Asia’s senior citizens may be lacking vital eye health knowledge when it comes to cataracts.

Involving some 2,400 respondents aged 60 and above across six Asian countries including Hong Kong, India and South Korea, the survey revealed that up to 62% of Asians over the age of 60 believe cataracts can be prevented. More worryingly, 44% believed cataracts should be fully developed before treatment. While age–related cataracts are a part of getting older, the progressive disease can lead to visual impairment and blindness unless treated.

When compared to touch, taste, scent and hearing, 90% of those surveyed, people aged 60 and older, see vision as the most important of the five senses. However when it comes to eye check-ups, many do not regularly see an eye care professional. Approximately 12% of those surveyed indicate they almost never see an ophthalmologist; 19% of those surveyed said they almost never see an optician; and 18% almost never see an optometrist.

The survey also seems to match up to previous local studies conducted in Malaysia. A National Eye Survey (NES) conducted in 2014 found that 216,000 Malaysians became blind because of delays in cataract surgery, and the condition also caused 272,000 others to be visually impaired. The NES also found that among 63,000 Malaysians aged 50 and above who were blind, 60% could have been treated. A further 350,000 people in the same age group had low vision, with 80% being treatable.

“While lifestyle factors may impact cataracts, it’s a progressive disease that can only be treated by surgery,” says Dr Wong Jun Shyan, Consultant Ophthalmologist at the International Specialist Eye Centre in Kuala Lumpur. “Waiting isn’t the answer. If you have any symptoms, including blurry vision, see an eye care professional and seek advice on how and when you should be treated. Annual check-ups are also very important for seniors and it worries us that so few are regularly seeing an eye care professional.”

Cataract facts

A cataract is a clouding of the normally clear lens of your eye. The lens of your eye is made of mostly water and protein. The protein is arranged in a precise way that keeps the lens clear and lets light pass through it. But as we age, some of the protein may clump together and start to cloud a small area of the lens.

For people who have cataracts, seeing through cloudy lenses is a bit like looking through a frosty or fogged-up window. Most cataracts develop slowly and appear not to disturb your eyesight at first. Over time, the cataract may grow larger and cloud more of the lens, making it harder to see.

Despite popular belief, there are no sure-fire ways of preventing cataracts – at least not scientifically. Most cataracts are a result of ageing and long-term exposure to ultraviolet light; the protein in the lens changes from the wear and tear it takes over the years.

Some are caused by injury and certain diseases and in rare cases by exposure to toxic materials and radiation. Occasionally cataracts are present at birth, due to the baby’s mother having had rubella during the pregnancy, or due to genetic defects.

However, there are some risk factors that researchers suspect increase the possibility of getting cataract, such as smoking and diabetes. “Diabetes-related vision problems are a big problem here, so it’s important to manage your diabetes if you have it,” says Dr Wong. “Studies have also shown that smokers are twice as likely to develop cataracts, and the risk increases further if you are a heavy smoker.”

Most of us know the tell-tale symptom of a cataract — cloudy vision. However, almost half of the respondents in the Alcon survey could not name more than one symptom; some 12% even mistakenly listed ‘itchy eyes’ as a symptom of the condition.

Other possible signs of cataract include light glare and sensitivity; colours looking faded or “yellowed”; seeing halos around light or light sources; having double vision in one eye; or even needing to change your eyeglass or contact lens prescriptions too frequently. “Needless to say, if you’re having to go to change your glasses every so often compared to before, you should get your eyes checked regardless of your age,” adds Dr Wong.

Cataract surgery meanwhile, involves removing the clouded lens and replacing it with a clear artificial lens. The artificial lens, called an intraocular lens, is positioned in the same place as your natural lens. It remains a permanent part of your eye.

For some people, other eye problems prohibit the use of an artificial lens. In these situations, once the cataract is removed, vision may be corrected with eyeglasses or contact lenses.

Dr Wong says that while some may be concerned about having their eye go under the knife, cataract surgery is now a rather routine procedure unlike the times of yesteryear. While there may be some discomfort following surgery, healing generally takes place within eight weeks.

“As with most types of surgery, there is a risk of infection and bleeding. That said, if your cataracts are left untreated, the more likely and immediate concern is that it will slowly cause you to go blind,” he adds.

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