Smooth Recovery From Cataract Surgery

How to Have a Smooth Recovery From Cataract Surgery

 

 

Cataracts are small clouding of your eye’s lens that can greatly affect your vision. As people age, cataracts often form in their lenses and can cause your vision to blur or become impaired at night.

 

There are numerous types of cataracts, but the most common are age-related cataracts and affect large numbers of elderly populations. Fortunately though, cataracts are easily treatable and can be completely removed from your eyes with a simple surgery.

 

 

If you have noticed a slight clouding of your vision or have noticed that glares bother you greatly, then contact your eye doctor for an appointment. They can diagnose you with a simple appointment and can talk with you about your treatment options.

 

 

Risk Factors

 

 

Age is the most common risk factor for developing cataracts. As people age they may start to develop blurry vision. People tend to notice the first decreases in their vision around age 40 or 50. Often, this is the beginning of cataracts. Other risk factors for developing cataracts include: Family History, Diabetes, Glaucoma, Trauma, Smoking, UV Light and Steroids.

 

Patients with a strong family history of cataracts and other eye diseases will have an increased risk of developing cataracts as they age. If you have a family history of any eye diseases, then you need to be seeing an eye doctor regularly. An eye doctor can watch for the signs and symptoms of cataracts and determine the proper course of treatment for you as you age.

 

Diabetes is another risk factor for developing cataracts. Constant exposure to high blood sugar can damage your eyes and put you at a greater risk for developing many eye disorders, including cataracts.

 

Glaucoma in itself is not a risk factor for developing cataracts, however many simple surgeries that help reduce your symptoms of glaucoma can actually increase your risk for cataracts. This is due to the trauma your eyes will undergo during surgery.

 

Trauma of any kind, including an injury or surgery, can greatly increase your risk for developing cataracts in your lifetime.

 

Other lifestyle choices including smoking, constant exposure to UV light, and persistent steroid use can increase your overall risk for developing cataracts.

 

 

Causes and Symptoms

 

Most people who do develop cataracts have a few questions. Often, at the top of their list, is how their cataracts developed. Your eyes are phenomenal, and can allow you to see a great amount of detail all around you. They work similarly to a camera lens. Human eyes have a lens that lies directly behind your iris and your pupil. This lens will focus light onto your retina. Certain neural connections will transfer the light into an image that your brain recognizes and you will be able to see everything around you.

 

The lens of your eye is composed mostly of proteins. These proteins are arranged very intricately to allow the most light into your eyes. As you age, the proteins will begin to degrade and you may develop small clumps of protein in your lenses. These clumps of protein are cataracts. As you continue to age, they can grow larger and make your lens cloudy. The cloudiness comes from your lens not being able to refract light perfectly.

 

At first, cataracts will not typically cause any symptoms. Once they begin causing symptoms, they have grown significantly and are becoming detriment to your vision. Once symptoms do develop they can include: blurry vision, double vision, faded color vision, sensitivity to glares and vision distortion.

 

 

Treatment

 

Once diagnosed, the main treatment for cataracts is surgery. Cataract surgery is an elective surgery that is almost never considered an emergency. For this reason, if you do have cataracts then you have the decision to keep your vision as is, or to undergo surgery. However, cataracts can cause blindness if left untreated for many years.

 

 

Cataract extraction is a simple surgery that can be completed in an eye surgical office. If you have cataracts in both of your eyes, then surgery can be completed on both eyes, but at different times.

 

During surgery, an eye surgeon will numb your eye and extract your cataract by removing or dissolving your lens. Then, he will place a new lens in your eye and give you perfect or close to perfect vision. Many older people do opt to have surgery, because after surgery, they do not have to use glasses or contacts to improve their vision.

 

If surgery is not for you, then you could wear glasses or contacts to improve your vision. However, corrective glasses may not work for everyone, and will not cure your cataracts. The only cure for cataracts is to remove them surgically.

 

 

Complications of Cataracts

 

Cataracts are one of the most common reasons for blindness around the world. If they grow too large, then they can impede your vision greatly and cause you to lose sight in the affected eye. However, most people go to the eye doctor long before their vision is greatly affected by their cataracts.

 

While cataracts need to be taken out to completely restore your vision to its optimum level, some people opt to keep their cataracts. For these people, their largest risk would be blindness. However, if they see their eye doctor regularly then they can watch the size and shape of their cataracts to ensure that they do receive proper treatment before they lose their sight. There are no other complications of cataracts that are known.

 

 

 

Healing After Cataract Surgery

 

 

Your cataract surgery recovery should be short and uneventful, as long as your health is good and you don’t have other major eye problems. Statistics also show that your chances of a good outcome and sharper vision after surgery are excellent.

 

Uncomplicated cataract surgery often takes no longer than about 10 minutes to perform. But immediately after the surgery, you will need to rest in a recovery area until you are less groggy from sedation or anesthesia. Typically this takes about 30 minutes to an hour.

 

You must have someone available to drive you home after the procedure. You’ll be given a pair of sunglasses to wear on the trip home to protect your eye from bright light and glare.

 

If you are sleepy or tired when you get home, you might want to rest in bed for a few hours. Depending on your cataract surgeon’s advice, you may be able to remove the protective shield placed over your eye within several hours after the procedure.

 

Just remember that you will need to tape the shield back over your eye at night or during naps, for protection while you recover from cataract surgery, at least for several days.

 

 

What Is the Typical Cataract Surgery Recovery Time?

 

Don’t be alarmed if your vision seems cloudy, blurry or distorted after you first remove the eye shield. It can take some time for your visual system to adjust to the removal of the cataract and adapt to the intraocular lens used to replace your eye’s natural lens.

 

During this adaptation period, some patients even report seeing “wavy” vision or distortions. This phenomenon, if present, should last only an hour or so.

 

You may also develop red and bloodshot eyes because of temporary damage to blood vessels on the surface of the “white” of your eye (sclera) during cataract surgery. As your eye heals, the redness should dissipate very quickly within several days.

 

If you received an injection of anesthesia through the skin into the lower portion of your eye, you may notice some bruising similar to a black eye. This, too, should fade within a few days.

 

Many patients report clear vision within several hours after cataract surgery. But each person heals differently, and you may need as long as a week or two before you see images in their sharpest focus.

 

Typically, you will have a follow-up appointment with your cataract surgeon the day after the procedure to make sure there are no complications. If you don’t notice any improvement in blurry vision or you feel eye pain or significant discomfort in the days following this visit, you should report this to your surgeon.

 

Sometimes people report some dry eye or “scratchiness” after cataract surgery. But these sensations should subside as your eye heals, unless you already had problems with dry eyes prior to having the procedure.

 

Your cataract surgery recovery should be complete in about a month, when your eye is completely healed.

 

 

How Can You Achieve the Best Cataract Surgery Recovery?

 

You might be surprised at how good you feel and how easily you will be able to resume normal activities even the day after cataract surgery.

 

However, you should observe a few precautions during the first week or so, to make sure you avoid developing an infection or sustaining an injury to your eye while it heals.

 

 

Your eye doctor typically will prescribe antibiotic eye drops to prevent infection and anti-inflammatory eye drops to help reduce any internal inflammation.

You’ll need to apply the eye drops several times daily for about the first week during your cataract surgery recovery.

 

 

Depending on the amount of postoperative inflammation you have, you may need the drops for a few weeks to a month. Make sure you use these eye drops exactly as prescribed.

 

Oral pain relievers such as acetaminophen may be prescribed, if needed. Typically, however, you should feel only slight discomfort after cataract surgery.

 

 

Tips For a Safe and Speedy Recovery

 

  • Don’t drive on the first day.
  • Don’t do any heavy lifting or strenuous activity for a few weeks.
  • Immediately after the procedure, avoid bending over, to prevent putting extra pressure on your eye.
  • If at all possible, don’t sneeze or vomit right after surgery.
  • Be careful walking around after surgery, and don’t bump into doors or other objects.
  • To reduce risk of infection, avoid swimming or using a hot tub during the first week.
  • Don’t expose your eye to irritants such as grime, dust and wind during the first few weeks after surgery.
  • Don’t rub your eye, which is a good idea even when you aren’t recovering from surgery.

 

Protective eye patch

A protective patch will be placed over your eye following cataract surgery. (Image: Vance Thompson Vision)

 

 

Generally speaking, you should be able to perform these activities within a few hours of your surgery:

 

  • Computer work
  • Light TV watching
  • Showering or bathing

 

For the best cataract surgery recovery possible, follow your doctor’s detailed instructions about how to protect your eye following your procedure. Usually these instructions will be given to you as a handout that you can take home with you on surgery day.

 

If you need cataract surgery in both eyes, your surgeon usually will wait at least a few days to two weeks for your first eye to recover before performing a procedure on the second eye.

 

 

Cataract Surgery Recovery and Typical Outcomes

 

Cataract surgery is one of the safest and most commonly performed surgical procedures in the United States. More than 3 million cataract surgeries are performed in the U.S. each year, and most people have excellent outcomes with no cataract surgery complications.

 

Past studies show:

 

  • Almost 96 percent of eyes that had no other problems such as other eye diseases prior to a cataract procedure achieved at least 20/40 uncorrected distance visual acuity, which legally is good enough to drive without eyeglasses or contact lenses.
  • In all eyes, including those with pre-existing eye conditions other than cataracts, almost 90 percent of all patients had good outcomes.
  • Fewer than 2 percent of eyes had sight-threatening complications.

 

In rare cases, sight-threatening cataract surgery complications such as endophthalmitis — an inflammation of the inside of the eye, usually caused by an eye infection — can occur.

 

People who experience serious complications often have other health conditions such as diabetes or high blood pressure.

 

A relatively common complication of cataract surgery that usually can be treated easily is posterior capsular opacification (PCO), which can cause your vision to become cloudy months or years after cataract removal. A simple laser procedure called a posterior capsulotomy usually can clear up the cloudiness and restore sharp vision.

 

 

 

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1 Wolters-Kluwer Pharma Solutions, B+L Brand Management Report, 5/13/11
2 March 2009 Retinal AMD Tracker, Decision Analysts, Inc.
3 The Age Related Eye Disease Study 2 (AREDS2) Research Group. Lutein + Zeaxanthin and Omega-3 Fatty Acids for Age-Related Macular Degeneration [published online]. JAMA. 2013;309(19):doi:10.1001/jama.2013.4997
4 NEI Press Release: NIH Study Provides Clarity on Supplements for Protection Against Blinding Eye Disease, www.nei.nih.gov/news/pressreleases, accessed May 17, 2013

 

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Diabetes – Not Really Fun

 

You’ve seen them on TV or viewed them online.

You couldn’t help that they caught your eye or made your ears perk up, in spite of yourself.

 

Diabetes Commericals

 

We’re talking about those ever-more-prevalent diabetes commercials, most brimming with smiling faces and bundles of energetic excitement about whatever the particular product, medication or message aimed at PWDs (people with diabetes). Sometimes it’s hard to swallow.

 

 

Yep, some even have catchy tunes, creative spins, or big-name actors and personalities to bump up interest in whatever’s being marketed.

Here’s an example.  These people are too happy and I think they’re giving the average viewer the wrong idea that diabetes management is a casual affair.  What do you think?

 

 

Though it is becoming increasingly common, type 2 diabetes is a serious disease. If you or someone you care for has been diagnosed with type 2 diabetes, it is very important that the disease be managed proactively.

 
Diabetes increases your risk for many serious health problems – take it seriously! 
 
It is important to keep your blood sugar, blood pressure, and cholesterol in a healthy range. You should learn the basic steps for managing diabetes and staying as healthy as possible.
 

 
With the correct treatment and recommended lifestyle changes, many people with diabetes are able to prevent or delay the onset of complications.
 

Long-term effects of diabetes

 

 

The most common long-term complications of diabetes include:

  • damage to the large blood vessels of the heart, brain and legs (macrovascular complications)
  • damage to the small blood vessels, causing problems in the eyes, kidneys, feet and nerves (microvascular complications).

Other parts of the body can also be affected by diabetes, including the digestive system, the skin, sexual organs, teeth and gums, and the immune system.

 

Diabetes and cardiovascular disease

Cardiovascular disease includes blood vessel disease, heart attack and stroke. The risk is greater for people with diabetes, who often have increased cholesterol and blood pressure levels. Smoking, having a family history of cardiovascular disease and being inactive also increase your risk.

To reduce your risk and pick up any problems early:

 

  • Have your blood pressure checked at least every six months, but more often if you have high blood pressure or are taking medication to lower this.

 

 

  • Have your cholesterol checked at least yearly, as well as an HbA1c (average blood glucose over the past three months).
  • Further pathology tests such as an electrocardiogram (ECG) or exercise stress test may also be recommended by your doctor.

 

Eye disease and diabetes

 

 

Diabetes-related eye problems include:

 

  • Retinopathy – with this condition, the blood vessels in the retina become damaged and eventually this can affect vision.
  • Retinopathy has various stages. In its early stages, there are usually no symptoms, so having a full diabetes eye check is essential to detect it early. Regular eye checks help detect any changes and allow for early treatment where needed to prevent further damage.
  • Macular oedema – the macular is part of the retina and helps us to see things clearly. Swelling of this area can happen when the blood vessels in the retina are damaged and cause fluid to build up. This can lead to the macular being damaged and vision may be blurry. Treatment is available. Early detection is important.
  • Cataracts – the lens of the eye becomes cloudy and can cause things such as vision becoming cloudy, distorted or sensitivity to glare. People with diabetes can develop cataracts at an earlier age.
  • Glaucoma – the pressure of the fluid within the eye builds up to a higher level than is healthy. This pressure over time can damage the eye. Glaucoma occurs in people with and without diabetes, but is more common in people with diabetes.

While most damage to the eyes is free of symptoms in the earlier stages, there are certain symptoms that may occur and these need urgent review. If you have flashes of light, floaters, blots and dots or part vision missing, seek urgent medical assessment.

Regular eye checks

Everyone with diabetes should have a professional eye examination by an ophthalmologist or optometrist when they are first diagnosed, and then at least every two years after that.

 

 

It is important that you inform the person checking your eyes that you have diabetes. If retinopathy or another abnormality is found, eye tests will be required every year, or more frequently if advised by your ophthalmologist.

 

Kidney damage and diabetes

 

 

People with diabetes are at risk of kidney disease (nephropathy) due to changes in the small blood vessels of the kidneys. Kidney disease is painless and does not cause symptoms until it is advanced.

Screening is very important. Kidney damage can be diagnosed early by detecting microalbumin (very small amounts of protein) in the urine. Everyone with diabetes should have a urine check for microalbumin at least once a year. Your doctor will also monitor your kidney function, including estimated glomerular filtration rate (e-GFR), with a blood test.

If problems are picked up early, nephropathy can be slowed or prevented with the right treatment. Medication called ACE inhibitors and angiotensin receptor antagonists helps to protect the kidneys from further damage. These tablets can also be used to treat high blood pressure.

 

Nerve damage and diabetes

 

Nerve damage (neuropathy) is usually caused by high blood glucose levels. Damage can occur to the sensory (feeling) and motor (movement) nerves of the legs and feet, arms, hands, chest and stomach, and to the nerves that control the actions of body organs.

Neuropathy

People who drink large amounts of alcohol can have similar nerve damage. Vitamin B12 deficiency can mimic signs and symptoms of peripheral neuropathy. Long-term Metformin (diabetes treatment) use (over three to five years) can increase your risk of vitamin B12 deficiency, and doctors will sometimes test for this.

 

To help prevent nerve damage:

 

  • Keep your blood glucose levels in target range.
  • If you drink alcohol, keep within the recommended guidelines.
  • Don’t smoke.
  • Talk to your doctor about any problems you have with your hands, arms, feet, or legs, your stomach, bowels, or bladder.

 

Foot problems and diabetes

 

The feet of someone with diabetes are at risk of damage when the blood supply in both large and small blood vessels is reduced. Nerve damage (peripheral neuropathy) often results and structural abnormalities can also occur, for example, clawed toes.

Reduced blood supply and reduced nerve function can delay healing, increase the risk of infection, reduce feeling in the feet, and lead to ulcers and structural foot problems.

 

Look after your feet by:

 

  • seeing a podiatrist at least once a year. They will assess the health of your feet by checking the blood supply, nerve function and looking for changes in the structure of your feet.

 

 

  • Checking your feet every day or get someone to help you if you are unable to check them yourself. Look for cuts, blisters calluses, corns, tinea (especially between the toes) and any changes you notice. If treated early and without delay, you can help prevent complications occurring

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  • moisturizing using a moisturizer (such as sorbolene), especially if you have areas of dry, rough or cracked skin on your feet and heels, can help keep your feet healthy
  • protecting your feet by wearing comfortable, supportive shoes that fit well.

 

Skin problems and diabetes

 

People with diabetes may experience very dry skin due to damage to the small blood vessels and nerves. A common problem for people with diabetes is very dry skin on the feet, but this may be more generalized.

There are also other skin conditions related to diabetes. High blood glucose levels over time can affect the health of the skin. The skin acts as a barrier to protect our bodies from infection so it is important to keep the skin as healthy as possible. If the skin becomes dry, it can lead to cracks and possibly infections.

To reduce the risk of skin problems:

 

  • Make sure your blood glucose is well controlled – keep your blood glucose levels and HbA1c within recommended ranges to reduce the risk of skin infections.

 

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  • Wear gloves when you use household cleaners and solvents.
  • Avoid very hot baths and showers.
  • Take care not to have your feet too close to heaters, especially if you have neuropathy, as you may not be able to feel the intensity of the heat.
  • Use a cream or lotion on your skin after bathing, preferably one that is not perfumed. Use non-scented soaps or soap alternatives.
  • If you notice you have a skin problem, see your doctor.

 

Teeth and gum problems and diabetes

 

People with poorly managed diabetes are at increased risk of tooth decay and gum infections. This is due to damage to the small blood vessels supplying the gums and teeth. Dental and gum infections can also lead to high blood glucose levels.

Not looking after your teeth and gums can cause the gums to become inflamed and loosen around the teeth. Poor oral care is also strongly linked with an increased risk of heart disease.
To reduce your risk of teeth and gum problems:

  • See your dentist regularly (every six months) for a check-up.
  • If you have dentures, make sure you brush your dentures and gums with a soft tooth brush.

 

Mental health and diabetes

 

 

Living with and managing either type 1 or type 2 diabetes can lead to stress, anxiety and depression. This can affect your blood glucose levels and how you manage your diabetes in general. Over time, this can affect your health.

It is important to talk to your doctor if you are going through times of stress, depression or anxiety. Your doctor can refer you to a counselor, psychologist or psychiatrist by providing a diabetes mental health plan.

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Diabetes, particularly type 2, has been linked with Alzheimer’s disease and vascular dementia. Brain changes, resulting from reduced blood supply to the brain over time, appears to be associated with an increased risk for development of these conditions.

 

 

Diabetes and infections

 

Your immune system helps to prevent and fight infection. High blood glucose levels slow down the action of infection-fighting white blood cells. This makes it more difficult for the immune system to do its job.

 

Support your immune system and reduce your risk of infections by:

 

  • getting plenty of rest
  • washing your hands often
  • protecting yourself against infection
  • having a yearly influenza (flu) immunization.

 

 

 

  • ask your doctor about the pneumonia vaccine, especially if you are over 65
  • seeing your doctor if you have an infection or are unwell.

 

Thyroid problems and diabetes

 

People with either type 1 or type 2 diabetes are at increased risk of thyroid disease. This includes both overactive and underactive thyroid. Thyroid disorders can affect general health and may affect blood glucose levels.

Thyroid function is assessed by a blood test. Check with your doctor if you are not sure whether you have had your thyroid function checked.

 

Sexual dysfunction and diabetes

 

Reduced blood supply and nerve damage can affect sexual function. Erectile dysfunction (impotence) in men is the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance. This is a common problem for men of all ages and is more common in men with diabetes.

Erectile dysfunction is not a disease, but a symptom of some other problem – physical, psychological or a mixture of both. Most cases of erectile dysfunction are physical, such as nerve or blood vessel damage.

In women, sexual dysfunction is also reported, although there is a lack of research in this area. It is difficult to know whether this is directly related to hormonal changes such as menopause, or to diabetes.

It is important to seek help from your doctor or diabetes educator.

 

 

Managing Your Diabetes

 

Managing diabetes is something that you do not have to do on your own.

There are health professionals available to help you. Take charge of diabetes management by doing your part and communicating regularly with your healthcare provider. 

 

 

Be Proactive

 

Proactive diabetes management can go a long way toward reducing the risk of long term complications.

 

 

Please share your experience or tips on type 2 diabetes and it’s complications.

 

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