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Thursday, April 28, 2011

Cataracts, Surgery And Recovery

By Owen Jones

You have to be very careful with your eyes because they can so easily be damaged beyond repair. My eyesight started to deteriorate as I reached forty, like most people. My friends and family put that down to the fact that I was sitting in front of a computer screen for about twelve hours a day and had done since I was twenty-eight. Still, there was nothing I could do about that, that was my work. I was self-conscious of wearing glasses at first, but you soon become over that.

My eyes continued to get worse and at a greater rate than friends of a similar age, but I thought that that was only the luck of the draw. However, one morning about ten years later, I woke up and it was as if my glasses were dirty. I spent the next day or two cleaning them, but I could not seem to move the dirt on the right lens.

By that time, my vision was too bad to see without glasses and I only had the one pair. I had moved to rural Thailand and procuring a second pair was no easy feat.

After a couple of days of cleaning and polishing my glasses a friend offered to take me the 75 km to the nearest good hospital. The opthamologist looked in my eyes and said: "I am very sorry, but you are senile". I had been called mad before, but not senile. I was fifty-two. It is not really a statement that beggars a question, so I merely looked at him and put on a glum expression, hoping that I was not confirming his diagnosis.

He looked at me and then looked in his desk, pulled out a book and opened it. "You have premature senile cataracts" he corrected himself. I was not sure whether that was any better as it implied that other parts of me may begin failing early as well. Anyway, I thanked him and left. I had no idea what to do next, but at least I knew better that to continue wasting my time attempting to clean my already spotless glasses.

My wife is very practical and she arranged for us to go to an even better hospital 650 km away. I was seen by one of the hospital's senior eye surgeons within the hour and was told that I had a cataract in my right eye and that there was a decent opportunity that I would get one in the left eye as well. Then she shocked me by asking: "Do you want me to remove it now?"

It was too big a decision for me to take there and then without any information, so we discussed the operation, she gave me a leaflet and I made an appointment to return the next day. The next day, I was in the operating chair. I was not going to have Laser Correction, but the full replacement of the lens. The operation is carried out under local anaestetic and does not hurt but it can be uncomfortable at times.

The surgeon cut a small incision of two millimetres just to the outside of the colour of my eye and squirted in some liquid. She then vibrated that fluid with ultra-sound to break up the lens in my eye and washed the bits of lens out with more fluid before inserting the new lens through the same hole.

By this stage of my life, I could just see light and dark with my right eye, but at one point my eyesight just ceased entirely. It was like watching a window shatter before your eyes only to realise that there was nothing but blackness beyond. Now I definitely was blind in that eye. There was a bit of discomfort, but the surgeon kept talking to me and then she said: "Wait, wait, wait, can you see me?"

And I could.

Absolutely perfectly. Better than I would have been able to fifteen years before, but everything was so bright that it dazzled. I had not noticed how dingy my world had become. A cataract is like having a net curtain over a window, it cuts out a great deal of light. Therefore, the first thing you become aware of whilst you have had a cataract removed is a flood of light. Your world literally is a brighter place - to such an extent that the light hurts.

Be cautious with light after the surgery, it cannot bring about lasting damage, but it honestly does hurt. A passing vehicle can reflect sunlight into your eye and catch you unawares. If you are driving or riding a motorbike, it could be very dangerous. Another danger is reflection. You have an open wound on your face which can be infected by wind-borne germs.

The week after the operation is a great deal more dangerous than the procedure itself. You have an open wound in your eye which they do not stitch. It is left to repair itself, which is not a problem, if you take precautions.

You have to put two types of drops in your eye four times a day and prevent getting water in your eye at all costs. That means do not go out in the rain and do not wash your hair in the shower. Dirt and consequent infection are your biggest enemies, so put the drops in regularly, avoid dust (and the powdered dog faeces mixed in with it) and all water and be very careful of light.

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