Another Reason to Get Cataract Surgery: It can Make you 48 Percent Safer on the Road

The ability of cataract surgery to restore sight is well known. People say they’re stunned by the vibrancy of color after surgery and the improvement in night vision. Some can even reduce their reliance on glasses. But can you quantify that improved quality of vision? To find out, researchers in Australia used a driving simulator to test patients’ vision before and after cataract surgery. They found that near misses and crashes decreased by 48 percent after surgery. The researchers present their study today at AAO 2019, the 123rd Annual Meeting of the American Academy of Ophthalmology.

Cataracts are a normal consequence of aging. They happen gradually over years, as the clear lens inside the eye becomes cloudy. The effects of a developing cataract are sometimes hard to distinguish from other age-related vision changes. You may become more nearsighted; colors appear duller and glare from lights make it harder to see at night. By age 80, about half of us will have developed cataracts.

Cataract surgery replaces the cloudy lens with an artificial lens. The surgery is low-risk, fast and effective. But not everyone has surgery right away. The decision is usually based on how much the cataract is interfering with daily life activities. Ophthalmologists typically operate on one eye at a time, starting with the eye with the denser cataract. If surgery is successful and vision improves substantially, sometimes surgery in the second eye is forgone or delayed. However, most people get significant benefit from having surgery on the second eye. Depth perception is improved, vision is crisper, making reading and driving easier.

To better understand the true benefit of cataract surgery to patients’ quality of life, Jonathon Ng, MD, and his colleagues at the University of Western Australia, tested the driving performance of 44 patients before they had cataract surgery. The driving simulator assessed a variety of variables: adjusted speed limits, traffic densities, uncontrolled intersections and pedestrian crossings. Patients were put through the driving simulator again after their first surgery and then again after their second eye surgery. After the first, near misses and crashes decreased by 35 percent; after the second surgery, the number fell to 48 percent.

While visual acuity – how well one sees the eye chart – is an important method to assess a person’s fitness to drive, it’s an incomplete assessment, Dr. Ng said. Quality of vision is also an important indicator. Improved contrast sensitivity and better night vision improves drivers’ safety on the road.

“In Australia and other countries, people may often wait months to receive government funded surgery after a cataract is diagnosed,” said Dr. Ng. “These results highlight the importance of timely cataract surgery in maintaining safety and continued mobility and independence in older adult drivers.”

Some things to consider, when considering cataract surgery:

  • Can you see to safety do your job and to drive?
  • Do you have problems reading or watching TV?
  • Is it difficult to cook, shop, climb stairs or take medications?
  • Do vision problems affect your independence?
  • Do bright lights make is harder to see?

Source: American Academy of Ophthalmology

Eating Colourful Fruits and Vegetables Lowering Risk of Age-related Cataracts

A $5.7 billion global medical bill to restore sight for the estimated 45 million people with cataracts could be slashed in half by a diet rich in colourful fruits and vegetables, according to an international study.

Researchers from China and the University of South Australia have published the first study of its kind to verify the link between foods high in antioxidants and a lower risk of age-related cataracts (ARC).

UniSA Senior Research Fellow Dr Ming Li and colleagues from Xi’an Jiaotong University analysed 20 studies from around the world looking at the impact of vitamins and carotenoids on cataract risk.

Despite some inconsistencies, the findings overwhelmingly support the benefits of eating citrus fruits, capsicum, carrots, tomatoes and dark green vegetables such as spinach, broccoli and kale to delay the onset of ARC.

Their paper has been published in the American Journal of Clinical Nutrition ahead of World Optometry Week (March 26-30).

“Age-related cataracts are the leading cause of visual impairment among the elderly throughout the world, with unoperated cataracts contributing to 35 per cent of all blindness,” Dr Li says. “Although cataract extraction surgery is an effective method to restore vision, it will have cost society more than $5.7 billion by 2020.”

With the population ageing dramatically and an increasing number of people needing surgery, urgent action is needed, the researchers say.

“If we could delay the onset of ARC by 10 years it could halve the number of people requiring surgery.”

Improvements would rely on global changes to most of the world’s diet, however, with current consumption of antioxidants well below the recommended level to prevent age-related cataracts.

Source: University of South Australia


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Cataract Surgery, Hearing Aid May Boost the Aging Brain

You won’t jump for joy when you’re told you need hearing aids or cataract surgery. But get this: Both appear to slow mental decline in older adults.

That’s what researchers concluded after studying more than 2,000 people in England who had cataract surgery and more than 2,000 Americans given hearing aids.

“These studies underline just how important it is to overcome the barriers which deny people from accessing hearing and visual aids,” researcher Piers Dawes, of the University of Manchester in England, said in a university news release.

“It’s not really certain why hearing and visual problems have an impact on cognitive [memory and thinking skill] decline, but I’d guess that isolation, stigma and the resultant lack of physical activity that are linked to hearing and vision problems might have something to do with it,” said Dawes, a lecturer in audiology and deafness.

For comparison, the researchers looked at thousands of people who had not had cataract surgery or obtained hearing aids.

The investigators compared the rates of mental decline before and after the patients had their vision and hearing improved. The rate of mental decline was halved after cataract surgery and was 75 percent lower after starting to use a hearing aid.

Dawes noted that people might not want to wear hearing aids due to stigma, because the amplification is not good enough, or because they’re uncomfortable.

“Perhaps a way forward is adult screening to better identify hearing and vision problems and in the case of hearing loss, demedicalizing the whole process so treatment is done outside the clinical setting. That could reduce stigma,” Dawes suggested.

“Wearable hearing devices are coming on stream nowadays which might also be helpful. They not only assist your hearing, but give you access to the internet and other services,” he added.

According to Dawes’ colleague, Asri Maharani, “Age is one of the most important factors implicated in cognitive decline. We find that hearing and vision interventions may slow it down and perhaps prevent some cases of dementia, which is exciting — though we can’t say yet that this is a causal relationship.”

The cataract surgery study was published in the journal PLoS One. The hearing aid study was published earlier this year in the Journal of the American Geriatrics Society.

Source: HealthDay


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Cataract Surgery for Senior Drivers Tied to Reduced Car Crash Risk, Costs

Cheryl Platzman Weinstock wrote . . . . . . . . .

Cataract surgery can significantly reduce car crashes involving senior drivers and the cost of those accidents to the community, researchers say.

Their study involved 2,849 drivers age 60 and older in Western Australia, all of whom had cataract surgery on both eyes and were involved in vehicular crashes as the driver.

Altogether, 1,312 participants were involved in 1,347 crashes in the year before their first eye cataract surgery, 775 participants were involved in 850 crashes in the period between first and second surgery, and 895 participants were involved in 916 crashes as the driver in the year after the second surgery.

After accounting for other risk factors, the researchers found a 61 percent reduction in crash risk after these drivers’ first cataract was removed and a 23 percent reduction in accidents after their second cataract operation.

Altogether, the total cost of the accidents, in Australian dollars, was $80.5 million (US$57.30 million) in the year before the first eye surgery and AUS $60.4 million in the year after the second eye surgery. The study team calculated the total cost of the surgeries was AUS $5.1 million, so the reduction in crashes credited to the procedures netted a community savings of AUS $14.9 million.

“These results provide encouragement for the timely provision of first- and second-eye cataract surgery for drivers,” Lynn Meuleners and colleagues at the Curtin-Monash Accident Research Center in Perth write in the journal Age and Ageing.

Cataracts, a clouding of the lens of the eye, are a leading cause of blindness in the U.S. and about half of all Americans will either have cataracts, or have had cataract surgery, by the time they reach 80, according to the National Institutes of Health.

“I think that the findings that the likelihood of a motor vehicle accident is less after the first-eye surgery and also after the second-eye cataract surgery may influence individuals who are on the fence about having cataract surgery, especially on the second eye,” said Anne Coleman, a professor of ophthalmology and epidemiology at the David Geffen School of Medicine of the University of California, Los Angeles, who wasn’t involved in the study.

As individuals age, they may delay cataract surgery because they start to adapt to the reduced vision they have, Coleman said by email. Individuals who are driving, have a motor vehicle accident, and still have cataracts should consider being evaluated for cataract surgery since it may lessen the likelihood of additional motor vehicle accidents, she added.

“I don’t think we need proof that cataract surgery works. The number of cataract surgeries in the U.S. is already very high. Most people who need cataract surgery get it done,” said Dr. Alan Sugar, vice chair of ophthalmology at the University of Michigan’s W. K. Kellogg Eye Center in Ann Arbor.

The study has “confirmatory value that cataract surgery and cataract surgery in both eyes, works,” added Sugar, who also wasn’t involved in the research. “This is good,” he said in a phone interview, because insurers historically have not wanted to reimburse patients for second-eye cataract surgery.

Past research has found that cataract surgery reduces mortality, falls and the odds of hip fractures as well as car crashes. Cataract surgery has also been found to increase quality of life, the study authors write.

The majority of the study subjects were men, 70 years and older, married, and nearly 95 percent had at least one other health problem.

The authors, who did not respond to a request for comments, point out that the risk of crashes after second-eye surgeries was higher than after first-eye surgeries, but still significantly lower than before the first-eye procedures. This may have been because of overall aging of the study group, they write.

The study may influence a new trend to do both eyes the same day, Sugar said.

Source: Reuters


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Diabetes Doubles Chance of Developing Cataract

People with diabetes are twice as likely to develop cataract as the general population and the relative risk is highest in those aged between 45 and 54, according to a new study published in the journal Eye.

Researchers analysed medical records from 56,510 UK-based diabetes patients aged 40 or over and found that cataract was diagnosed at an overall rate of 20.4 per 1,000 people. This compares to a rate in the general population of 10.8 per 1,000.

Diabetics aged between 45 and 54 were considerably more likely than non-sufferers to develop cataract. Those diabetic patients aged between 45 and 49 were 4.6 times more likely to, and diabetics aged between 50 and 54 were 5.7 times more at risk than their healthy counterparts.

The study used data from the Clinical Practice Research Datalink, which covers around 7% of the UK population and is representative of the overall demographic with regard to age, sex and geographic distribution.

Cataract is one of the main causes of global sight loss. In a previous study by the Vision Loss Expert Group, it was revealed that the condition accounted for significant vision loss or blindness in 65million people worldwide.

Co-author Rupert Bourne, Professor of Ophthalmology at Anglia Ruskin University’s Vision and Eye Research Unit, said: “The report has shown that having diabetes doubles your risk of being diagnosed with a cataract, and that this risk is six times higher if a diabetic patient has significant diabetic retinal disease, called diabetic maculopathy.

“This is only the second such report on cataract incidence in the UK’s diabetic patients since the 1980s and it further emphasises the importance of the NHS Diabetic Eye Screening programme in early identification and treatment of diabetic eye disease to prevent sight loss.

“This is an interesting example of how a very large primary care dataset of electronic patient data, in this case the Clinical Practice Research Datalink, can be used to investigate risk factors for eye disease.”

Source: EurekAlert!


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