Age-related cataract prevalent but treatable

Age-related cataract is prevalent in the Philippines and in most other countries but it is highly treatable unlike most other eye diseases whose damage can be permanent and irreversible. There are, however, rare cases of congenital cataract.

Dr. Pik Sha Chan-Uy, a cataract specialist practicing at the two-year-old Asian Eye Institute, a modern eye care center located in Rockwell, Makati City, said the bulk of eye diseases being treated at AEI involves cataract.

She is the first clinical fellow to complete training in pediatric ophthalmology and adult strabismus under Dr. Nathalie Azar of the Harvard Medical School.

When detected and treated early, cataract can even be removed with the simple use of special eye drops or even dilution, which would be less costly for patients suffering from it.

There are two ways of extracting cataract, namely phacoemulsification and the traditional ECCE (extra capsule cataract extraction).

Phacoemulsification, commonly used at AEI, is nothing but breaking the cataract on the lens into pieces and vacuuming these pieces through the tip of a needle that is attached to a big machine that suctions the cataract and lens out. This way, a smaller incision is required.

At AEI, 99.5 percent of cataract cases are surgically treated with phacoemulsification, she said.

Once extracted, the lens is immediately replaced with an artificial lens so that soon after the local anesthesia wears out, the patient can readily see with a perfect 20/20 vision, she said.

The implanted lens does not dissolve in time and when correctly placed inside the eye, normally lasts a lifetime. Its power can be calculated in a way to change a patient’s need for glasses after surgery, Uy said.

Another surgical method, widely done in the old days, is the ECCE, which requires cutting up and practically scraping off the lens, thus requiring stitches after surgery. This procedure is very painful, tedious and lasts very long. Usually, the patient is confined in a hospital for as long as the stitches stay.

In the past, patients were also made to wear glasses with thick lens to be able to see once more. But this is now replaced by the implanted plastic lens.

Nowadays, both procedures require the immediate implant of the plastic lens, she added.

Phacoemulsification is painless, fast and can be done in outpatient surgeries, while ECCE, which is manually scraping the cataract, is painful and produces lots of stitches that require the patient’s confinement and extra care.

But while cataract is age-sensitive, many can acquire them at a young age. "Some get it much earlier, and others later," she said.

Aside from age, other causes of cataract are trauma (when the eye is hit during a ballgame or when a child’s eye is hit by sharp pointed objects) and inflammation of the eye.

Uy said she once had a pregnant mother who was struck with German measles during pregnancy and when her child reached his fourth month, he got stricken with cataract.

"For so long as the cataract is not accompanied by any other eye disease, it is treatable permanently and the damage done to the eye is reversible," she said.

Uy’s experience in cataract surgery involves both adults and children. She finds it doubly difficult treating kids since they are restless and apprehensive.

"I have to play with them first and talk to them so that I win their confidence. But once I do that, everything runs smoothly," she said.

A regular annual eye check-up can go a long way in preventing cataract from getting worse, she said. "Often, Filipinos see an ophthalmologist only when they have symptoms of losing their eyes to diseases," she said.

Sometimes, she said, people with 20/20 vision won’t know they have cataract unless they see an expert with the proper technical tools to conduct such tests.