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How do I get more information?
The biomedical definition of a cataract is a clouding
of the eye’s lens that can cause vision problems. The most common type is
related to aging. More than half of all Americans age 65 and older have a
cataract. By far, the leading cause of blindness
among adults in the Philippines is cataract, accounting for around 400,000
cases.
In the early stages, stronger lighting and eyeglasses may lessen vision
problems caused by cataracts. At a certain point, however, surgery may be
needed to improve vision. Today, cataract surgery is safe and very effective.
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Cataracts are a clouding in the lens of the eye.
This anatomical misconception is everywhere. As a resident, I have seen this
at the outpatient department of the PGH, as a practicing consultant, patients
would see me in clinic at the Asian Hospital with the same concern. It seems
that economic class is not a determinant for proper eye anatomical knowledge.
Pterygium, an actinic overgrowth of conjunctival tissue unto the cornea, has
always been mistaken for cataracts. One sees this often from people who have
been alerted by their neighbors and/or friends to the presence of developing
“cataracts” that allegedly need to be scraped, “kailangan nang kayurin ang
katarata.” Corneal ulcers have been mistaken for cataracts. This is common
with soft contact lens (SCL) wearers who do not practice responsible use of
these lenses. Recurrent non-removal of SCL during sleeping time decreases the
oxygen diffusion into the cornea. This relative anoxia causes epithelial
breakdown which leads to corneal ulcers. Corneal ulcers decrease vision,
causes eye redness, tearing, pain, whitish opacification of the surface and
damage to the integrity of the eye. I often see these patients in clinic
panicking that they have developed a cataract overnight. I also often hear
patients coming in saying that there is a “film” on their eye. This “film”
really is nothing but the blurring of vision that is related to the “cloudy”
decrease in vision (blur) because of the developing cataractous lens.
Related to the misconception of clouding at the
surface of the eye is the misconception that cataracts can be removed from the
surface of the eye with a laser (also see Myth 2). In fact, because the
cloudy lens is inside the eye, it cannot be removed with a laser. From talking
at length to literally hundreds of cataract patients, I have found that many
of them confuse cataract surgery with LASIK surgery, which is performed with a
laser. However, the goal of LASIK surgery is to reshape the cornea, which is
the surface of the eye. By changing the light-bending power of the cornea
through LASIK surgery, the eye can compensate for nearsighted or farsighted
vision. LASIK surgery does not, however, repair cataracts. There is a
cataract-related procedure that utilizes a YAG laser (see Myth 3).
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Cataracts cannot be removed with a laser. The
cloudy lens must be removed through a surgical incision. However, after
cataract surgery, a membrane within the eye may become cloudy. This membrane
can be opened with laser surgery. I cannot really blame the patient who enters
my clinic door asking for “modern laser” cataract surgery. “Dok, yung
kapitbahay ko ni-laser, gusto ko laser-in mo ang katarata ko.” Unscrupulous
ophthalmologists let them hear what they want to hear. These eyeMDs are either
too busy to explain or are downright “cheats”. There is no marketable laser
technology to remove cataracts currently. It is actually with the use of an
ultrasonic handpiece combined with a suction and irrigation system that does
the job via a microincision. The Dodick laser photolysis cataract removal
system, however approved by the FDA last year, has yet to be marketed in a
widespread fashion because of its inefficiency. Other lasers are used
routinely to treat different abnormal conditions of the eye, among them
glaucoma, macular degeneration and diabetic retinopathy.
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Several patients have seen me in clinic saying
“bumalik ang katarata ko!” This is in fact not true. What happened was a
secondary or “after” cataract occurred. This occurs when the original lens
capsule that holds the new lens implant becomes cloudy. This cloudiness
decreases visual acuity and increases glare. Using a YAG laser, the eye
surgeon makes a tiny opening in the capsule, which allows light to enter the
lens once again. The treatment is quick and painless and is performed in the
office of your eye surgeon.
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“Every patient who enters my clinic expects to
come out with a prescription for a medication.” This has been stated by
mentors time and time again. Of course I never believed this, only to find out
that it was true. This is probably the reason why so many patients patronize
“anti-cataract” eye drops. Oftentimes I would see a patient managed by a more
senior eyeMD and they would wave around their bottle of anti-cataract eye
drops. Although this so-called "anti-cataract" eyedrops from reputable
pharmaceutical companies are available in drugstores (not wanting are herbal
remedies or "cleansing diets" for cataract treatment), there is still no
convincing evidence that medical therapy works to reverse the process of
cataract progression. The only scientifically proven method of treating
cataracts is surgery. Even though the evidence is slim at best, the strength
of folk and popular pressure is strong.
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“Doc, hinog na po ang katarata ko!” or “Hindi pa
po hinog ang katarata ko, kaya pahingi na lang po ng anti-cataract drops.” How
often does one hear this? I’d say often enough. With modern cataract surgery,
a cataract does not have to ripen before it is removed. When a cataract
prevents you from doing the things you like or need to do, consider having it
removed. It is often difficult to convince a patient that visual disability is
an indication for cataract removal. The practice of the old days still prove
strong today.
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“Dok, tatangalin ba ang mata ko pag tinangal mo
ang aking katarata?” The eye cannot be transplanted. It is connected to the
brain via the optic nerve, which cannot be reconnected once it is severed. The
cornea — the clear front part of the eye — can be transplanted. Surgeons often
use plastic intraocular lens implants (IOL's) to replace natural lenses
removed during cataract surgery. vi
Patients have this misconception
that a cataract is like a spare part that you can remove and replace with a
new one. They also sometimes think that the entire globe is removed and
replaced with a new globe. This is probably strengthened by fictional shows
like the Minority Report of Tom Cruise where you see an eye being replaced by
another in order to change his retinal imprint (good movie, though).
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“Ha? May katarata na po ako, eh bata pa ako ha!,”
says a 35-year old poorly controlled diabetic female. “Hindi po ba sa mga
matatanda lang yan?” While a cataract is common among older individuals, a
form of cataract can occur in young adults or children as well. Also, anyone
who has diabetes or has suffered from an eye trauma early in life is at a
higher risk of developing cataracts at a younger age.
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“Naku po! May katarata po si lola. Matanda na po
siya, hindi na niya kayang maoperahan!” Each year, more than 1.35 million
people undergo cataract surgery with relatively few complications. The
patient's ophthalmologist will discuss the potential risks prior to surgery.
Patients should remember that statistically, cataract surgery is among the
safest and most successful surgical procedures performed in the world today.
The traumatic imprint brought about by the difficult surgeries experienced by
our grandparents during the 70s and earlier, still hold true today.
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“Hindi po ba bawal yumuko, bawal maligo, bawal
gamitin ang mata, pagkatapos ng operasyon?” These are among the numerous DON’Ts that everybody believes should be followed to the letter once they
undergo cataract surgery. Again, this may be related to the “old school”
management performed during the time of large incision, multiple stitches,
Extracapsular cataract extraction or Intracapusular cataract extraction.
Nowadays, in most cases, patients often can see well enough to resume normal
activities a few days after having cataract surgery. Additional vision
improvement can continue over the following weeks and months. However, if you
also have additional eye problems, such as glaucoma, your recovery time might
take longer.
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“Dok, hindi ba hindi ko na kailangan ng salamin
pagkatapos ng pag-laser ng aking katarata?” Since the implanted lens is
computed for distance vision, most people will require glasses for near vision
after cataract surgery. I have several patients who seem to have “selective
memory” regarding the need for reading glasses after cataract surgery. They
forget that we have included this in our preoperative discussion.
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There are numerous other myths out there
regarding cataract. These less common myths include: Cataracts are contagious;
Cataracts are made worse by close work such as reading, sewing, watching movies,
or looking at television; Cataracts are related to cancer.
Ophthalmologists, together with the Philippine
Academy of Ophthalmology are hand-in-hand in its crusade to educate the layman,
health care providers and different institutions about the myths and facts
regarding cataracts. Several support groups are assisting in disseminating
valuable information to crush the entrenched falsely based beliefs and
practices. We are currently equipped with pamphlets, posters, websites, which
disclose all of this vital information. The provider ophthalmologist is in the
most central role as educators of each and every patient who enters his clinic.
It is a captured moment to extend the proper information to each individual. The
task is gargantuan to say the least, but only with a valid persistent attempt
can one truly hope to achieve proper education of the masses.
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References
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Ophthalmic Consultants Philippines Co. Cataract, 06
December 2004, <http://www.Cataract.com.ph> (27 December 2004).
-
Resources for the Blind. Blindness in the
Philippines, <http://www.blind.org.ph/blind_phil.html> (27 December
2004).
-
Webnox Corp. Meaning of Myth, 27 December
2004. <http://www.hyperdictionary.com/dictionary/myth> (27 December 2004).
-
Cayuga Medical Center. Myths About Cataract
Surgery, 27 December 2004 <http://www.cayugamed.org/articles/read.dbm?ID=267>
(27 December 2004).
-
Ophthalmic Consultants Philippines Co. Pterygium, 6 December 2004 <http://www.eye.com.ph/pterygium.htm> (27
December 2004).
-
Vista Laser Eye Center. Myths and Facts,
27 December 2004. <http://www.vista.com.my/cataract/overview_myths.htm:> (27
December 2004).
-
Ophthalmic Hyperguide. Cold phaco for brunescent
cataracts, <http://www.ophthalmic.hyperguides.com/default.asp?section=/tutorials/cataract/cold_phaco/tutorial.asp>
(27 December 2004).
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American Eye Center. Cataract, 27
December 2004 <http://www.eyecenter.com.ph/humaneye/cataract.asp> (27
December 2004).
-
Twentieth Century Fox. Minority Report, <http://www.minorityreport.com>
(27 December 2004).
-
Prevent Blindness America. Myths and Facts
About Cataract, 27 December 2004 <http://www.pearlevision.com/webapp/wcs/stores/servlet/PearleVision/StoreContent/popup/cataracts_myths.jsp?langId=-1&catalogId=10001&storeId=10001>
(27 December 2004).
-
Prevent Blindness America. Myths and Facts
About Cataract, 27 December 2004 <http://www.pearlevision.com/webapp/wcs/stores/servlet/PearleVision/StoreContent/popup/cataracts_myths.jsp?langId=-1&catalogId=10001&storeId=10001>
(27 December 2004).
-
Prevent Blindness America. Myths and Facts
About Cataract, 27 December 2004 <http://www.pearlevision.com/webapp/wcs/stores/servlet/PearleVision/StoreContent/popup/cataracts_myths.jsp?langId=-1&catalogId=10001&storeId=10001>
(27 December 2004).
-
Kelogg Eye Center. Cataract: Definitions,
Symptoms and Treatment, 27 December 2004 <http://www.kellogg.umich.edu/patientcare/conditions/cataract.html>
(27 December 2004).
-
Eye Care For You, Inc. Cataract Surgery,
27 December 2004 <http://www.eyecareforyou.com/ECFYCatSurgery.htm> (27
December 2004).
-
Helman Cecil G. Culture, Health and Illness. 4th
ed. (Reed Educational and Professional Publishing Ltd 2000) 136-137.
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There are several ways of reaching the ophthalmologists of EYE REPUBLIC Ophthalmology Clinic:
Hover note: Please place your mouse cursor over the red box
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ONLINE ACCESS
WEBSITES.
http://www.EyeRepublic.com.ph - EYE REPUBLIC
Ophthalmology Clinic
http://www.OCP.com.ph - Ophthalmic
Consultants Philippines Co. -
http://www.LASIK.com.ph - Refractive
Surgery Resource
http://www.Cataract.com.ph - Cataract Surgery Resource
http://www.Eye.com.ph - Eye
Information Online
http://www.EyeDoc4Kids.com.ph - Eye Information for Kids
http://www.Retina.com.ph - Retina
Surgery Resource
http://www.Glaucoma.com.ph - Glaucoma
Online
http://www.Uveitis.com.ph - Uveitis Online
EMAIL. After writing down your comments,
suggestions, problems and/or questions, kindly tell us how
to get in touch with you by providing your name, email,
home/office numbers, and mobile phone.
General inquiries - help@EyeRepublic.com.ph
Refractive Surgery Service - refractive.surgery@EyeRepublic.com.ph
Glaucoma Service - glaucoma@EyeRepublic.com.ph
Cataract Service - cataract@EyeRepublic.com.ph
Doctors - eyemd@EyeRepublic.com.ph
Administrative - president@EyeRepublic.com.ph
Website - webmaster@EyeRepublic.com.ph
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BLOG. Send us your comments.
EYE REPUBLIC
Ophthalmology Atlas
CLINIC INFORMATION
Mobile E-Yellow Pages. Via
SMS, text LUK4 EYEREPUBLIC
(send to 2851 for Globe and Sun Cellular, and 2951 for Smart). |
EYE REPUBLIC Ophthalmology Clinic
Manila
3/F Don Santiago Building Units 309-310
1344 Taft Avenue, Ermita
Manila, 1000 Philippines
Direct and Fax: (632) 536-2398
Trunk Line: (632) 523-8271 to 79 local 30
Mobile: (63917) 899-2020
Map and directions
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EYE REPUBLIC
Ophthalmology Clinic
Asian Hospital
and Medical Center
5/F Medical Office
Building (MOB) Suite 509
2205 Civic Drive,
Filinvest, Alabang
Muntinlupa City,
1781 Philippines
Direct:
(632) 771-9253
Direct and Fax:
(632) 771-9254
Mobile: (63917) 795-2020
Map and Directions
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EYE REPUBLIC Ophthalmology Clinic
Medical City
6/F Medical Arts Tower Inc (MATI) Suite 602
MERALCO Compound, Ortigas Avenue
Pasig City, 1604, Philippines
Direct and Fax: (632) 632-7846
Mobile: (63917) 537-2020
Map and directions
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EYE REPUBLIC
Ophthalmology Clinic
St. Luke's
Medical Center
6/F
Cathedral Heights Building Complex (CHBC)
North Tower Suite 614
279 E. Rodriguez
Sr. Boulevard
Quezon City, 1102
Philippines
Direct and Fax:
(632) 407-3883
Mobile: (63917) 855-2020
Map and directions
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CLINIC HOURS
First-Come, First-Served
Monday to Saturday 9:00 AM to 6:00 PM
All clinics are closed on Sundays and Holidays
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CATARACT
MYTHS information compiled by
Dr. Manolette R.
Roque and initially uploaded on May 1, 2005.
Last updated on
September 14, 2007.
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