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Why does everything seem a little blur?

Pank Jit Sin
27 Dec 2018
Consultant Ophthalmologist Cataract and Refractive Surgeon

We often associate decline in visual acuity to a natural progression as we grow older. While this may be true for the most part, modern medicine and knowledge is here to help us grow old more optimally and gradually.

One of the more common problems causing vision loss in those aged 40 and above is cataract. Cataract is the clouding of the eye’s natural lens due to ageing. However, some other factors can contribute to cataract, too. This includes prolonged use of corticosteroid eye drops and also steroid creams near the eye. Some are born with congenital cataract and require surgical help earlier. Diabetes, too, can lead to premature cataract formation. Additionally, trauma (injury to the eye) and high degree of short-sightedness can also contribute to cataract formation.

What happens first?
The initial sign of cataract formation is dull vision. Things that used to be intensely coloured appear to have a more washed out appearance. This is due to the opacity of the lens increasing. There is also the possibility of double vision and poor night vision. Some patients may complain about difficulty in seeing at night so they prefer to stay at home instead of going out after dark.

Cataract sufferers may also complain of glares and haloes and face sensitivity to strong light. Some associate glares and light sensitivity to astigmatism but if you’re already in your 40s and 50s, it is better to get an ophthalmologist to check out if the symptoms indicate early cataract.

With cataracts, wearing glasses, medication and supplements won’t help in the prevention or reduction of symptoms. Neither will eye drops. Be wary of “miracle eye drops” being sold online or through direct selling which claim to heal all manner of eye conditions. It is never a good idea to gamble with sight. Ultimately, surgery is the most effective way to restore vision loss caused by cataract.

Cataract procedures have come a long way since the early days of bladed surgery, with current technology allowing no-blade surgeries to be carried out with improved precision and faster recovery time. With no-blade surgeries, cuts are guided by optical coherence tomography (OCT) and the diseased lens can be removed without physically breaking it into small pieces as the lens has already been pre-softened by an ultra-low energy laser beam. 

In terms of replacement lenses, too, much improvements have been made. While we’re used to the sight of our parents or grandparents wearing thick glasses after cataract surgery, the introduction of the bifocal intermediate intraocular lens has allowed patients to be glass-free post-surgery.

The myth of mature cataract, where one is supposed to let the cataract turn fully opaque before surgery, is just that—a myth. The decision to perform cataract surgery should not be based on the cataract’s ‘maturity’ but rather necessity. If one feels the cataract is already impeding one’s way of life and interfering with daily activities, then it is time to get rid of the diseased lens before complications occur. Undergoing surgery later in life to remove cataracts comes with a higher risk of complications due to older age. In some patients, the condition may lead to glaucoma and other eye diseases. What is often overlooked is the anxiety and depression caused by poor vision.

Of course, cataract surgery is not without its risks. Every person has different risks depending on age and current health condition. Always check with your doctor or surgeon if you are suitable for surgery before going ahead with the procedure.

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