New glasses might not be the answer if you find the words on a page are blurry or the glare of headlights bothers you when you drive at night.
It may be a sign of aging - cataracts.
Ophthalmologists say sooner or later, almost everyone will get them.
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(Mirror photo by Gary M. Baranec)
Thelma Holmberg has her eye checked by Dr. Todd Sponsler after her recent cataract surgery.
A cataract is the clouding of the lens inside the eye, and the only way to fix it is surgery," said Dr. Todd Sponsler, an ophthalmologist with Altoona Ophthalmology Associates, 600 Pleasant Valley Blvd.
During surgery, the clouded lens is removed and replaced with an acrylic or silicone implant known as an artificial intraocular lens.
The changes in the lenses of eyes that cause cataracts begin to occur when a person is about 55 years of age, he said. Most patients are about 70 years old when they have them removed and replaced with implants.
Surgery is usually based on two factors - the patient's ability to see and if the problem affects his or her quality of life.
"Insurance will pay for the surgery if the patient's vision is worse than 20/40 and if the surgeon can document complaints, such as the patient having trouble driving at night or having trouble reading," Sponsler said. "If the patient has no trouble with their vision, surgery is generally not necessary, as long as their vision is legal for driving which sometimes must be considered."
When a person with cataracts is ready for surgery, it is not advisable to put it off, he said.
The older one gets, the more difficult it may be to heal, he said, adding that a 60-year-old and a 90-year-old might not heal the same.
Sponsler also said that as a person ages, their health status can suddenly change and become a factor.
"If you have suffered a heart attack or a stroke, your health may not be good enough to undergo the surgery," he said.
Dr. Parag D. Parekh, an ophthalmologist with Laurel Eye Clinic, 176 Vision Drive, Duncansville, said some people can get by with vision that is worse than 20/40, while others have trouble with 20/25.
"Everyone's demands on their vision is different," he said.
The surgeon will meet and talk with the patient to determine if blurry vision is causing trouble with his or her daily activities.
Thelma Holmberg of Altoona, a patient of Sponsler, had cataract surgery on one eye two years ago and on the second eye Aug. 20.
"I had other problems, and I just put it off," she said.
"I would look at things and couldn't see clearly," Holmberg said. It was getting harder to read."
Parekh said the vast majority of the time, the surgery is performed under local anesthesia that puts the patient in a twilight mode.
"The eye is totally numb and the patient feels no pain," he said. "We administer medication to relax the patient. He is on Cloud 9, but he is awake for safety purposes."
Sponsler said it is similar to the state of a person undergoing a colonoscopy.
Doctors at Altoona Ophthalmology Associates perform surgery at Altoona Regional Surgery Center and doctors at Laurel Eye Clinic perform it at their facility - the Laurel Laser Eye Surgery Center.
"The Altoona Regional Surgery Center offers not only an outpatient setting, but is close to Altoona Hospital if medical issues arise in elderly patients," Sponsler said.
Parekh said a surgery center is safer, quicker, less costly and more convenient than a hospital operating room for the procedure. At Laurel Eye surgery center, the operating room is used exclusively for eye surgeries and the doctors, nurses and staff specialize in eye operations, he said.
"Recovery is quick and easy," Parekh said. Patients must apply eye drops for about four weeks that contain a steroid to aid in healing and an antibiotic to prevent infection.
He said patients are warned not to do any heavy lifting or bending and not to rub their eye. A shield protects the eye while they sleep.
"You can go to work the next day, watch TV or read, but no gardening or kick box aerobics - just take it easy," Parekh said.
He said one eye is done at a time with surgery scheduled for the second eye about a month later.
The procedure is quite different from years ago when patients were hospitalized for a couple of weeks with sand bags to stabilize the head and keep it from moving, Sponsler said. No implants were available, so patients had to wear thick glasses to see.
Today, implants can correct presbyopia (blurry vision when reading that occurs at about age 40) and astigmatism, Parekh said. Insurance does not cover the cost of these special implants, he said, but noted that this technological advancement was not even available 10 to 15 years ago.
For Holmberg, having her sight restored in both eyes makes it easier to create her floral arrangements that she sells at craft shows.
When the doctor removed the bandage the day after surgery, "everything was nice and clear. It was wonderful. You just can't imagine," she said.
