There is no escaping it. Advancing age means diminishing eyesight. Sometime after age 40, we learn to appreciate reading glasses. But when vision becomes blurry, colors don’t seem as bright and it becomes harder to drive at night, it may mean that you are beginning to develop cataracts, the most common cause of reversible vision loss in the United States. In parts of the world where surgery is not available, cataracts are a leading cause of blindness.
To see well, light rays must enter the eye through the pupil and then focus, via the lens, into the retina, a layer of light-sensitive cells at the back of the eye. A cataract occurs when the lens becomes cloudy. When light is not able to move through a clear lens, vision is impaired.
Although there are other causes, most cataracts are the result of aging, and most develop slowly. With age, our eyes’ lenses becomes thicker, cloudier and less flexible. According to the American Academy of Ophthalmology, those between ages 52 and 70 have a 50 percent chance of developing a cataract. By age 75, that number rises to 70 percent.
In addition to age, risk factors for cataracts include diabetes, obesity, smoking, high blood pressure, excessive sunlight exposure and family history.
The good news about cataracts is that they can be corrected surgically. New developments in surgical technique and implantable lenses have made cataract surgery safer and more effective than ever.
Los Altos-based ophthalmologist David F. Chang, M.D., has written a book to help people understand cataracts and make informed decisions regarding surgery. “Cataracts: A Patient’s Guide to Treatment” (SLACK Inc., 2012) is reader-friendly, easy to understand and full of good information.
Chang begins by explaining how the eye works, how cataracts happen and how they are diagnosed. This sets the stage for the rest of the book, which focuses on surgical procedures and other choices available to patients.
One of the most important choices a cataract patient must make involves selection of an intraocular lens (IOL). Initially developed during World War II, IOLs replace the existing, cloudy lens. Current versions provide excellent vision correction, are lightweight and flexible, and are permanently fixed within the eye. There are a number of types of IOLs, including monofocal, multifocal, accommodating and turic. Chang provides a good description of each, along with careful explanation to help patients understand and select the lens that best meets their individual needs.
Also notable is a chapter discussing issues in cataract surgery involved when a patient faces special circumstances, such as glaucoma or macular degeneration. A glossary at the end of the book is quite valuable for the layperson, especially when the subject involves the use of complex words, like “phacoemulsification” or “pseudoexfoliation.”
When readers finish this book, they will be well prepared for all aspects of cataract surgery – before, during and after the procedure.
For those readers who want to delve deeper into the subject of cataract surgery, there is a clinical textbook called just that: “Cataract Surgery” (Saunders Elsevier, 2010). This is a book that doctors read during their surgical training, so it explains surgical procedure in great detail. It is not for everyone, but it would be an interesting resource for those who are able to grasp highly technical medical writing and want to know as much as possible about IOL choices and management of unique situations.
Both “Cataracts: A Patient’s Guide to Treatment” and “Cataract Surgery” can be found on the shelves at Stanford Health Library, along with other relevant books and videos. Stanford Health Library librarians offer free research assistance to answer specific questions. Trustworthy online information can be found on the Health Library’s website at healthlibrary.stanford.edu/resources/bodysystems/eye_cataract.html#cataract.
The main branch of Stanford Health Library is located in the Hoover Pavilion, 211 Quarry Road, Suite 201. Hours are 9 a.m. to 5 p.m. weekdays. Other branches are located on the main level of Stanford’s Cancer Center and in East Palo Alto at the Ravenswood Family Health Center.