Search for tag: "cataracts"
There used to be just one operation for treating cataracts but those days are gone. Today, there are a lot of options, and you can choose what’s best for you. Eye surgeon Dr. William Barlow…
August 26th, 2015
Announcer: We're your daily dose of science, conversation, medicine. This is The Scope, University of Utah Health Sciences Radio.
Interviewer: It's The Scope Health Sciences Radio, broadcasting live at Be Well Utah in South Jordan. It's the South Jordan Family Fair and we're learning all sorts of great things about health and right now we're going to learn a little something about the eyes and cataracts. Doctor Barlow, I don't know what your first name is. William.
Dr. Barlow: William.
Interviewer: Dr. William Barlow is an Ophthalmologist at Moran Eye Center. And we're going to talk about cataracts. And if I understand correctly, many years ago, there weren't a lot of options. There was just kind of one thing you did, but that's changed now.
Dr. Barlow: That has. So, back in the day, cataracts, you'd have surgery, remove the cataract, and then a few weeks later you'd get your glasses prescription. Doctors loved it because it was simple, it was easy, and you didn't have to spend a lot of time educating patients. You just said, "You've got a cataract, you need cataract surgery," we do cataract surgery, and then they come and get their glasses. Today, we have a lot of technology, a lot of different options available to patients. So some patients may choose to have cataract surgery and have their glasses updated after surgery, but other patients that would like to be spectacle independent or to be free of or less dependent on glasses, there are lots of surgical options available to them, different lens technologies that are available.
Patients do have a lot of astigmatism and we have beautiful toric lenses that help to correct that. Patients who are interested in seeing well at distance and up close, if they have a healthy eye other than the cataract they can have what's called a multifocal lens. It's almost like a bifocal inside the eye that allows them to see distance and up close comfortably without glasses.
Interviewer: Wow, really? A bifocal inside the eye, is that annoying? Because from what I understand, one eye is corrected one way and the other eye is corrected the other way, right?
Dr. Barlow: So that's monovision, that's the concept you're talking about, which can be done with cataract surgery. People who have done that with contact lenses are usually very good candidates for that where you have one eye, your dominant eye typically, targeted for distance vision, and then the non-dominant is a mild nearsightedness to allow you to see up close. The multifocal lens allows you to do that with both eyes together, provides you with a little bit better quality vision up close, relative to monovision, but both are very good options.
The bifocal idea is slightly different than what you would think of when you think of a bifocal, a lined lens, with one part for distance and one part for near. It's a, what we call, a diffractive pattern so it has little rings that separate the light into two focus points simultaneously, and the brain chooses the image based on where you're looking. So when you're looking a distance one image is going to be in better, sharper focus. The brain will focus on that. Or if you're looking at things up close, the brain will choose the image that's in better focus for that. So you've got those two focus points. It works very well.
There have been several iterations of this technology. The most recent iterations have been demonstrated to be very effective without causing a lot of problems that were noted with the original lens technology with this multifocal concept where that had a lot of glare and halo effect with bright light sources That has been reduced significantly with adjustments to those patterns that are used in the lens.
Interviewer: It sounds like whatever you thought you knew a few years ago, probably you don't know anymore and should really talk to an expert like yourself.
Dr. Barlow: Yeah, it continues to change. The technology is ever advancing. Lots of different areas in the world, obviously in different aspects but certainly with ophthalmology, no difference.
Interviewer: And when a patient comes in, you start talking, "All right. Here are your options," I mean it's very personalizable, depending on what a person wants, right? Like what their lifestyle is, do you ask a lot of those types of questions before making a decision?
Dr. Barlow: Absolutely, you want to ask about what they like to do, are they outdoors oriented, do they do a lot of mountain biking, climbing, hiking, golfing? Do they do a lot of computer work, do they do a lot of reading, do they do a lot of sewing, whatever it is, where is their world located
Interviewer: It's a different procedure, yeah.
Dr. Barlow: Where do we want to target their vision and vision quality? And it's not just lens technology that's available. There are different technologies that help in terms of doing this surgery. So a femtosecond laser that helps to do steps with the surgery, can do it more precisely than any of us can do as a surgeon and we're pretty good surgeons, but the laser's just more accurate. It's just the reality. So these different technologies are being introduced that help us to make the surgery potentially more accurate, more safe, so it's an exciting time for us.
Interviewer: What's on the horizon? I mean, you're talking about all the things that have changed just recently. Is there anything on the horizon that you can talk about? Now that I've got an expert here, I'd love to hear about it.
Dr. Barlow: So on the horizon, lens technologies, there's discussion of a lens that can be placed in the eye and then we can use different types of light to adjust it and set it, if you will. So if we're slightly off with the prescription one way or the other we can use that light to adjust it.
Dr. Barlow: There are certainly concepts or ideas about lenses that are flexible inside the eye. So our natural lens when we're young, the reason we're able to see a distance and then look at things up close is that we can flex and change the shape of the lens, so people are looking at that, softer materials, different things. These are still very primitive in terms of where we're at, but that's where we're going, that's where we're headed to try and recreate the natural lens. We lose the ability to see things up close and we start to develop cataracts related to these lens changes. Can we maybe be able to do surgery at a younger age at some point to correct those issues?
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Advancements in the treatment of cataracts tailor the procedure to better fit individual patients. Dr. Craig Chaya from the Moran Eye Center talks about how these options can improve quality of life.…
July 24th, 2014
Interviewer: If you have cataracts today, it could be a whole different treatment plan than it was 15 or 20 years ago. We'll examine that next on "The Scope".
Announcer: Medical news and research from University Utah physicians and specialists you can use for a happier and healthier life. You are listening to "The Scope".
Interviewer: It used to be there was one way to treat a cataract. Now there are a lot of different ways and it's actually very personalizable. We're going to find out more about that with Dr. Craig Chaya right now from the Moran Eye Center. Let's talk about some of the treatment options for cataracts because it used to be real simple. There was one thing that could be done. Now there are a lot of things. There are a lot of treatment options somebody might want to consider.
Dr. Craig Chaya: Right. For example, there are a lot of patients with cataracts that actually suffer from astigmatism as well. Astigmatism is a curvature issue with the cornea and often times that needs to be corrected in order for patients to have their best vision. Some of those options include glasses after cataract surgery or sometimes we can do some certain types of incisions that we can make on the cornea to make it more round and spherical, more regular shaped.
Interviewer: So actually while you're in there doing the surgery you might be able to do fix some of that other vision as well.
Dr. Craig Chaya: Correct. And now we've got these great lenses that not only reduce or eliminate the cataracts, but also help to reduce astigmatism at the same time, almost a two for one. And that really for the patient helps to reduce the dependence on glasses.
Interviewer: Yeah, so that's one treatment option. What are some of the other treatment options?
Dr. Craig Chaya: Some of the other treatment options are there are certain types of lenses that allow people to see both far away and up close without having to use glasses, really giving people independence from glasses and helping patients to be able to be more youthful so to speak in order to be able to enjoy their life, and not be so dependent on needing glasses for certain tasks. So those lenses are what we call multifocal lenses and those can be a benefit for the certain type of patient that's really motivated to want to get out of their glasses, and they are willing to accept that.
Interviewer: So kind of like bifocal lenses.
Dr. Craig Chaya: Correct, yeah.
Dr. Craig Chaya: We would call them multifocal lenses with this certain type of technology, so that's another advancement in technology that has been beneficial for many patients. Another one would be being able to just customize where we would put a lens. I can think of one patient particularly that loves to read in bed. And that person didn't want to have to read with glasses in bed. So for that particular patient I chose a lens that allowed that patient to see clearly while reading and then that person decided to have glasses to be able to see far away. So that choice was really an individual decision that I could not make for that person without having . . . hear them tell me what their hobbies were, what their expectations were before and after surgery.
Interviewer: So it sounds like you ask a lot of those types of questions now to make sure that it fits their lifestyle.
Dr. Craig Chaya: I think it's important. You have to, I think. Otherwise, patients are . . . You put them in a possibility of being disappointed after a cataract surgery and I've had some. And part of that has stirred me to be more informative preoperatively to ask patients, "What is it that you're expecting after cataract surgery? What is it that you desire with the lenses afterwards? And what are your hobbies? What are some things that you like to do? Ultimately many patients say, "Doctor, help me choose. I'm not sure what to do." But I think this conversation needs to take place ahead of time in order to be able to choose the appropriate lens for a patient.
Interviewer: So are there any other considerations when it comes to cataract procedures that somebody should be aware of?
Dr. Craig Chaya: Yes, in the several years there has been a new advancement in technology. Traditionally we've taken cataracts out by using ultrasound technology by breaking lens up into small pieces and then vacuuming it out, but now we have the assistance of using lasers. Lasers allow us to be a little bit more precise or actually a lot more precise than we can by our own hands. And lasers have been employed in cataract surgery to help soften the lens to make it easier to remove. So what would normally be a very difficult lens to remove in very challenging circumstances, laser cataract surgery may help us to make those changes and do those surgeries, and make them more routine and safer for the patient.
Interviewer: Yeah, a lot more safe.
Dr. Craig Chaya: Yeah.
Interviewer: What else is on the horizon that you're excited about?
Dr. Craig Chaya: Well, the Holy Grail is a lens that has excellent vision, both at the near and at far, and we're still waiting for that lens. We don't have one that has really met all the different criteria for an excellent lens that can focus up close and far away with no decrement and quality of vision.
Interviewer: Yeah, that's a challenge I'd imagine.
Dr. Craig Chaya: Yeah, and people are working hard at it. It is truly the Holy Grail of cataract surgery, so I think we're getting a lot closer than we were ten years ago though.
Interviewer: I don't know. I think the Holy Grail would be the Steve Austin bionic eye. I think that would be pretty neat.
Dr. Craig Chaya: X-ray vision, that would maybe be the next Holy Grail.
Interviewer: Yeah, do you have any final thoughts for somebody that's facing some cataract surgery? I think you gave some great points of consider what your hobbies are, consider what your lifestyle is. Anything else?
Dr. Craig Chaya: I think it's important for anybody that's undergoing cataract surgery or about to undergo cataract surgery to have a really deep conversation with their doctor to let them know what their expectations are because sometimes in a busy practice it may go unnoticed, or it maybe an issue where a doctor may assume that a patient wants a certain type of lens. But I think it's important for patients to know that there are options now. It's not a one size fits all. We really want to try to tailor make this cataract surgery for the individual.
Announcer: We're your daily dose of science, conversation, medicine. This is "The Scope", University of Utah Health Sciences Radio.
Once daunting and scary, cataract surgery is now performed routinely and safely. Dr. Craig Chaya of the Moran Eye Center talks cataract facts. He discusses the causes, effects, prevention and…
July 10th, 2014
Interviewer: Cataracts, what do you need to know? We're going to talk about the basics of cataracts next on The Scope.
Intro: Medical news and research from University Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.
Interviewer: We're with Dr. Craig Chaya. He's with the Moran Eye Center. Talking about cataracts today, we're going to cover a little bit of ground here in case you're kind of curious as to what they are, what kind of damage they can cause and what solutions are out there right now. Thank you Dr. Chaya, I appreciate your time.
Dr. Chaya: Thank you, Scott. I appreciate it.
Interviewer: First of all, let's talk about cataracts. What is, on the very basic level, a cataract?
Dr. Chaya: The cataract is basically when the lens, the natural lens of the eye, becomes cloudy and it no longer can focus light properly and it tends to scatter light and that's what leads to the blurry vision that often people complain about with cataracts.
Interviewer: Like Vaseline on a camera lens maybe?
Dr. Chaya: Or fog...
Dr. Chaya: ...looking through a smoke screen.
Dr. Chaya: Those are common symptoms that people describe.
Interviewer: And what causes that?
Dr. Chaya: What happens is the lens which is normally very clear and as it ages or it undergoes certain changes that promote the development of a cataract certain proteins develop in the eye and accumulate in the eye that cause it to become cloudy and it's no longer able to maintain that transparency.
Interviewer: Yeah, do we know why that happens?
Dr. Chaya: Yeah, mainly these proteins accumulate. Oxidative damage occurs in the lens. There are certain medications that can sometimes cause acceleration of cloudiness...
Dr. Chaya: ...of the lens and basically that's the bottom line is the cloudiness, whether it comes from different pathways or it's trauma or inflammation or just age related changes, the lens, the end all is that it gets cloudy.
Interviewer: So, is there anything that I can do to prevent them if they're going to happen to me?
Dr. Chaya: Yeah, you know there's a lot of things that you can do to prevent cataracts. Most of the cataracts that we see are age related cataracts and those age related cataracts are often due to a variety of things but the main top risk factors include things like excessive UV light exposure, excessive sunlight exposure, also certain medications like steroids can promote the development of earlier cataracts. Trauma is another one that could lead to cataract development.
Interviewer: Like what kind of trauma?
Dr. Chaya: Eye trauma...
Dr. Chaya: ...of any kind, whether it be hobbies related or sports related...
Interviewer: Oh, okay...
Dr. Chaya: ...accidents...
Interviewer: ...some assault to the eye of some sort.
Dr. Chaya: That's correct. Direct blows to the eye, that concussive nature of the energy can go back and disrupt the lens fibers and cause clouding of the lens.
Interviewer: Alright, so it sounds like wear some eye protection if you're really concerned.
Dr. Chaya: Definitely.
Interviewer: Uh, maybe wear sunglasses.
Dr. Chaya: Yes.
Interviewer: But, uh, don't get freaked out about the sun because it's, is it a real major problem?
Dr. Chaya: You know, in this part of the world we have such great tools, great technology to be able to address cataracts. The great news about cataracts that I think we should really highlight is that it's reversible.
Dr. Chaya: Yeah, we can actually take the cataract out, put a new artificial lens in there and really restore people's vision back.
Interviewer: And I've heard that as far as getting something that that's one of the best things you can get because your eyesight is going to be fantastic.
Dr. Chaya: Often times, patients after surgery are really amazed at the level of quality vision that they can see with, with the new lens.
Dr. Chaya: And we like to call it high definition vision after the surgery and people are just dramatically, their vision is dramatically improved and their perception of colors is often one thing that they really vividly describe to us.
Interviewer: And from what I understand, this surgery is not that bad.
Dr. Chaya: You know what; it's come a long way. Maybe thirty years ago patients were admitted to the hospital for a week, they had sandbags over their eyes. They really couldn't move around very much.
Dr. Chaya: And now it's outpatient surgery and most of the time the surgery's done under 30 minutes. Patients don't have to be put to sleep and the recovery is very quick.
Interviewer: Wow, that's crazy, so like two, three day recovery and you're seeing clearly, more clearly than you had in years probably?
Dr. Chaya: Yeah, many patients describe the next day saying "Wow, this really has made a difference."
Interviewer: So, is there anything that could go terribly wrong if I have cataracts and I'm not taking care of them, if I don't come in for treatment?
Dr. Chaya: Well, you know cataracts are going to cause blurring of your vision and also are going to decrease your ability to see in certain contrast levels, especially at night. Patients often complain about not being able to see the lines at night or not being able to see street signs until they get close. So, from a safety standpoint, definitely, having cataracts can impair your driving skills. Another common one is balance. You need good vision to be able to stay balanced.
Dr. Chaya: And so, it's been demonstrated that removing cataracts can actually help decrease the risk for hip fractures, for example, in elderly patients.
Interviewer: Wow, and those are terrible when that happens.
Dr. Chaya: Yes, definitely. So, I think improving vision overall, reversing the cataracts and improving people's vision, can help keep people safe.
Dr. Chaya: Yeah.
Interviewer: I just want to be clear on one thing though, if you can't convince Grandma that she needs to go get the operation for a couple of years, her eyes aren't going to suffer anymore are they?
Dr. Chaya: No, cataracts are really not an emergency.
Dr. Chaya: It's very unusual circumstances where cataracts actually become an emergency where it's important to get this cataract out sooner rather than later.
Interviewer: Alright, any final thoughts on the topic of cataracts?
Dr. Chaya: Cataracts, I think, it's really important to understand that removing the lens, the lens is responsible for about one third of why you see clearly, the cornea is another important one, so sometimes patients after cataract surgery they may not see as well as they'd like to and there are other reasons, but certainly cataracts are a major important reason why people don't see well in their older years.
Interviewer: But safe surgery...
Dr. Chaya: Safe surgery.
Interviewer: ...good surgery.
Dr. Chaya: Good outcomes, generally people, over 90% of patients, are very happy after cataract surgery and really the lowest complication rate of most surgeries that we have in medicine.
Outro: We're your daily dose of science, conversation, medicine; this is The Scope, University of Utah's Health Science's radio.