Cataract Surgery Complications

As with any surgery, cataract surgery poses risks to the individual. Potential cataract surgery complications range from minor eye inflammation to devastating vision loss. While the exact risks are specific to each individual, the most common difficulties arising after cataract surgery are as follows:

  • Infection
  • Bleeding
  • Persistent inflammation – bruising, swelling and irritation of the eye
  • Cystoid Macular Edema
  • Retinal tears or detachment
  • Dislocated Lens
  • Rupture of the Posterior Capsule
  • Dislocated lens material
  • Changes in eye pressure (intraocular pressure)
  • Astigmatism
  • Posterior Capsule Opacity
  • IFIS
  • Dry eye syndrome
  • Droopy eyelid (ptosis)

We will deal with each one of these conditions in turn, but first we need to understand the procedure itself.

 

About the Operation

The operation usually lasts around 15 to 20 minutes, and starts with the application of an anesthetic:

  • Once the anesthetic takes effect, a tiny cut is made on the surface of the eye.
  • Ultrasound energy is used to break up the cloudy lens (cataract), which is then removed through a small tube.
  • The lens sits inside a sac of thin tissue called a capsule. This is kept in place to support an artificial replacement lens (intraocular lens), which is inserted through the same cut after the cataract is removed. It’s folded to help insert it through the cut.
  • The intraocular lens unfolds once it has been positioned in the eye. The lens is made from plastic or silicone and remains permanently in your eye.

The complications that may arise from the above procedure are many and varied, and we start with the most severe.

 

Infection (Endophthalmitis)

Endophthalmitis is the most serious complication of cataract surgery and can occur after routine cases. It is a rare, but serious, postoperative infection inside of the eye and it can have a devastating consequence on a patient’s vision with some patients losing all light perception and becoming blind.

Endophthalmitis symptoms include excessive eye redness, pain, light sensitivity, and worsening vision, perhaps loss of vision. These symptoms normally manifest themselves a few days after surgery.

Diligent surgeons undertaking cataract surgery do go to great lengths to reduce the possibility of this intraocular infection. Nonetheless, even with these precautions, endophthalmitis occurs in approximately one out of 3,000 cases, although other studies have reported the incidence of endophthalmitis to be between 0.13% and 0.7%(1).

The primary source of this intraocular infection is considered to be bacteria from the patient’s cornea and conjunctiva surfaces or from the lacrimal glands, eyelids, or extraocular muscles. The bacteria most frequently isolated are mainly staphylococcus epidermidis which account for 70% of culture-positive cases, whereas staphylococcus aureus is isolated in 10% of culture-positive cases and streptococcus species in 9%. However, if an infection already exists with these bacteria and comes into contact with the surgical site, this could lead to serious visual impairment.

If a patient does develop endophthalmitis, intraocular antibiotics are often injected directly into the eye to minimize the spread of the infection. Sometimes an additional surgery (vitrectomy) is performed to remove the jelly-like substance of the eye; which is hoped will subsequently control the infection.

 

Bleeding

While bleeding can occur inside the front of the eye where the actually surgery is being performed, which is quite rare, more serious acute bleeding can occur in the choroid. This infrequent and unpredictable bleeding is known as choroidal hemorrhage.

The choroid is a delicate pattern of fine blood vessels that supplies and nourishes the retina. It usually occurs in elderly patients or patients who have high blood pressure or have glaucoma, but it is very unpredictable. In some cases of choroidal hemorrhage, the bleeding is localized, but in more severe cases of choroidal hemorrhage, visual loss can be substantial.

 

Inflammation

Since cataract surgery was first introduced, inflammation has always been accepted as a natural consequence of the procedure. Inflammation can cause light sensitivity, pain or achiness in the eyes.

In addition, bruising or a Black Eye may occur if an injection has been used around the eye to complement or replace anesthetic eye drops.

Another possible inflammatory condition is where swelling occurs in the cornea. The cornea is the transparent front part of the eye that covers the iris, pupil, and anterior chamber. Corneal edema is associated with cloudy vision, or the appearance of halos around lights, which may be transient or permanent. This condition occurs when the cornea is unable to keep itself clear, and the cornea becomes overly hydrated.

Toxic Anterior Segment Syndrome or TASS is a non-infectious inflammatory condition that may occur following cataract surgery. It is usually treated with topical corticosteroids in high dosage and frequency.

While immediately after surgery anti-inflammatory agents may be given to the patient to resolve the inflammation and to reduce patient discomfort, persistent inflammation may continue, or even worse, cystoid macular edema may develop and endanger the eye.

 

Cystoid Macular Edema

The retina is the neural tissue which lines the entire inside of the back part the eye. The very center of the retina is called the macula, which is the part of the retina that responds to light, and which is responsible for central vision.

After cataract surgery, inflammation can sometimes cause retinal blood vessels to leak fluid which accumulates in the macula, causing the nerve cells to swell and cause decreased central vision. This swelling is referred to as cystoid macular edema, and may occur weeks, months or even years after an otherwise uncomplicated surgical procedure.

 

Retinal Detachment

Cataract surgery increases the risk of retinal detachment, which should be considered a medical emergency. Retinal detachment can occur months or years after a perfectly successful cataract procedure.

Retinal detachment is a condition that occurs when a tear in the retina (caused by the surgery) allows fluid to seep through. This seepage causes the retina to then detach from the back of the eye. This problem occurs in approximately one half of one percent of cataract surgery patients.

The symptoms of retinal detachment include ‘floaters’ (little cobwebs or specks that seem to float about in the field of vision), flashing lights, shadows or dark spots, bubbles or curves in the field of vision, or the more sinister sensation of a veil being pulled across the line of vision.

When diagnosed with retinal detachment, the shorter the time to reach treatment, the better the overall prognosis.

 

Decentered or Dislocated Intraocular Lens Implant (IOL)

In some cases after cataract surgery, the artificial lens (intraocular lens) moves or does not function properly and may need to be repositioned, exchanged, or removed. Symptoms of a lens implant that has moved or become dislocated could be where the patient may report seeing the edge of the lens implant, or the patient may develop double-vision. If the intraocular lens is too badly dislocated, there could be a significant decrease in the visual acuity of the patient.

 

How can an IOL become badly positioned or dislocated?

In most cataract surgeries, the intraocular lens is placed inside the “capsular bag,” which contains the cloudy natural lens or cataract of the eye.

During cataract surgery, considerable effort is made to maintain the integrity of the capsular bag so that the intraocular lens can be positioned correctly within it. As the capsular bag is extremely thin (approximately the thickness of a single red blood cell), it can sometimes rupture or break.

Also, the capsular bag itself may become dislocated because of the weakness of the fibers that hold it in place.

If IOL dislocation occurs following cataract surgery, repositioning the lens should be done as soon as possible to avoid the lens implant becoming settled and ‘scarring’ into place.

 

Rupture or tear of the Posterior Capsule

A posterior capsular tear may be a complication that occurs during cataract surgery. The rate of posterior capsular tear among skilled surgeons is between 2% to 5%.

During the cataract surgery procedure, the cloudy lens material of the cataract is “chopped up” and suctioned to remove it from the eye. However the membrane that surrounds the lens is left in place to support the new implant. Occasionally it is possible that the posterior lens capsule will tear or rupture during this procedure.

If this occurs, surgical management may involve a procedure known as an ‘anterior vitrectomy’, which aims to remove and repair the body that fills the interior of the eyeball between the lens and the retina so that the Intraocular Lens Implant (IOL) can be properly set into position.

 

Dislocated Lens Material

Posteriorly dislocated lens material is the rare occasion where fragments of the cataract lens have fallen into the back cavity (vitreous cavity) of the eye. Often small pieces of posteriorly dislocated lens material are well tolerated by the eye without problems. However, when larger pieces are present and could cause the development of excessive inflammation, a vitrectomy may be required to remove the lens material.

 

Glaucoma – Intraocular Pressure

Glaucoma refers to a category of eye disorders often associated with a dangerous increase in internal eye pressure (intraocular pressure or IOP), which can damage the eye’s optic nerve which is the vision nerve responsible for transmitting light-generated nerve impulses from the retina to the brain. We interpret these electrical signals as vision.

If IOP remains high, (ocular hypertension) treatment options after the cataract surgery include eye drops, laser procedure, or additional surgery.

 

Astigmatism

Astigmatism is a common condition that may cause blurred vision. The distorted vision is due to the eye’s cornea or lens having an irregular shape. Cataract surgery can induce astigmatism if during the procedure it was necessary to use sutures or stitches as a result of the Corneal incision not sealing correctly. Such an event may distort the shape of the Cornea and therefore bring on astigmatism.

If swelling alone caused the astigmatism then it will gradually go away as the swelling diminishes. If the astigmatism was caused by the use of stitches, then once they are removed it is likely that the Cornea will return to its original shape.

 

Posterior Capsule Opacity (Secondary Cataracts)

One of the most common complications of cataract surgery is posterior capsule opacity (PCO), when the eye tissue that encloses the artificial lens becomes cloudy and may cause the vision of the patient to become blurred. This condition is called an after-cataract. An after-cataract can develop months or years after cataract surgery.

During cataract surgery, the surgeon removes the cloudy natural lens of the eye, i.e. the cataract and replaces it with an intraocular lens implant. When the cataract is removed, the surgeon makes every attempt to maintain the integrity of the capsule that contained the natural lens so the new lens can be placed within it. However, between 20 to 30 percent of patients who have intact posterior capsules have haziness of the capsule, so vision becomes blurry. This is because after cataract surgery, the posterior capsular cells may undergo hyperplasia and cellular migration, showing up as a thickening, opacification and a general clouding of the posterior lens capsule.

The problem can be treated with a laser procedure known as YAG laser capsulotomy. A laser removes the hazy posterior capsule from the line of sight without making an incision or “touching” the eye. The most important risk with the YAG laser capsulotomy is that the retina can become detached from the inner back of the eye.

Statistics suggest that the lifetime risk of a detached retina as a cataract surgery complication in the United States is about 1 percent. That number rises to about 2 percent after YAG laser capsulotomy.

 

Intraoperative floppy iris syndrome (IFIS)

If the male patient is taking prostate drugs to improve urine flow at the time of the cataract surgery, then there is a risk that a complication known as intraoperative floppy iris syndrome (IFIS) may develop. Higher rates of detached retinas during cataract surgery also have been associated with use of these drugs.

Typical alpha-blocker prostate drugs relax the prostate muscles to help the bladder empty. They can also affect muscles in the colored part of the eye, the iris. During cataract surgery, the eye’s pupil can suddenly constrict and thereby hinder the surgeon’s ability to successfully complete the operation, resulting in possible complications.

About 95 percent of nearly 1,000 cataract surgeons who responded to a 2008 American Society of Cataract and Refractive Surgery (ASCRS) survey said that they have indeed encountered IFIS in men taking alpha-blocker prostate drugs. The problem is complicated by the fact that most men fail to inform their eye surgeon that they are taking these alpha-blockers for prostate or other problems in the first place.

 

Dry Eye Syndrome

Dry eye disease (keratoconjunctivitis sicca) is a condition that can occur after cataract surgery. Symptoms include ocular dryness, burning, sensation of an irritant in the eye (foreign-body sensation), blurred vision that clears upon blinking, and stickiness of the eyelids (especially upon waking). Several factors known to exacerbate dry eye are present around the cataract surgery procedure itself. These include the disruption of the corneal nerves and the toxic effect of various medications used during the surgery such as antibiotics, steroids and anti-inflammatory drugs.

 

Droopy Eyelid (Ptosis)

Ptosis simply means droopy eyelid. The most common cause of ptosis in adults is the separation of the levator muscle from the eyelid. This may occur after eye surgery such as cataract surgery.

Treatment is usually surgical and involves tightening of the lifting (levator) muscle within the eyelid, with multiple procedures possible to achieve the desired outcome. Conclusion

From serious infection to the less troublesome droopy eyelid syndrome, the potential consequences of cataract surgery do make somber reading. In the extreme, a complication could lead to the complete loss of vision. That is why many people, better-informed about the risks and with greater product knowledge about the alternatives, are choosing remedial medications rather than surgery. Can-C Eye drops are one such alternative to surgery. For the first time cataracts can be treated simply by the daily use of eye drops. Specifically designed of the treatment of senile cataracts and using a unique, patented formula containing the active ingredient N-acetylcarnosine, Can-C Eye drops gently but effectively halt and then reverse the progress of cataracts.

 

References

Mamalis N, Kearsley L, Brinton E. Postoperative endophthalmitis. Curr Opin Ophthalmol 2002;13:14-18. Keywords:

  • Endophthalmitis
  • Choroidal hemorrhage
  • Cystoid Macular Edema
  • Retinal Detachment
  • Intraocular Lens Implant
  • IOL
  • Rupture of the Posterior Capsule
  • Glaucoma
  • Intraocular pressure
  • IOP
  • Astigmatism
  • Posterior Capsule Opacity
  • PCO
  • IFIS
  • Dry eye syndrome
  • Pptosis

Cataracts The Statistics

When you think of someone suffering from cataracts you probably think of an elderly person. And there’s good reason for this – if you look at the statistics concerning cataracts it’s fairly clear that cataracts and aging go hand in hand. Indeed, many people regard cataracts as an unavoidable effect of advancing age.

Before we examine the facts and figures in a little more detail, it is important to remember that there are a number of different types of cataracts and that not all forms are associated with increasing age – although, as we shall see, the majority are. In fact age and cataracts are so closely related that the most common form of cataract is usually referred to as a senile cataract. However, cataracts can develop at any stage of life – even before birth but these types of cataracts (known as congenital cataracts) are very rare indeed. For example, in 2002 only 1 baby was born alive in the United Kingdom with congenital cataracts. This equates to congenital cataracts occurring at a rate of just 0.34 per 10,000 British births.

It is also important to understand the terminology that is used when looking at statistics. When the term ‘prevalence’ of cataracts is discussed it usually refers to the estimated population of people who are managing cataracts at any given time. On the other hand, the term ‘incidence’ of cataracts refers to the annual diagnosis rate, or the number of new cases of cataracts diagnosed each year. This does mean that these two statistic types can differ. For example, a short-lived disease like seasonal flu can have high annual incidence but low prevalence, whereas a life-long chronic disease like diabetes has a low annual incidence but high prevalence. It’s important therefore when looking at statistics that the two terms are not interchanged as they are statistically different.

 

So just how common are cataracts?

Cataracts are very common. It is estimated that they affect around 60% of people over the age of 60. To put this in to some sort of context let’s look at the situation in relation to the United States.

According to “Research to Prevent Blindness” complied by the National Institute for Science Education, the prevalence of cataracts in the United States is staggering with around 5,500,000 people having a cataract interfering with their vision. This equates to a prevalence rate of approximately 1 in 49 or 2.02% of the American population. The incidence rate (i.e. the number of new cases diagnosed each year) stands at around 400,000 which means that approximately 1 in 679 or 0.15% of the population are newly diagnosed with cataracts annually. This figure can be extrapolated to 33,333 new cases per month or 7,692 per week, 1,095 per day or 45 new diagnoses per hour!

The global incidence of new cases of cataract blindness is unknown. Researchers have estimated that for India alone 3.8 million people become blind from cataracts each year(1). Worldwide the incidence figure is likely to be at least 5 million. What about the age of those suffering from cataracts?

As we’ve already mentioned cataracts and aging tend to go hand in hand. Although there are different sorts of cataracts such as congenital cataracts and cataracts that occur as a result of trauma to the eye, the majority of cataracts are aged related and are therefore usually known as senile cataracts. Not surprisingly this is reflected in the statistics with about 60 percent of Americans between the ages of 65 and 74 showing some signs of cataract.

 

This age associated trend is evident if you look at hospital episodes related to cataracts. According to Australian statistics, in 2001-02 0.4% (87) of hospital episodes in public hospitals for senile cataract occurred in females aged 35 to 44 years. By the age of 45 to 54 years this had risen to 2.33% (472) of hospital episodes and the figures for women continued as follows:

  • Age 55 to 64 years = 8.46% (1,715) of hospital episodes for senile cataract in public hospitals
  • Age 65 to 74 = 30.89% (6,259) of hospital episodes for senile cataract in public hospitals
  • Age 75 to 84 = 46.35% (2,321) of hospital episodes for senile cataract in public hospitals

 

This trend is reflected in other countries. For example according to the Department of Health in England in 2002-2003 the mean age of patients hospitalized for senile cataract was 76. And whereas 15-59 year olds accounted for only 6% of hospital consultant episodes for senile cataracts , 63% of hospital consultant episodes for senile cataract occurred in people over the age of 75.

And, of course, as people in the world live longer and as the world’s population continues to expand, the number of people with cataracts is growing. The population aged over 60 years is expected to double during the next 20 years from approximately 400 million now, to around 800 million in 2020. This increase in the elderly population will result in a greater number of people with visual loss and blindness from cataract who will need eye services.

The situation is also slightly confusing because doctors classify cataracts according to the location of the opacity, or clouding, of the lens. The most common form of senile cataract is the nuclear sclerotic cataract that affects the central part of the lens called the nucleus. Less common are cortical cataracts that generally appear as a cloudy opacity in the part of the lens called the cortex (the peripheral, or outer part, of the lens) and posterior subcapsular cataracts that develop on the back surface of the lens (directly underneath the lens caspsular bag that houses the lens).

 

How many people are blind as a result of cataracts?

Globally cataracts are the leading cause of blindness. It is estimated by bodies such as the World Health Organization that senile cataracts are responsible for around 19 million cases of blindness. But just how prevalent cataract blindness is tends to be region specific. For example in Africa and Asia, cataract accounts for nearly half of all blindness. In fact 85% of the cataract-blinded people live in the world’s poorest countries. In the wealthy developed first world nations, blindness due to cataracts does not feature quite as highly – for example in the United States, out of the 5.5 million people suffering from cataracts around 43,000 are blind as a result. Interestingly though cataracts are still the third leading cause of legal blindness in the United States.

The reason for this discrepancy is essentially an economic one. Although cataracts can be surgically removed, in many countries surgical services are inadequate barriers to surgical uptake, such as cost, lack of information, and transportation problems. For many therefore treatment is simply financially out of reach and they remain blind. In fact, globally only 10 to 20% of all cataracts are removed even though treatment can provide useful vision in 90-95% of cases.

Cataracts are also an important cause of low vision in both developed and developing countries. And just as with cataract blindness, even where surgical services are available, low vision associated with cataract is likely to still be prevalent.

 

How are cataracts usually treated?

As mentioned above, the answer to this is surgery. In fact, surgery is so ingrained as being perceived as the only treatment for cataracts, that 100% of hospital consultant episodes for senile cataract required hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03). Approximately 10 million cataract operations are performed each year in the world(2). In the United States cataract removal is one of the most commonly performed operations with over 1 million cataract extractions taking place each year.

The cost is phenomenal. In the United States in 2001 alone almost 10 million people visited a physician’s office for cataracts (National Hospital Ambulatory Medical Care Survey: 2001). The cost of cataract surgery in the U.S. is about $3,500 per eye and is usually covered by Medicare or most private health insurances. This result is that cataract surgery costs Medicare more money than any other medical procedure. How successful is cataract surgery?

There can be no denying that surgery to remove an affected lens is an effective way of treating cataracts. It is estimated that about 90 to 95 percent of people who undergo cataract surgery regain very good vision – perhaps even better vision than they had before surgery. But it is still a surgical intervention and as such carries with it inherent risks. Is there a non-surgical alternative?

 

Quite simply the answer is ‘Yes’!

Developed specifically to treat cataracts, Can-Ct Eyedrops now offer a safe non-surgical alternative to cataract surgery. Using a unique patented formula, Can-C Eyedrops gently but effectively work to halt and reverse the progress of cataracts – and all without the need for surgery.

 

References

  • Minassian DC, Mehra V. 3.8 million blinded by cataract each year. Br J Ophthalmol. 1990;74:341-43.
  • Vision 2020: The Cataract Challenge. Community Eye Health. 2000; 13(34): 17-19.

 

Acknowledgements

Can-C is a registered trademark of … and/or its affiliates

All other names and marks may be (registered) trademarks of their owners, and are used for reference or identification only.

 

Keywords

  • Cataract
  • Congenital Cataracts
  • Senile Cataracts
  • Posterior subcapsular cataract
  • Nuclear sclerotic cataract
  • Cloudy opacity

The Aging Eye

As our bodies age, change inevitably occurs. Stiff limbs, grey hair and wrinkles probably spring immediately to mind. Certainly we become stiffer and less agile and our bodies shrink and sag as they lose their youthful shapeliness as the years pass by. Unfortunately the changes that age brings have a tendency to make our bodies much more vulnerable and prone to dysfunction. And our eyes are by no means the exception to prove the rule.

For a start everybody’s vision deteriorates with age independent of any aging eye diseases. One of the main reasons for this is that it is the pupil that determines how much light actually reaches the retina (the light sensitive layer of tissue at the back of the eye upon which images are focused on – it’s the retina’s job to then convert these images in to electric signals and to send them to the brain via the optic nerve). Unfortunately, the extent to which the pupil is able to dilate decreases with age and the inevitable consequence of this is that older eyes receive much less light at the retina. The statistics are pretty stark. The light adapted eye of a 20 year old receives six times more light than that of an 80 year old. In dark adapted conditions, the 20 year old eye receives about 16 times more light. In other words, for an older person, it’s a like wearing medium-density sunglasses in bright light and extremely dark glasses in dim light.

For most of us, increasing age also brings with it the need to use reading glasses – even if you’ve never had to wear glasses before. This decline in vision is usually due to a condition known as presbyopia which refers to the eye’s increasingly inability to focus on near objects. Although no-one really knows what the exact mechanisms at play are that result in presbyopia, research strongly points to it arising from a decline in the elasticity of lens. A loss of power in the muscles that bend and straighten the lens (the ciliary muscles) might also be responsible.

Aging also brings with it a dramatic slowing in dark adaptation. Color vision changes cause a reduction in the ability to discriminate blues and blue-greens. The aging lens and cornea also cause glare by light scattering and aberrations of the cornea increase with age. All of this leads to poor vision especially when the pupil dilates in the dark.

Perhaps the most irritating aspect of aging and the impact that it has on our vision as we grow older is the fact that our eyes just don’t seem to work as well as they did when we were younger. It all becomes a bit more of an effort, requiring us to concentrate harder and the need for higher levels of illumination just to reach the same perceptual levels as we did when we were young.

And that’s just the effect of the normal aging process quite apart from the age related diseases that can develop. We have, of course, already mentioned presbyopia but there are a number of other disease conditions that can affect the aging eye. And, although, here we are concentrating mainly on cataracts, it would be remiss to not at least mention these other conditions namely glaucoma, age-related macular degeneration (ARMD) and dry eye syndrome.

Glaucoma is a condition that affects the optic nerve – the large nerve that carries electrical signals from the retina to the brain. The optic nerve is therefore crucial for vision – without it we could not see. If someone is suffering from glaucoma, their optic nerve is damaged and their ability to see becomes increasingly affected. At first peripheral vision is gradually destroyed, then central vision. If nothing is done total blindness will eventually result. The optic nerve damage that happens when someone is suffering from glaucoma usually results from higher than normal intraocular pressure (pressure within the eye itself). Although incurable, it can be well managed by the use of eyedrops that effectively lower intraocular pressure.

In fact there is evidence that Can-C eye-drops can help alleviate the intra ocular pressure associated with glaucoma. Inside the eye is the Schlemm canal which acts as a valve passing waste products out into the blood and also acting in its own right as a pressure valve too. Over time the canal gets somewhat blocked with cross-linked proteins, otherwise known as glycated end products, impaired materials that need to be disposed of.

It is know that Can-C eye-drops help to prevent the formation of cross linked proteins and to aid their disposal. Thus from the anecdotal evidence of users who have seen reductions in their intra ocular eye-pressure, thus alleviating their glaucoma, it is assumed that Can-C is helping to literally unclog the Schell canal.

Age -related macular degeneration is a condition that affects the central part of the retina known as the macula. Blood vessels under the retina leak blood and fluid, damaging retinal cells and causing blind spots in central vision. Age related macular degeneration affects vision in the opposite way to glaucoma in that it is central vision that is affected first with peripheral vision being left intact. There are two types of age related macular degeneration known as wet and dry forms. The dry form is the early stage of the disease and will lead to the wet form in about 10% of cases which results in more severe vision loss. Age related macular degeneration is the most common cause of irreversible vision loss in the developed world. It is a very common condition. For example in the US approximately 11% of the US population aged 65 to 74 are affected by the condition.

There has been a remarkable development and clinical evidence that a products known as MZS can help significantly reverse age-related macular degeneration. For more information about this please click here.

Dry Eye Syndrome is an uncomfortable chronic condition that affects more women than men usually beginning in mid life. It is caused by a problem with tear production. We deal with this in more detail at (put in link here …)

But perhaps one of the most well known age related eye conditions is senile cataract. A cataract is defined as a cloudiness or opacity within the lens of the eye. The lens itself is a transparent, biconvex structure that, along with the cornea, helps to refract light so that it focuses on the retina and provides us with a clear, sharp image. By changing shape, the lens is able to change the focal distance of the eye so that we are able to focus on objects at various distances. This process is known as accommodation.

In a healthy eye the lens is transparent which allows light to pass easily through it. It is crucial for good vision and any loss of this transparency will produce less optimal vision. If the lens starts to become cloudy (in other word a cataract begins to develop) light does not pass easily through it and the result is that the image that reaches the retina becomes fuzzy and dull. The effect is a bit like looking through frosted glass or looking from behind a ‘waterfall’. In fact, the literal meaning of the word ‘cataract’ is waterfall. It should be stressed that a cataract is not a ‘new’ growth in the lens. Cataracts are defined as any cloudiness or opacity in the lens of the eye and the term ‘cataract’ simply means that the lens is not completely transparent any more.

 

There are several different types of cataracts and they are generally classified by two different criteria – location in the lens and origin. When classified by location types of cataract include:

  • Nuclear Sclerotic Cataract – This is the most common type of cataract that develops as a result of the aging process. A nuclear sclerotic cataract produces a gradual yellow cloudiness and hardening of the nucleus, or central portion, of the lens. The result is a gradual deterioration in vision
  • Cortical Cataract – Whereas a nuclear sclerotic cataract is located in the central part of the lens, a cortical cataract clouds the periphery of the lens, called the cortex. Cortical cataracts generally look like wheel spokes which point inward towards the nucleus of the lens. The effect of a cortical cataract is that light scatters when it hits the spokes
  • Posterior Subcapsular Cataract – This type of cataract occurs on the back of the lens, below the capsular bag which encases the lens, typically starting near the center of the back part of the capsular bag. If you suffer from this type of cataract you are most likely to experience light sensitivity, blurry near vision, and glare and halos. Posterior subcapsular cataracts most commonly develop in people who suffer from diabetes or who have taken steroids for a prolonged time period

 

Cataracts are also classified depending upon their origin i.e. the manner in which they develop. Classifications include:

  • Age-Related Cataract – This is the most common type of cataract. Although senile cataracts can develop in your 40s and 50s they are far more likely to become an issue when you reach your 60s and 70s. They are very common indeed and it is estimated that they affect around 60% of people over the age of 60
  • Secondary Cataract – This type of cataract develops secondary to some other problem – such as a result of undergoing eye surgery. Diabetics and steroid users are also prone to developing secondary cataracts Traumatic Cataract – A traumatic injury to the eye can result in cataracts developing. Such a cataract may not form immediately after the injury, but may develop years later
  • Congenital Cataract – Although rare, some children are born with cataracts. This type of cataract is referred to as a congenital cataract
  • Radiation Cataract – This type of cataract develops as a result of exposure to certain types of radiation, particularly ultraviolet light. Radiation cataracts are very rare

 

It’s clear then from looking at the above list that there are a number of risk factors that significantly increase your chances of developing cataracts. For example, being diabetic, using steroids, and having received an eye injury all increase your risk of suffering from cataracts. Some risks are, of course, totally unavoidable – for example more women than men develop cataracts, as do people who suffer from myopia (short sightedness) and people with brown irises. Other risk factors such as smoking and sunlight exposure are within your control.

But by far and above the greatest risk for developing cataracts is aging. Cataracts appear to develop as a result of changes in the arrangement of the proteins in the lens. Normally these are laid out in such a way that the lens is kept transparent but as we age, the protein structures can alter and opacities form as proteins start to clump together. The result is, of course, that some of the light entering the eye is no longer able to pass through the lens and reach the retina which leads to the distortion in vision. Unfortunately, no one really knows what causes these changes happen. However, it does appear to be part and parcel of the normal process of aging which is why cataracts are so common among the older population.

At first the changes in the eye that lead to opacities developing may not be discernable. Early cataracts are so microscopically small that although they do block a tiny amount of light it simply doesn’t affect what you are seeing. And as cataracts do not cause pain or redness you may not realize that you have a problem. In fact cataracts can begin many years before they actually affect your vision although for some people they develop more quickly. Cataracts also usually form in both eyes but may develop more quickly in one eye than the other.

Gradually though your vision will be affected as it becomes increasingly blurry. Glare in low-light conditions can also be problematic which can particularly affect your ability to drive at night. You may also experience other problems such as reduced color vision. Remarkably some people actually experience an initial improvement in their vision (a phenomena known as second sight) although this is only temporary and gradually vision will deteriorate.

Once your cataracts have been diagnosed and the issues with your vision are becoming problematic, your ophthalmologist will probably advise you that you require surgery as the only way to treat your condition.

But surgery is now no longer the only option available to you. Thanks to remarkable developments in the treatment of cataracts, Can-C Eye drops now offer a ground breaking alternative to surgery. For the first time cataracts can be treated simply by the daily use of eye drops. Specifically designed of the treatment of senile cataracts and using a unique, patented formula containing the active ingredient N-acetylcarnosine, Can-C Eye drops gently but effectively halt and can even reverse the progress of cataracts.

And the results are evident incredibly quickly. Even after just 1 month of treatment, the effects of Can-C carnosine eye drops are clearly visible – breaking down the damaged proteins that cause the cataracts.

What’s more, by combining the use of Can-C Eyedrops with Can-C Plus capsules you can make your treatment regime even more effective. Can-C Plus is a nutritional supplement that actively improves the environment in the eye, making it even more receptive to Can-C Eyedrops.

So even though growing old is unavoidable and brings with it increased risks of developing cataracts, Can-C Eyedrops at last mean that surgery is no longer the inevitable conclusion you must reach. By allowing you to take control of your condition, you can now turn back the hands of time and what was once thought of as just being part and parcel of growing old, can now be treated gently and effectively, without the need for any invasive procedures at all.

Dry Eye Syndrome

If your eyes persistently feel dry and you suffer from any or all of the following:

  • A gritty/scratchy, or filmy feeling in your eyes
  • Itchy eyes
  • Red eyes
  • A burning sensation in your eyes
  • A feeling of having a foreign body in your eyes
  • Blurred vision
  • Being sensitive to light

Then the chances are you have dry eye syndrome. And you aren’t alone. Dry eye syndrome, a disorder of the tear film, is incredibly common affecting a significant percentage of the population, especially those older than 40. In fact it’s estimated that around 25-30 million people in the United States alone are affected with dry eye syndrome, with a similar incidence rate worldwide. And whilst dry eye syndrome might not discriminate between races, it is more common in women than men.

 

What is dry eye syndrome?

Tears are essential when it comes to keeping our eyes healthy. Not only do tears help to keep our eyes feeling comfortable by flushing out unwanted dust and debris, they also play a vital role in providing us with optimal vision and protection against microorganisms that inhabit our eyes. Tears are able to achieve this because they contain enzymes that work to neutralize these microorganisms.

 

The tear film itself is made up of three main layers:

  • The top, most superficial layer is in fact a very thin layer of lipids that are produced by the meibomian glands and by oil glands in the eyelids known as the glands of Zeis. The lipid layer is important because it helps to decrease the amount of tear evaporation from the aqueous layer beneath it
  • Sandwiched in the middle is the aqueous layer. This is the thickest of the three layers and is essentially composed of a very dilute saltwater solution. The aqueous layer is produced by the lacrimal glands found under the upper eyelids and the accessory tear glands. The role of this layer is to keep the eye comfortable and moist and wash away any dust etc that might get into the eye
  • The innermost layer, a layer of mucus, is the thinnest of the three. It is produced by the conjunctiva – the clear skin that lines the eye – and its function is to spread the aqueous layer evenly over the eye

Defects within any of these layers can result in a chronic lack of sufficient lubrication and moisture on the surface of the eye – in other words dry eye syndrome.

The medical term for dry eye syndrome is keratitis sicca or, if referring to defects within the aqueous layer, keratoconjunctivitis sicca or KCS.

 

What causes dry eye syndrome?

The most common causes of dry eye syndrome are related to defects within the aqueous layer. Put simply, the lacrimal glands or associated glands near the eye either (a) fail to produce enough tears or (b) the tears that are produced have a chemical composition that means that they evaporate too quickly. Tears may also evaporate too quickly if there are defects within the top layer of lipids if, for example, the meibomian glands are not functioning properly.

 

There are number of other reasons why dry eye syndrome occurs. These include:

  • Poor tear production as part of the natural aging process
  • As a symptom of systemic diseases such as lupus or rheumatoid arthritis
  • Incomplete closure of the eyelids – interestingly the increased popularity of cosmetic eyelid surgery or blepharoplasty can lead to incomplete eyelid closure which in turn may cause dry eye syndrome. If the eyelids cannot be closed, the eyes may dry out because of tear evaporation. Certain conditions such as stroke may also make it difficult for you to close your eyes on your own – and again your eyes may become dry from tear evaporation
  • Oil glands becoming blocked or oil being produced that is too thick both of which can lead to an insufficient amount of oil to cover the aqueous layer to prevent its evaporation
  • Infections along the eyelids or the eyelashes such as blepharitis. The bacteria that cause the infection also breakdown the oils in the top tear layer. This can result in too little oil and too much tear evaporation
  • A deficiency of the tear-producing glands
  • Some medications, such as antidepressants, certain blood pressure medications, antihistamines and oral contraceptives may decrease tear production
  • Hormonal changes particularly during the menopause (which may be why dry eye syndrome is more common in women than men)
  • Abnormal mucus production – this can lead to the poor spread of tears over the eye which can lead to the surface of the eye drying out and even becoming damaged, even though more than enough watery tears may be present
  • The long-term use of contact lenses – a very common complaint amongst contact lens wearers Smoking – research indicate that smoking certainly increases your chances of developing dry eye syndrome

 

Can external factors affect dry eye syndrome?

The symptoms of dry eye syndrome can certainly be exacerbated by a number of external factors. For example when you read, watch TV, sit in front of your computer for long periods of time or in fact perform any task that requires close attention with your eyes, you may not blink as often. If you do not blink as often, excessive evaporation of your tears occurs. Symptoms also appear to worsen if your eyes are tired eyes or towards the end of the day.

Where you live may also have a direct effect upon your condition. If you live somewhere where there is more moisture in the air, your tears will evaporate more slowly, which in turn keeps your eyes more comfortable. Conversely, dry and dusty climates, windy conditions, higher temperatures, and low humidity all seem to take their toll on the sufferer. In fact, in the United States, the National Women’s Health Resource Center reports that Texan cities such as El Paso, Midland, Dallas and Fort Worth dominate when it comes to dry eye hot spots. This data was derived from the National Oceanic and Atmospheric Administration’s Climatic Data Center and the Environmental Protection Agency.

But it’s not just outside the home or office that can affect your eyes. If you spend your time inside but in air conditioning or where there is a dry heating system, your eyes can quickly dry out.

 

Can watery eyes be a symptom of dry eye syndrome?

On the face of it this might sound ridiculous and contradictory, but sometimes dry eye syndrome can lead to watery eyes. When your eye becomes slightly dry and irritated, it may initiate a reflex action that causes large amounts of tears to be produced all at once. The eyes do this to try and make themselves feel comfortable again.

The problem is that your eyes can only cope with a certain volume of tears at any one time, so if too many tears are produced all at the same time, the excess tears simply pour out your eyes and down your cheeks. These excessive tears do not of course help your dry eyes at all as they are completely wasted as they fall down your cheeks. Once the excessive tearing reflex action finishes, your eyes will simply become dry and irritated and the whole cycle may begin again.

 

What’s the prognosis if you suffer from dry eye syndrome?

Although incurable, dry eye syndrome isn’t usually too much of a problem for the sufferer – more of an irritating inconvenience than a threat to vision. Certainly, it can be annoying and can make some daily activities such as watching the TV, driving, reading or using the computer for any period of time uncomfortable and much less pleasurable but it’s unlikely to lead to any actual loss of vision.

For the small minority of people who experience severe dry eye syndrome, the outlook is bleaker. Excessive drying out of the surface of the eye may result in an increased risk of serious infections. Ultimately, scarring, thinning, and even perforation of the cornea may occur. As a result, vision, or even the eye itself, may be permanently lost – but is should be stressed that this would only occur in a small minority of cases where dry eye syndrome is severe.

 

What can you do to help alleviate the condition?

There are a number of things that you can do to try and ease your condition. You could for example:

  • Use a humidifier to pump moisture into the air
  • Turn down the speed of ceiling and/or oscillating fans because excessive air movement can dry out your eyes
  • Use air filters where necessary. Large amounts of dust or other particles in the air can worsen the symptoms of dry eye. Filters can help to remove these aggravating elements from the air around you
  • Avoid rubbing your eyes too much
  • If you suffer from dry eye syndrome as a result of meibomian gland dysfunction, rosacea, or blepharitis, you might find hot compresses and eyelid scrubs/massages with baby shampoo useful
  • Use lubricating eyedrops – and this is where Can-Ct Eyedrops really come into their own and can be particularly useful

 

Can-C Eyedrops and dry eye syndrome.

With their unique, gentle but effective anti-oxidant formula Can-C Eyedrops have not only been proven to halt and even reverse the progress of senile cataracts, but they can also help to successfully alleviate the symptoms of dry eye syndrome.

Containing N-acetylcarnosine, a natural and powerful anti-oxidant form of the dipeptide amino acid carnosine, Can-C Eyedrops help to successfully restore the eyes’ natural balance to their former healthy state. In doing so they are able to provide daily relief to dry eye syndrome sufferers by providing the extra lubrication that is needed to help keep eyes moist and comfortable. Add to this the fact that Can-C Eyedrops are safe to use with contact lenses and are not weighed down by reports of negative side effects, it’s easy to see why they are, without a doubt, the most effective dry eye solution currently available.

What’s more, there is growing evidence that the n-acetylcarnosine in Can-C helps to unblock proteins, proteins that can accumulate in the lacrimal ducts causing blockages- like a clogged drain! Thus Can-C helps to reduce these blockages and allow more tears to travel down the duct and onto the eye, thus alleviating the dry eye syndrome itself!

This is remarkable in itself and we have had many reports from Can-C users that once they have used the drops consistently for 3-5 months that their eyes appear to have more natural lubrication themselves.

Thus Can-C eye-drops provide the only two step approach to dry eye treatment, firstly they coat the eye in lubricants that help immediately alleviate the dry-eye problem and secondly, they can work ‘in the background’ to help improve the eye’s natural lubricant production.

 

Conclusion

Dry eye syndrome is a common condition that while annoying to the sufferer, typically does not seriously threaten your eyesight. However, severe dry eye syndrome can lead to vision loss in the most extreme of cases.

While the remedies for dry eye syndrome are typically practical in nature, many people are now choosing the simple solution of applying the Can-C eyedrops. They offer the great advantage of delivering extra lubrication to keep the eyes moist, even for contact lens wearers.

 

Acknowledgements

Can-C is a registered trademark of International Antiaging Systems and is approved and patented by Innovative Vision Products.

All other names and marks may be (registered) trademarks of their owners, and are used for reference or identification only.

 

Keywords

  • Dry Eye Syndrome
  • Tear glans
  • Tear ducts
  • Tearducts
  • Meibomian glands
  • Lacrimal glands
  • Keratitis sicca
  • Keratoconjunctivitis sicca
  • KCS
  • Blepharoplasty
  • Blepharitis
  • Can-C
  • CanC