Published: 26 February 2022

We are frequently asked if it’s wise to have cataract surgery if you have Macular Degeneration. Let’s start with some background. Cataracts and Age-related Macular Degeneration (AMD) are both leading causes of visual impairment in the elderly population. Cataracts develop when the normal clear lens gets cloudy with age. This is correctable with cataract surgery, which involves replacing the cloudy lens with a clear, artificial lens. While cataracts affect the front part of the eye, AMD causes damage to the retina, which is the inner back lining of the eye. In the past, there was a concern about cataract surgery causing progression of AMD. It was thought that there was an inflammatory component to AMD and the normal inflammatory response after cataract surgery may lead to AMD progression. But studies have looked at patients who underwent cataract surgery compared to patients who didn't have cataract surgery and the progression of AMD was not significantly different between the two groups. However, those patients with AMD who underwent cataract surgery had a significant improvement in vision. AMD patients can further be characterized as having wet or dry AMD, and only those with wet AMD require treatment. Patients with wet AMD need injections to decrease the growth of new blood vessels and reduce fluid in the retina. A 2015 study showed that after cataract surgery, there was an increase in fluid in the retina of patients with wet AMD. Therefore, in patients with wet AMD, we usually want the wet AMD to be stabilized before the patient has cataract surgery. Sometimes an injection may be given prior to cataract surgery to prevent any inflammatory changes that may be associated with cataract surgery. The majority of the studies on the subject conclude that it is safe to have cataract surgery even if you have AMD and in most cases there is a significant improvement in vision. Removing the cloudy lens also helps the ophthalmologist to better monitor the status of the AMD. Article contributed by Dr. Jan Pan.

Published: 13 February 2022

Recent Census Bureau data shows a population of approximately 71 million baby boomers (the generation born from 1946-1964). What does that have to do with low vision you may ask? Approximately 40 million people worldwide have some sort of blindness, and aging increases the incidence of macular degeneration and other vision impairment that qualifies them as “low vision” persons. Low vision is a condition of the eye in which the vision falls below 20/70 in the better seeing eye. It impairs the recipients, rendering them unable to perform daily tasks that others take for granted. With this rising aging population, the awareness of low vision therapy, diagnosis, and treatments are more widely available. Low vision treatment can help people recover from decreased visual function due to retinal disease, brain injury, neurological damage, and other causes. It is not only the elderly population that is affected--approximately 20% of low vision patients are children under the age of 18. Childhood genetic disorders of the eye such as retinitis pigmentosa, albinism, Bests disease, ROP, rod/cone disorders, and glaucoma are among the causes of low vision in the pediatric population. What can be done to help these millions? There are eye care practitioners that specialize in low vision, as well as therapists. They train the patient to adjust their current lifestyles to make them more independent and utilize the current salvageable vision they do have. For example, if a person has lost their central vision due to macular degeneration, they can be trained to use their peripheral vision to accommodate for many tasks. Because patients with low vision cannot be corrected with regular eye glasses, the use of telescopes, magnifiers, computer generated aids, training, biofeedback, and optical magnification devices are among some of the resources available to help. Occupational therapists also employ orientation and mobility assistance to help patients in their daily living skills. There are many technologies that help to improve vision. One such technology is a bionic eye device that uses a pair of glasses with a camera that transmits video data to an implant in the back of that patients eye (the retina). This device uses technology similar to cochlear implants that stimulate auditory nerve signals to restore hearing. In the same way, visual impulses can be restored by stimulating neurons in the retina, brain, or optic nerve. Maybe the Bionic Man TV series wasn’t too far out there and can someday be a reality............restoring vision to millions. For more valuable information on low vision visit: National Eye Institution Prevent Blindness American Optometric Association AOA American Occupational Therapy Association AOTA American Academy of Ophthalmology AAO