With some trepidation, my husband, Richard, who is 73 and otherwise healthy, finally decided it was time to have the cataract removed from his left eye, which had a visual acuity rating of worse than 20/200 (being able to read 20/20 on the eye chart is "normal").
Poor vision affected nearly everything Richard did. In anything less than perfect light, he needed a magnifying glass to read, despite prescription glasses. He could no longer drive at night — the glare was blinding and not being able to see the road clearly was terrifying. During the day on unfamiliar roads, he relied on me to read road signs, because he didn't see them soon enough to follow them.
So with encouragement from me and his 89-year-old bridge partner — who had already had cataracts removed from both eyes and was able to abandon the thick glasses he had used for distance vision and now only needs reading lenses — he decided to go ahead with the surgery.
After a preoperative health checkup and eye exam by the ophthalmologic surgeon, he entered a freestanding eye clinic at 8 one morning and walked out an hour and a half later with a "new" eye, able to walk the streets, drive and even read without glasses. The morning after surgery, the acuity in his left eye was already 20/25, and further improvement was expected as it healed.
It is nothing short of amazing. I can only hope he will soon decide to have the cataract removed from his right eye, which would result in more balanced vision. This deceptively simple surgery, which, like any operation, has its risks, can be life changing.
People who remember when cataract removal involved general anesthesia, days in the hospital, weeks immobile at home and the subsequent need to wear Coke-bottle glasses may find it hard to believe how much the operation has changed. And some may be needlessly postponing surgery as a result.
While in the past people waited until a cataract was fully "ripe" and nearly blinding before having it removed, the current recommendation is to have the surgery as soon as a cataract interferes with normal activities, including driving, watching television, climbing stairs, playing tennis, cooking and reading. In fact, the more advanced a cataract becomes, the more difficult — and risky — the surgery.
Today, cataract surgery is nearly always performed under local anesthesia as an outpatient procedure that takes less than two hours. The clouded lens that is removed is replaced with an individually fitted artificial lens that can result in near-perfect visual acuity — the ability to see distance. Or for those who prefer a correction of near vision for reading, an artificial lens can do that instead. For some people, even a multifocal lens can now be fitted, to improve both near and far vision.
But I'm getting ahead of my story. For my husband, the surgery had yet another benefit. His doctor, Mark Lebowitz of KLM Ophthalmology in Brooklyn, explained that Richard's vision was further impaired by a rather severe astigmatism, an irregularity of the cornea that resulted in an eye shaped more like a football than the basketball shape of a normal eye. This made it difficult for the eye to bring light to a point focus on the retina, no matter how good his glasses. So, at the same time that the surgeon removed the cataract, he made a small self-healing incision to reshape the cornea and correct the astigmatism.
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