Jul 17, 2008

THE EYE MAN: All cataracts not alike

By Andrew Soss / Daily News Columnist

Dr. Soss: I'm a 38-year-old man who was born with a cataract in my right eye. My parents for some reason (maybe cost) did not ask to have my cataract removed when I was younger. I never saw out of that eye, and not knowing any better, I always accepted it. But recently I went to an eye doctor to consider having the cataract removed so that I could see out of that eye. I was really surprised when he said that whether I have the cataract removed or not, I would still not be able to see out of that eye. That doesn't make any sense. I hear about people having cataract surgery all of the time. I've never heard anyone mention that their doctor told them that they would see the same whether the cataract was removed or not. What's going on here?

B.L.



B.L.,

Not all cataracts are alike; just as not all results from cataract surgery are alike. The type of cataract that you are describing is called a congenital cataract. This type of cataract, present at birth, is very obstructive to the pathway of focused light entering the eye. As a result, unless the cataract is removed at the earliest possible age, the vision associated with that eye is grossly reduced. As time passes with this obstruction, the visual pathways and areas of the brain associated with vision will not develop properly (or with many passing years; not develop at all).

As a result of waiting until you are 38 years of age to have this cataract removed, there will only be a potential cosmetic improvement. There will not be any functional improvement of the vision because the area of your brain associated with functional vision from that eye does not exist. It never had stimulus associated with vision to develop.

The people that you here about all of the time, who have cataract surgery, are people who, after many years of having good clear, crisp vision; start to develop a slow, gradual recoverable loss of vision. The reason their vision is recoverable, is because it existed in association with healthy, intact brain centers, which fully developed functional vision and visual pathways (which remained unaffected). Fortunately, in your case, you have one healthy functioning second eye. It is important for you to protect that eye with protective eyewear at all times.



Questions to Dr. Soss should be sent to his e-mail theeyedoctor@att.net or via his Web site at www.dr-andrewsoss.com. All answers and opinions are those of Dr. Soss and not necessarily shared, endorsed or affiliated with this or any of our newspaper agencies.

Dr. Andrew C. Soss, OD, FAAO, has been practicing for over 20 years. During that time he has been a clinical instructor in the department of ocular pathology at the University of California. As a primary eye care provider in private practice in Burlingame, he is also board certified in the diagnosis, treatment, and management of primary open angle glaucoma.