Several years ago, at a routine eye exam, I was told I had cataracts. A cataract is any opacity in the transparency of the lens of the eye which blocks light from reaching the retina. This causes a loss of sight which can manifest as mild vision problems to partial blindness. Treatment for cataracts involves surgery to remove the affected lens and replace it with an intraocular lens implant. I was only in my mid 50s and mentioned to my ophthalmologist that I didn’t think cataracts usually became an “issue” until the late 60s or early 70s (and I was mostly basing that on it being the ages when both my parents had cataract surgery). While she agreed that cataract surgery was more commonly performed in ones late 60s and early 70s, she did tell me she did indeed sometimes do cataract surgery in people in their 50s and even people in their 40s. She told me mine did present a little early but would not be “ripe” or ready for surgery for a few more years.
Cataracts in Dogs and Cats
Most all I knew about cataracts when I was diagnosed was from what I learned about them in veterinary school. Back in 1984, in my clinical year of veterinary school, I had the privilege of getting to watch a veterinary ophthalmologist perform a cataract surgery in a dog. At the time, the veterinary college I attended was “in between” ophthalmologists and did not have a clinical ophthalmologist on staff. Neither did the college have an ophthalmologist on staff my second year of veterinary school when I took the ophthalmology academic course (which was combined with Audiology). I remember being given two sets of notes to learn and study from, so most of the course was a “learn on your own” or “do it yourself” course. One set of those notes was by Glenn A. Severin, DVM, who was recognized nationally as an expert in veterinary ophthalmology.
He taught ophthalmology for many years at Colorado State University Teaching Hospital. He was considered “the man” in veterinary ophthalmology. I was told if we covered his notes and studied them in detail, we would probably have a pretty good working knowledge of ophthalmology. My clinical year, when I rotated through ophthalmology, the college brought in a board certified veterinary ophthalmologist I believe from Atlanta, GA. She saw patients and performed surgeries in clinics once or twice a week as well as I remember. Teaching students, however, was not her forte and ophthalmology was an area that I quite frankly felt pretty weak in. But I did feel fortunate that I got to witness a cataract surgery. Most of my classmates did not get that opportunity.
We see senile (old age) cataracts in dogs a lot. Most dogs eight years of age and older have some degree of haziness or cloudiness in their lenses due to cataracts. Cataracts are also common in diabetic dogs. Cats do get cataracts but not very commonly. When they do occur in cats, they are usually due to injuries, trauma, or infection. Surgery is usually only done on animals who have a great deal of difficulty getting around.
Back in the mid 80s, when I observed the canine cataract surgery, veterinary medicine had not yet started using intraocular lens implants for cataract surgery. So the dog we did surgery on, had his entire lens removed, which contained his dense white cataract. It always amazed me that we could just go in and remove that dog’s lens. I always wondered how the dog was able to focus without a lens in his eyeball, and in all honesty, he probably didn’t focus very well. The surgery restored his vision but he lost some visual acuity because the lens was no longer present to focus light on his retina. But he did very well and saw good enough to get around even though I’m sure things were somewhat blurry for him. It never fails…. dogs always amaze me! We did an electroretinogram (ERG) on the dog prior to surgery to make sure he had adequate functioning retinas. There would be no sense in doing the cataract surgery if the retinas were damaged.
My ophthalmologist told me human medicine didn’t start implanting the intraocular lenses in humans until around 1985. Veterinary medicine lagged behind this a few years and began using lens implants in the early 1990s.
My Vision Worsens
My early cataract symptoms began as seeing haloes around headlights and street lamps at night. The haloes were white and smoky appearing at first but later became rainbow colored. Then I began seeing starbursts when I looked at lights which produced an annoying glare. When I went for my eye exam last year in 2020, my vision had significantly worsened. Things were becoming blurry, I was not able to read eye charts and it was like I was looking out of very dirty windows. My doctor said my cataracts were ready for surgery. But my husband had JUST had hip replacement surgery the week before, which had been cancelled and rescheduled a few times thanks to COVID. He still needed help and couldn’t drive and the last thing we needed was for both of us to be down and out. I was also not real thrilled at the thought of having elective surgery during the COVID pandemic so I put surgery off.
Over this past year, my vision deteriorated even more. I stopped driving at night because I could no longer read street signs and because now when I looked at headlights, I was seeing double and triple headlights. Headlight glare was overpowering and my world was much darker. My “windows” became much more smoky and hazy. Colors, especially white colors, became dingy yellow and almost a light brown color. All colors seemed faded. I also started having double vision when I read writing on the television. Also I could not see facial features in much detail on the TV or in real life. When I would look up at the moon at night, I would see 3-5 moons superimposed on each other with my left eye and a double moon with my right eye. I decided when I no longer felt safe driving during the day, that it was time to have surgery. Things were getting more and more blurry and this was particularly noticeable when my husband and I would go walking at dusk. I was missing deer and other wildlife that he was able to see. The leaves on trees were all looking blurry. One thing I had noticed I was doing was walking into a room where the lights were on, but switching the lights off and then back on. I think I was driving my husband crazy doing this and he asked me one day why I KEPT doing that? It was because my world had become so dark, that I was always thinking surely the lights could not be on. But they were on. It was definitely time for surgery!