Help is at hand

[Andrew MacLean]

I attended the clinic today and saw Dr Ramaesh. He is well. I think I may have walked past James in the corridor, in which case, my apology.

The sight in my right eye (grafted December 2003) has deteriorated very rapidly (really just since the end of last month), and I am now virtually blind in that eye again. My left eye (now ten weeks post graft) has not yet recovered to the point where I have useful distance sight in it, although I do have good reading vision in that eye.

Dr Ramaesh will take out the cataract from my right eye. He expects the surgery to be within six weeks, and I have a regular appointment for his clinic again at the beginning of May. By then I should have had the cataract surgery, and recovered to the point where my sight is tollerably good in the right eye. Meantime my left eye should be improving all the time, although I think there is a cataract lurking in there, too.

Andrew

[Pat A]

Andrew
Sorry to hear that you need cataract surgery now - but having had cataract surgery myself in August 2006 if there is anything I can help you with, rather than the other way round, please feel free to ask! If it is the cataract causing your current loss of sight you should notice an almost instant improvement. Even though surgery didn't resolve my problem (which was the multiple images that KC gives) I was still able to see more clearly within an hour of the op and colours are much more vivid than they were!

Have you discussed the type of lens your surgeon will give you? I had the choice of curing my short sightedness or being able to read without glasses but needing specs for distance. I chose the former, which, with hindsight, was possibly the wrong choice for me becuase the surgery worsened my KC (at that time undiagnosed) and so reading is now very difficult for me as reading glasses don't of course help with KC. But I believe there are some new "multi focal" lenses now available - I'd push for those if you can.

Anyway, do shout if I can help.

Pat

[jayuk]

Andrew

Is the graft failing in the eye or is it the cataract thats causing the vision loss?

J

[Andrew MacLean]

Pat

Thanks for the offer of advice. It is always welcome! I have not got to the point of talking about types of intraocular lens yet, but I will when I see the surgeon at the pre-theatre appointment.

Jay

The Cataract seems to be of the Posterior Subcapsular variety, and it is affecting my sight in two ways.

1 It is pushing my grafed cornea forward so that it is both tipping forward and flattening.

2 It is blocking the light, and causing it to scatter.

Dr Ramaesh is confident that removing the cataract will give me good sight again. He is just a little puzzled by the rapidity with which my sight deteriorated.

Andrew

(added later) I found an abstract Abstract

[james mckinlay]

andrew i thought thats was you in the corridor i have virtually no sight in the left eye and only caught a glimpse of you.

if i had realised sooner that it was you i would have stopped and spoken to you.

im sorry you are not having a good time at the moment.

just keep fighting as it is easy to lose focus but when the grafts do settle down the vision you can get it is incredible.

once again im sorry i didnt notice you quicker.

all the best keep us posted

james

[Val G]

Sorry to hear of your problems Andrew. I hope to hear of some improvements in the not too distant future.

[Andrew MacLean]

James

Without a good eye between us, it is no surprise that we can miss each other in the hospital.

Actually I have a funny story about that. When I first lost my sight, before my first graft, I had to find a clinic. I found my way to the outpatients department, but did not know which line to join.

I just stood in the first one and waited for my turn. I asked if I was in the correct line and the clerk said, look at the sign.

"What sign"

"that sign"

"Oh but the problem is that I am here because I can't see"

The poor clerk was so embarrassed. She nearly came across the counter to help me find a seat!

Andrew

Thanks to everybody for kind messages. I shall keep you posted.

A

[Andrew MacLean]

Pat

Can I ask what sory of cataract you had? Dr Ramaesh told me that mine was a Poserior Subcapsular Cataract. It is known that this can be induced by the topic use of corticosteroids (eyedrops). I think that this was his way of telling me that he had a hand in the growth, just as he will have a hand in the removal of this problem.

On researching the matter I have found that there are several different sorts of cataract. Although I do not seem to have any of the main three, they are:

1 Nuclear cataract is the most common type of cataract, and is related to the aging process. The nucleus gradually hardens and becomes opaque, causing difficulty identifying colors and seeing at a distance.

2 Cortical cataract is the next most common type, often affecting people who have diabetes. Wedge-shaped opacities develop in the cortex, interfering with the passage of light. This can result in problems with glare and loss of contrast, as well as difficulty with distance and near vision.

3 Subcapsular cataract develops under the back of the capsule or elastic covering of the lens and is common in people with diabetes or high myopia, adults with retinitis pigmentosa, and in people taking cortisone. This type of cataract can cause glare sensitivity and blur.

The other one that I may have to look out for in future is the Posterior Capsular Cataract, which can grow after the initial cataract has been removed. I'll worry about that another day.

Andrew

[Pat A]

Andrew
Mine was a Cortical cataract I understand. Apparently it is this particular type of cataract that frequently - although not always - causes monocular double vision, which is why I guess my KC went undiagnosed initially. I still have the cortical cataract in my right eye, which Moorfields advise should be left well alone at the moment as it is not too advanced and is not the cause of my multiple image vision. I too have been warned about the possibility of Posterior Capsular Cataract developing later but I understand that this is very easily treated with laser, so I'm not worrying about that at the moment anyway! It is actually when the lens capsule covering becomes opaque following cataract surgery - the laser just makes a small hole in the lens capsule and vision is restored.
My understanding is that the posterior subcapsular cataract is a common type of cataract at the back of the lens (cortical affect the sides, and nuclear the middle) - there are lots of websites explaining the different types and possible causes. But basically the majority are I'm afraid down to the ageing process, although can be triggerred or exacerbated by other factors eg use of corticosteroids eyedrops as in your case. Mine are apparently common to people with diabetes - and although I have many symptoms of diabetes, I actually am not sufferring from it! I've been tested so many times I've lost count and it's always negative!

Hope that's helpful. Do shout if I can help further.

Pat

[Andrew MacLean]

Pat, thanks for that. I'm having to run pretty fast to get up to speed so that I'll have an idea what to ask when I go back to see the surgeon.

I had no idea that cataracts came in such variety! The most frequently observed: Nuclear cataract , Cortical cataract (yours) and Subcapsular cataract . Then the less frequent Posterior Capsular and Posterior Subcapsular.

Neither did I have any idea that these different sorts of cataract had different causes and called for different treatment. Still, I have always enjoyed playing catch-up. thanks for your help: I have no doubt that I'll be back!

Andrew