Cataracts - in younger person

moneyistooshorttomention

Ah - so the Torik type is the dearer one then. Didnt realise it's down to the particular prescription the person has. I know my friend is very shortsighted indeed. Dont think she has astigmatism (I think I would have remembered if she'd said she had that - as I have it myself - though no-one can tell).

I listened to that radio programme and it rather confirmed my suspicion that the fact she doesnt seem to wear sunglasses ever (I've never seen her in a pair yet) hasnt helped and may be one reason she has them pretty early. She's very conscious of just how much her lenses cost anyway to have these special "look normal" ones - whereas someone with a more normal (ie less costly) prescription can "ring the changes" with multiple pairs of glasses including reactolite ones and prescription sunglasses to protect our eyes.

teddysmum

I had mine diagnosed just over two years ago with no progress since and my optician says they are, in fact, not even as bad as she originally thought.


I think they may well be genetic as my grandmother had them and was completely blind by her mid sixties, my mother died in her fifties, so we'll never know about her situation but I am 68,had them at 66, but not at 65 (have annual sight and retinopathy tests).


I'm very surprised about needing GA for younger people because of sensitivity, as I am very precious about my eyes,( hating even water splashing into them, having to give up on contacts , unable to bear self-applying eyedrops and after feeling very nauseous after an intensive investigation of a large floater), so asked both to my optician and the hospital specialist (as well as an internet friend who had one cataract done last year) about a GA when my time comes.


Both professionals said that GA was not an option, especially for older people, as it is, even though small, a risk being taken. The friend had also asked about GA for herself and was told the same.


I can't imagine why a younger person's eyes would be more sensitive, as mine have always been that way and people's tissues become more fragile with age.


Being aware of what is being done, terrifies me , but the friend said she felt nothing and was ready to have the other done, as the result is so good.


Ops are being done later to cut the number done ,hence cost, but my optician said that doing them later makes no difference to the outcome. I certainly don't want mine done early, especially as they are not affecting me

wondercollie

The doctors in my hospital offer valium or Ativan as a mild sedative before applying the freezing drops.

GA's hike the price of the procedure considerably due to the length of stay post op to meet legal requirements. An overnight stay is costly as there are meals to be provided, doses of medication usually taken at home to be given and the fact that a bed is lost to someone who really doesn't need it.

moneyistooshorttomention

I guess this is where the risks of general anaesthetic need weighing up - by the patient themselves. It's up to the patient themselves to decide whether they are willing to take any risks involved. What would those risks amount to?

wondercollie

moneyistooshorttomention wrote: »

I guess this is where the risks of general anaesthetic need weighing up - by the patient themselves. It's up to the patient themselves to decide whether they are willing to take any risks involved. What would those risks amount to?

No, it's not up to the patient to decide.

Let's see, death is the first thing that comes to mind. Multiple comorbities raises the risk considerably.

Not everyone from follows instructions and tells the truth. Going under a GA with a full stomach? Aspiration.

And yes, we did have a patient die during a retinal surgery under a GA. Elderly, diabetic with high blood pressure deemed fit for surgery by his GP. His heart just gave out.

My father was deemed unfit for a GA for prostate surgery due to his lung cancer. It was done under a spinal anaesthetic. The doctors didn't want to put a terminallybill man at risk.

So a GA for a routine 10 minute per eye procedure is risky

moneyistooshorttomention

Personally - I do think its the patients decision.

But risk of death is something my friend wouldnt find acceptable. So - yep...I can see she will want it herself under local then.

Admitted I went ahead and had a general anaesthetic (for an operation that could have been done under local) years back and didnt admit to having a cold (which I gather was inadvisable from my pov). So I do know patients lie sometimes. I might have got it wrong - but thought at the time that the risk amounted to dying (rather than waking up ill) and I wasnt the slightest bit bothered if I'd died - so I lied and went ahead. The risk of waking up ill would have deterred me though.

powerful_Rogue

wondercollie wrote: »

The doctors in my hospital offer valium or Ativan as a mild sedative before applying the freezing drops.

GA's hike the price of the procedure considerably due to the length of stay post op to meet legal requirements. An overnight stay is costly as there are meals to be provided, doses of medication usually taken at home to be given and the fact that a bed is lost to someone who really doesn't need it.

My cataract surgery was at 9am and I was out at 12.30

Once I'd woken from the GA - They gave me a ham sandwich and a cup of tea and I had to wait for 1 hour so they could make sure I was ok, then discharged.

Only medication I was given was the usual eye drops they give everyone to take home after the op.

GlasweJen

I thought I was opening a post to read about congenital cataracts in a young adult by the title.

The fact is most people have cataracts in their 60s, I have early opacities and I'm 31. It's completely normal. This generation of 60 year olds generally tend to have been rubbish at looking after their eyes, foreign holidays in high UV areas with no sun glasses, smoking from a young age, rubbish diet with nowhere near enough green veg.

Yes the NHS will wait until the cataract is causing the vision to drop. If the patient is struggling in dim light then turning on a lamp will help, you don't just jump into surgery! Usually surgery isn't scheduled until the eye is no longer meeting driving standards.

As for the mono vs multifocal issue, the NHS will fix the clinical problem. The problem is that the lens is too cloudy to give good vision and a new lens will fix this. The surgeon will usually calculate it so that the patient will have no prescription after the surgery for distance but you will need reading glasses. Multifocal lenses in theory will fix both distance and near but don't get amazing reviews so why would the NHS fit them? It's not going to kill your friend to have to get a pair of reading glasses.

Oh and a lot of surgeons will refuse a general for cataracts meaning the waiting list will be longer even when your friends cataract is at the stage of being done, the list for local will be much shorter and she will be out of the hospital a lot quicker afterwards.

moneyistooshorttomention

I would say both my friend and I were under the impression that only the elderly got cataracts - ie people in their 80s for instance.

At the earliest the young elderly (actual fact young elderly - ie in their 70s) - not clinical definition young elderly (ie that is apparently in late middle age as we are).

I've not come across anyone, to my knowledge, with cataracts under 70 before now - hence "younger person".

As stated, my friend isnt a "fighter" by nature - and so I expect she'll go for what the NHS wants her to go for - ie local anaesthetic. This is an "attraction of opposites" friendship LOL.

elsien

moneyistooshorttomention wrote: »

As stated, my friend isnt a "fighter" by nature - and so I expect she'll go for what the NHS wants her to go for - ie local anaesthetic. T.

The NHS isn't going to pay for someone to have a more risky GA when it's clinically not necessary, and why should they? It's nothing to do with being a "fighter" or not, it's what is most appropriate and cost effective for the patient.
If she wants more choices then she has the option to pay for the privilege.