Wednesday, November 7, 2012

Cataracts and Cushing’s

Circumstances force me to interrupt my planned series for a short discussion on Cushies and cataracts.  I’ve been having growing problems with my sight lately and suffered from eye strain and headaches as well.  One day I noticed that when I closed one eye type on the monitor screen and in printed material simply disappeared.  I already knew I had cataracts in both eyes in the early stages and feared one of them had accelerated its development.  My fear was confirmed and my doctor wants me to have the cataract removed as soon as we can get it done while my eyes are stable.

Cataracts are a condition where the lens of the eyes becomes opaque.  As cataracts develop the patient experiences increasing difficulty seeing.  It will probably be things like not being able to read type which or an eye exam which will be the first clue that something’s wrong.  However, the cataract will eventually cause complete blindness in the eye if left untreated.

The formation of cataracts in cases of steroid treatment and exogenous Cushing’s syndrome (Cushing’s caused by medical therapy) is a well known side affect.  However, research seems to document that cataracts are not a common side effect in endogenous, or Cushing’s caused by tumors.  I didn’t find anything on it, but I imagine that cataract formation or acceleration would be a likely danger with the use of glucocortical steroids such as prednisone for the treatment of inflammation or injury with a patient who already has exposure to elevated levels of cortical steroids to begin with because of Cushing’s syndrome.  That is another reason steroids should be used with care to treat Cushies.

The treatment for advanced cataracts is removal and replacement with an artificial lens.   While reading through the brochure I was given I found out that great strides in advancement in both the surgery and the lenses have taken place since my days as a practicing nurse.  It is now possible in people with no astigmatism, or even certain cases of astigmatism to have such sight improvement after surgery that eyeglasses are no longer needed.  However, most cases of people with astigmatism will still require eyeglasses.

As with any other surgery there are risks.  According to the patient plan I was given they include cornea/retina injury, hemorrhaging, pain, blurred vision, double vision and loss of vision.  Since I’m on clotting therapy the risk of hemorrhaging is especially pronounced and I will probably have to go on a heparin bridge to reduce the likelihood of that complication.  That requires an added week before the surgery can be done.

Naturally I will not be in a position to write for awhile after the surgery and don’t know how long my recovery to the point I can resume writing will be.  But I will be back and will continue with the series I started.

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