What are diabetes cataracts?

Cataracts are cloudy areas of the eye lens (located in the front of the eye) that do not allow enough light to pass through to the retina (located in the back of the eye) for the image to be recorded by sensors attached to the retina.  This is analogous to a dusty lens on a camera, and causes a diabetes patient's vision to appear cloudy.

Cataracts don't just develop in diabetics.  People who do not have diabetes may develop cataracts through normal aging or because of physical injury to the front of the eye.  Sometimes cataracts can be congenital at birth.

After going through two laser surgeries to stop blood from leaking into each eye near the retina, and two vitrectomy operations to remove blood and scar tissue from the vitreous gel (the clear fluid gel in the white center portion of each eye) that was putting too much pressure on each retina located in the back of the eye, my loved one's vision miraculously improved from 20-500 to 20-30! 

This was great news, but not the end of it.  Even after these four procedures to treat her diabetic Retinopathy, she still had blurry vision due to cataracts in both eyes.

Her retina specialist recommended cataract surgery to correct the remaining cloudiness or blurriness. He also needed to be able to see the retina located at the back of the eye during future eye exams, so the cataracts had to be removed.   We went to a cataract surgeon in Tampa, Florida, and had the procedure explained to us.

After numerous tests used to measure her eye for the surgeon to select the most appropriate lens, the cataract surgery was scheduled for a later date.  During cataract surgery, the surgeon replaced her cloudy eye lens with a clear, plastic manufactured lens.

Unlike the vitrectomy procedure that required admittance to a hospital, her cataract surgery was performed on an outpatient basis, but she still had to get all the routine hospital pre-operation tests done by her general doctor before she could be cleared for cataract surgery.

She had the most common type of cataract surgery performed, phacoemulsification, where the surgeon made a small slit in the cornea and capsule of the eye and used ultrasound to break up the cloudy lens.  The particles were then suctioned or vacuumed out and the replacement plastic lens was inserted through the small incision to replace the cloudy lens.  There were no stitches, which used to be the common practice, which substantially reduced pain and healing times.  After the operation, I had to administer several different types of eye drops all at different intervals on different days.  The eye drops were used to prevent infection (antibiotic) and reduce swelling (steroid) in the eye. 

For those of you that are not too squeamish, here is a link to an informative cataract surgery animation video found on YouTube:  http://www.youtube.com/watch?v=Go82c4f1emc

We are still waiting for my loved one's eye to completely heal after her cataract surgery, but we wanted to share our positive and negative results so far.  Recall that after the vitrectomy procedures we were so elated with the vision improvement.  Before her surgery, the cataract procedure was explained to us, and the doctor did not promise perfect vision, but the nurse was getting us so excited, because the nurse told both of us that my loved one would be able to see vibrant colors and her vision would be so clear her vision would be like when she was in her twenties.  We anticipated major improvement in her vision.   

Unfortunately, so far in the healing process, she cannot see far distances clearly with her eye that had the cataract removed.  It's as if her long distance vision was made worse because of the cataract surgery.  The eye surgeon explained that because my loved one's prior extensive vitrectomy surgery and damage, plus the saline solution which replaced the vitreous (which is more viscous) during her vitrectomy surgery, the lens which is naturally supported by the vitreous gel could not be supported adequately by the saline solution, which resulted in her focal point being much closer than he anticipated based on her eye measurements. 

I just wish he would have explained this focal point issue was a possible outcome BEFORE her cataract surgery due to her diabetes, rather than after the surgery.  He explained after the fact that many of his other diabetes patients had the same result and these patients actually are happy with what he called, "monovision," where she could see near objects clearly, read the newspaper, see a computer screen up close with her new lens, and use her other eye for long distance vision, where she can't see clearly for objects up close with that eye, but can see objects more clearly from farther away. 

I asked him if my loved one would develop headaches from monovision, and he told us that no, her brain would automatically make the adjustment without headaches. 

Her only other option would be to replace her lens with another size lens, but he advised that her measurements were accurate and because of the saline solution and scar tissue from the prior vitrectomy, he could not guarantee that a new replacement lens wouldn't make here near vision that she has now, more blurry.  I know, I know, this sounds confusing, and I am still confused about some of the details myself, so I will update this page as she continues to heal and we learn more information.

Apparently, she can either get corrective glasses or contacts to improve her vision.  I'll let you know once we know what happens.