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    • CommentAuthorcarma
    • CommentTimeAug 13th 2008
     
    Hi all, I was just wondering if any of your AD loved one needed Cataract surgery? I'm sure they have advanced to make this a relatively simple procedure. If any of you have some experience with this, please let me know. My Husband has cataracts pretty bad and I'm trying to decide if I should let them fix it. He is in stage 6.
    • CommentAuthorSunshyne
    • CommentTimeAug 13th 2008
     
    carma, my husband's neuro had a fit when she saw how bad my husband's cataracts are, the first time she saw him (three years ago), and she squawks about them each time she examines him. He insists he does not need the surgery. I might attribute this to fear of having the surgery, except it is clear he can still read fairly fine print on his good days (i.e., any problems are associated with visual agnosia, not the cataracts per se.) He has had laser iridotomy for closed angle glaucoma in both eyes (simple procedure, went well, no problems ... it required keeping track of different eye drops at different times in each eye, but of course, I took care of that.)

    I trust the ophthalmologist who did the laser iridotomy. She assured me that cataract surgery is something you can do when you choose ... there isn't ever a point where it gets so bad that it damages the chance of a good outcome for the surgery. She suggested that we defer the cataract surgery until my husband obviously needs it, i.e., that the cataracts are preventing him from doing what he wants.

    My father (a doctor) told me to always trust a surgeon who recommended against surgery... :-)

    If you think the surgery would improve your husband's quality of life, it's my understanding the surgery is fairly simple. But if he doesn't seem bothered by the cataracts, I wouldn't do it. Any type of surgery can be distressing to an ADLO.
    • CommentAuthoriggy
    • CommentTimeAug 14th 2008
     
    I'm an optometrist who works in an ophthalmology clinic - we see dementia patients with cataracts on a regular basis. So, here's my 2 cents:

    1. Studies have shown that dementia patients who have had cataract surgery tend to be less agitated than those who haven't. Would you be a happy camper living with blurred vision during your waking hours? Even dementia patients have quality of life issues. (I'm not sure I would trust a Neuro to assess the severity of a cataract - probably looking with a direct ophthalmoscope through an undilated pupil.)What is your husbands Best Corrected Visual Acuity (BCVA) at distance?

    2. It's easier to operate on dementia patients in the earlier stages of the disease. No surgeon wants to take a combative/uncooperative patient into the OR.

    3. We have more than a few older patients in our practice who hemmed and hawed about having cataract surgery and then a totally unrelated health problem hit them (cardiac problems, severe stroke etc.) and they are no longer good candidates for surgery - and now they're stuck with crummy vision for the rest of their life. Tomorrow is never guaranteed.

    4. Cataract surgery tends to open the angles a little bit more. (I won't go into the anatomy here - ask your ophthalmologist). A cataractous lens tends to be a larger lens which tends to push the iris forward, therefore crowding the anterior chamber angle.

    5. Of course you don't want to be pushed into any surgery - but today's clear cornea/no stitch cataract surgery is a safe and relatively quick procedure (approx. 20 minutes) to restore clear sight. Unless the cataracts don't meet the Medicare guidelines for surgery, there's no benefit in waiting.

    My wife, age 57, has had EOAD for seven years and now shows early posterior subcapsular cataracts (they tend to be the faster growing kind). For all of the above reasons, we'll be having surgery sooner rather than later.

    I'm new to this board - mostly a lurker. Like most of you, I'm stressed to the max.

    iggy
    •  
      CommentAuthorStarling*
    • CommentTimeAug 14th 2008
     
    I've had both eyes done last year. At that point my husband was still in an early enough stage that he could help ME with the drops. They don't put you out for this surgery, so I would consider it if the surgeon thought it should be done. But they did have to give me extra "stuff" to keep me calm because I was really frightened by the whole thing.

    If your husband is cooperative, go for it. Since you have to do the multiple drops several times a day for several days BEFORE the surgery you ought to know if he is going to cooperate or not. He also will need to wear a plastic eye patch for 24 hours after the surgery and every night for a week while he sleeps so he doesn't rub his eyes. If he can't stop rubbing his eyes during the first week, that eye patch will need to go back on again.
    • CommentAuthorcarma
    • CommentTimeAug 14th 2008
     
    iggy, welcome to our family. Thank you all for the great information that you gave me. Starling when you mentioned the eye patch, i immediately got alarmed. I know my DH will not leave it on. He had eye surgery about 3 years ago, he had a ingrown eyelid. And he was not cooperative at all, after the surgery. I will go tho the opthamologist and see how bad his cataract is and if it is real bad, I think I go ahead and let him do it. My husband cannot read anymore or write, when I ask him if he want new glasses, he says that he sees just fine. Thank you all again for your help.
    Anne
    • CommentAuthorAdmin
    • CommentTimeAug 14th 2008
     
    Iggy,

    Welcome to my website. Honest, there are many men here - they're just quiet. They read, but only post occasionally, usually when they are so stessed they can't keep it in any longer, or have some vaulable information to share, as you just did. I hope you have taken time to read the home page - www.thealzheimerspouse.com - there is so much information there - check out the left side topics, and scroll through the Previous Blog Section and read #143 - it is a salute to the male caregivers.

    Thank you so much for the cataract information.

    joang
    • CommentAuthordivvi*
    • CommentTimeAug 14th 2008
     
    Welcome, Iggy. like your name! we learn so much from our guys input here wish they'd post more!and happy to have you join. as you know if you've been lurking there is tons of information and help with handson care ideas. divvi
    • CommentAuthorSunshyne
    • CommentTimeAug 14th 2008
     
    Iggy! You joined JUST when you were needed! :-)

    Welcome to the family.
  1.  
    Welcome, Iggy and thanks for your comments. They were very helpful.
  2.  
    My wife, stage 4, had both eyes done this spring/summer. No problems what so ever and she now can see better without glasses than she could see with glasses before the surgery. Both the surgery and the recovery were uneventfull.

    Charlie
    • CommentAuthorcarma
    • CommentTimeAug 14th 2008
     
    Thank you Charlie, this is really good news. I will make an appointment for my DH and go from there.
    Anne
    • CommentAuthorJanet
    • CommentTimeDec 30th 2009
     
    My husband has only been diagnosed with MCI, although I would say he is stage 4 now. He is going to have cataract surgery in a couple of weeks. The doctor gave him a choice of two kinds of lens implant. With the standard lens, he will still have to wear glasses after the surgery, although they might not need to be as strong as his are now. His current glasses are strong and he needs to wear them at all times. After Medicare and insurance, we will probably have to pay about $1000 per eye. With the other lens, he shouldn't need glasses except cheap drugstore ones for reading fine print. If we get those, we will have to pay about $2900 per eye. It will take him a little longer to adapt to the expensive kind.

    I'm trying to figure out what to do. I go back and forth on it. On the one hand I think about the cost, the time to adapt, and also the possible progression of the disease. That is, if he progresses really fast, he might not use the lenses long. On the other hand I think about reading about some of your spouses losing their glasses a lot and think it would be nice if he didn't need them.

    I'm inclined to get the expensive ones, but I'm still wavering. I would appreciate any advice.
  3.  
    Janet, I had cataract surgery on both eyes this fall and all went well for me. I had 2 options. The option I took cost me zero. Medicare and supplimental Insurance paid all. I think all I will need are the cheap reading glasses. I bought a pack of 4 and now a month after the
    last surgery, I think I need a different strength. I think I will wait 1 more week to get a new prescription. The second option was to make it so I probally would not have to even have reading glasses and I would have to pay $2500 for each eye.
    •  
      CommentAuthorStarling*
    • CommentTimeDec 30th 2009
     
    I had the Medicare approved lenses put in 3 years ago. I use very low cheaters to read and nothing to drive. I needed stronger lenses after the first surgery and much lighter ones after the second one and I've stayed stable every since.