is definitely one of the long term side effects of steroid use. I am facing surgery in the very near future. While my medical problems are a list long, this is one that really scares me. I have heard good things about this type of surgery, but, I am very sensitive about my eyes. It would be difficult for me to even allow someone to simply put drops in my eyes. I need total honesty here. Anyone that has had this surgery, what are possible problems or any thing that is not well known. I am terrified!!
Hi - I have steroid induced cataracts. Have been on some dose of Prednisone for over 20 yrs. This?
- 18 Oct 2013 by BeYondRepair
- 22 October 2013
- cataract, anxiety, prednisone, side effect, steroid
Added 18 Oct 2013:
I am asking about cataract removal only. Any one had this kind of surgery??
Added 21 Oct 2013:
In my stupidity, I thought a cataraxt was like a growth of some sort that could be removed. I did not understand there is removal of the actual lens, thought it was what is on the lens that is removed. This is totally out of my medical range. Could some one that has had this type of surgery please share their experience?? I need to know what it feels like and what they do to keep your eye open. No way I can do it!!
I obtained some questions that you can ask to put yourself at ease and be informed about your operation.
1) How long will I have to wait?
2) Can I be treated as a day case
3) How many operations have I done
4) Do you specialize in cataract surgery
5) What is your complication rate
6) What kind of anaesthetic will be used?
7) What is your accuracy of biometry?
Biometry is the process that uses either laser or ultrasound to predict the correct lens implant power and getting it right is a key part of a successful operation
8) Are you going to try anything on me that is new to you?
9) Will you be providing a multifocal lens?
10) While it's possible that multifocal lenses can improve your vision for distance and for reading so that no further correction is required, in practice this is not always achieved. Contrast is reduced by certain types of multifocals and biometry has to be very accurate to get good results. There is also a period of adjustment required on the part of the patient to a diffraction type of multifocal lens. In a recent survey by the United Kingdom and Ireland Society of Cataract and Refractive Surgeons, only 5% of its members had used multifocal lenses.
11) Is surgery really necessary?
Unnecessary cataract operations could result in a worsening of vision. The first question to ask the surgeon is whether you definitely need surgery. In general, surgery should be considered if your eyesight interferes with your daily life and affects your ability to read or work.
I hope this helps in some way.
I hope I can answer some of your questions, while I have not had cataract surgery myself, I have helped ophthalmologists do hundreds, maybe thousands of them. I worked in Ophthalmology for several years in both the clinical setting and the surgical setting. First of all, try not to be scared because, most likely, this will be the easiest surgery you have ever had. After it is determined that you have cataracts and are a good candidate for surgical removal and replacement with an IOL (Intraocular lens implant) you will have a thorough work up measuring the depth of the eye and the curvature of the cornea-you are not alone in your thoughts that cataracts are a growth-many people think this when it is actually a clouding of the natural lens in the eye, so they remove the lens and replace it with an implant when it becomes too clouded-it looks like gazing through a glass of cloudy iced tea when you look at a cataract through a microscope. It not only blurs the vision, it can change the way colors look, it can cause halos or spokes around lights at night, often whites will look dingy brown (after, everything will looks so bright and fresh, you will be amazed at what you have been missing-since a cataract comes about slowly you dont notice the drastic changes until it is suddenly removed!) In the old days, before lens implants, they would wait until the cataract was very, very bad before surgery then after surgery, folks wore very, very thick "cataract glasses"-you may remember those, before the 70's they were common still. Since they removed the lens, folks were more or less blind if they lost those glasses or broke them and couldnt afford a new pair. Thank goodness lens implants were invented. Drs now days have gotten so good at putting in these implants that generally people dont even need sutures, the surgical opening is so small, it seals itself so you have the "no stitch cataract removal procedure". In carefully measuring the curvature of the cornea and measurements of the depth of your eye, the surgeon will chose a lens accordingly so if you wear glasses, the lens may correct for that power and unless you have a great deal of astigmatism, you may not need glasses after surgery except to read, like most of the over 40 population. They do have multifocal lenses and they are getting better but when I was helping with surgeries, they were still causing complications and some people were happy with them and some were not, but at any rate, this was in the early to mid 2000 and we just didnt use them much then so I really cant tell you a lot about multifocal lenses but I think they still prefer to use a regular IOL implant and have the patient wear reading glasses. If you say, oh I take my glasses off to read, then you are likely nearsighted so when your vision is corrected with an IOL, you will need reading glasses for close but likely wont need them for far (unless as I mentioned, you have a high level of astigmatism). Once you are tested and the lens is picked, you are ready for surgery. You will be brought to the pre-op area of the surgical suite, they will ask you to void your bladder, have you change into a gown, and some places have you wash your face with a special soap (some do not and it really doesnt matter-in theory, some feel that washing the face then a disinfectant paint or second wash in surgery is better but in my experience, I have worked in places that did both and there wasnt any difference in rates of infection) They will have you sign consent forms and get you into a gurney, hook you up to the heart monitor and may put a clip on your finger to monitor your blood oxygen levels and will put a blood pressure cuff on you. Usually you will then talk to the anesthesiologist or anesthetist who will talk to you about your health problems, if you are diabetic, they may do a fingerstick blood glucose level. They will also put in drops to dilate your eyes. Dont worry, we do lot of eyes and we are good at putting them in people who hate drops! The nurse will put in an IV access for the medication to put you to sleep. Now you will be awake during the surgery but you wont feel anything or see anything. Your eye that they are operating on is anesthetized and your other eye is covered by a drape. They put you to sleep just for a few minutes so they can anesthetize the eye you are having surgery on. If your health is really, really bad, I have seen surgeons do it without putting the person to sleep but that is pretty rare. In all my years doing this I have only seen it done while the person was awake a couple of times. You wake up in a few minutes and you will not be able to open the operative eye but the other one will work just fine. You are then wheeled into the surgery room where the actual surgery will take probably less than 10 minutes. It is the pre-op and post-op that take up most of the time you are there. After surgery you are taken to a recovery area and they will give you juice and a light snack and check your vital signs and give you your instruction on how to care for the eye and when to return to the office. Some docs will patch the eye for the day and some do not. If they do not patch it is best to rest quietly most of the day because as your surgical eye "comes to" meaning the numbness wears off, you may have some double vision until the eyes start working together again and this can be a little disorienting for a hour or two at most. You will probably be advised not to bend over at the waist for a few days. Most likely, they will bring you to the office in the next day or two to look at the implant and make sure everything looks good. They will do only one eye at a time. This is because as with any surgery there is risk of infection, the risk is low but it exists and so they do only one eye at a time, just in case. There is some risk, very tiny, that the IOL could move. The biggest risk is that of infection but if you use your drops and wash your hands often and keep your hands away from your face, it shouldnt be a worry. Most people have little discomfort-maybe a little scratchy feeling or a feeling that something is i the eye. Dont rub your eyes for any reason! If you find the irritation annoying, take Tylenol or ibuprofen (or what ever they tell you to use). It is really a simple procedure. Be sure that your Dr is well experienced and that his complication rate is low. You can check him out under your states Board of Medical Examiners to be sure he doesnt have a bunch of complaints against them. Keep in mind that even the best of surgeons may have someone who wasnt happy and filed a complaint but if you see multiple complaints, find a new surgeon!! With a good surgeon, this will probably be the easiest surgery you will ever have and you will laugh at yourself for being frightened. It is the unknown that scares us so now you know a little of what to expect. It may go a little different but this should give you a general idea of what to expect. Good luck, if you have questions, feel free to ask!
- Prednisone Information for Consumers
- Prednisone Information for Healthcare Professionals (includes dosage details)
- Side Effects of Prednisone (detailed)
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