Wednesday, March 19, 2014

My experience with cataracts

I was first diagnosed with cataracts around 2008 or 2009 during a routine eye exam (a yearly exam).  Even prior to that I used to feel some amount of cloudiness in the vision, but this was the first mention of cataract.  I was told it was very early and probably not even affecting the vision, but that wasn't true because I had already been feeling it.  I was 38 then and this is pretty early for being a cataract patient.  While I'm hearing of some cases of people in their 30's or 40's getting cataracts, they are rare.  It is more likely to affect people in their 60's and beyond.

During the next several years, until I finally had surgery in March 2014, I tried several things to reverse the cataracts using holistic methods.  The best I was able to achieve was an arresting of the condition, but by then my right eye was already very bad and the left eye was marginal.  Reading, using the computer, and driving all became increasingly difficult over time.  That I had a very visually intensive job as a computer engineer, and one that involved a lot of air travel and very erratic hours, only made the holistic approach more challenging.   I had to be very organized and carry all of these things with me on business trips.  I also had other health/metabolic issues affecting me at the same time.  Perhaps if the situation was different (not as demanding a job, no other significant health issues), I might have been able to arrest the development sooner and may have been able to delay surgery longer.  Delaying surgery is always a good idea because there might be new less invasive surgical techniques down the line, as also better lenses.  For example, the LenSx laser that I opted to use for my surgery was approved by the FDA only in 2012.

Natural remedies

But first, here are of the things that I tried, despite being told by all doctors that there is no natural remedy for this.  Googling for holistic solutions to cataract was a daily ritual for a long period of time, until I finally felt I had exhausted all possibilities.

I completely changed my diet based on Ayurveda to help with the condition--see my earlier post about using Ayurveda as a guide for diet.  I hardly ever cooked at home prior to that.  I had to learn how to cook simple foods from basic ingredients and tried to eliminate processed foods as much as I could.  I also attended two panchkarma sessions at the Ayurvedic Institute.  They told me about the making a triphala tea eye wash (see below for more details).

I contacted several Ayurvedic clinics in India including Kottakal, Sunethri, and Sreedhareeyam and was told that it is not possible to reverse a matured cataract.  (Update: A reader of this blog sent me a fourth center, which like Sreedhareeyam is focused on eye health -- Prakash Nethralaya.  I have not contacted them.)

I tried several things in the eyes, all separately at different times, not together.
  • Castor oil: This was mentioned to me by an Ayurvedic practitioner.  I tried this for a few months.  Did nothing as the cataracts kept getting worse.
  • Itone eyedrops: These are Ayurvedic drops.  I tried these for several months but they didn't do much.
  • Cineraria maritima:  These are homeopathic drops.  I tried these for several months but they didn't do much either.  Note that these are available in single-use vials from Boiron, but they just claim that it "soothes red and irritated eyes."
  • Triphala tea eyewash: This seemed to work reasonably well at arresting progress.  I was able to go several months without noticing much change, but still there was still slow progression. To make triphala tea, I would boil 1/2 teaspoon of triphala in one cup of water for about 5 minutes, wait till it cooled down and the sediment settled, and then filter it through a coffee filter (more like 3 or 4 filters).  I'd use some right away and store the remainder in the refrigerator for use over the next few days.  It is not recommended to keep the tea without refrigeration.
  • Khakhra Mul Ark/Dhak Ki Jadka eye drops: These are Ayurvedic drops.  The Khakhra Mul one is only available in India.  The Dhak can be purchased in the US from Kayakalpa.  These ones seem to work well at arresting the condition, but at least over the one year that I used them fairly regularly, they were not able to reverse the condition.
There is one eye drop that I did not try because I was not sure about the safety -- N-Acetyl-Carnosine. One holistic practitioner suggested putting a drop of honey in the eye, but there are so many types of honey that I wasn't sure about which one to use so I skipped that.

Along the way, I also came across this page which recommends a raw foods diet for curing cataract.  Since I wasn't ready for something like that because of other digestion/metabolic issues that I had going on, I am not able to report on whether or not it works.

Overall, I was quite disappointed that I wasn't able to reverse the cataracts holistically.  Also, the rate of progression of cataract was very fast in my case.  In < 5 years, the right eye went from being quite usable to extremely blurry.  And since I wasn't seeing much success during the process, it got very discouraging; I just didn't feel like trying anything else for the last year or so and instead just continued with whatever had given me some reasonable results (the triphala eyewash and dhak eye drops).

Cataract surgery

As I was pretty dependent on the left eye for all my tasks, when I first noticed the left eye getting worse I started to panic and scheduled surgery.  I had been seeing two surgeons in the area for this.  I was trying to decide whether to get laser-assisted surgery (the surgery is bladeless) or the regular type.  I decided to go with the laser-assisted surgery using the LenSx laser because it promised a quicker recovery and more accuracy when making the incision.  The only downside to the laser-assisted surgery is an increase in eye pressure during the procedure.  The surgeon probably would not recommend it if he thought it might be a problem.  

There are several choices for the intra-ocular lens (IOL) -- monofocal, multifocal, and accommodating.  I chose the monofocal lens which meant that I would need glasses or contacts for either reading or distance.  A couple of surgeons suggested I correct for near since that is how I spend most of my time -- indoors and working on a computer -- plus, I was already used to being dependent on glasses for distance.  Multifocal and accommodative lenses are harder to fit and people that have them report mixed satisfaction.

Day of Surgery

I went in to my afternoon appointment on an empty stomach.  After checking in and making the payment, I had to wait in the waiting room until it was time for pre-op.  In pre-op, they usually get an IV started to allow them to give patients medication for anesthesia/pain.  I refused anesthesia and the IV (I had previously discussed this with the doctor).

They put a dozen or so different drops in the eye for numbing and dilating it.  They put an x under the eye to be operated and put a patch on the other eye.   Then I was rolled in the room for the laser surgery.  The laser machine made some measurements and then made the incisions.   Then it chopped the lens with the cataract.  Next I was wheeled into the operation room where the lens was broken into bits using ultrasound, vacuumed out of the eye, and the IOL placed.  During this part of the procedure, since I wasn't under anesthesia I did feel some discomfort in the eye.  As soon as the surgery was done,  could see with the eye.  The lens used was an Alcon AcrySof IQ SN60WF IOL.

I was given some dark glasses and sent home.  At home my vision started to get cloudy.  I called the doctor and was told that was normal.  I also experienced a lot of watering from the eye.  And after a while nausea set in (not normal based on the literature I had received) and it persisted for the next couple of days.  

Post surgery

The day after surgery I went in for a checkup and was told the eye was healing fine.  The next day the eyelid appeared swollen.  I called and was asked to come in.  I went in and by then the swelling had subsided.  The doctor checked the eye and said everything looked fine.  I complained about a flickering sensation, kind of like strobe lights.  He said that was normal and it would subside.

Perhaps my biggest issue post surgery was being able to drive.  Because of the difference in image sizes between my myopic left eye and the operated right eye, it would simply not possible to wear eyeglasses as the brain couldn't reconcile the images.  Because the operated eye was corrected for near vision, I would eventually need a prescription to correct it for distance.  The only option was to use a contact lens in the left eye which I got on the 3rd day after surgery at my local Walmart vision center.  That seems to be working OK.  I had some experience wearing contact lenses during my high school and early college years, but then discontinued wearing them in my later college years because of eye irritation.  If one is very near-sighted, I'd strongly recommend using contact lenses before surgery to minimize the discomfort of unbalanced vision post surgery.  Unfortunately the doctors office offered little counseling in this area -- they were of the opinion that I should muddle my way through a week or two and get the second eye operated right away.  But I wanted the right eye to heal reasonably well before considering surgery for the second eye.

Post surgery log

One week -- I am still using the anti-inflammation drops, so I'm not sure how the eye will feel once I stop those.  I am also experiencing some flickering in the vision and at times it's quite bothersome and requires that I shut  my eyes.

Two weeks -- The flickering is still there.  The doctor's office says this is normal and may take several months to heal completely but that it should eventually subside.  There are also some other symptoms I've experience including intermittent pain the eye (despite using the anti-inflammation drops), occasionally feelings of fogginess with distance vision and night vision being affected, and one night I had a burning sensation and watering after using the anti-inflammation drops.  I also occasionally have the sensation of a drop of water in the upper right corner of the eye.   I wish the doctor's office had been better with communicating what to expect after surgery.  They seem a lot less responsive to questions and concerns, which is quite disappointing.  While it may be a routine surgery for them, it's my first time going through this experience.  If they had a sheet detailing various "normal" side effects that one might experience for each lens type that would have been extremely helpful.  Is it really that hard to do?

Three weeks -- Still experiencing the flickering and also the feeling of a drop of water in the upper right corner.  Today was my first day without the steroid inflammation drops, and so far the eye feels OK.  No unusual irritation, pain (occasional slight dull pain but that could just be due to eye strain), or significant foreign object sensation (slight intermittent sensations are there).

Four weeks -- Still experiencing flickering and the feeling of looking through a drop of water at the top right corner of the eye.  Very occasional foreign body sensation.  Had a followup appointment with the doctor.  He said it should get better over the next couple of weeks but may take months to subside.

Five weeks -- Still experiencing flickering.  The feeling of looking through a drop of water is a little better , but still present.  Foreign body sensation is much more significant (almost a pinching sensation in the eye).  Occasionally observe that a certain area of vision is "smudgy."

Ten weeks -- Still experiencing flickering, but a little less.  The feeling of looking through a drop of water is still better, but I experience it occasionally.  Foreign body sensation, and burning sensation happen on and off and are sometimes quite significant.  Occasionally still observe smudgy areas.

~20 weeks -- Still experiencing flickering and in some lighting conditions (especially in bright sunlight or pointed light sources) it can be very bothersome.  Foreign body sensation is a bit less and I haven't had burning sensations recently.  Occasionally still observe smudgy areas. --

~2 Years -- flickering has improved over time, but I do notice that I have a droopy eyelid and it is unlikely that will ever improve (it hasn't improved in the last 2 years).  However, around August 2016, about 2 1/3 years following surgery, I started to experience the development of secondary cataract and the associated symptoms -- difficulty seeing signs at night, glare/sensitivity to light, etc.

References

A prospective study on postoperative pain after cataract surgery

5 comments:

  1. There was a long pending 'Thanks' to you for playing a part in me getting to know Triphala usage for eyes with your above post. (I used somewhat higher dose 1 tsp for one wash). It worked wonderfully for me (High myopia, not cataract) - doing away with lots of unease like dry eyes, unclear vision and others, and I think its sign that it also lowers IOP nicely.
    I was probably lucky that I experimented with it well after all the stressors to eye (high
    indoor time, not much time under Sun, high computer usage, incorrect food and others) were off - else, probably I would have been unable to see results of such a wonderful thing just because they were lost somewhere in continuing stressors impact.
    i.e. I used it as to say Sorry to eyes for not being a good host all these years and as a
    promise to improve now on rather than asking it to improve them to serve me better. - difference being how to handle stressors. i.e. Use triphala and expect eyes to cope better vs Take off stressors (to my current understanding) and use triphala to say sorry for imposing stressors in past.

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  2. I love how extensively you've written on this topic. I was hoping to find some natural solutions to take care of the eyes to prevent cataracts and that's how i've chanced upon your amazing post. i have always wanted to know which brand castor oil you have used in your eyes. most of the places i have enquired don't sell castor oil that can be used in the eyes, please let me know, thank you. do you still experience the flickering?

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  3. The brand that I used was Heritage Store. As for the flickering, it is almost gone. It still occurs in certain lighting conditions, for example, when I am standing under bright canister ceiling lights.

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  4. Pls guid me if i can use castor oil for cataract problem, if yes, which brand and from where to buy? thnx and regards, brij

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    Replies
    1. The brand that I used was Heritage. But like I mentioned in the post, I did not find it helpful.

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