The world is so big, I want to see it. But for Mr. Chen, a hobbyist photographer and writer in Hangzhou’s Jianggan District, it was only after a 13-year interval that he was able to see what spring looks like once again.
His cataracts were discovered during a screening in October 2013. Over the decades, he has published hundreds of articles in major newspapers and magazines in the province and has been awarded “excellent correspondent” several times.
In recent years, his eyes have become increasingly difficult to see, and each time he writes, his eyes almost have to be pressed against the paper to be able to write. Later, he switched to an older cell phone with a larger font, holding a magnifying glass in one hand and editing text messages in the other.
In June last year, his cataract was successfully treated in less than half an hour at the Zhejiang Eye Hospital, and a bright, clear world has since returned to his eyes.
What happened to the cataract that blocked the window of the heart? Let’s go into the delicate system of the eye and get a glimpse of the mystery.
In the last issue of “Do you know your window to the soul”, we told you that there is a zoom lens in the eye called the lens that hides behind the pupil. This lens is transparent and disc-shaped, with no blood vessels, and is connected to the wall of the eye by a long, thin, delicate band (the medical name for the suspensory ligament), which is connected to the lens by a group of muscles (the medical name for the ciliary muscle) that cooperate with the zoom. Once this clear lens becomes opaque, it is called a cataract. Mildly cloudy early cataracts, at this point, usually only mildly affect vision and do not need to be treated for patients whose vision requirements are not very high.
However, for a case like Mr. Chen, the cataract has seriously affected his vision. Cataracts do not develop overnight, but have a gradual evolution that can start from the middle or periphery, from the front or the back. Mr. Chen’s cataract started to cloud from the periphery and slowly progressed, so he experienced long years of chaos and confusion. Mr. Chen was happy and had some regrets. If I had known that the recovery after surgery was so fast, I would have done it earlier.
Clinically, we usually classify age-related cataracts into three types: cortical, nuclear and posterior subcapsular. Cortical cataract is mainly characterized by gray-white clouding of the lens cortex, and its development process can be divided into four stages: incipient, immature, mature, and overripe. By the time a cataract approaches the mature stage, onlookers can see the unusual white color, and by this time, the patient has been groping in the dark for a long time. It is the cataract that ordinary people can notice. At this time, the cataract is highly developed and the patient can’t see with his or her hands.
Nuclear cataracts, in which the clouding of the lens begins in the center of the lens, where the embryonic nucleus is located, gradually worsens and slowly expands to the periphery, mostly occur in people with high myopia and in patients who have undergone glaucoma and vitreous surgery. The nucleus becomes denser, the refractive index increases, and the patient’s myopia worsens. In severe cases, no matter how many glasses are prescribed, the vision cannot be improved. This is the appearance of nuclear cataract, where the onlookers do not see the difference in their eyes, but they often meet their old friends as if they do not know them.
Posterior subcapsular cataracts usually have a cloudy start in the middle of the posterior subcapsular membrane, located in the visual axis area, and can affect vision at an early stage. In this group of patients, it is very confusing to them that they can see relatively well in a room and their vision is fine on a hospital vision chart, but when they go out into the sunlight they struggle and cannot even see bus stop signs. This is because, when they get to a place where the light is stronger, the pupils contract (automatic adjustment of the aperture), the intensity of exposure is sharply reduced, resulting in less light entering the retina and chaos, not only poor focus and the sense of fog obscuring.
I think of a bank executive who had done it in the early years, posterior subcapsular cataract, vision 1.0, he approached me several times to complain about the inconvenience of seeing things clearly, but because the vision table vision is normal, he and I could not make up our mind to operate, until once he took the bank staff outdoor activities, in the sunlight to pull out the prepared speech ready to speak, but found that he could not read the speech and was forced to do an impromptu off-script He was forced to give an impromptu off-the-cuff speech. I went to see him on the afternoon of the surgery and he sighed that his eyesight had returned to what it was when he was in the army. After the surgery, his vision was still 1.0, but he felt that his vision was both bright and dark.
For cataract patients, the timing of surgery is very important, and it is not like some people’s legend that you can operate only when it is ripe. Moreover, the eye may have other abnormalities besides cataracts. So, readers, if you feel discomfort in your eyes, go see your doctor early.