Trends in Cataract Research
by KATHRYN VANCE
In the first meeting of the new year on Tues ., Jan . 10 , the GLMS Foundation Senior Physicians Speaker Series welcomed Dr . Joern B . Soltau . Interim Chair , Dr . Sam Yared , introduced Dr . Soltau to speak on new trends in ophthalmology research . Dr . Soltau grew up in Germany , where he received his medical degree and then completed his residency at Washington University in St . Louis , Missouri . He then went on to complete a glaucoma fellowship at the Bascom Palmer Eye Institute in Miami , Florida . He currently serves as a Professor and the Chair of the University of Louisville Department of Ophthalmology and Director of Glaucoma Services .
After giving a brief overview of the anatomy of the eye , Dr . Soltau reminded the attendees that when the lens of the eye becomes cloudy , we encounter a cataract . Cataract is the leading cause of world blindness , but fortunately , is completely reversible . The lens is a biconvex , avascular , transparent structure and is about 4 mm thick and 9 mm in diameter . There are no blood vessels and no nerves inside the lens , making cataract surgery possible because once inside the eye , there is no sensation .
In diagnosing cataracts , patients often come in with a complaint of blurry or distorted vision , and common issues include glare at night and starburst or halos around streetlights , especially when driving . Early cataract treatment was known as “ couching ,” where you would stick a needle behind the cornea and into the lens , pushing the lens into the vitreous . While still blurry , the patient would be able to see light and shapes . As things developed further , especially with anesthesia available , surgeons were able to remove the entirety of the lens . The problem is that it is difficult to put a lens implant in the eye when the entire lens is removed . Now , surgeons make a round opening in the lens capsule and break the cataract in small pieces , removing it and replacing it with a lens implant .
In 1949 , Harold Ridley implanted the first Intraocular Lens Implant ( IOL ). However , for many years , ophthalmologists in the U . S . and around the world thought that putting a lens implant into the eye was malpractice and did not become widely accepted until the 1980s and 90s ; it is now considered standard care . To know what strength IOL to use , the physician must measure the length of the eye and the shape of the cornea using infrared light and specific formulas . While many patients get both eye implants for distance or near , another solution is monovision : usually the dominant eye for distance and the non-dominant eye for near . This is especially popular for people who have used contact lenses in the past . Other types of implants include toric IOLs , which can be used to correct astigmatism , extended-focus IOLs , which are used to enhance the range of vision , and multi-focal IOLs , which can do distance and near at the same time depending on where you ’ re looking .
Cataracts can be prevented by avoiding UV light and wearing sunglasses when outside for extended periods of time , avoid smoking and eating a diet of green leafy vegetables . Luckily , cataract surgery is readily available in the U . S . and the entire procedure is done in about 10-15 minutes with topical anesthesia .
The GLMS Foundation Senior Physicians Speaker Series is moving to the first Tuesday of each month ! For more information or to get meeting information , please contact Kimberly Risinger at kimberly . risinger @ glms . org .
Kathryn Vance is the Communication Specialist at the Greater Louisville Medical Society .
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