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While it was once necessary to wear uncomfortable thick-lens eyeglasses to see well following cataract-removal surgery, today, that's no longer the case. Vonna's cataract was removed with a laser—and replaced with an artificial lens. Since the surgery, her vision has improved so much that she no longer needs to wear glasses to tackle everyday tasks.
Eye-care innovations like Vonna's surgery can improve and even restore Canadians' vision. Here are a few of the latest breakthroughs.
An intraocular lens (IOL) is a medical device that is implanted inside the eye to replace the eye's natural lens, as in Vonna's case. IOLs have been used in cataract surgery since the 1960s. Over time, there have been improvements in the lenses to help address issues such as narrow range of vision and nighttime "halos" (the appearance of bright circles around lights). Now, an even better IOL is available. Approved by Health Canada in 2015, the Tecnis Symfony IOL extends the range of a patient's vision to allow more depth of field and to substantially reduce halos.
Even those who want to improve their vision but don't have cataracts can benefit from the new lens. Dr. Sheldon Herzig, cofounder of Toronto's Herzig Eye Institute, performs refractive lens exchange, or lens-replacement surgery, for many patients. "Sometimes, people want to get rid of their glasses, but they don't have cataracts yet," says Dr. Herzig, who treated Vonna's cataract.
A 2015 report found that 33 percent of Ontarians with diabetes aren't regularly screened for diabetic retinopathy, the leading cause of blindness in working-age Canadians. An earlier report from the Institute for Clinical Evaluative Sciences found a similar trend among low-income neighbourhoods in Toronto. "It inspired me to address the issue," says Dr. Michael H. Brent, chief of retina service at the University of Toronto.
He teamed up with the South Riverdale Community Health Centre to start a screening program. Dr. Brent first identified the marginalized, mostly low-income communities where diabetes patients weren't getting tested due to cost and inconvenient doctor's office hours. Then, he helped set up eye exams at five community health centres in the Toronto area.
What's exciting about these centres is their use of teleophthalmology, a way to assess eye health through digital and telecommunications equipment. Technicians and registered nurses take images of patients' eyes, which are then sent digitally to Dr. Brent. He remotely grades the level of diabetic retinopathy and recommends a course of action for the patient. "This program is one way to help patients who aren't getting screened and are at risk of going blind from diabetic retinopathy," says Dr. Brent. Similar teleophthalmology screening programs exist in British Columbia, Alberta, Manitoba, Quebec and Newfoundland.
Vision correction surgery
LASIK surgery has been a godsend for many patients with nearsightedness, farsightedness and astigmatism (blurred vision that results from a defect of the cornea, the clear tissue that covers the coloured part of the eye). The procedure, which entails using a laser to reshape the cornea and correct impaired vision, has one key drawback: After recovering from LASIK, some patients experience dry eyes.
Now, there's a better option: small incision lenticule extraction (SMILE). This new laser-eye-surgery technique barely disturbs the surface of the eye, and, because the cornea and its nerves are virtually untouched, there are fewer instances of postoperative dry eyes. Dr. Herzig says he and his colleagues regularly perform SMILE. "In the future, I believe this technique is going to replace LASIK."
New contact lenses
If you've been told that you can't wear soft or rigid contact lenses, you might have better luck with scleral contacts. While traditional contacts cover only the cornea, scleral ones extend to cover the sclera (the white of the eye). These lenses are a great option for patients who have had corneal grafts, as well as those with extremely dry eyes, corneal irregularities caused by keratoconus (a degenerative corneal disease that causes thinning of the cornea and coning out of the tissue) or other corneal disease.
Scleral lenses trap a protective reservoir of fluid between the cornea and the lens, which makes wearing them more comfortable, says Dr. Bronwyn Mulherin, optometrist and co-owner of Downtown Optometry Clinic in Fredericton. "Because you're essentially bathing the cornea in moisture all day long, for some patients, these lenses provide a level of comfort that isn't found with other lenses."
Keep your eyes happy
Looking for eye-health resources? There are plenty of excellent apps you can download. Just keep in mind that, even though apps can offer great insight, they don't replace a visit to the doctor.
- Vision-testing apps, which measure everything from visual acuity to level of eyestrain, are available for iOS and Android devices. Try Vision Test and EyeXam.
- Don't understand your eye doc's diagnosis? Complete Anatomy: Eye—Practical Series ($5 per month or $50 per year for the full package) has in-depth information.
- Need to "borrow" someone's sight? Be My Eyes is a free app that, via video chat, connects a visually impaired user with a volunteer who can help with tasks like reading an expiration date or identifying a bill.
If you're living with any of these ailments, your eyesight might be at risk. Get a vision-care plan from your doctor.
1. Diabetes can lead to blindness as well as cataracts and glaucoma (degeneration of the optic nerve caused by high pressure in the eye).
2. Untreated hypertension or high blood pressure can damage the retinal blood vessels and lead to an eye disease called hypertensive retinopathy, which can cause seriousvision problems.
3. Autoimmune diseases—think rheumatoid arthritis, Crohn's disease and ulcerative colitis—can negatively impact your eyesight, leading to conditions such as dry eyes, cloudiness and pain.
4. Hyperthyroidism, a condition in which the thyroid produces too much of the hormone thyroxine, can lead to various thyroid eye disorders.
5. Prolonged use of corticosteroid medications can cause cataracts or glaucoma.
Some eye conditions are hereditary. If you or someone in your family has congenital cataracts, congenital glaucoma, retinal degeneration, optic atrophy or macular degeneration, share your medical history with your doctor.
For more tips on preventative measures for taking care of your overall health, visit our Prevention channel.
This story was originally part of "Eye Openers" in the May 2016 issue. Subscribe to Canadian Living today and never miss an issue!