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2010 02 26

Cataract surgery returned joy and colours to my life

Eye diseases

8 min. skaitymo

operuota katarakta - gydymas sugrąžino gyvenimo spalvas

By Agnė PUTEIKYTĖ

Article appeared in Gimtasis Rokiškis newspaper
20 February 2010

People say that no one is too young to become ill. This proved to be right for Asta Jakuntavičienė, a 32-year old resident of Rokiškis. She says that since early childhood the word ‘cataract’ was used around her as much as the word ‘mum’. This condition affected Asta’s grandmother, mother, uncle and brother. “The condition is transferred from generation to generation, and is relentless at torturing my family,” says the young woman.

Progression of condition

During the interview with the Gimtasis Rokiškis newspaper, Asta said that she noticed the first symptoms of the hereditary condition when still at primary school. Due to her worsening eyesight she sat as close to the board as she could and reading made her eyes tire very quickly. These things were a constant reminder of her fate which she shared with her closest family. “It was obvious that cataracts would not spare me. When I became a teenager, my eyes got weaker and weaker, and the sparkle in them was nearly gone... The progression of the disease was especially noticeable when I turned eighteen. I was still at school when I took my driving test. Medics told me that my eyesight was barely within the driving “limits”. They predicted that my vision would only deteriorate. The only help then was some eye drops that slowed the progression of the disease a little. There wasn’t even a thought of a full recovery then, and it was only much later that I found out about cataract surgery as a possible solution for me..." says Mrs. Jakuntavičienė.

Only after childbirth

Asta who has an eight-year-old daughter with her husband Teisutis, works as the arts director at Juodupė town culture club. “I learned about the latest cataract treatment method about 10 years ago. This surgery helped my mother’s brother with his vision problems. However, at that time doctors recommended that I should have a baby first. My farewell to cataracts had to be postponed. I was 24 when my daughter was born. I was busy with all the business of being a young mother, giving all my attention to my daughter. But then one day… I found myself hardly able to read the product labels," she explained.

Learning to adjust

The time flew and Asta’s first born turned seven... “I am ashamed to say, I had totally neglected myself. I saw the deterioration of my vision as inevitable, and was patiently learning to live my own way. I didn’t even notice how I learned to press the buttons on my mobile without even looking at it. I couldn’t see the numbers anyway... Friends and acquaintances knew about my condition, so no one was surprised when I would pass them on the street without saying hello. I could no longer recognise the facial features of anyone only a few steps away. I started to rely on my fingers instead of my eyes for orientation. I touched furniture and dishes to check if there was dust, and if the dishes were clean. My vision deteriorated, but my hearing became sharper, making me sleep ‘like a rabbit”. I could hear every scratch and every whisper,” says Asta.

Running around music notes

Finally, in March last year, the young woman found herself at the end of her patience. Asta, who studies music teaching at Rokiškis Branch of Panevėžys College, says that it was becoming harder and harder for her to read the lecturers’ writing on the board during the exam session, and during her practical classes music notes started moving around on the stave... “I felt inadequate. I kept asking my fellow students to tell me what they had copied from the board and would play the accordion by ear as I could not see the music anymore. I could spend no more than ten minutes at the computer or with a book, as my eyes became sore and red, and eventually blacked out,” she remembers. Asta admits that travelling to work in Juodupė became her biggest challenge. “One morning I realised that even when driving I was relying on my memory, and not my eyes; I knew every pothole and every turn. I prayed to God to protect me from cyclists on the road, as I would not have been able to see them myself,” Asta confesses.

Delay threatened with blindness

Mrs. Jakuntavičienė realised that her irresponsibility might cost another person their life and decided to take action. One day she called her brother to enquire about the cataract surgery performed at the Medical Diagnostic and Treatment Centre, V. Grybo street, Vilnius. “I have been waiting for this call for a long time now. You have finally realised that this cannot be delayed any longer,” this is what Asta’s brother told her straight away. Her brother was right. Having examined Asta, doctors concluded, that one or two more years could have put her at risk of complete blindness. Asta admitted to having a similar premonition herself. She could only see as far as the end of her arm, and further than that the entire world became a uniform mass of subdued colour... “On the last days before the surgery, my husband read the newspaper to me aloud, as if trying to comfort me or help me get my bearings in this world. The vision in my left eye was 8%, and in the right eye – 10% of what a person with good vision has. I stopped looking at people on the street, I was preoccupied with not stumbling on anything,” she says of her experiences.

The colours of life come back

Nearly a year ago, in March of 2009, Asta underwent cataract surgery for her left eye, and a month later – for her right eye. The cloudy natural lenses were removed and replaced with artificial intraocular lenses. “When they removed the bandage after the first surgery, I gave a shout of surprise. I stayed in that peculiar trance for half a day. The picture on the wall which was dull in colour the day before, was now bright and scintillating. The doctor’s face which looked strangely expressionless before the operation, now had a distinct nose, lips etc… I was amazed at the entire world and crying tears of joy. My brother joked that I would have to be introduced to all my family again, as I might have imagined them differently," Asta says as she becomes tearful again.

When is the right time for surgery?

The main factor is deteriorating vision which starts affecting the quality of life and interfering with everyday activities. Delay is not recommended for those who have been diagnosed with a cataract, because the damaged lens becomes harder with time and makes the surgery more complicated, and the risk of post-operative complications also increases. If a cataract is left untreated for a very long time, intraocular pressure may increase and glaucoma may develop.

Which lens to choose?

During surgery the cloudy lens is replaced with an artificial intraocular lens. Following the surgery patients no longer need to wear thick lens spectacles, their vision is good, they see bright colours again and can lead a normal life. Advanced technology has enabled the development of foldable artificial lenses than can be implanted in the eye through a tiny incision (2.75-3.2 mm). Moreover, the Medical Diagnostic and Treatment Centre performs implantation of the so called pseudoaccomodation lenses, which allow patients to see well both close up and far away post-surgery, as well as astigmatism correcting toric lenses. The latter were implanted in Asta’s case.

After cataract surgery

Cataract surgeries are performed in the out-patient setting and post-operative hospitalisation is not required. Patients are allowed home the same or the next day, and continue treatment under the doctor’s instructions.

Instead of epilogue

The cost of Mrs. A. Jakuntavičienė’s cataract surgery, performed at the Medical Diagnostic and Treatment Centre by an experienced microsurgeon, Dr Darius Aukštikalnis, was covered by the Territorial Health Insurance Fund (TLK). The patient only had to pay for the intraocular lenses. This year patients also have a choice of soft lenses that are compensated by TLK. The price of surgery with the above lenses starts from 488 Lt, the procedure is performed safely and quickly using a modern ultrasound device. Following the surgery, about 95% of patients regain 50-100% of their earlier vision and can go back to their usual jobs and other activities.
Asta is happy to have made up her mind about the surgery, and not to have missed her chance. “I can enjoy my bright and colourful life again. But I was so close to swapping this wonderful world for the white cane of a blind person..." smiles the young woman.

About cataract

Cataract – clouding of the lens of the eye is still the main cause of blindness all over the world. It is a common disease, especially among the elderly. Age-related cataract affects people over 50 due to the metabolic changes in the body.

Cataracts may also develop in young people, and are usually caused by various systemic disorders, trauma or harmful environmental impact.
The main symptom of this condition is gradual worsening of the eyesight in one or both eyes. At first people notice that objects have lost their vividness, they see them as if through a fog or matte glass, and sometimes experience double-vision. They feel blinded by bright lights, it’s hard for them to see on a sunny day and previously worn glasses do not fit anymore. The deteriorating vision makes reading and driving difficult, and eventually the eyes are only able to differentiate between light and dark.

There is no medicine that could eliminate the cloudiness in the lens. The surgery which takes about 20-45 min is the only cataract treatment method which can successfully restore good vision.

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