Cataract Surgery - Yea or Nay?

Pat6177

My DH has mixed dementia, Alzheimer’s and vascular. He was diagnosed in 2020 and is probably early stage 5. He went to eye dr last week and she said that he has cataracts in both eyes and he should have surgery. DH says he has no difficulty with his vision and doesn’t want to have it done. (He no longer drives.) My concern is that the cataracts will progress faster than the dementia and he will be legally blind and I will need to lead him around. His main past time is reading on the iPad or iPhone. I realize reading is a skill he will lose as the dementia progresses. Again, which will progress faster - the dementia or the cataracts?

I would like to hear from people whose LOWD had cataract surgery and how that worked  out and also if the LOWD didn’t have recommended surgery and how that worked out. 

If he’s going to have the surgery, I think the sooner the better. As the dementia progresses, the post op period will just get more difficult.

Thanks in advance!

toolbeltexpert

Pat my wife has had both eyes done,the surgery and sedition didn't  cause any lasting trouble, but and you knew that was coming, she now says they ruined her eyes because she now really needs reader glasses for sure. Before she didn't need then often. She has 20/20 vision. In my dw case I had them done cause she is so healthy she may well out live me. But dementia is gonna win in the long run. I loved how she first commented how everything is so clear and I picked up on her vision being better. It's just every morning she can't read the alexia, time and date because it's smaller type up close. Hope this is helpful. Good luck either way, I don't think it's gonna matter with dementia there are to many variables. If your dh is functioning fine with his up close I personally wouldn't get it done.

harshedbuzz

Pat-

That's a tough call. 

TBE's wife's surgeon used a newer protocol with time release abx plug which eliminated a lot of the post-op drops. 

Antibiotics & Cataract Surgery: New Frontiers (reviewofophthalmology.com)

Not all surgeon's use this technique; DH's surgeon (a professor of ophthalmology at an Eye Hospital) does not. Every doc seems to prescribe slightly different care. My one BIL had general anesthesia in the hospital, the other had mild sedation in the hospital. One had 4 weeks of drops, the other 2.

DH's aftercare was a bit different for one eye because of the depth of the cataract. Even if it is used, there are safety measures around protecting the eye and preventing the patient from rubbing. DH slept in an eye shield for a week and also wore safety glasses for a time. He had drops for just over 4 weeks in each eye (he had something like 4 different drops installed in different combinations 4 times daily the first 2 weeks) which meant just over six weeks of drops total and maintaining a daily chart for each eye to keep track. You would need to do this part for him.

It might make sense to have a consult with the surgeon and also touch base with the neurologist overseeing the dementia in making the decision. 

Almost all the folks I know are thrilled with their results except my mom's friend who struggles with near vision even with readers. She's kind of whiny by nature anyway.

HB

David J

As a person without dementia who had had cataract surgery, I think it would be hard for a PWD. I have two implants with different focal lengths, allowing me to see over a range of distances. The doctor told me that most people’s brains learn how to interpret the mix of the two focal lengths, but some people have problems focusing and have headaches. Someone with dementia may not be able to learn, even subconsciously, how to see with the implants. That is just my non-medical opinion based on my own experiences. I agree with others that input from both the eye doctor and brain doctor is needed.

harshedbuzz

Victoria2020 wrote:

HB - maybe Mom's friend could try a multifocal reader --I use them in the kitchen and for doing desk work to get a larger in focus field of vision. Reading I have to use 2 single strengths- one for watching a laptop movie  [Netflix subtitles] at a slight distance  and one for reading on the same  laptop. Couldn't imagine a PWD doing this juggling.

This sounds like what my one BIL did. He was working as an ER doc and wore old school trifocals which allowed him to see pupils, throats and ears through the lowest portion, his computer through the middle section and everything else through the top. When he wasn't working, he didn't wear glasses and would borrow his wife's readers which was quite the fashion statement when we went out for dinner. 

Mom's friend has had at least one stroke, mild diabetic retinopathy and glaucoma. I wonder if that impacts her vision. Her DD takes her to the eye doctor a lot, so I'm sure they're doing what they can for her.  

 

Whyzit

Pat6177, I just had cataract surgery and am still doing the eye drops routine. I could not see anything but faint light in one eye because the cataract was so thick. It would be wise to find out how dense the cataracts are and the prognosis because you don’t want to be in the position to lead your DO around. My surgeries should have been done a year ago but I got bumped twice due to the surgeon becoming unavailable. Rescheduled to January, I came down with Covid so was bumped to the end of the list. My eyesight changed drastically in that year. I am so thankful to have it done and to be able to see out of both eyes. I need readers and can hardly wait for my final appointment in another month to have an accurate prescription. It takes 5 to 6 weeks for the eyes to fully heal after cataract surgeries. By the way, my DH who is level 5 puts the drops in my eyes because he does a better job than I can.

Best wishes to you as you evaluate your choices. It is a hassle to be sure, but eyesight is important no matter what level your LO is at. 

​fesk

My mother had cataract surgery and tolerated it well. She was given a certain lens that allowed her to see both near and far so reading glasses have not been needed.

She may have been earlier than stage 5 though. I thought the sooner we got it done the better. She was mildly sedated for each surgery. There were some restrictions as to bending or lifting I believe after the surgery for a day or so and an eye patch needed to be worn the first day/night. She didn't like the eye drops and there were many several times a day for weeks. 

We were lucky that she had no issues. 

Bootzie

I know the Dr can put in a lens for reading only. That would seem to be better for someone with dementia. Once the healing is over, they can pick up things to read w/o looking for their glasses. Personally, that’s what I think is most important.

Pat6177

Thank you everyone for your responses. DH has been using reading glasses for years and has them sprinkled all over the house. I think I will try to get DH to go see the cataract specialist for the evaluation and see if he can provide some idea of how quickly DH’s cataracts will progress. Thanks for all your comments about the lenses. Lots of things to ask about - if I can get DH to go for an evaluation!