vision problems

I had a severe (and devastating) attack of Optic Neuritis in left eye in Jan 2014. This never cleared up and left me with permanent sight damage. In a consultation with the eye clinic at the Neuro. Hospital last week I heard that in addition to this, my left eye which I felt had deteriorated, now also has evidence of cataract.

I was too shocked and surprised to ask any questions so I am putting them to the forum.

  • has anybody any experience with this?

  • for cataract you can be put on a waiting list for an operation - is there any point in this or all round too risky?

  • is the cataract likely to deteriorate further?

Any help/advice much appreciated!

Hi,

I don’t think cataracts have any direct connection with MS, although I believe they are a possible risk/side-effect of steroid use.

I’m sure if it were me I’d be squeamish about any surgery, especially involving the eye, but as I understand it, cataract surgery is a very straightforward, low-risk procedure, these days.

I do think untreated cataracts usually will deteriorate further, yes. I’m sure if you discuss the pros and cons, they will advise you how “risky” it is, but my belief is: “not very”, and there are thousands of quick and successful cataract operations every year. If it was the previously good eye (your right) that was affected, there might be more of an issue, as anything going wrong could mean you were left with little sight in either eye. But as long as you’ve still got sight in the “good” eye, they would probably say it’s no more risky than for anyone else.

Of course, the other side of the coin is they might say it’s “not worth bothering”, since you are never going to regain full vision in the left eye, regardless of the cataract op. But if you have been offered the opportunity to join the waiting list, I assume they believe it’s both safe and worth it!

Tina

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Hi Tina, many thanks for your kind reply.

Part of the problem is that I went to the appointment by myself and in addition to the eye problem I also have very bad memory problems,cognitive difficulties and can’t remember much…I think it was suggested that the left eye was already ‘useless’ so not much point in doing anything. I don’t think they offered an operation. On the other hand any improvement to my current vision would be hugely welcome!

Ah, that is what I was wondering!

It would kind of make sense if they’d said it wasn’t worth it - not because of any danger, but because of the limits to what would be achieved, considering the existing impairment on that side anyway.

But, if you are at all unsure what your options are, you should receive a copy of a letter to your GP, summarising the consultation, what was found, and any recommendations. That should make clear whether cataract surgery is an option, or has been rejected because it won’t make a significant improvement.

I always (actually, only nearly always - I don’t think I got the last one for some reason) get a summary of my consultation automatically. However, if you don’t receive it, it doesn’t mean there wasn’t one. Probably just that it’s gone to your GP only, but not to you. However, you’re still entitled to see it.

As your appointment was only last week, I’d give it a while (a few weeks, even) to see if anything turns up, summarising what was said. If it still doesn’t after that, get in touch with your GP, to ask if they’ve heard anything, and explain that you want to understand where you stand about surgery.

If the letter effectively says its a no-go, because your vision independent of the cataract isn’t good enough, you could still ask for a second opinion. I don’t know if there are criteria, a bit like those for DMDs, for deciding whether cataract surgery is worth it or not. But even if one consultant thinks it’s not, you still might find someone willing to do it for you.

Tina

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Hi,

i have ON in both eyes and my eye sight had deteriated quite a lot then I was informed I was losing the sight in both eyes and needed cataracts. I have not regretted having both eyes done as it has improved my sight for which I am exceedingly glad that I did I also have Glaucoma which was another factor in my case. But you must make your own mind up for the pro’s and con’s. Hope this helps in some small way. Wishing you good luck.

Janet

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I have had an “incipient” cataract for several years (like 7-8), and certainly before my MS started to be obvious.
The optometrist who first diagnosed it, now alas retired, was someone who I totally trusted.
His take on cataracts was that they could develop from the “incipient” stage very rapidly - or never develop at all.
He said it was possible the “incipient” one could never develop at all while one in the other eye could start and be a problem within six months.
There is nothing you can do yourself that will change this.

There are no national guidelines for having the appropriate surgery, but NHS Choices has this to say:
“In the past, people with cataracts were encouraged to wait until they could hardly see. These days, surgery to remove a cataract can be done at any stage once your ability to function is affected.”

That last is the bit that matters, but note that your local CCG may have their own ideas.

I would be thinking in terms of having your left eye done first to see how much benefit you get, and then having bthe right eye done. Like Tina says, go and talk to your GP; he can always refer you to an opthalmologist at your local district hospital.

Geoff