Cataract Questions

[Prime2515102]

Pre-existing conditions: congenital ocular albinism, nystagmus and astigmatism.

I was wondering if visual deterioration can occur before cataracts are detectable. The reason I ask is that my vision started getting worse about 8 years ago (about age 30). I started getting ophthalmic migraines 1 to 2 times a week (previously it was 1 to 2 times a year) so I decided it was time to start wearing glasses. I didn't wear glasses at all prior to this. The migraines stopped completely. At the time, nothing was mentioned to me about cataracts.

I had been to see an eye doctor 4 times I believe since then (3 different doctors). About 3 1/2 years ago was the last visit to the eye doctor where there was still no mention of cataracts.

About 3 or 4 months ago I went in to get new glasses because mine broke and I had been wearing the glasses I got 8 years ago (kept them as a backup). This is when I was told I had cataracts. Apparently my vision was too blurry to be able to tell that it was cataracts causing the problem so I can't say when the problem was detectable, by me, as cataracts.

I've heard of cataracts with rapid deterioration but going from nothing at all to surgery in 3 1/2 years seems a bit excessive to me. But then, I'm not a doctor.

Is there any reason the doctor I saw 3 1/2 years ago would've decided not to mention it to me (this was not my usual doctor)? Is it possible the deterioration started 8 years ago but the cataracts were undetectable or was that something else entirely? I see a lot of people start wearing glasses in their late 20's to early 30's so I figured it was just natural age-related vision loss.

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Post-Surgery

Another question I have is this... I had the lens replaced in my left eye already and after surgery my vision was very blurry. After about 3 days my near vision cleared up nicely. Up close my vision is as good as it was in my teens (I'm a 1 1/2 months short of 38 now). However, my distance vision (after roughly 20 inches, I haven't actually measured it) is blurrier than it's ever been, to the point that I probably shouldn't be crossing streets. Granted, I don't have glasses yet (still need to get the right eye done) but as I mentioned, I didn't need to wear glasses at all before all this in spite of the astigmatism. The doctor said everything looked good at both post-op visits and the problem was able to be corrected through the phoropter (I think that's what they're called) at the second post-op vistit (a week after surgery), which is great, but it seems rather terrible that it's this bad without correction.

Is this normal? Will I have any more improvement?

Thanks

[John C Hagan III, MD, FACS, FAAO]

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[Prime2515102]

Yeah, I never hoped for improvement over 20/200... but I did expect to be able to see relatively well without glasses. Right now, I could see better (distance) with the cataract.

Thank you for your reply :)

[John C Hagan III, MD, FACS, FAAO]

3 1/2 years is a LONG time. No it is not unusual for a cataract to develop from nothing to needing surgery especially in cataracts that form in younger people often these are psc  posterior subcapsular cataracts.

People with your conditions almost never have normal vision and cataract surgery will not be expected to restore anything like 20/10 vision. Best you can hope for is what your vision, with glasses was when you were in your late teens.

Yes cataracts occur more often in ocular albinism.

JCH MD

[Prime2515102]

I forgot to ask.. The doctor that actually told me I had cataracts said that they are typical for people with my condition (I assume he meant ocular albinism) but he acted like he didn't even believe I had it so I don't trust anything he said to me.

Is that true? Is this typical or is getting cataracts this young completely unrelated?

Thanks