Eye Issues: Cataracts, Dryness, and Floaters Explained

Various Eye Problems

Last weekend, I underwent a retinal examination.
After completing the basic vision test (after dilation, my right eye was -8.75 diopters and my left eye was -8.25 diopters), the doctor first checked if I could receive dilating drops.
At that moment, the doctor indicated that I had mild cataracts in my left eye.
After the dilating drops were administered and my pupils were enlarged, the doctor confirmed the presence of mild cataracts again and prescribed a bottle of eye drops for me, which are intended to relax the eye muscles.
I would like to inquire:
1.
For patients with mild cataracts, is it sufficient to only use eye drops that relax the eye muscles?
2.
I have previously experienced dry eyes, inflammation, and the formation of eye stones, with many doctors stating that my eye stones are due to my constitution.
Does this condition conflict with mild cataracts? Are there any precautions I should take regarding medication, such as avoiding steroids? Additionally, do the eye drops and artificial tears commonly prescribed by doctors potentially contain steroids?
3.
The mild cataract was detected before dilation; is it true that cataracts can be diagnosed without dilation? The doctor only asked me to lean against a machine, and I had previously undergone similar examinations for inflammation using that same machine.

4.
In the past, when I was tired or on sunny days, I would see streaks or lines, and some doctors said that this is floaters.
However, it occurs inconsistently, leading some traditional Chinese medicine practitioners to say that floaters should always be present and not appear sporadically as in my case.
Which explanation is correct?

Ann Her, 20~29 year old female. Ask Date: 2019/02/14

Dr. Cai Wenyuan reply Ophthalmology

Hello,
1.
It may mean observation.

2.
Short-term use has minimal impact.

3.
It is acceptable.

4.
Most symptoms are intermittent.

Wishing you peace and health,
Dr.
Tsai Wen-Yuan,
Director of Ophthalmology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2019/02/14

More Info

Understanding eye issues such as cataracts, dryness, and floaters can be complex, but it is essential for maintaining good eye health. Based on your recent experiences and questions, let's delve into each of these concerns.

1. Mild Cataracts and Treatment: Mild cataracts, as noted by your doctor, can often be monitored without immediate intervention. The prescription of eye drops to relax the eye muscles is a common approach to alleviate discomfort and improve vision temporarily. However, these drops do not treat the cataract itself; they may help with symptoms related to eye strain or discomfort. If your cataract progresses and begins to interfere with daily activities, surgical options may be considered. Regular follow-ups with your ophthalmologist are crucial to monitor the cataract's progression.

2. Dryness and Inflammation: Chronic dryness and inflammation can indeed complicate the management of cataracts. Dry eye syndrome can lead to discomfort and may exacerbate any existing eye conditions. It is essential to use preservative-free artificial tears to manage dryness, as they can provide relief without causing further irritation. Regarding your concern about eye drops containing steroids, it is vital to consult your doctor before using any medication. While some eye drops may contain steroids, they are typically prescribed for specific inflammatory conditions and should be used under medical supervision. If you have a history of eye stones (likely referring to meibomian gland dysfunction or chalazia), this may be related to your overall eye health and should be discussed with your eye care provider.

3. Diagnosis of Cataracts: Cataracts can often be diagnosed without dilation, especially if they are significant enough to affect vision. The machine your doctor used likely employs a technique called slit-lamp examination, which allows for a detailed view of the eye's structures, including the lens where cataracts form. Dilation can provide a more comprehensive view of the retina and other internal structures, but it is not always necessary for diagnosing cataracts.

4. Floaters and Their Variability: Floaters, or the "strings" you see, are typically caused by changes in the vitreous gel that fills the eye. They can appear more prominently under certain conditions, such as fatigue or bright lighting. The variability in your experience with floaters may be due to changes in the vitreous or how your eyes respond to different stimuli. While floaters are often benign, sudden changes in their appearance or an increase in their number should prompt an immediate consultation with an eye care professional to rule out any serious conditions, such as retinal detachment.

In summary, managing mild cataracts, dryness, and floaters requires a comprehensive approach that includes regular eye examinations, appropriate use of eye drops, and monitoring for any changes in symptoms. It is crucial to maintain open communication with your eye care provider about your symptoms and treatment options. They can provide personalized recommendations based on your specific situation, ensuring that your eye health is prioritized. Always remember that proactive care and early intervention can significantly impact your overall vision and quality of life.

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