Cataracts and Glaucoma: Age-Related Myths and Treatment Options

Hello, doctor. I would like to ask you about the relationship between cataracts and glaucoma?

Hello, Doctor.
I apologize for bothering you, but I would like to ask about my father, who is 71 years old.
Recently, he has been experiencing dry and uncomfortable eyes.
He visited an ophthalmologist, and since I wasn't there to hear his account, I found it a bit strange and wanted to ask.
The doctor said my father has moderate cataracts and elevated intraocular pressure causing glaucoma.
My father mentioned that he asked the doctor if this was due to his age, and the doctor responded that it was unrelated to age.
He prescribed a bottle of artificial tears to relieve dryness and a bottle of brimonidine to manage the elevated intraocular pressure and glaucoma.

I am confused because cataracts are known to be significantly related to age; doesn't aging naturally lead to eye degeneration? How can it be unrelated to age? Additionally, if cataracts do not affect daily life, is treatment unnecessary? I noticed there were no related eye drops prescribed.
My father does not wear glasses and could only see clearly the second line on the vision test chart, but he says it doesn't affect his daily life.
The doctor advised him to return for a follow-up in two months.
I thought I would seek a different doctor's opinion first.
Thank you.

Acan, 20~29 year old female. Ask Date: 2021/03/15

Dr. He Jianxian reply Ophthalmology

Cataracts are strongly correlated with age; the older you get, the more likely you are to develop cataracts.
Generally, the demand for vision is related to an individual's lifestyle.
If there is a need for extensive reading or the use of digital devices, the demand for good vision is higher.
However, if one's daily activities do not require significant visual effort and are of a more routine nature, the quality of vision required is not as high, and there is no associated risk.
This information is provided for your reference.
Dr.
He Jianxian, Department of Ophthalmology, Nantou Hospital.

Reply Date: 2021/03/15

More Info

Cataracts and glaucoma are two common eye conditions that often affect older adults, and understanding their relationship with age is crucial for effective management and treatment.
Cataracts are characterized by the clouding of the eye's natural lens, which can lead to blurred vision, difficulty seeing at night, and sensitivity to light. While it is true that age is a significant risk factor for developing cataracts, they can also be influenced by other factors such as genetics, prolonged exposure to UV light, smoking, and certain medical conditions like diabetes. In your father's case, the ophthalmologist's comment that age is not the sole factor may refer to the fact that while age is a primary risk factor, it is not the only one. Cataracts can develop due to a combination of these factors, and some individuals may experience them earlier than others.

Regarding the treatment of cataracts, the decision to proceed with surgery typically depends on the severity of the cataract and its impact on the patient's quality of life. If your father is experiencing significant vision impairment that affects his daily activities, surgery may be recommended. However, if he is able to manage his daily life without significant vision issues, the ophthalmologist may suggest monitoring the condition until it progresses to a point where surgery becomes necessary. It is essential to have regular follow-ups to assess the cataract's progression.

On the other hand, glaucoma is a condition characterized by increased intraocular pressure (IOP) that can damage the optic nerve, leading to vision loss. It is often asymptomatic in its early stages, which is why regular eye exams are crucial for early detection. Your father's diagnosis of "high eye pressure causing glaucoma" indicates that the ophthalmologist is concerned about the potential for optic nerve damage. The prescribed medications, such as the eye drops for lowering eye pressure, are essential in managing this condition.
The relationship between cataracts and glaucoma is complex. While cataracts themselves do not cause glaucoma, the presence of cataracts can make it more challenging to assess the optic nerve and monitor glaucoma progression. Additionally, some treatments for glaucoma, such as certain types of eye drops, can lead to cataract formation over time.
In summary, while age is a significant factor in the development of cataracts, it is not the only determinant. Regular eye examinations are crucial for monitoring both cataracts and glaucoma, especially in older adults. If your father is experiencing discomfort due to dry eyes, the prescribed artificial tears (like "派滴兒") can help alleviate symptoms. It is also essential to follow up with the ophthalmologist as recommended to monitor both conditions and adjust treatment as necessary.

If your father is not experiencing significant vision impairment from his cataracts, the ophthalmologist may recommend a watchful waiting approach. However, if his quality of life is affected, surgery may become a viable option. It is always best to have open communication with the healthcare provider to understand the rationale behind treatment decisions and to ensure that your father's eye health is managed appropriately.

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