Cataract Surgery: Tips for Caregivers

Healthy Eyes & Dementia

If your loved one has both dementia and cataracts, they may benefit even more from receiving corrective eye care. As Dr. Waite warns, patients with dementia may be unable to express their concerns about cataracts verbally. Patients may have difficulty performing normal activities or caring for themselves due to cataracts, and this can even cause depression.

Furthermore, improved eyesight may enhance elders' cognitive function and provide them with increased sensory stimulation. Waite explains that cataract surgery can make a significant impact on patients with dementia. During a time when things are already too foggy, this surgery has the potential to enhance their quality of life even if they cannot express their appreciation.

Future with a Clear Focus

After cataract surgery, elders may find it difficult to administer their own medications effectively, especially eye drops prescribed to prevent infection. During the first two to four weeks following surgery, caregivers should expect to help their loved ones with drops multiple times a day. If your loved one is unable to follow this protocol and you cannot assist, you may want to consider medical home care.

Waite recommends finding low-vision products and services that are available in your area if your loved one does not qualify for surgery. He adds that glasses, magnifiers, telescopic lenses, closed-circuit televisions, and other visual aids can also improve quality of life.

Cataract surgery (or any other kind of visual impairment) can seem intimidating, but in addition to restoring your loved one's sight, you may also be able to give them some independence-which will greatly benefit you both.

Cataract Surgery Types

Cataract surgery has two types.

During phacoemulsification, or Phaco, an incision is made along the cornea, the dome-shaped, clear surface of the eye. A tiny probe is inserted into the eye by the doctor, which emits ultrasound waves that soften the lens and break it up, so it can be suctioned out. Most cataract surgeries today are performed using phacoemulsification, also known as small-incision cataract surgery.
During extracapsular surgery, the doctor makes a longer incision on the cornea and removes the cloudy core of the lens in one piece. The remaining lens is suctioned out by the surgeon. After removing the natural lens, it is often replaced by an artificial lens called an intraocular lens (IOL). It is a clear, plastic lens that requires no maintenance and becomes a permanent part of the eye. It helps improve vision by focusing light clearly onto the retina. The elderly parent will not feel or be able to see the new lens. There are some people who cannot receive an IOL. They may have another eye disease or have problems during surgery. For these people, a soft contact lens, or glasses that provide high magnification, may be recommended.

As you approach surgery day, consider these tips:

It is important to maintain proper eye health before cataract surgery. Your optometrist may recommend eyelid hygiene and dry eye treatments. These precautions have been shown to improve comfort and vision after surgery.
Generally, a consultation appointment is set up prior to surgery. Discuss risks, different lens implant options and your vision needs with the cataract surgeon. Ask any questions or concerns you may have.
Measurements of the eye will be made prior to surgery.
Let your optometrist and ophthalmologist know of any medical conditions you have, such as diabetes and high blood pressure.
Provide your optometrist and ophthalmologist with a list of medications you take.
You may be instructed to stop taking certain medications before or on the day of surgery.
You may be asked to use eye drops before surgery.
You may be asked to fast before surgery.
Arrange to take the day off from work on the day of surgery.
Arrange for a ride home on the day of surgery.
On the day of surgery: – Bring your health card – Bring any other insurance cards you may have – Bring sunglasses – Do not wear eye makeup – Do not wear contact lenses – Make sure you leave with the necessary post-surgery instructions

Seniors' Risks Associated with Cataract Surgery

Health insurance plans typically cover the cost of treatment of cataracts. However, it is important to check your coverage before cataract surgery to determine the level of impairment it covers.

Before cataract surgery, your parent may be asked to temporarily stop taking certain medications that increase the risk of bleeding. As with any surgery, cataract surgery has risks, such as infection and bleeding. After surgery, keep the eye clean, wash your hands before touching the eye, and take the prescribed medications to prevent infection. If the eye is severely infected, you may lose vision.

There is a slight increase in the risk of retinal detachment after cataract surgery. Other eye disorders, such as high myopia (nearsightedness), can further increase the risk of retinal detachment.

In addition to flashes or floaters, a retinal detachment can cause sudden changes in vision. A retinal detachment is a medical emergency. Your elderly parent should seek immediate advice from an eye care professional if they notice an increase in floaters or flashes. You should go to an emergency room or hospital if necessary. The eye should be examined by an eye surgeon as soon as possible.

Retinal detachments do not cause pain. If treated early, retinal detachments may prevent permanent vision loss. The sooner you get treatment, the more likely you are to regain good vision.

How Successful Is Cataract Surgery?

People who undergo cataract surgery generally have better vision afterward, and it is one of the safest and most effective types of surgery.

Preparation for Cataract Surgery

In the weeks before surgery, the doctor will conduct some tests to determine the right type of IOL, including measuring the cornea's curve and your eye's size and shape.

It is important for caregivers to plan for preparatory care. Your elderly parent may need to be instructed to not eat or drink anything 12 hours before surgery. It is common for doctors to prescribe antibiotics and anti-inflammatory drops to be administered two to four times daily into the patient's eye, and a senior may need assistance getting the drops into the eye properly.

Cataract Surgery: What to Expect During and After

When your loved one arrives at the hospital or eye clinic, drops will be given into the eye to dilate the pupil. The area around the eye will be washed and cleansed. The operation usually lasts less than one hour and is almost painless. Many people choose to remain awake during surgery. Others may require a short period of sleep.

If your parent is awake, he or she will have an anesthetic to numb the nerves in and around the eye. After the operation, a patch may be placed over the eye. Your loved one will rest for a while. The medical team will watch for any problems, such as bleeding. Most people who have cataract surgery can go home the same day. The patient will need someone to drive them home.

If your parent experiences mild discomfort, the doctor can suggest treatment. Itching and mild discomfort are common after cataract surgery. Fluid discharge is also common. The eye may be sensitive to light and touch. If your parent experiences discomfort, the doctor can suggest treatment. After one or two days, mild discomfort should subside.

You may need to use eye drops for a few days following surgery to help your parent heal and prevent infection. Ask your doctor about how to use eyedrops, how often to use them, and what side effects they can have. It is important to avoid rubbing or pressing on the eye. Your elderly parent needs to wear eye shields or eyeglasses to protect the eye.

It's important to remind your loved one not to bend over from the waist when picking up objects, as it increases pressure in the eye. They can be active by walking, climbing stairs, and doing light household chores.

Most seniors will be healed within eight weeks. Your doctor will schedule follow-up exams.

The Complications of Cataract Surgery

It is rare for surgery to cause problems, but they can occur. The most common problems after surgery are infections, bleeding, inflammation (pain, redness, swelling), loss of vision, double vision, high or low eye pressure, and loss of vision. When treated promptly, these problems usually resolve themselves.

In some cases, the eye tissue that surrounds the IOL becomes cloudy, causing blurred vision. This is known as an after-cataract and can develop months or years after cataract surgery. After-cataracts are treated with lasers. The doctor uses a laser to make a small hole behind the lens to allow light through. This procedure is called a YAG laser capsulotomy and is painless, rarely causing increased eye pressure or other eye problems. A doctor may prescribe eyedrops to lower eye pressure before or after the procedure as a precaution.

How Soon Will Normal Vision Return?

Your parent can resume many activities on their own, but their vision may be blurry. The healing eye needs time to adjust so that it can focus properly with the other eye, especially if the other eye has a cataract. Ask the doctor when your parent can resume driving.

Your loved one may be noticing that colours are very bright after receiving an IOL. The IOL is clear, unlike your natural lens, which may have had a yellowish/brownish tint. In just a few months after receiving an IOL, your parent will become accustomed to improved colour vision. When your parent's eye heals, a new pair of glasses or contact lenses may be required.

Cataracts: What to Do If You've Already Lost Vision

A low vision service or device may help your parent make the most of his or her remaining vision if your parent has lost some sight due to cataracts or cataract surgery. Ask your doctor for a referral to a low-vision specialist. Low vision counselling, training, and other special services are offered by many community agencies and organizations. Low vision services may be offered by a nearby school of medicine or optometry.

If your elderly loved one requires support after cataract surgery, speak with one of our team members to see how Ideal Caregivers 4u can assist.

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