More common in the elderly population, the disease is one of the main causes of blindness in the world, but it can be reversed with simple surgery.
At the age of 80, Ana de Oliveira, from Minas Gerais, had already “accepted” that the changes she had been noticing in her vision were a sign that time was passing. Until one day she came to the conclusion that everything had become too blurry.
“I would close and open my eyes to check, and it was as if I saw the figures ‘softening’, I didn’t recognize anything. I was scared”, she recalls.
They were the effects of cataract, an eye disease that makes the transparent lens that allows light rays to enter for the formation of an image, which was already at an advanced stage in his eyes.
Worried about her aunt, who could no longer sew or cook – her favorite activities – Viviane, Ana’s niece, sought help from the SUS (Unified Health System).
“From the first process until we managed to reverse the problem, she got worse. I would go to the health center and even call the city hall asking to give priority to her exams, who was already almost losing her eyesight”, she says.
When Dona Ana, who lives in Santa Luzia (MG), was finally referred for surgery, after waiting more than a year, she was almost blind.
“Although it is reversible in most cases, if the cataract progresses too much it can cause complications that lead to blindness”, explains ophthalmologist Tiago Cesar, who performed the operation on the retired woman, who is now 82 years old.
The latest survey carried out by the CBO (Brazilian Council of Ophthalmology), in 2019, shows that cataracts account for 49% of blindness in the country, although the number of surgeries has doubled between 2009 and 2019. The survey also shows that 74.8% of blind people in Brazil could have cured or prevented the condition if they had received appropriate treatment in time.
Between 2019 and 2021, adding up all regions of Brazil, there was a 35% drop in the main tests for detecting cataracts, show data from the CBO (Brazilian Council of Ophthalmology). According to Cristiano Caixeta, ophthalmologist and president of the Council, the drop was expected, since the disease, although progressive, is usually reversible.
“As most patients with the condition are elderly, it was not worth the risk of exposing them to the risk presented by the pandemic. In 2021, we begin to return to normality in the rate of exams.”
“When the doctor told me that I could go blind, I despaired. I already have problems with my spine and knee, I walk with a cane, so, without vision, what would I do?”, she says.
Dona Ana managed, with surgery on one eye at a time, to completely recover her vision.
“It was a relief. I even thought I would go blind, but I got the surgery through the SUS and I didn’t pay anything. I went back home and watched things, looking at the corners that were dirty and before I couldn’t see. The doctor just asked me a few days away from the stove, and I stayed.”
Cataract diagnosis and treatment
The signs found in the routine ophthalmologic examination are loss of visual perception and alteration of the transparency of the lens.
According to Tiago Cesar, professor of ophthalmic surgery at the Faculty of Medical Sciences of Minas Gerais, surgery for cataract correction, the only possible treatment for the disease, is complex from a technical point of view, but simple for the patient.
With a scalpel, the surgeon makes small incisions in the cornea, the first structure of the eyeball. Then, with a kind of very fine pen, using an ultrasonic equipment, he removes the lens, the “natural lens” of the eyes and the part in which the disease is present. Finally, an intraocular lens is placed in the same location.
“The person sleeps and the medical team, made up of a surgeon, anesthesiologist, surgeon and nurse, performs the procedure in 20 to 30 minutes. Recovery is fast and patients do not usually have complaints of pain in the postoperative period. stitches or sutures and on the first day the person feels a significant improvement.”
“When we remove the tampon, the person usually cries. It is to rehabilitate one of the main senses, even more so for an elderly person who has already lost other body functions. It is common, even before treatment, for these patients to develop associated depression”, tell the doctor.
The causes of cataracts are not well defined, but epidemiological studies associate it with age. It is not possible to prevent cataracts with a single action or specific treatment. In addition to genetic influence, there are environmental factors that can contribute to the appearance of the condition, such as exposure to excessive sunlight without protection, poor diet and smoking.