For most people having a cataract is no big deal…cataract schmataract…whateva. You schedule a surgery, choose whether you want to see close or far away, have your surgery and then…voila, you can see again. It feels amazing, I’ve heard. A miracle of modern science.
Stop. Stop right there. While I agree with the idea that science has come a long way, and people with many different diseases are the beneficiaries of that work, for people with uveitis it’s a lot more complicated.
When I, tell you I have a cataract I can’t just go schedule a surgery. I have to wait. Sometimes months. Sometimes years. I have to wait for the medicines to kick in and work, and if they don’t. then cataract surgery is not in the cards for me. If they do, they have to keep working so that I have no inflammation in my eye for three to six months.
The outcome can be different too. I was super excited for my first (and only at this point) cataract surgery. My sister had just had cataracts removed and didn’t even have to wear glasses afterward. She was really pleased with hers, and I was hopeful for mine.
But, it didn’t go like that for me. There wasn’t great clear vision afterward. And the removal of the cataract actually caused more inflammation, and more trips to the ophthalmologist and more needles in the eye.
A cataract, simple as it may seem, is one of the vice’s of treating uveitis. Steroids, which are the go to drug for treating inflammation because they are usually very effective, cause cataracts. And around and around we go. If you do the treatment you will eventually have cataracts, which may or may not be removed.
If you opt out on the steroid route, you may have the option of some sort of systemic drug which doesn’t cause cataracts. However, the further you get down that lovely list, the crazier the side effects become. And…if you’re at the point where you’re looking at the stronger systemic drugs, chances are you can’t really opt out of the steroids in the eye, one way or another, while you wait and see if those systemic drugs are working. If I did, I would make matters a LOT worse than they already are.
The systemic treatments so far haven’t worked for me, except for Prednisone (an oral corticosteroid), but it’s a drug that you can’t be on long term.
Currently, I have a cataract in my right eye that is large enough it needs to be removed. But, it can’t be. Not yet. My eyes haven’t been “quiet” (meaning no inflammation) at all for over two years. And until they are, I live with lessening vision in the right eye and problems with glare and light.
I’m doing pretty well though so far. And you never know what new procedure or drug is just around the bend. If I’m the guinea pig that helps someone else see better later, maybe a daughter or a granddaughter, or a friend, well…then some good has come of this. That’s all I want really, is some good to come of it.
I want good to win. Always.