Yes, you read the title correctly. A 27 year old with cataracts. What?!
Apparently cataracts after cancer treatments are actually pretty common. Something to do with the long-term steroid use that is included in a lot of treatment protocols.
I had no idea that this was even a possibility while I was going through my cancer treatments, so I imagine some others out there going through treatment may not be aware of the possibility either. In this post I’d like to describe what led me to go get my eyes checked out, a little bit about the treatment options, and then go into what the surgery was like. I hope that this can help anyone that also ends up developing cataracts after treatment like I did!
The Symptoms
I started noticing little things happening last year (2021) like my wife saying “look at that plane over there” and I would have no clue what she was talking about. Clear blue sky and no plane in sight. Or at least no plane in my sight.
Or we’d be on a boat searching for lobster traps to avoid (if you’ve ever driven a boat out on the ocean you know the feeling), everyone else would point them out, and I’d be sitting there thinking to myself “how the heck did they see that?”
And then right around daylight savings time at the end of 2021, I started noticing that the headlights from oncoming vehicles were totally blinding me when I was driving at night. It was so bad that I actually stopped driving when it got dark outside.
The night driving ended up being such a “glaringly” (pun intended) obvious symptom of an issue with my eyes that it eventually sent me to the optometrist.
The Diagnosis
When I went to see the eye doctor, I went in thinking I would need a pair of glasses. I have never worn glasses before, so I figured my eyesight was just getting worse after treatment and that some sort of corrective lens would do the trick. No biggie, plenty of people wear glasses.
So I went through the usual eye tests. I read the letters on the wall across the room while the optometrist continuously changed the lenses that would make my vision better or worse and would make the letters clearer or blurrier.
I thought she was finding out what glasses prescription I would need!
But then she took a really bright light, shined it in my eyes, and everything else went black except for that light. I couldn’t see anything else around the room. In fact, during a different test with similar conditions, I was asked to read letters on the wall with the light shining near my eye and I couldn’t even see the chart, let alone try to read the letters that were on it!
So sure enough, the doctor told me that even though she usually had this conversation with people quite a bit older than me, I had atypical cataracts that were probably brought on by my previous cancer treatments. Or more specifically, from the steroids that I had been put on in years prior.
That is when the optometrist referred me to an ophthalmologist, who then confirmed my cataracts and recommended surgery as the best (and really only) option.
What Are Cataracts?
A very, very simplified description of how the eyeball works (since I am not a doctor) is that it takes in light from the world, and the brain processes that light to form the images that we see.
One of the parts in the eyeball that takes in this light is called the lens. The lens in an eyeball works much like the lens of a camera. Light comes into the lens, and then based on the focal point of that lens, distance to whatever it needs to focus on (and yes some other physics and science stuff that I won’t geek out on right now) the camera auto-adjusts to make the image clearer for the picture. And our eyes can actually auto-adjust as well just like the camera to make the things we look at as clear as possible!
But like a camera, if the lens gets foggy or cloudy, it is much harder to see and needs to be swapped out with a new one. A cataract clouds the lens of the eye. Imagine looking through a foggy window, and that is what it is like to have cataracts. Most images are blurry, and when light shines on it, that light scatters like crazy, which is why headlights were so unbelievably bright in my eyes.
Not ideal for driving at night, that’s for sure!
The Treatment Options
Unfortunately, the only permanent fix for cataracts is surgery. And it generally requires two surgeries because a lot of surgeons will not want to do the procedure on both eyes at once. Generally they are spaced a few weeks apart to allow the first eye to heal prior to operating on the second.
Sometimes cataracts have been known to stop progressing on their own which makes surgery unnecessary, but mine were so bad that they were already negatively affecting my day-to-day life. So even if they stopped getting worse, it wouldn’t really fix my problems. Multiple doctors told me that they would not get better on their own, so surgery was my only option.
However, on a positive note, it is one of the most performed surgeries in the world and has been done the same way for years and years. In fact, after talking to my surgeon, I found out that he has performed thousands of these procedures throughout his career. I was shocked!
Cataract surgery is, simply put, the process of swapping out the natural lens of the eye with an artificial one. One that will not degrade over time.
So which lens do I get? Are there options?
Please remember that I am in no way shape or form a doctor. So I can’t give advice on any of this. But in my research, I found that there were really two routes to go.
The first option is the lens that has been used for as long as this surgery has been happening. This lens is called a monofocal lens. As the name suggests, this lens has one focal point (one distance that is perfectly clear), meaning that they allow for long-distance vision or close-up vision, but not both. Whichever distance is not chosen must be corrected with glasses.
The second option is multifocal lenses. These lenses are much newer technology and can utilize long-distance and close-up vision by utilizing different “regions” of the lens to make multiple distances look clear. I read that the brain would naturally adapt and learn where to look through the lens depending on how far away the object being looked at is.
This sounds really cool in theory, however in my research I found that these rarely work without issues. Articles (and my surgeon) were saying that if they aren’t perfectly done, they cause all kinds of problems. There is little margin for error with this type of lens. In fact, the surgeon that is performing my procedures will not put them in because he does not think that they work as well.
And just from a physics standpoint (and this is just me nerding out), I imagine that there would have to be some type of gradient between the different segments of the lens, causing light to do some strange things where the changes in the type of lens occurs.
But I am not saying that to discourage anyone from going that route! Please, do your own research, talk to actual doctors, and do what is right for you. The only reason I bring this stuff up is because it was how I rationalized going with option #1 for myself. I took the long-distance vision lenses, meaning that I will need reading glasses when I finish the second surgery. I wanted to go with the lenses that have been used and proven for a very long time, and the ones that made the most sense for me.
The Surgery
At the point of writing this post, I have had one of the surgeries done. My left eye now has an artificial lens and my right eye still has the original lens with the cataract.
For this surgery, the preparation was simple. I started by getting my eyeballs measured at the doctor’s office. It was pretty cool actually; he used an ultrasound to gather data about the dimensions of my eyes and then the machine gave results stating the size lens that I would need. Then, I had to use two different eye drops four times per day for the two days leading up to my procedure.
Pro tip: I would highly recommend having someone drive you home from this appointment! To do some of the tests they put eyedrops in that dilated my eyes and I was definitely straining to see when I went back out into the sunlight. I was happy to have my wife drive me home!
On the day of the procedure, I arrived at the hospital about an hour and a half early because there is some preparation to do on the actual day as well. Four eye drops this time, three times each, all within an hour or so.
Once all of the drops were done and the medical release forms were signed, the nurse came in to take me into the operating room, where the anesthesia team began sedating me.
For this procedure, they generally just do twilight anesthesia with a local anesthetic at the eye being operated on. At this point, it sounds like it is generally pretty simple for most people. The anesthesia team uses enough medication to make the patient drowsy enough to not really care what the surgeon was doing, but awake enough to hear him calling out instructions.
Then, the surgeon makes a small incision in the eye, pulls out the old lens, and puts in the new one. Piece of cake.
Well, for those of you that don’t know me, I have this thing about anything touching my eyes. I despise the thought of anything going near my eyes. I don’t even like when I have to touch my own eyes myself. Just trying to do something as simple as eye drops is a process and a half for me (or at least it was before I had to start doing them so often for this procedure).
Oh, and of course if you’ve read Mental Health As A Survivor: PTSD Has No Timeline, you know that even though I have made amazing progress with my self-development and self-healing practices, I still have some stuff that triggers crazy, debilitating anxiety.
So yeah. Not the best combination of character traits to have going into eye surgery.
Anyway, I was awake during the surgery like I was supposed to be, but I 100% cared about what was going on and did not like it one bit. I did not want to be in there, which made it very hard to listen and understand what the surgeon was telling me to do. He was telling me not to move my eye around, but my eye was totally numbed and I was loopy enough from the medications that I didn’t know what the hell my eye was doing. Not to mention, everything was dark except for a tiny light because my eyes were covered. And I think the anesthesia (or anxiety?) must have caused me to forget his instructions because all I could remember were a few people I had spoken with prior to my surgery telling me to “stare at the light.” So, I did my best to look at the little light, but still just heard the surgeon telling me over and over again to keep my eye still.
Needless to say, after the surgery the first thing the surgeon said to me was “yeah, it went well, but I’m putting you totally to sleep for the next eye.”
Even though this was very tough for me, this procedure is probably super easy for someone that doesn’t mind anything touching their eyes, or doesn’t have any PTSD triggers associated with it. In fact, everyone I talked to beforehand said it was a piece of cake. But for me, honestly, it was very challenging and was very much out of my comfort zone, and for those of you aware of my history, you know there is not much that makes me uncomfortable anymore!
If you’re like me and do not like people touching your eyes, it may be worth discussing with your doctor whether or not being totally asleep is an option to hopefully avoid the surgery anxiety!
Pro tip: I’m not even joking here when I say I had the best english muffin of my life after this surgery. The hospital I got this surgery done at offered me an english muffin with strawberry jelly right when I got back into my room, and it was so good I had to ask for a second one. And I don’t know if it was a little bit of the happy gas still in effect or not but that muffin was pure bliss. MUCH needed after such a stressful procedure. So anyways I’ll stop fantasizing about my english muffin and give the pro tip. Make sure you have something good to eat afterwards! It definitely helped my stomach after all of the medications.
The Recovery
I won’t go into too many details, but this surgery really triggered a lot of my PTSD. I had an extreme amount of anxiety the following week that took a lot of energy and patience to get through, but the part of this recovery that didn’t involve PTSD wasn’t too bad, all things considered. There really wasn’t too much physical discomfort at all.
The first night, right after the procedure, I had a big eye patch taped onto my face that I wasn’t allowed to take off, and I needed to take a couple of pills to help reduce the amount of intraocular pressure within the eye that was operated on. The next day, I went in for a follow-up where I was able to remove the eye patch, do the “read the letters” eye exam again, and get the pressure on my eyes tested to make sure it was at a healthy level.
Afterwards, once again, it’s a lot of eye drops. Three different kinds four times per day until my doctor told me I could drop one of the medications and do the other two drops three times per day.
Along with the eye drops, eye protection was required to make sure nothing is able to get into my eye and cause any issues (hitting my eye on something, a bug flying into it, anything at all). This was something as simple as a pair of safety glasses from Home Depot. In fact, I still need to wear these for about a month!
At night, that same eye patch that I went home with on the first night needs to be taped on so that nothing gets in my eye at night, and so that I don’t accidentally itch or rub my eye in my sleep.
So, all in all, this stuff is slightly inconvenient, but the recovery really isn’t too bad physically. As I mentioned, I am just over a week out from my first surgery, and I am already starting to see clearly with my new lens! However, the entire recovery process can take about six weeks to get to see the maximum benefits.
The biggest inconvenience during this awkward in-between phase that I am in right now is that one eye is getting pretty clear, but the other one is still wicked blurry. This honestly gets a little dizzying! If I look at a computer too long for work (or even writing this blog post) I start to get a headache and get a little dizzy. But overall it’s pretty manageable with patience, and my brain is starting to learn how to deal with the two different eyes. It is pretty amazing how fast humans can adapt to new situations.
But that’s pretty much it! Right now I am a dizzy pirate that can’t read things up close, but hey at least I’ll be to drive at night again sometime soon-ish! All jokes aside, I am very happy that I am doing this. With the results that I am already seeing, it was worth the anxiety trigger and the tough surgery (at least for me) to be able to see clearly again. I am seeing colors like I haven’t seen them in a long time. They are richer, deeper, and clearer with my new lens than I can ever remember them being and I am so grateful that this surgery was an option for me.
So I hope that this post can provide some in“sight” (sorry I know these puns are awful) on what cataract surgery is like for any of you out there that may develop them after long term steroid use. I sincerely hope that I didn’t scare any of you with my own personal surgery experience, I just want to be as transparent as possible with you all.
Every single person I talked to before this surgery told me that it was absolutely nothing to be afraid of and that it was the easiest surgery they’ve ever had. I personally just happened to have a mental trigger that made this a little worse for me than for some others, but that absolutely does not mean it will be like that for everyone.
Also, like I said, in my opinion the results so far are totally worth it!
If anyone has any questions, please feel free to reach out to me and I would be happy to help in any way that I can. I will keep the Survivor State of Mind Instagram up to date with the progress of my second surgery as well!
I hope this helps!
As always guys, I’m available through my contact page if you have any questions, tips of your own, topics you would like to see covered, or just feel like chatting to someone that’s been through it. I am always here for you.
-Alex
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Featured photo is one of my own!