Dr. T Fletcher Urges Cataract Checks on World Sight Day

Cataracts are among the most frequent reasons people lose clarity of vision, and with World Sight Day arriving on the second Thursday of October, the Bryanston practice of Dr. Taryn Fletcher is putting the condition in the spotlight this month in Johannesburg. Dr. Fletcher, an ophthalmic surgeon, runs a practice focused on microincision cataract surgery, medical retinal disease and aesthetic ophthalmology, with cataract care at the heart of what she does. Her message to Johannesburg residents is simple: if your eyesight has been changing gradually, book an eye examination instead of assuming it is just a normal part of getting older.

Understanding cataracts

Positioned behind the iris and pupil, the eye's lens functions in much the same way as a camera lens, directing light onto the retina at the back of the eye. Water and protein make up most of its structure. With age, the protein may begin to clump, forming cloudy patches within the lens. These patches tend to expand over time, and a developing cataract increasingly scatters and obstructs the light travelling through. Vision becomes blurry, dull or troubled by glare, whether in daylight or after dark.

Both eyes are usually affected, although the condition does not always progress at the same rate in each. When one eye is worse than the other, people may notice a clear imbalance in how well each eye sees. Dr. Fletcher's practice points out that cataracts rank as a leading cause of visual loss, and that occasions like World Sight Day serve as a timely nudge to get the eyes assessed.

Symptoms to watch for

Since cataracts tend to develop gradually, many people adjust without noticing how much their vision has actually changed. According to the practice, the following signs may indicate a cataract:

A spectacle or contact lens prescription that needs changing oftenVision that is cloudy, blurry or dimSensitivity to light or problems with glareColours looking faded or tinged with yellowHalos appearing around lightsTrouble seeing at night, including when driving after darkNeeding brighter light to read or do close workDouble vision in a single eye

Not every cataract behaves as expected. A nuclear cataract, which develops in the centre of the lens, can initially sharpen near vision, something occasionally referred to as second sight. Cortical cataracts appear around the edges of the lens in a pattern resembling the spokes of a wheel, and posterior subcapsular cataracts develop on the lens's back surface. To know for certain which type is present and how advanced it is, an assessment by one of Johannesburg's ophthalmologists is the dependable route.

Risk factors beyond age

While ageing is the most common cause, other factors also raise the likelihood of cataracts. The practice identifies a family history of the condition, diabetes, high blood pressure, obesity and smoking among them. Exposure to ultraviolet radiation contributes too, a point worth noting in a sunny country with summer approaching. Some medications are linked to cataract formation, including corticosteroids, cholesterol-lowering statins and hormone replacement therapy. The list also covers heavy drinking, past eye inflammation or injury, earlier eye surgery and high myopia.

Lifestyle choices may offer some protection as well. Oxidative stress connected to an unhealthy lifestyle has been associated with cataracts, so eating plenty of antioxidants could help. The practice mentions omega 3 fatty acids found in oily fish, lutein and zeaxanthin in orange and leafy green vegetables, vitamin E from seeds and leafy greens, and vitamin C. Wearing sunglasses that block 100 percent of UV rays is recommended, especially now that October is bringing longer and brighter days to the Highveld.

Deciding on surgery

A cataract does not always call for an operation straight away. Early on, new spectacles, magnifying aids and improved lighting can make a difference. Surgery is typically recommended when vision has declined enough to get in the way of daily tasks such as reading, driving or work. It is regarded as a minor procedure and is the most frequently performed elective operation.

During surgery, the cloudy natural lens is taken out and a clear artificial intraocular lens, or IOL, is put in its place. Through a tiny incision at the front of the eye, the surgeon uses a fine instrument to break up the cataract, removes it gently and then inserts the replacement lens. No overnight stay is required, though patients must arrange for someone to drive them home. If both eyes have cataracts, they are generally operated on separately, a few weeks apart, giving the first eye time to heal. An assessment with an experienced ophthalmologist in Johannesburg allows the timing to be tailored to the individual patient.

Lens options for every lifestyle

The variety of lenses now on offer is one of the biggest advances in cataract treatment. The practice explains that some lenses correct only distance vision, others correct both distance and near vision, and others are designed specifically for astigmatism. Monofocal lenses, the most widely used, focus at a single set distance, which means reading glasses may still be needed. Multifocal lenses function much like bifocal or progressive glasses, with separate zones for different distances. Accommodating lenses behave more like the eye's natural lens and may cut down on the need for reading glasses, and toric lenses are used to address astigmatism. Talking through these choices with an opthalmologist ahead of surgery helps each patient select a lens suited to their job, interests and everyday life.

Dr. Fletcher's background

Dr. Fletcher earned her Bachelor of Medicine and Surgery from the University of the Witwatersrand in 2005. Following her internship and community service, she became a medical officer at St John Eye in 2008, and she qualified as an ophthalmologist in 2013. She went on to serve as an honorary consultant at Helen Joseph Hospital and to work as a locum in private practice, then established her own practice in 2014. She holds the qualifications MBBCh (Wits) and FC Ophth (SA).

In addition to cataracts, the practice treats glaucoma, age-related macular degeneration, flashes and floaters, pterygium and diabetic eye disease, and also provides aesthetic treatments. Many people with cataracts have other eye conditions too, such as glaucoma or retinal changes related to diabetes, so a thorough examination is carried out before any procedure.

Book an eye exam this October

World Sight Day reminds people around the globe that a great deal of vision loss can be treated or controlled if it is caught early. Anyone who has noticed glare from oncoming headlights, colours losing their vibrancy or a prescription that never seems to stay the same would do well to schedule an eye examination this October. Families can help too, by urging older relatives and anyone living with diabetes to get their eyes checked.

Details about the practice, the procedures it offers and how to get in touch are available to patients and referring doctors at https://drtfletcher.co.za/.

About Dr. T Fletcher

Dr. Taryn Fletcher is an ophthalmic surgeon practising privately at Bryanston Place Office Park, 199 Bryanston Drive, Bryanston, Johannesburg. Her practice specialises in microincision cataract surgery, medical retinal disease and aesthetic ophthalmology, and it also treats glaucoma, macular degeneration, pterygium and flashes and floaters. Dr. Fletcher completed her medical degree at the University of the Witwatersrand in 2005, qualified as an ophthalmologist in 2013 and opened her own practice in 2014.