Tyler Thompson knew he had a problem when driving at night became a safety risk.
“It came on slowly, but I noticed that nighttime driving was becoming harder and harder, especially when the blacktop roads were wet,” he said. “I eventually decided I was not going to drive at night anymore, because it wasn’t safe.”
That was before Thompson, now 78 and living on Hancock Point, had cataract surgery to replace the clouded lenses in his eyes that were blurring his vision. Made up of proteins and water, the lens is the part of the eye that focuses images on the retina for processing by the brain. With age, those proteins can clump together, making a once-clear lens more and more opaque. Over time, that blurs vision.
Cataracts are a common phenomenon of aging. The National Eye Institute estimates that by age 80, half of Americans have cataracts or have had cataract surgery. The surgery involves dissolving and removing a clouded lens and replacing it with an artificial lens in a procedure that usually takes fewer than 20 minutes.
“There was an absolutely immediate difference,” Thompson said of his post-surgical vision. “The surgery itself was a piece of cake. I didn’t feel a thing.”
Dr. Garth Wilbanks performs 10-12 cataract surgeries on a busy morning as an ophthalmologist with Eastern Maine Eye Associates in Bangor. He describes cataracts as a byproduct of longevity.
“Cataracts are a normal aging process of the eye’s lens, much like wrinkles are a normal aging process of the skin,” Wilbanks said. “The most common risk factors for cataract formation are increasing age, as almost everyone over 55 or 60 has some lens clouding, and sun exposure, smoking and medication such as prednisone.
“The healthy, over-55 population continues to increase, along with increased visual demands such as driving, reading and using computers,” he said. “That means more and more people will want their cataracts removed to maintain their independent lifestyles.”
Wilbanks performs routine cataract surgery in an ambulatory surgical unit rather than a hospital to minimize the risk of infection and to reduce costs. Patients arrive about an hour before surgery for eye dilation and are given a sedative.
“Anesthesia involves taking medicines by mouth or an intravenous drip, or both,” Wilbanks said. “The eye itself is asleep from topical drops or minimally invasive local blocks. Most patients are enjoying the mild sedation and find out 10-15 minutes later that it’s time to leave. The eye doesn’t see much the day of surgery, but most folks are seeing much better the next day and are back to driving.”
If cataracts need to be removed from both eyes, a second surgery is scheduled, usually within a few weeks of the first.
“Most people want their other eye done as soon as possible,” Wilbanks said. “The second eye is usually done one to three weeks later, but sometimes both eyes are done during the same week, if needed by the patient. The main factor determining the timing of the second eye is what works best for the patient.”
The cost of cataract surgery varies widely, depending on where it’s done. A Web-based cost comparison for the Bangor area, which also includes Lincoln and Millinocket, shows hospital-based cataract removal can run as high as $10,100 per eye, while cataract removals performed in an ambulatory setting are billed as low as $3,500, with an average cost of $4,700.
Affecting the cost is the type of artificial lens implanted. Traditional implants can be focused to accommodate near or far vision, but not both. While there is a next-generation lens that facilitates both near and far vision, the cost is not covered by health insurance.
As an avid sailor who lives in a seaside home with panoramic views of Frenchman Bay and Mount Desert Island, Thompson treasures his new-and-improved vision.
“The difference in my vision is astonishing,” he said.
For information about cataracts and treatments, visit the National Eye Institute online at www.nei.nih.gov/health/cataract/cataract_facts.asp.