FW: Cataracts Hurt Driving Skills

[Guest guest]

Cataracts Hurt Driving Skills

By Ed Edelson

HealthScoutNews Reporter

TUESDAY, Aug. 20 (HealthScoutNews) -- This isn't an eye-opening revelation,

but it's reassuring to know: Cataract surgery among older people cuts in

half

the risk of being involved in a car crash.

" It is an additional piece of evidence that patients need to be aware of

when

they are weighing the risk of having cataract surgery, " says Owsley,

a professor of ophthalmology at the University of Alabama at Birmingham. She

is the lead author of a paper on the finding, which appears in tomorrow's

issue of the Journal of the American Medical Association.

It may seem obvious that someone whose vision is reduced by cataracts --

which means half of all Americans 65 or older -- will do better on the road

with surgery, but no one has documented that benefit until now. Cataracts

are

a clouding of the lens in the eye. When the clouding becomes too dense,

surgery is the answer.

" When we counsel our patients about cataract surgery, we must discuss risks

and benefits, and until this paper, there was no quantifying evidence about

what risks they take if they don't have the surgery, " says Dr. Wayne F.

Bizer, a spokesman for the American Academy of Ophthalmology.

In the study, Owsley and her colleagues compared the driving records of 277

patients diagnosed with cataracts at 12 eye clinics in Alabama from 1994 to

1996. In a follow-up averaging about five years, the 174 people who had

cataract surgery had a 53 percent lower risk of auto crash involvement than

the 103 people who didn't have the surgery.

The people who didn't have the surgery drove a lot less than those who did,

logging only half the number of passenger miles -- which could be an

indication that cataracts were limiting their mobility.

That self-imposed limitation could be important to an older person who wants

to remain busy and employed, Owsley says. " If they want an active lifestyle

and part of that lifestyle is working, one of the critical issues for them

is

driving, " she notes.

Studies like this are important because many people have an unwarranted fear

of cataract surgery, Bizer says.

" When you tell them they need cataract surgery, half of them will fall out

of

the chair, " he says. " Many people find it terribly frightening. They may

remember what cataract surgery was in the age of their parents, when you had

sandbags on each side of your head and you were in the hospital for two

weeks. And some are afraid they might go blind from surgery, which is a very

rare occurrence. "

Many people don't know about the safety of the procedure. " One idea that may

be getting lost is a very low complication rate, " she says.

The great majority of cataract operations now are done as outpatient

procedures, in which the patient spends only a few hours in the doctor's

office or hospital. The medical advances that made outpatient surgery

possible have been eagerly seized upon not only by ophthalmologists, but

also

by cost-conscious health-care providers.

" Medicare made it that way, " Bizer says. " To be reimbursed, it has to be

outpatient surgery unless there is a co-morbid condition such as diabetes or

cardiovascular disease that requires the patient to spend a night in the

hospital. "

Many factors can influence the decision to have cataract surgery, Owsley

says, including other chronic conditions and the availability of family

support. However, people considering the procedure should know that " it is

one of the safest surgeries we have, " she says.

SOURCES: Owsley, Ph.D, professor, ophthalmology, University of

Alabama at Birmingham; Wayne F. Bizer, D.O., clinical professor,

ophthalmology, Nova Southeastern University, Fort Lauderdale, Fla.; Aug. 21,

2002, Journal of the American Medical Association

Copyright © 2001 MDchoice.com, Inc. All rights reserved.