Cataract News

BETHESDA, Md., March 2008 — Protein fragments found in the eye's natural lens contribute to development of cloudy vision resulting from cataracts commonly found in older people, according to an article in the March issue of Journal of Biological Chemistry.

Researchers say the highly ordered structure of these proteins (called crystallins) normally allows transmission of light and resulting clear vision.

But when crystallins begin to break down as part of the aging process, light becomes scattered.

Normally, the eye's natural lens provides clear transmission of light. But cataracts clouding the lens cause unclear vision.

Cataracts result when tiny, abnormal protein fragments bind to and disrupt function of normally shaped crystallin proteins.

Researchers believe these abnormal fragments are left over when other proteins attempt to "chew up" and remove damaged crystallin proteins in the eye.

BOSTON, January 2008 — Yellow plant pigments known as lutein and zeaxanthin may help protect eyes against cataract formation, according to a report published in the January issue of Archives of Ophthalmology.

Scientists at Brigham & Women's Hospital and Harvard Medical School examined dietary information provided by 35,551 female health workers who originally enrolled in 1993 in the Women's Health Study. Dietary and other health factors involving participants were analyzed for an average 10-year period. Of this study group, 2,031 developed cataracts.

Investigators concluded that women with the highest intake of lutein and zeaxanthin were 18 percent less likely to develop cataracts. Scientists also found that women with the highest intake of vitamin E were 14 percent less likely to develop cataracts.

Lutein, zeaxanthin and vitamin E are all antioxidants, which help protect against molecules (free radicals) that destroy cells in the eyes and other parts of the body.

FRIBOURG, Switzerland and ROCHESTER, N.Y., November 2007 — New discoveries about the way proteins clump together in the eye's natural lens have given Swiss and U.S. researchers additional insights into possible future therapies that might prevent formation of cataracts causing cloudy vision.

Researchers at the University of Fribourg in Switzerland and at Rochester Institute of Technology in the United States conducted simulations demonstrating that certain proteins within the eye's usually clear natural lens clump together through weak attractions that, when disrupted, can cause the lens to cloud over and form a cataract.

Currently, the only effective remedy for cataracts involves cataract surgery, in which the eye's natural lens is replaced by an artificial one.

Researchers studying two crystalline eye lens proteins found that they either separate (no mutual attraction, left) or form clumps (strong attraction, right). The eye's natural lens stays clear, and cataracts do not form when attractions between these proteins are maintained such that they stay uniformly mixed (middle). (Photo courtesy of N. Dorsaz & G. Foffi/EPFL & IRRMA)

"By combining experiments and simulations, it became possible to quantify that there had to be a weak attraction between the proteins in order for the eye lens to be transparent," said Swiss researcher Giuseppe Foffi.

Experimental results were published in the Nov. 9 issue of Physical Review Letters.

ROCHESTER, Minn., July 2007 — More than half of Americans will have cataracts or undergo cataract surgery by age 80, according to the July issue of Mayo Clinic Women's HealthSource.

The health publication notes that cataract surgeons no longer recommend waiting for a procedure until a cataract has "hardened" or matured. Instead, cataracts are surgically removed when vision problems caused by the eye's clouded natural lens begin to interfere with daily activities.

People who are 65 or older should have eye exams at least every two years so that age-related eye conditions such as cataracts can be monitored.

OTTAWA, April 2007 — People who undergo cataract surgery within six weeks of booking their procedure have better visual outcomes, as well as increased quality of life and fewer adverse events such as falling, says research reported in the April 24 issue of the Canadian Medical Association Journal.

In contrast, people who waited six months or longer for cataract surgery experienced more adverse events.

Study authors say that, in North America, 50 percent of people between 55 and 64 will develop cataracts within a decade. About 85 percent of people older than 75 develop cataracts.

SYDNEY, Australia, April 2007 — Cholesterol-lowering drugs known as statins were found in two Australian studies to reduce risks of developing both cataracts and advanced age-related macular degeneration.

Researchers found in one investigation that statins inhibited development of cataracts by 50 percent. Results from both studies were published in the April issue of American Journal of Ophthalmology.

ROCHESTER, N.Y., March 2007 — Medicare will now pay an extra $50 in reimbursement for each use of Bausch & Lomb's SofPort Advanced Optics intraocular lens during cataract surgery.

The special "new technology" designation awarded by the Centers for Medicare and Medicaid Services also applies to the Violet Shield version of the intraocular lens, which filters potentially eye damaging ultraviolet and violet light.

The SofPort Advanced Optics lens won the special designation allowing extra reimbursement because of demonstrated ability to reduce certain visual aberrations that may occur with more traditional intraocular lens designs.

FORT WORTH, February 2007 — The U.S. Food and Drug Administration recently approved a new aspheric version of Alcon's AcrySof ReStor intraocular lens (IOL) for cataract surgery.

The lens, known as the AcrySof ReStor apodized diffractive aspheric IOL, addresses presbyopia by providing different zones enabling vision correction at near to far distances. An Alcon Laboratories statement says the newly approved aspheric optics design is the only one currently available in the United States in a presbyopia-correcting lens.

Researchers previously have produced evidence that aspheric lenses, which are somewhat flattened at the periphery, may help offset aberrations in the eye that can cause vision problems such as reduced night vision and contrast sensitivity.

BALTIMORE, February 2007 — A recent ruling by the Centers for Medicare and Medicaid Services allows Medicare recipients to choose an astigmatism-correcting intraocular lens for cataract surgery.

While the ruling allows Medicare coverage for basic cataract surgery, patients must pay out-of-pocket for any extra features of a basic intraocular lens such as for astigmatism correction. But in the past, astigmatism-correcting IOLs were not covered at all.

Specific astigmatism-correcting IOLs approved for basic coverage will be listed at a future date, according to the Medicare announcement.

DENVER, December 2006 — If your eye doctor has told you that you have "early cataracts" not yet requiring eye surgery, you may notice you are less able to spot pedestrians dressed in dark clothing when you drive after dark.

This is because early cataracts can significantly decrease contrast sensitivity and adversely affect your night vision, according to a study conducted by Queensland University of Technology in Brisbane, Australia.

Study results presented at the 2006 American Academy of Optometry conference in Denver were based on night driving experiments using specially equipped goggles. These goggles simulated blurred or hazy vision associated with early cataracts or other early visual impairment in drivers with otherwise normal vision.

"Driving performance under nighttime conditions is significantly degraded by the effects of early visual impairment," researchers concluded in the study. "These effects were greatest for the cataract condition despite the fact that they [drivers] took longer to complete the course."
 

ALICANTE, Spain, October 2006 — A recent study indicates that conductive keratoplasty (CK), using low-heat radio waves to reshape the eye's surface (cornea), may be an effective and safe way to improve low or moderate near vision problems for people who have had cataract surgery.

Researchers in Alicante, Spain used CK to correct residual near vision problems in 16 eyes of 16 patients who had undergone cataract surgery. Near vision was improved in most eyes following the CK procedure without any complications, according to study results reported in the September 2006 issue of the Journal of Cataract and Refractive Surgery.

[Read more about conductive keratoplasty (CK)]

WASHINGTON D.C., August 2006 — Several medical associations have warned patients that the common prostrate drug, Flomax, and similar medications known as alpha-blockers could cause problems during cataract surgery.

Patients on Flomax or similar medications should notify their eye surgeon before undergoing cataract surgery in which the eye's natural, cloudy lens is replaced with an artificial one, according to a joint advisory issued in August 2006 by the American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery and the American Urological Association.

Flomax, commonly used to treat an enlarged prostate, and other alpha-blockers can cause abnormal movement of muscles controlling the opening and closing of the iris. This muscle movement causes the pupil to appear smaller or larger, in response to the presence or absence of light.

During cataract surgery, the pupil must stay enlarged or dilated to allow the eye surgeon proper visibility while the eye's lens is removed. But Flomax and certain other alpha-blockers, including Hytrin, Cardura and Uroxatral, can interfere with pupil dilation, creating a condition known as intraoperative floppy iris syndrome.

Medical experts say cataract surgeons who know that a patient uses these types of medications can take extra precautions, such as use of additional eye drops, to make sure the pupil stays dilated to prevent unexpected complications during cataract surgery. The advisory emphasizes that these alpha-blocker drugs are otherwise safe in relation to vision and eye health.

DELHI, India, July 2006 — An evaluation of tobacco use among 3,924 adults in rural India found that using smokeless tobacco (snuff or chewing tobacco) is associated with a higher likelihood of getting a cataract, according to a report in the British Journal of Ophthalmology.

A 72 percent higher than normal prevalence of cataracts existed in the 1,705 tobacco users in the group. Among the smokeless tobacco users, the prevalence was more than twice as high as for the smokers. Nine times more heavy users of smokeless tobacco had cataracts than the heavy smokers in the group.

According to researcher Dr. Prema Raju of the Vision Research Foundation, cadmium levels in the blood of smokeless tobacco users are three times higher than in non-users, and since cadmium renders a certain kind of antioxidant inactive, the eye's natural lens suffers oxidant damage, which may lead to cataract development.

MONTREAL, July 2006 — Older people with asthma who use cortisone-based medications in their inhalers might consider asking their physicians about reducing dosages to avoid cataracts or their progression, say researchers at McGill University Health Centre in Montreal.

The Montreal researchers in a large-scale study found that people older than 65 using daily doses of inhaled corticosteroids (ICS) to reduce risk of attacks of asthma or chronic obstructive pulmonary disease (COPD) increase their risk of developing cataracts by 24 percent.

Results of the study of more than 100,000 older Quebec residents were published in the June 2006 issue of European Respiratory Journal.

"We recommend that elderly asthma sufferers keep using these very effective medications, but make efforts to reduce the dose of ICS as much as possible," epidemiologist and senior study author Samy Suissa, MD, said in a news release.

MADISON, Wis., June 2006 — Cholesterol-lowering drugs known as statins could decrease the occurrence of a common type of age-related cataract, according to study results announced in June 2006 by the University of Wisconsin School of Medicine and Public Health in Madison.

Researchers say follow-up studies are needed. But initial results from close examination of 1,299 people who participated in the Beaver Dam Eye Study from 1998 through 2000 uncovered a strong correlation between use of statins and reduced incidence of common nuclear cataracts.

When other risk factors such as smoking and diabetes were eliminated to achieve a balanced comparison between people who used statins and those who did not, statin users were found to have a 60 percent reduced risk of developing advanced nuclear cataracts.

SANTA ANA, Calif., March 2006 — An artificial (intraocular) lens known as Tecnis has received a "new technology" designation, meaning that its special design enables extraordinary results in correction of certain vision defects, leading to potential for improved night vision and contrast sensitivity.

The Centers for Medicare and Medicaid Services (CMS) announced that the "new technology" designation for the Tecnis intraocular lens, used to replace the eye's natural lens during cataract surgery, was effective in late February 2006. The special designation means that an extra $50 Medicare reimbursement per lens will be awarded to qualified surgical centers for a five-year period as a way of encouraging new technology.

Under the new designation, Advanced Medical Optics (AMO) based in Santa Ana, Calif. is now able to market the Tecnis lens under the unique classification of reduced spherical aberration. Because the lens incorporates a technology known as wavefront for analyzing the way the eye sees, certain vision distortions (higher order aberrations) not addressed by ordinary lenses can be corrected.

"We have had a number of our Tecnis patients comment on their enhanced vision at night and in other low light conditions, adding a margin of safety to their activities, especially for driving," R. Bruce Wallace III, MD, said in a company news release. Wallace is clinical professor of ophthalmology at Louisiana State University Medical School.

NAGANO, Japan, February 2006 — Japanese researchers have found that reduced cholesterol levels within the eye's natural lens and in a portion of the brain linked to vision (cerebral cortex) could be an underlying cause of cataract formation in some cases.

A study in the February 2006 issue of the Journal of Clinical Investigation noted that low cholesterol levels related to genetic defects appear associated with abnormal development of a thin layer of tissue known as epithelial cells, needed for lens transparency and clear vision. When cataracts form, the eye's natural lens becomes cloudy.

The study analyzing cataract formation in eyes of rats was conducted by researchers at Shinshu University Graduate School of Medicine in Nagano, Japan.

Researchers noted that findings related to cataract development may need to be considered when medications lowering cholesterol are given to patients.

BALTIMORE, December 2005 — A study found that cataract incidence in the United States could increase by 1.3 percent to 6.9 percent by 2050, if ozone depletion in the stratosphere continues unabated. The estimated 830,000 extra cases of cataracts could cost $3 billion in cataract operations, and this is based on 2003 cost levels. Ozone is the substance that screens us from most of the ultraviolet radiation of the sun. The researchers looked at data on cataract incidence and UV radiation exposure from more than 2,500 subjects in a Maryland population-based study. The results were published in the December issue of American Journal of Epidemiology.

EXTON, Pa., November 2005 — Othera Pharmaceuticals began a phase II clinical trial of an eye drop called OT-551, to see if it can prevent or slow the progression of cataracts in people who have undergone vitrectomy surgery. A vitrectomy is the removal of vitreous from the back of the eye; it is performed to correct retinal defects.

"It is generally accepted in the ophthalmology community that a link exists between vitrectomy surgery and subsequent cataract formation," said Dr. Leonard Parver, a retinal surgeon and the medical director for Othera. "Removal of the vitreous from the back of the eye exposes the lens to oxygen-free radicals, and in the great majority of the cases where the patients have their natural lenses, vision-impairing opacities will form within nine to 12 months."

OT-551 will also be evaluated for treatment of early-stage and advanced dry age-related macular degeneration (AMD), by protecting against retina photoreceptor cell death and inhibiting angiogenesis, which is the growth of new blood vessels that could lead to the wet form of AMD.

REYKJAVIK, Iceland, August 2005 — Good vision is essential for flying a plane, but a study has found that airline pilots have an increased risk of developing nuclear cataracts, compared with non-pilots. Researchers at the University of Iceland in Reykjavik studied 445 men, 79 of whom were commercial pilots and 366 of whom had never been pilots. All were at least 50 years old, and other cataract risk factors were controlled for in the analysis. Among the 71 men with nuclear cataract, 15 were employed as commercial pilots. The increased risk was attributed to cosmic radiation exposure, which also affects astronauts.

In other news, NASA announced that 21 proposals to study radiation exposure and its health consequences, including cataracts, cancer and other tissue damage, were accepted and that they would receive $19 million in total funding.

BOSTON, July 2005 — The debate continues to rage on whether fruits, vegetables and the antioxidants they contain really do discourage cataract formation. A "modest protective effect" was observed by researcher William Christen of Harvard Medical School and Brigham and Women's Hospital. His team conducted a ten-year study of more than 35,000 female health professionals. When the study began, none of the women had cataracts. By the end of the study, those who had eaten the most fruit and vegetables were 10 percent to 15 percent less likely to have cataracts than the other women.

The researchers did note that the women who ate a lot of these foods were also healthier in other ways because they tended to get more exercise and see their doctors more regularly (including eye doctors). So they were unable to isolate the produce-rich diet as the sole cause of fewer cataracts. The study was published in the American Journal of Clinical Nutrition.

REYKJAVIK, Iceland, July 2005 — Begun in 1996, the five-year Reykjavik Eye Study was designed to look at the deterioration of eyesight in 1,379 people age 55 and older. In the cataract portion of the study it was found that those who were moderate drinkers of red wine had about half the risk of developing cataracts as nondrinkers. The red wine drinkers were also ahead of the game compared with drinkers of mostly beer or spirits, who had fewer cataracts than nondrinkers (but not significantly fewer). The researchers said they couldn't determine if white wine drinking also reduced cataract risk, because white wine isn't consumed in Iceland as much as red wine, and not enough study participants drank significant amounts of white wine.

BALTIMORE, Md., May 2005 — The Centers for Medicare and Medicaid Services (CMS) have ruled that Medicare beneficiaries may choose intraocular lenses (IOLs) that correct presbyopia for an additional fee as part of their Medicare-covered cataract surgery. These newer IOLs correct vision at more than one distance and offer the possibility of little or no dependency on reading glasses. Before the ruling, Medicare patients were limited to receiving the traditional distance-vision IOLs that don't correct near vision. Read more about cataracts and cataract surgery.

FAIRFAX, Va., April 2005 — The American Society of Cataract and Refractive Surgery (ASCRS) has alerted eye surgeons that they should watch for a potential complication of cataract surgery possibly associated with a type of muscle relaxant known as tamsulosin or Flomax (Boehringer-Ingelheim Pharmaceuticals Inc.), Review of Ophthalmology reported in its March 2005 edition.

Flomax typically is prescribed for older men who have enlarged prostates and difficulty urinating (benign prostatic hypertrophy or BPH). The drug may also be used off-label to treat women with urinary retention, the journal said.

An ASCRS news release said eyecare providers are concerned that Flomax may at times be linked to Intraoperative Floppy Iris Syndrome (IFIS). IFIS, a potential complication of cataract surgery, involves loss of muscle tone in the colored portion of the eye (iris) responsible for pupil dilations and contractions governing the amount of light entering the eye.

Eye surgeons who have noted the possible link between IFIS and Flomax said the medication's apparent side effects are potentially serious because the eye's pupil must remain properly dilated and stable for proper cataract removal.

Eye surgeons have been asked to report any possible issues related to Flomax and cataract surgery directly to the U.S. Food and Drug Administration so that appropriate guidelines can be developed for managing cataract patients who might be taking the medication.

SANTA ANA, Calif., April 2005 — Just FDA-approved, the ReZoom multifocal refractive intraocular lens is designed to distribute light over five optical zones to provide distance, intermediate and near vision for cataract patients. The idea is to reduce the need for spectacles, including reading glasses, after cataract surgery. ReZoom already has CE Mark approval in Europe for treatment of presbyopia; it is made by Advanced Medical Optics.

FORT WORTH, Texas, March 2005 — A new artificial lens (intraocular lens) that often can restore sight at near, intermediate and distant ranges following cataract surgery received U.S. Food and Drug Administration approval, said Alcon Inc. officials in a news release.

"The clinical studies supporting the approval showed that 80 percent of patients who received the AcrySof ReSTOR lens did not use glasses for any activities after cataract surgery," the release said.

Other intraocular lenses may produce vision at all ranges by depending on the action of the eye's muscles (accommodation). But the AcrySof ReSTOR lens provides different ranges of vision based on a lens configuration that enables specific distribution of light in response to how wide or small the eye's pupil might be. This light distribution design is called apodized diffractive optics.

Most current intraocular lenses used for cataract surgery are able to restore vision only in limited distance ranges, which means patients often must use eyeglasses or other corrective lenses following surgery.

Alcon officials say surgeon training for use of the lens will begin in the United States in April, followed by commercial shipments of the lens in May.

MONTPELLIER, France, March 2005 — Recently released results from a large French study indicate that amino acids and vitamins needed to maintain eye health could be missing in lower protein diets and may lead to development of cataracts, Archives of Ophthalmology reported in its February 2005 issue.

More than 2,200 people between ages 60 and 95 were included in final results of the Montpellier, France study, in which researchers noted that levels of essential amino acids and B vitamins could be lower in significant numbers of people who have cataracts.

Protein markers of plasma albumin and transthyretin were used in the analysis, which showed that low levels of transthyretin in particular can be associated with formation of the most common type of cataract (nuclear cataract) associated with aging processes that lead to clouding of the eye's natural (crystalline) lens.

CHICAGO, December 2004 — A study that measured the lead levels in 795 men age 60 and older found that those with the most lead in their bodies were 2.7 times more likely to have cataracts than the men with the least amount of lead.

The researchers measured the lead in the participants' shin bones, where lead tends to remain for many years. It is not clear what the link is between lead exposure and cataract development, but the researchers speculated that lead may have something to do with changes in the cells of the eye's lens that lead to clouding of the lens. Lead has also been linked to high blood pressure and dementia in adults, as well as mental retardation and death in children.

The research, conducted by Dr. Debra Schaumberg and associates at Harvard Medical School, was published in the Journal of the American Medical Association.

BASIN, Mont., August 2004 — Radon is a known carcinogen, yet thousands of people are visiting radon mines in Boulder and Basin, Montana, to inhale the toxic gas, says a report by the Associated Press. Why? They are under the impression that radon can cure what ails them, be it cataracts, arthritis or migraines.

Doctors express bewilderment as to why people would inhale a cancer-causing gas that has not been shown in any study to have any therapeutic effect. They emphasize that most of the ailments that people are trying to cure with radon are easily treatable with non-toxic therapies or surgery. Click here for information on cataract surgery.

BOCA RATON, Florida, June 2004 — Dr. Charles Kelman, who invented phacoemulsification, the procedure that uses an ultrasonic device to break up cataracts in the eye so they can be suctioned out with a needle, died of lung cancer at age 74.

Phacoemulsification is an outpatient procedure that is the most common way to remove cataracts now. Before its invention, cataract removal required a hospital stay of several days.

A New York City native, Dr. Kelman studied medicine at the University of Geneva in Switzerland and was a clinical professor of ophthalmology at New York Medical College. He received the National Medal of Technology in 1992 from then-President Bush and was inducted into the National Inventors Hall of Fame in 2004. Read more about phacoemulsification and cataract surgery.

FORT WORTH, Texas, May 2004 — Most cataract surgery patients receive monofocal intraocular lenses (IOL), which restore their distance vision but require them to use reading glasses for reading and other close-up activities. The AcrySof ReStor IOL has demonstrated that it can substantially restore the ability to see both near and far, in a Phase III clinical study presented recently at the American Society of Cataract and Refractive Surgery annual meeting.

In 566 patients who received the lens, 99 percent achieved distance visual acuity of 20/40 or better, with 88 percent seeing 20/25 or better. Regarding near vision, 74 percent of those who had the implantation in both eyes achieved 20/25 vision. (This means they could read stock quotes printed in a newspaper.) And 85 percent achieved 20/40 or better vision at intermediate distance (the standard 60 cm distance between a person and his computer screen).

The AcrySof ReStor lens has received approval for marketing in Europe already, and Alcon Inc., the manufacturer, anticipates FDA approval in 2005.

PEAPACK, N.J., May 2004 — The FDA approved new labeling for the Tecnis intraocular lens that says it can reduce postoperative spherical aberrations and improve night driving simulator performance. Since drivers over 65 are more likely to be involved in car crashes than people in their 30s, 40s and 50s, manufacturer Pfizer Inc. considers this label change significant.

The company says the lens was designed to improve the functional vision of cataract surgery patients — in other words, to improve the ability to see objects in varying light conditions, such as nighttime, rain, snow, fog and twilight. The FDA approval was based on a clinical study that measured ocular spherical aberration and night driving simulation in cataract surgery patients, comparing the Tecnis lens with a traditional acrylic lens.

INNSBRUCK, Austria, February 2004 — Diabetic rats that were given eyedrops containing verapamil, a calcium channel-blocker, developed fewer cataracts than rats that did not receive the eyedrops. And any cataracts that did form were less dense. The University of Innsbruck researchers said they could not explain the mechanism but suggested that verapamil be tested for age-related cataracts as well. The research is important for diabetics, since they are at high risk for cataracts. The study was published in the British Journal of Ophthalmology.

FORT WORTH, Texas, January 2004 — According to research, blue light may cause retinal damage. So Texas-based Alcon developed the AcrySof Natural foldable intraocular lens.

The lens, which is used to replace a cataract patient's eye's natural lens that has become clouded, filters both ultraviolet and portions of high-energy blue light.

The yellow-tinted intraocular lens has been available overseas since 2002 but is now FDA-approved for the U.S. market.

HO CHI MINH CITY, Vietnam, January 2004 — More than 38,000 poor people with cataracts have received free surgery during the past decade, as part of an effort to eliminate cataract-caused blindness in Ho Chi Minh City, Vietnam. The surgeries were funded by the Ho Chi Minh City Association in Support of Poor Patients, according to the Vietnam News Agency.

In related news, China, too, is addressing its eye problems, says ChinaDaily. The country has more than 5 million bind people, about 18 percent of the worldwide total, with 400,000 people developing cataracts each year. The Sight First China Action program helped more than 2.6 million cataract sufferers regain their vision from 1997 to 2002. Now the government plans to strengthen treatment programs in the villages, where only 10 percent of cataract patients can afford treatment.

ALISO VIEJO, Calif., November 2003 — The FDA has approved the Crystalens, an intraocular lens (IOL) that replaces the eye's natural lens in cataract surgery. According to developer eyeonics inc., Crystalens is the first accommodating IOL that lets cataract patients focus seamlessly at all distances, as the eye's natural lens would. In most cases, eyeglasses and contact lenses would not be needed for everyday tasks after Crystalens implantation. This is different from standard, non-accommodating IOLs, which are normally good only for distance vision, requiring eyeglasses or contact lenses for intermediate or close-up vision.

FLORIDA, November 2003 — If you're 80 or over and a Florida resident, you will not be able to renew your driver's license unless you pass a vision test at either an eye doctor's office or the Department of Motor Vehicles. The new law, which goes into effect in January 2004, requires 20/40 vision for everybody, either with or without eyeglasses or contact lenses.

Florida's new law looks comparatively lenient considering some of the other states that have special requirements for seniors. In New Hampshire, vision and driving tests are required for those 75 and older. In Utah a vision test is needed if you're 65 and older, while in Oregon it's 50 and in Maine it's 40.

The law will affect a lot of people: more than 650,000 of Florida's drivers are 80 or older, and it is likely that those with advanced cataracts or vision loss from glaucoma or macular degeneration who are still on the road will not pass the vision test.

WINSTON-SALEM, N.C., November 2003 — We've all heard that blind people tend to develop better hearing over time. But even if your vision is only somewhat poor, such as with cataracts, using your listening and hearing skills may help you perform certain tasks better, according to a study performed at Wake Forest Baptist Medical Center.

Researchers asked study participants to point to the location of a light that would shine randomly in a dark room. Usually the room was silent, but at times a sound occurred at the same time as the light. Participants who had good vision found the light easily and were not helped by the sound to find it. When they wore goggles to blur their vision, they had difficulty finding the light, except when the sound came on at the same time. The sound improved their score to the same level as with their normal vision.

The research suggests that people with cataracts or other vision problems can be taught to heighten their sound sensitivity and use that skill to help with everyday tasks.

ST. LOUIS, September 2003 — A soft, elastic polymer gel may someday be used to replace the clouded natural lens that is removed during cataract surgery. Researchers at Washington University say the gel would be injected into the capsular bag, the cavity from which the eye's natural lens is removed.

The material is a modified hydrogel, similar to that used for extended wear contact lenses. Its injectability would eliminate the need for the slit that is normally cut in the eye to insert a replacement lens, so the surgery could be less invasive. Animal testing may begin in 2004, but there is no knowing when the technology may be available for humans. One problem is that the gel currently doesn't have a high enough refractive index to allow the eye to focus clearly, so a new formulation may be necessary. Researchers are also considering the gel to correct presbyopia, the age-related inability to focus up close.

SAN FRANCISCO, September 2003 — Cataracts are the cause of nearly 50 percent of all global blindness, according to the American Academy of Ophthalmology. But almost 20 million people who need cataract surgery must go without.

The Academy has designated October as World Blindness Awareness Month and says that cataracts and other eye diseases, such as trachoma and onchocerciasis, will cause 100 million people to lose their sight by 2020 if nothing is done. More than 1.5 million people are blind because of vitamin A deficiency, measles and other problems. And more than 135 million people are going through life without the means to correct their nearsightedness, farsightedness and other refractive errors.

Despite the fact that we have the scientific knowledge to correct the situation, every five seconds a person goes blind, at an estimated economic cost of $28 billion a year. The Academy says it is addressing the problem of global blindness through its public service foundation, Eyecare America, which uses the volunteer services of member physicians for treatment and education.

GAITHERSBURG, Md., July 2003 — A first in cataract surgery appears to right around the corner: the FDA is likely to approve a focusing intraocular lens (IOL). Today's IOLs do not focus, and correct vision in one zone only (such as your distance vision); you need to wear glasses to see in other zones. The CrystaLens Accommodating IOL focuses in much the same way your eye's natural lens does and is designed to reduce or eliminate the need for glasses following cataract surgery.

The FDA Ophthalmic Devices Panel voted unanimously to approve the CrystaLens, and the FDA typically follows its panels' recommendations. C&C Vision, which makes the CrystaLens, hopes to make the product available later this year or early in 2004.

MADISON, Wis., December 2002 — Cataracts are associated with an increased risk for early macular disease, and cataract surgery is associated with an increased risk for late macular disease, a recent study found. The late form typically causes more serious symptoms and vision loss.

Those with cataracts were 1.3 times as likely to develop early age-related maculopathy (ARM); there was no association with late ARM. Those who had cataract surgery, however, were 3.8 times as likely as those who did not to develop late ARM; there was no association with early ARM.

The researchers reported their findings in the November 2002 issue of Archives of Ophthalmology.

BETHESDA, Md., December 2002 — Infants who weigh less than 2,500 grams (about 5.5 pounds) when they're born are three to four times more likely than heavier babies to develop infantile cataracts, a recent study found.

Infantile cataracts are rare and occurred in fewer than 1 percent of the children in the study. Doctors examined the children's eyes at birth, four months, one year and seven years and published their results in the November 2002 issue of Archives of Ophthalmology.

BIRMINGHAM, Ala., October 2002 — Patients who undergo cataract surgery and intraocular lens implantation have half the number of car accidents as those who do not have surgery for their cataracts, a recent study found.

The study followed 277 patients with cataracts; 174 had surgery and 103 did not. The researchers checked police-reported crash records for four to six years from patient enrollment, to March 1999. They reported their findings in the August 21, 2002 issue of JAMA (Journal of the American Medical Association).

CHARLESTON, S.C., October 2002 — A group of doctors has discovered that intraocular lenses (IOLs) can degenerate. In an article in the September 2002 issue of Ophthalmology, they described 25 IOLs from the 1980s and early '90s that had cloudy spots; for most of the 18 patients, this resulted in a vision decrease. The degeneration was not limited to one brand, and the researchers think it may have been caused by "manufacturing variations."