My mum has moderate Alzheimer's and is now on a waiting list for a cataract operation on one eye. She is 85. I understand such operations are done with a local anethsetic with the patient fully awake. I have concerns as to whether my mum who forgets alot from day to day and seems unaware of many things would cope with such an operation. I know sometimes it can be done under general anethsetic but it seems from other postings that this can have a bad effect on someone with Alzheimer's. Any advice appreciated.
Cataract Operation
- Thread starter realist1234
- Start date
Hi Realist1234,
How coincidental that you should post this today - this morning I took my Mil to a pre-op appointment at the local hospital, as she has been on the waiting list for cataract surgery for 10 months.
She has AZ and VaD, and has declined a lot over the last 10 months, sadly. She is unable to remember any reassurances about hospital visits, and gets very stressed and anxious when we go, and has also developed a pretty bad tremor, in her right hand/arm in particular, which is worse when she is stressed. And the thought of anything being 'done' to her when she is actually awake, is something that has always scared her. (In fact, she is anxious at the thought of any operation or treatment, whether awake or asleep, to be honest). Like your Mum, her short term memory is really bad, she can forget information literally within moments of being told something - and is likely to get very worked up during any examination, never mind an actual operation.
The upshot of today is that the surgery under local anaesthetic is a non-starter, as far as the hospital are concerned. She would have to keep completely still, and as she can (and does) find the tremor gets a lot worse when she is stressed, that is an issue for a start. She can get very agitated, and behave very irrationally - the chances of that happening during the procedure are more than average, I would say, if she were awake
So - she is to see an anaethetist, for another pre-op visit, and we will have to take his views on board, before any decision as to whether or not the surgery can go ahead with a general anaesthetic. She has COPD and angina, so there are issues there to start. And the Doctor today confirmed the possibility of the dementia being made much worse by a general anaesthetic.
Add to that, post op care - the eye drops afterwards, I can administer, so that's not an issue, but its likely she will continually forget that she has had any procedure done, and is likely to rub at her eyes if they are sore or irritated - she just won't remember not too.
I honestly don't think that it will go ahead - I know hubs and I are not in favour of anything that is likely to cause her dementia to get worse, the decline is heartbreaking enough at its current speed, so that alone makes us reluctant. And I do think the chances of her doing herself some damage by rubbing at her eyes afterwards are really hight - more of a certainty than a probability, I'm afraid.
I think you need to list all your concerns, take on board any advice from the surgeons/doctors involved, and then decide - and consider post op, not just the actual surgery too.
Good luck x
How coincidental that you should post this today - this morning I took my Mil to a pre-op appointment at the local hospital, as she has been on the waiting list for cataract surgery for 10 months.
She has AZ and VaD, and has declined a lot over the last 10 months, sadly. She is unable to remember any reassurances about hospital visits, and gets very stressed and anxious when we go, and has also developed a pretty bad tremor, in her right hand/arm in particular, which is worse when she is stressed. And the thought of anything being 'done' to her when she is actually awake, is something that has always scared her. (In fact, she is anxious at the thought of any operation or treatment, whether awake or asleep, to be honest). Like your Mum, her short term memory is really bad, she can forget information literally within moments of being told something - and is likely to get very worked up during any examination, never mind an actual operation.
The upshot of today is that the surgery under local anaesthetic is a non-starter, as far as the hospital are concerned. She would have to keep completely still, and as she can (and does) find the tremor gets a lot worse when she is stressed, that is an issue for a start. She can get very agitated, and behave very irrationally - the chances of that happening during the procedure are more than average, I would say, if she were awake
So - she is to see an anaethetist, for another pre-op visit, and we will have to take his views on board, before any decision as to whether or not the surgery can go ahead with a general anaesthetic. She has COPD and angina, so there are issues there to start. And the Doctor today confirmed the possibility of the dementia being made much worse by a general anaesthetic.
Add to that, post op care - the eye drops afterwards, I can administer, so that's not an issue, but its likely she will continually forget that she has had any procedure done, and is likely to rub at her eyes if they are sore or irritated - she just won't remember not too.
I honestly don't think that it will go ahead - I know hubs and I are not in favour of anything that is likely to cause her dementia to get worse, the decline is heartbreaking enough at its current speed, so that alone makes us reluctant. And I do think the chances of her doing herself some damage by rubbing at her eyes afterwards are really hight - more of a certainty than a probability, I'm afraid.
I think you need to list all your concerns, take on board any advice from the surgeons/doctors involved, and then decide - and consider post op, not just the actual surgery too.
Good luck x
Thanks Ann this was very helpful.
Hi Realist1234,
How coincidental that you should post this today - this morning I took my Mil to a pre-op appointment at the local hospital, as she has been on the waiting list for cataract surgery for 10 months.
She has AZ and VaD, and has declined a lot over the last 10 months, sadly. She is unable to remember any reassurances about hospital visits, and gets very stressed and anxious when we go, and has also developed a pretty bad tremor, in her right hand/arm in particular, which is worse when she is stressed. And the thought of anything being 'done' to her when she is actually awake, is something that has always scared her. (In fact, she is anxious at the thought of any operation or treatment, whether awake or asleep, to be honest). Like your Mum, her short term memory is really bad, she can forget information literally within moments of being told something - and is likely to get very worked up during any examination, never mind an actual operation.
The upshot of today is that the surgery under local anaesthetic is a non-starter, as far as the hospital are concerned. She would have to keep completely still, and as she can (and does) find the tremor gets a lot worse when she is stressed, that is an issue for a start. She can get very agitated, and behave very irrationally - the chances of that happening during the procedure are more than average, I would say, if she were awake
So - she is to see an anaethetist, for another pre-op visit, and we will have to take his views on board, before any decision as to whether or not the surgery can go ahead with a general anaesthetic. She has COPD and angina, so there are issues there to start. And the Doctor today confirmed the possibility of the dementia being made much worse by a general anaesthetic.
Add to that, post op care - the eye drops afterwards, I can administer, so that's not an issue, but its likely she will continually forget that she has had any procedure done, and is likely to rub at her eyes if they are sore or irritated - she just won't remember not too.
I honestly don't think that it will go ahead - I know hubs and I are not in favour of anything that is likely to cause her dementia to get worse, the decline is heartbreaking enough at its current speed, so that alone makes us reluctant. And I do think the chances of her doing herself some damage by rubbing at her eyes afterwards are really hight - more of a certainty than a probability, I'm afraid.
I think you need to list all your concerns, take on board any advice from the surgeons/doctors involved, and then decide - and consider post op, not just the actual surgery too.
Good luck x
update - cataract
My mum had an appointment with the Consultant last week re a cataract operation. But she refused to open her eyes for the nurse for eye drops, and the Consultant said given her moderate Alzheimer's, he did not think there was any point putting her through an operation - she finds it hard to follow simple instructions etc. Although she has cataracts in both eyes, the Consultant said one eye's vision was above the threshold for driving and the other just below, so not too bad.
My mum had an appointment with the Consultant last week re a cataract operation. But she refused to open her eyes for the nurse for eye drops, and the Consultant said given her moderate Alzheimer's, he did not think there was any point putting her through an operation - she finds it hard to follow simple instructions etc. Although she has cataracts in both eyes, the Consultant said one eye's vision was above the threshold for driving and the other just below, so not too bad.
My friend's mum who has reasonably advanced dementia was told by the consultant that it would not be worth doing the op. My friend insisted and the Op was done a few months back. On the way back from the hospital her mum was commenting on things she could see from the wheelchair taxi. Prior to the op she insisted her TV had gone wrong and had stopped watching the films she used to enjoy. After the Op she commented that this new tv ( actually the same one) was now working and is now again enjoying her films. She lives with my friend ( her daughter) who is her full time carer. Mum has been unable to weight bear for some time and is also doubly incontinent. The cataract op has immensely improved her quality of life.
Tre
Tre
My mum also had a cataract op under local anaesthetic recently and she is at the mid/severe stage. She is also incontinent and has poor mobility. It has also improved her quality of life too, although she was very unsteady afterwards, fell and broke her arm.
I think it depends on whether they are able to keep still (with reminders) for 20 mins and if they are able to co-operate with drop instillation. Mum was good with both these things and it all went smoothly. If they move suddenly during the op, though, it could result in a lost eye and if they wont have the drops in afterwards it can set up a very nasty inflammatory reaction. If they wont have the drops in before-hand, like realists mum, then you cant get the local anaesthetic in and so cant do the op.
I think it depends on whether they are able to keep still (with reminders) for 20 mins and if they are able to co-operate with drop instillation. Mum was good with both these things and it all went smoothly. If they move suddenly during the op, though, it could result in a lost eye and if they wont have the drops in afterwards it can set up a very nasty inflammatory reaction. If they wont have the drops in before-hand, like realists mum, then you cant get the local anaesthetic in and so cant do the op.
Thanks for these posts, my friend has been recommended for this op and not sure if I can go with her but it helps me know what to say when I talk to her about it. Her sight has really deteriorated so it would be lovely if it improved her quality of life.
If you can go in with her it will help. There was a lot of hanging around and I was able to sit and chat with her and keep reminding her why she was there, otherwise I think she would have freaked. I was also able to talk to her consultant (who did the op) about what she was like and how long her memory lasted. He got one of the nurses to hold her hand and keep reminding her every few minutes what was happening and to keep very still.
We decided not to go ahead with the op for my mother when the surgeon said it would only marginally improve her quality of life. We knew she would not be able to sit still for the surgery, as she couldn't keep still for more than a minute in the chair for the consultation. We did not want to risk the possible effects from general anaesthesia and knew that Mum would not be able to keep from picking at her eyes. Given the state of her hands, this would have resulted in infections.
That was over 10 years ago and I have had no reason to regret our decision. But every person is different.
That was over 10 years ago and I have had no reason to regret our decision. But every person is different.
If its a good day for me I will try and go, I had to do as you describe for the scan she had which required dye injection and keeping still, the photographer was brilliant but had to shout at her to remember to keep still!
He did apologize after but it was critical and will be just as much so for the operation. Have concerns too similar to CanadianJoanne that eye will become infected after unless manage to get some care in before op - am still trying.Hospital not keen
My mother needed a cataract operation but we faced a lot of resistance from the hospital because of her dementia however we insisted they at least do the pre op review and although her behaviour was challenging an uncooperative at times we persisted and her operation was a success and greatly improved her quality of life.
The specialist who carried out the treatment understood the difference the op would make to Mum and was incredibly patient and understanding but the same could not be said for many of the hospital staff we encountered along the way
My mother needed a cataract operation but we faced a lot of resistance from the hospital because of her dementia however we insisted they at least do the pre op review and although her behaviour was challenging an uncooperative at times we persisted and her operation was a success and greatly improved her quality of life.
The specialist who carried out the treatment understood the difference the op would make to Mum and was incredibly patient and understanding but the same could not be said for many of the hospital staff we encountered along the way
My friend has had the op too and would seem, on speaking to her that it has improved her vision greatly. Not yet out of the woods recovery wise and that no help given to her in managing eye drops from surgery despite telling them her need and being told they'd arrange DN am so pleased it has helped though and of course she is.
that no help given to her in managing eye drops from surgery despite telling them her need and being told they'd arrange DN am so pleased it has helped though and of course she is.
It depends how squeamish you are
You don't have to look, they aren't going to be staring into your eyes!!! You can close your eyes, look the other way but keep talking and hand holding, just a thought. I'm afraid I have already got my consultant to agree to knock me out!! I am very squeamish about my own eyes but managed mum's eye shingles for several years!!! Needs must I suppose!
From way back when, I used to be an operating theatre technician. I found eye surgery fascinating to watch! But I've sat and held many a hand of a person who is having cataract surgery. You don't see the eyes, you would be sitting beside the patient. Don't suppose that is the norm now, though! This was nearly 40 years ago!
Oh heavens, that makes me feel old!
Oh heavens, that makes me feel old!
My husband had cataract surgery last year, under local anaesthetic. It certainly gave him a better quality of life, but he's only 68. However, the eye drops he had to take for a month after the operation were difficult to manage; now, a year later, with the dementia considerably worse, I would really hesitate.
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