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Suggest Treatment For Cataract While Treating Scleroderma And Lupus

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Posted on Sat, 25 Jun 2016
Question: I have a advanced cataract in my left eye. I have scleroderma and lupus also I am on steroids probably why I got cataracts. Terrified of surgery because of my health issues. I have read about eye drops
Can c to stop the progression and reverse cataract. It is n acetylcarnosine Have you heard of this and in your option can it reverse cataract. Terrified Diana
doctor
Answered by Dr. Ashok Kumar Dash (12 hours later)
Brief Answer:
Advanced cataract, uniocular which is steroid induced, should taper steroid.

Detailed Answer:
You are having a uniocular cataract and as per your history it is steroid induced cataract. First advise is to taper the steroid. You should exclude diabetes as well. As it is, now there is no medicine to treat cataract or stop the progress.

As you have mentioned acetylcarnosine, it has been tried and still in trial stage. No definite report is available about its effectiveness. No definite opinion can be given unless it is authenticated and recommended by medical authority. What is the status and vision of unaffected eye should also give visual status of cataract effected eye. In your case there is no urgency, since you have got one good eye. Regarding the use of acetylcarnosine drop you can take second opinion and recommendation from experts having much experience. Examining the associated disease it is evident that you have to continue steroid. You should discuss with treating doctor to prescribe dexamethasone which is less harmful. Give details of steroid you are taking with doses. Reversing cataract is not possible. Claims are theoretical.
If you have any further doubts/ queries, you may get back to me.
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Ashok Kumar Dash (19 hours later)
Saw the ophthalmologist today. Have a lot to tell you. He had recommended surgery because he said the cataract is blocking my vision. He does the chop block cataract surgery. The ophthalmologists I had seen locally does the laser assisted cataract surgery do you think one is superior than the other. Also regarding my prednisones you asked how much I was on I am on 16 mg I have been on about 10 mg inching up for the last 10 years possibly longer. I've developed high blood pressure and diabetes type two from the steroid complications. My hemoglobin A-1 C is about 7.0 they were recommending Met Forman but I was trying to do a diet controlled do you think I should try the metformin? My blood pressure is about 160/80 150/80 do you think I should start a blood pressure pill. You had mentioned about dexamethasone over prednisones what is the difference and how does it work differently. Do you think I should have the surgery or try the eyedrops? Very frightened of the surgery but don't know if I have any choice thank you so much also I didn't have my eyes dilated today because I was afraid of an allergic reaction and but I don't think he thinks it was a detached retina eye or anything like that I think he just thought it was a cataract? Can they see things without it being dilated I know not fully but do you think that would be the case just a cataract?
doctor
Answered by Dr. Ashok Kumar Dash (1 hour later)
Brief Answer:
You have anxiety neurosis for cataract operation.

Detailed Answer:
With surgery definitely your vision will improve. Firstly you should not be frightened for surgery. Dexamethasone is weaker then prednisolone, less dose of dexamethasone is equated with higher dose of prednisolone. You have to depend on steroid. In my opinion you should go for phacoemulsification. It will take less time and result is good for observing retinal hole tear and detachment, dilatation has to be done and doctor will take care of allergic reaction. Discuss all aspects and your doubt with doctor before surgery. If you are satisfied then go for surgery. More than treatment you have got anxiety neurosis. Take counseling from clinical psychologist. You can take metformin for the diabetes after consultation with your doctor.
Regards
Above answer was peer-reviewed by : Dr. Sonia Raina
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Answered by
Dr.
Dr. Ashok Kumar Dash

Ophthalmologist

Practicing since :1969

Answered : 12704 Questions

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Suggest Treatment For Cataract While Treating Scleroderma And Lupus

Brief Answer: Advanced cataract, uniocular which is steroid induced, should taper steroid. Detailed Answer: You are having a uniocular cataract and as per your history it is steroid induced cataract. First advise is to taper the steroid. You should exclude diabetes as well. As it is, now there is no medicine to treat cataract or stop the progress. As you have mentioned acetylcarnosine, it has been tried and still in trial stage. No definite report is available about its effectiveness. No definite opinion can be given unless it is authenticated and recommended by medical authority. What is the status and vision of unaffected eye should also give visual status of cataract effected eye. In your case there is no urgency, since you have got one good eye. Regarding the use of acetylcarnosine drop you can take second opinion and recommendation from experts having much experience. Examining the associated disease it is evident that you have to continue steroid. You should discuss with treating doctor to prescribe dexamethasone which is less harmful. Give details of steroid you are taking with doses. Reversing cataract is not possible. Claims are theoretical. If you have any further doubts/ queries, you may get back to me.