Cataracts Segment on the O.P.T. Network

Recently our very own Dr. Michael Redmond was featured on the O.P.T. Network to share information about cataracts! Watch the segment here or read the transcription of the segment below.

Some links have been added to provide additional resources or information.

 

Carlette Christmas (00:00):

Welcome back everybody to the OPT Network. This morning we’re talking about something that millions of Americans are affected by, and that is cataracts. We’re joined by Dr. Michael Redmond. He’s an ophthalmologist at Louisiana Eye & Laser Center Center. He’s also on the board of directors. And he joins us to talk about everything that we need to know and understand about cataracts. Dr. Redmond, Good morning and welcome.

Dr. Michael Redmond (00:26):

Glad to be here. Thanks for having me.

Carlette Christmas (00:28):

We talked to your brother, Dr. Patrick Redmond, about a month or so ago. Did you influence his wanting to be an ophthalmologist?

Dr. Michael Redmond (00:38):

I’d like to think I did. He obviously got to make his own decisions, but I think it’s a great path. It’s a great thing to help people see. You go home every day knowing you help people see, it’s hard to have a better job.

Carlette Christmas (00:54):

So when did you fall in love with it? When did you know? Because you go to medical school and you got to pick a specialty.

Dr. Michael Redmond (00:59):

Right. I had initially debated between optometry, which also treats the eyes, or ophthalmology. And ophthalmology is just more surgical-based. And it took a lot of thought. And it’s a longer road to hoe, so you had to be willing to do that. And so, I think as I got about halfway through college at Louisiana College, I said, “That’s the direction I want to go in.” And even when I went to medical school, the goal was ophthalmology. So still got to do all the other exciting things, deliver babies, treat heart attacks, fix broken bones, and take out appendixes, but the end goal was ophthalmology. So it’s what I always wanted to do.

Carlette Christmas (01:39):

Where does the desire to become a doctor come from?

Dr. Michael Redmond (01:43):

Well, I liked science when I was young. And I had an uncle that was a pharmacist, Redmond’s Pharmacy. Some people remember down on Third Street. So there was a little medical influence there. And another uncle that was a dentist. And so there was some influence, and I think just the desire, the science piece of it appealed. It all just kind of pointed in that direction.

Carlette Christmas (02:09):

And then, so your brother, he watches you go through the process, Patrick. And do you guys have a conversation about whether he will follow suit or what that will look like?

Dr. Michael Redmond (02:21):

Well, I think he probably had that desire also and got himself pointed in the right direction. And once he headed down that path, he went to TCU, and obviously you have to do well in college to have that opportunity. And so I think that along the way he was envisioning that and achieved his goal.

Carlette Christmas (02:46):

And so then you come back home and you start practicing. And one of your specialties becomes cataracts.

Dr. Michael Redmond (02:54):

That’s right.

Carlette Christmas (02:55):

So tell us, we’ve all heard the term, but what are they really?

Dr. Michael Redmond (03:01):

So I think the best way to think about a cataract is think of your eye as a camera. We all have a lens in our camera. And what a cataract is is when the natural lens just becomes foggy. So everyone’s looked through a pair of binoculars, looked through a camera that you just can’t get a clear picture. It doesn’t matter what you do, how you focus it, you’re looking through that fog. So what a cataract is is when the natural lens of the eye becomes foggy.

Carlette Christmas (03:29):

Why does that happen?

Dr. Michael Redmond (03:30):

It just happens. And so time is the biggest predictor of that, age. There’s lots of studies, maybe there’s a little vitamin deficiency throughout life. It may be the ultraviolet light is a factor. And so we do think there are probably some things that can be modulated during lifetime to reduce the risk, but the number one risk is age.

Carlette Christmas (03:53):

Wow. The number one risk is age.

Dr. Michael Redmond (03:55):

Right. Kind of a rough estimate, however old you are is the same percent chance that you have some degree of cataract. If you’re 70, there’s a 70% chance you have some degree of cataract. If you’re 80, it’s 80%. Now, just because you have a cataract doesn’t mean it needs to come off. There are plenty of people that get a slight cloudiness to their lens, but they see fine. That cataract doesn’t need surgery. They can be fixed with eye glasses, or maybe they don’t need anything at all. So the presence of a cataract doesn’t mean you have to have surgery. It just means, “Hey, we got a little cloudiness here. Let’s watch it.” And we don’t do surgery on a cataract until it disturbs people’s vision.

Carlette Christmas (04:35):

Can we treat a cataract … Okay, so I’m in my 50s, so I’ve got a 50% chance, I guess, of having cataracts. So how do we start to treat cataracts and treat our eyes before we get there?

Dr. Michael Redmond (04:49):

And I think the key, again, being outside, there are lots of outside people, even just back and forth in your car driving, protection from ultraviolet light. Sunglasses are big. In America, we probably don’t get the right nutrition. Vitamins, just a good multivitamin.

Carlette Christmas (05:07):

Which one? Just any multi?

Dr. Michael Redmond (05:09):

I think a Centrum Silver, whatever’s an age appropriate vitamin, a good multivitamin. There are lots of vitamins for the eyes, particularly for macular degeneration. We’re not talking about that. We’re talking about just a good multivitamin.

Carlette Christmas (05:22):

Do you believe in them? Do you believe that they really work?

Dr. Michael Redmond (05:24):

I do, I think as prevention. Particularly everybody’s different, right? Some people eat a great balanced diet. Most of us probably don’t. And so you don’t hurt yourself by taking that vitamin. And so I think that, again, when you take a good multivitamin, you’re covering all the bases. If there’s something you’re lacking a little bit, that will get made up for in that vitamin.

Carlette Christmas (05:45):

So as we talk about aging and the eyes just being a product of aging, the loss of eyesight, when we turn about 40, many of us need readers. Why?

Dr. Michael Redmond (06:03):

So different process altogether.

Carlette Christmas (06:06):

Totally different?

Dr. Michael Redmond (06:07):

Totally different, unrelated. And that’s confusing to people that say, “Look, I can’t see. I turned 40. I can’t see.” So let’s go back to that camera. The lens of that camera, the way to think about it, it has an autofocus on it until you’re 40. Up til age 40-

Carlette Christmas (06:22):

You don’t have to do anything, it’s just like your phone, it’ll just-

Dr. Michael Redmond (06:25):

It’ll zoom in. It’s going to focus. Wherever you look, it’s going to focus. Now, some people still need glasses to get their sharp distance, but even with the correction of the glasses, that lens is focusing up close. It’s focusing in the distance. At age 40, the focusing mechanism begins to fail. And between 40 and 50 you lose most of your focusing power. By 55, 58, it’s gone. Now, it doesn’t mean you can’t see at all. It means you only have one spot you can see because your camera can’t focus anymore. So if you’re one who can see in the distance fine, that’s your clear spot and any distance in from there that lens can no longer focus so you’re blurry. So what do we do? We put on a pair of reading glasses to achieve that focus point. We’re creating a new focus point because our lens can no longer focus.

Carlette Christmas (07:17):

And it’s just all something that happens just because of aging?

Dr. Michael Redmond (07:22):

It’s a guarantee. We guarantee it. And anyone wants to bet you on that one, you take the bet that when they get close to 40, in some it’s 45, they’re going to have difficulty with their near vision.

Carlette Christmas (07:34):

Wow. It’s hard to process. And you’re thinking with technology, there should be something that can fix it.

Dr. Michael Redmond (07:43):

Right. Tons of research, because hopefully we’re all going to make it past 40. And so there’s tons of research. There’s actually a drop being studied now that-

Carlette Christmas (07:54):

And eye drop?

Dr. Michael Redmond (07:55):

An eye drop that you would put in in the mornings and it allows you to focus during the day. Again, that’s not approved, but that’s something we’re watching, and we’re very excited about that. So there is millions of dollars and hundreds of thousands of man hours in research to say, “How do we fix that?”

Carlette Christmas (08:12):

Let’s take a break here, Dr. Redmond, but when we come back, I want to talk about when you know that cataracts have become a problem and how we treat it. Stay on point. We’re back right after this.

Carlette Christmas (08:26):

Welcome back, everybody to the OPT Network. Our guest this morning is Dr. Michael Redmond. And we’re talking about cataracts and our eyes overall, what we need to understand about really taking care of our eyes. And so before we talk about cataracts and what people need to know, how has COVID-19 affected the way that you all are doing business and taking care of the eye health?

Dr. Michael Redmond (08:56):

And everything’s changed. COVID has changed the world. And it’s changed the medical care. It’s changed eye care. So we want our patients to be safe. We want our employees to be safe. And so we have taken extreme measures. At our office now, at all of our locations, and we’re throughout the state of Louisiana, every patient that comes in will have their temperature checked. And that’s a very good screen for COVID. We ask that only the patient comes in. Normally we invite the whole family, “Come get the whole story.” But the more people you put in a place, just the more risky it is. Some people, obviously they have to have a family member. Younger children have to have a family member. We understand that. And so we have reduced the number of people we bring into the office at a time.

Dr. Michael Redmond (09:42):

And because we’re a large office, particularly our Alexandria office, we normally would have eight doctors in there a day. Well, obviously eight doctors are going to attract a lot of patients. So we have cut down the physicians that we allow, the optometrists and ophthalmologists that we allow to see patients in a day. So Alexandria now, we’re keeping mostly just four doctors. Now you say, “Well, who’s seen all the patients?” So those same doctors, we’re just going out to our rural clinics, Leesville, Natchitoches, Ferriday, Vidalia, Monroe, Ville Platte, Eunice, Oakdale. So we have a lot of clinics, and we’re just spreading our doctors out more. So people still need care, and we want to care for them.

Dr. Michael Redmond (10:23):

The physicians you’ll see, all of the technicians at our office, the front office staff, they’ll all have masks on. Every patient will have a mask on. The rooms, normally once you have your eyes examined, it’s a quick wipe down, now it’s a total disinfect. So that room, we have a team comes in, cleans that room, even just for a 10-minute exam, and that room is totally disinfected. So we take it very serious. We take the health and safety of our employees very serious, as well as the health and safety of every patient that walks in our office.

Carlette Christmas (10:56):

Sure. And there was one report that I read that talked about a man and he was in fact a doctor, that he believed that he contracted COVID through his eyes. Is there any fact about COVID coming through the eyes?

Dr. Michael Redmond (11:15):

There is. It’s fairly confident that it can be in the secretions of the eye. Day five to seven of a patient with coronavirus, they can get a pink eye, what looks to be a routine pink in our world. The eyes are red, there’s some matter coming out. Those patients can have coronavirus. So you can imagine as physicians and technicians, we have our fingers all up around their eyes. It can happen. And so again, just a really safe. We want people to be safe, our technicians to be safe. But that is fact what you read.

Carlette Christmas (11:52):

And the fact that our hands are touching so many things and where do our hands go?

Dr. Michael Redmond (11:57):

Naturally to our face. Interesting point, the physician that really discovered the coronavirus in China was an ophthalmologist. And he brought it to the attention of the Chinese government. And he was basically chastised for that. He ultimately died, but he did get the message out, “Hey, we’ve got a real problem here,” because he saw these patients with these red eyes that were dying.

Carlette Christmas (12:24):

And that’s one of the things that they talked about, that the eyes became so red in some of the patients. And so with that said, is there a way to treat those eyes when you find that or if you find that?

Dr. Michael Redmond (12:40):

Well, you just, like coronavirus, you treat it symptomatically. There’s not a lot of treatment yet. Now there are some new antiviral drugs that look promising. Remdesivir, which is an antiviral that was used in SARS, looks like it’s going to be effective. And so you basically just treat it what we call symptomatically. We put some drops, we try to sooth the eyes, but like the common cold, we don’t have a cure. We just try to make you better while you have it. So that’s the way this virus is. And even for the eyes, we can put some topical steroid drops and things that sort to improve the process, but it really just has to run its course.

Carlette Christmas (13:14):

Being that you realize, this is the first time I heard that the doctor who found the virus was an ophthalmologist, did the whole process and the whole idea of seeing people die and you knowing that you had to take care of patients, was it scary?

Dr. Michael Redmond (13:34):

I think for everyone it’s a little scary when you hear of a pandemic of this sort, particularly something we first think it’s going to be like a SARS or MERS where the mortality was 50 to 70%. But again, I think the vast majority, we’ve seen it throughout America, healthcare providers just become heroes and that’s what they do. And that’s what they were put here to do. And so just like the staff at our office, they didn’t miss a beat. They were there to take care of people. Our physicians never missed a beat. Our optometrists never missed a beat. So certainly I think there’s fear and anxiety as everyone would have. But I don’t think that we missed a beat. And you just put it behind you and you just say, “Let’s go forward and help people.”

Carlette Christmas (14:17):

And business going forward has certainly changed. Do you think that we’ll ever get back to where we were?

Dr. Michael Redmond (14:26):

It’s interesting, viruses, diseases, sometimes they run a course. Sometimes they stay. We don’t really know what’s going to happen with this virus. I’m very optimistic about a vaccine, which I do think with the fast track system, they already have some out there that are cooking. I’d love to see that before the end of the year. Now, whether we have it or not I don’t know. Until we have a vaccine, we’ll always live with coronavirus. We just figure out how to live with it. And time will tell how we’re going to live with it. Is it going to come back as a rage in the fall? We don’t really know. And so time’s going to tell us that.

Carlette Christmas (15:01):

Sure. And so as we talk more about cataracts, when should patients start to worry that they need to treat cataracts? And are there symptoms of cataracts before you get to that point where treatment is necessary?

Dr. Michael Redmond (15:19):

Right. Most patients have symptoms, and that’s why they seek care. Oftentimes patients think, “Hey, I just need new glasses.” And they go in, they see their optometrist, they see their ophthalmologist, and they measure them and say, “Look, I can’t get you any better with glasses.” My analogy is, if you’re sitting in your car and there’s love bugs and Vaseline on the windshield, you can put all the glasses on in that car in the world, you still have to look through the smudge. And so usually what patients notice, driving at night is a common one, starburst, halos, difficulty driving at night.

Carlette Christmas (15:54):

What does that mean, starbursts? Like things coming?

Dr. Michael Redmond (15:56):

So when you see a light, normally a light is a single target, right? A headlight, even though they’re bright, it’s a single. But a starburst mean it has all these little rays coming off of it. So instead of a discreet light, it’s just big smudge is a way to think about it. And so that’s hard to discern. Well, where exactly is the car? Where are the edges of the car? So night driving, low-light vision, dusk and dawn driving difficulty. Patients say, “Look, I just can’t read those signs on the roadway. I can’t tell when to exit.” So driving is a big thing that bring people in. Some people on the TV. “Look, I can’t read the little ticker tape across the bottom during the ball game.” Many people have difficulty reading. So the symptoms vary.

Dr. Michael Redmond (16:37):

Common to all, people just don’t see well. They’re just not seeing as well as they’re used to seeing despite the best pair of glasses they can get. And so usually symptoms bring patients in. For others, it happens very slowly over five to seven years. They don’t know they don’t see well. They go to the Driver’s License Bureau and they say, “Well, you can’t pass your driver’s test.” They say, “Well, of course I can.” “No, you really can’t.” Well, maybe they have 20/60 vision, and that cataract grew so slowly they didn’t know they had a problem. We see that very commonly.

Carlette Christmas (17:10):

Wow. Let’s take a break here, but when we come back we’re going to talk about what the treatment is, what the recovery time is, and what vision looks like after cataracts. Dr. Michael Redmond is our guest. Stay on point. We’re back after this.

Carlette Christmas (17:29):

Welcome back, everybody to the OPT Network. Our guest this morning is Dr. Michael Redmond from Louisiana Eye & Laser Center Center. And we’re talking about eye health, eye care, how COVID is affecting or could affect our vision, and what we need to understand about cataracts. Okay. So we see the camera. We see the lens changing. When we finally get there, is there a way to prevent this or this is just going to happen?

Dr. Michael Redmond (17:59):

In this day and age, it’s just going to happen.

Carlette Christmas (18:02):

Just going to happen. All right. So when it happens, what is the treatment?

Dr. Michael Redmond (18:06):

So once we get to a point a patient says, “Look, I just can’t see well anymore-”

Carlette Christmas (18:10):

And this with glasses, this is with contacts. This is with readers.

Dr. Michael Redmond (18:14):

Everything you can give them, they still cannot see. It’s blurry. They can’t pass a driver’s test. They can’t drive at night. So then, we talk to the patient and say, “Look, let’s think of that camera. The lens in your camera’s foggy. You’re not going to get a better picture until we fix that lens.” So what cataract surgery is-

Carlette Christmas (18:33):

Is that the best treatment? Is that the gold standard?

Dr. Michael Redmond (18:36):

That is the gold standard. And so what we’re going to do is remove the foggy lens. We’re going to replace that lens with a perfectly clear lens. And so, go back to your camera, now your camera has a nice, clear lens. So that camera, we hope and usually, has just a fabulous, nice, crisp picture. That’s what cataract surgery is. And there are lots of ways to go about it. It’s a day surgery. Patients have a little IV. I call it la la land. You don’t feel anything. Most patients, some remember being there, some don’t. 30 minutes after they’re done with the procedure, they’re headed home.

Carlette Christmas (19:12):

Really? Tell me about the new lens. What is the new lens?

Dr. Michael Redmond (19:15):

So, again, let’s go back to the camera analogy. Let’s go back to what we talked about at age 40. We can’t read, right? So historically, lens implants, we could only make it as good as the natural lens we had. That is we could only create a single focus point. So our goal used to be, “Hey, let’s maybe try to give you a shot to pass your driver’s test without glasses,” which is fabulous, but you can see nothing up close. That’s called a monofocal or a single focus lens. Now, probably for 15 years these multifocal lenses have been around. Every year they get better. We’re at a super high level of technology now. Now we can put a lens, we can replace that lens that you had that could only see let’s say, for example, in the distance, now you can pass your driver’s test without glasses. You can see the dashboard on your car without glasses. And you can read the paper without glasses. So we now have the ability to make people glasses free. And that really 20 years ago didn’t exist.

Carlette Christmas (20:19):

So with that said, being that we know we’re all going to have cataracts, should we start preventing that earlier by having these lenses replaced? Like I’m at an age where I’m struggling with trying to get the right prescription for contact lenses-

Dr. Michael Redmond (20:40):

And that’s a great question. And LASIK has been around a long time. LASIK can help us achieve a single focus point. But again, if I get you to pass your driver’s test at age 50, you’re not going to be able to read. And so that procedure does not give reading back.

Carlette Christmas (20:56):

That just gives distance?

Dr. Michael Redmond (20:58):

That gives distance, right. So now when we look at cataract surgery, there are patients who come in and say, “Look, I’m 50. I can see okay in the distance, but I can read nothing. I don’t want to wait till I get a cataract. I want my lens replaced.” Now, we changed the name because you don’t really have a cataract. We call it lensectomy. We’re going to take your lens out. We’re going to replace it with one of these multifocal lenses in the hopes that we have restored your ability to see in the distance, intermediate, and up close. And you won’t ever get a cataract because your lens has now been removed.

Carlette Christmas (21:35):

Lensectomy. So I won’t get a cataract?

Dr. Michael Redmond (21:38):

Right, because your lens is removed now so it can’t fog. Your lens has already been removed.

Carlette Christmas (21:43):

And so now I can see in the distance, and then I can see some up close?

Dr. Michael Redmond (21:47):

Correct.

Carlette Christmas (21:49):

Wow.

Dr. Michael Redmond (21:49):

No, most patients, the typical patient we’re doing that in is a cataract patient. And for the obvious reason, insurance pays for cataracts.

Carlette Christmas (21:59):

I was going to say, does the insurance pay for a lensectomy?

Dr. Michael Redmond (22:02):

So when you go to lensectomy, the insurance says, “Well, you see fine with your glasses on. That’s all we care about.” And so they consider it a cosmetic procedure. And so in that case, you have to pay for it.

Carlette Christmas (22:15):

But what if you’re having challenges already? They still see that as cosmetic?

Dr. Michael Redmond (22:19):

They consider that as just a life challenge. They say everybody has the challenge, and that’s just what they call a non-covered service.

Carlette Christmas (22:27):

So, but there is a way that through lensectomy, you can get this and you won’t have to deal with-

Dr. Michael Redmond (22:33):

And we do that. And there are people certainly who say, “Look, it’s worth it to me. That’s my goal. That’s what I want to achieve.” And we see people do that on a regular basis.

Carlette Christmas (22:42):

So that’s an option. But for those people that are past that point and have to have the surgery, when do you see the restoration of vision? How soon does that happen?

Dr. Michael Redmond (22:53):

So going back to the surgery itself, it’s a day surgery. Relaxation. Most people don’t know we’re doing it.

Carlette Christmas (23:01):

Are you asleep?

Dr. Michael Redmond (23:05):

We’ll call it sleepy. And some don’t have any recollection of the event and some do. But you come back the day after, some people see fairly good the day after, some very foggy. Everybody’s different. Usually day three is what I call the magic day. That’s where things, because you’ll get a little swelling, little inflammation, things begin to clear. And so two weeks is the peak vision. But day three, most patients with cataracts start to say, “Hey, things really got brighter. Colors, so more vivid.” I’ve been blamed for putting dust in people’s houses, dirt on the floor because they really couldn’t see it. But day three is when I tell people don’t be alarmed if it’s blurry the first few days, that’s when it will begin to clear. And then for one week we tell patients, take it easy.

Carlette Christmas (23:50):

Both eyes or one eye at a time?

Dr. Michael Redmond (23:52):

One at a time. And so there are some countries and even in California, they’re testing doing both at one time. The safety profile is just not there yet to ensure that that’s safe to do. So the typical scenario is do one eye, two weeks later, do the other.

Carlette Christmas (24:07):

Any pain associated?

Dr. Michael Redmond (24:08):

During the surgery, the surgery is totally painless. Some people have a little scratchy feeling a few days after. But I won’t call it pain free, but just more like you have a little trash or a little rough spot on your eye for a day or two.

Carlette Christmas (24:21):

And for those people that are on this journey, like myself, that are aging, tell us what the gold standard is in taking care of our eye health.

Dr. Michael Redmond (24:32):

So I think that getting them checked on a regular basis. The old “ounce of prevention” saying. If you have glaucoma, if you have macular degeneration, if you have diabetes and you’re getting retinopathy, the sooner things are caught, early cataracts, the sooner they’re caught, the better they can be dealt with and we can preserve people’s vision.

Carlette Christmas (24:53):

Because things like diabetes can cause you to lose your vision.

Dr. Michael Redmond (24:57):

Oh, the number one cause of blindness in less than 64 years of age. We see it every day. We see blind people every day from diabetes. And so, most of those people weren’t going every year. They have to go every year. Even if they see great, they have to go every year and have their eyes dilated to be screened for diabetes. And so you’re right, maintenance is the way to think about it. Just like we change the oil in our car on a regular basis, we just have to get our eyes checked by our optometrist, our ophthalmologist regularly, dilate the pupils, check the back, look for glaucoma, look for macular degeneration, look for diabetes. And all of these diseases, if caught early, you have a lot better chance of always seeing.

Carlette Christmas (25:35):

What’s macular degeneration?

Dr. Michael Redmond (25:37):

So go back to your camera. Let’s talk about the film of the camera now. So you can have a fabulous lens, but if we have a bad spot in the film and you get that portrait done, you’re going to have a smudge spot in the center. So macular degeneration is when the film gets a bad spot right in the center. And so people say, “Oh, I’m going blind from it.” No one ever goes blind from it, but they can’t see the big E maybe. They have good peripheral vision, but maybe they can’t drive anymore. Maybe they can’t read anymore. So it is very debilitating. Just to fix a different part of the eye.

Carlette Christmas (26:10):

Absolutely. Dr. Michael Redmond, thank you for taking the time. These are conversations that we’re going to have to continue because there’s so many questions that people really don’t know what to ask. And I think sometimes we take something as important as vision for granted. We just think it’s always going to be there, but it really isn’t, is it?

Dr. Michael Redmond (26:29):

No, it isn’t.

Carlette Christmas (26:30):

It’s constantly changing. Thank you so much. Our guest this morning has been Dr. Michael Redmond from Louisiana Eye & Laser Center Center, the total eye care team. If you are having challenges with your eyes, be sure and connect with the team at Louisiana Eye & Laser Center Center. Stay on point. We’re back after this.

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