Eye Health

Updated 15 February 2016

3 000 people waiting for their turn to see again

A 29-year-old man, who doesn't know what his daughter looks like, has been waiting for over a year for a cataract operation at Chris Hani Baragwanath Academic Hospital.

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The Gauteng Department of Health has almost halved the number of people awaiting sight-restoring cataract operations in the last year but more than 3 000 people are still waiting for their turn to see again.

Lawrence Mvelase spent his 20s as a taxi driver, working long days shuttling passengers between Duduza and Nigel on Johannesburg’s East Rand. In March 2014, he noticed changes in his vision – the road that so clearly stretched before him turned fuzzy – as did the faces of his passengers. He eventually lost most of his eyesight.

Read: Learners warned against playing with laser lights

In May, Heidelberg Hospital staff diagnosed the 29-year-old with cataracts, which is the clouding of a normally clear lens of the eye.

Distraught, Mvelase said he took comfort in the fact that an operation at Chris Hani Baragwanath Academic Hospital could remove his cataracts and restore his sight.

“It was painful for me when I was diagnosed with cataracts but I gained confidence when the doctor told me that this is not a permanent condition and that I would be healed through an operation,” Mvelase said.

cataracts, lawrence mvelase,Chris Hani Baragwanath

29-year-old Lawrence Mvelase is waiting for a cataract operation for almost a year now. (Image: Thabo Molelekwa/Health-e News)

He claims the hospital told him that he would have to wait three months for the operation at Chris Hani Baragwanath Academic Hospital’s St John’s Eye Clinic, which is one clinics in the province that performs cataract operation, but that was almost a year ago.

Mvelase is one of 1 503 patients awaiting surgery at the hospital, according to Gauteng Department of Health spokesperson Steve Mabona.

The hospital has managed to reduce its cataract surgery backlog by about 300 patients since March when Democratic Alliance shadow MEC for health Jack Bloom alleged that he had been told that equipment failures and an almost 50 percent vacancy rate were fuelling waiting lists at the hospital.

Vacancies to be filled

However, the department has indicated that current vacancies were not impacting the work of the unit, which also assists with cataract operations in Lenasia, adding that three consultants had already been short-listed and it plans to recruit three registrars soon.

Mabona noted that waiting times for surgeries at academic hospitals like Chris Hani and Steve Biko hospitals remain longer than those at other facilities due to in part teaching responsibilities.

In March, Bloom reported that health MEC Qedani Mahlangu cited waiting times as long as 18 months for surgeries at St. John’s Eye Clinic. According to Mabona, recent patient records may indicate that waiting times for some patients may have dropped to five months.

The number of people waiting for cataract surgeries provincially has dropped by almost half since June 2014.

The classification of cases

Mabona added that patients are prioritised according to need.

“It should be noted that not all patients on the waiting list have cataracts that result in blindness and classification of cases is hence applied,” he said “A patient can walk into an academic hospital and be booked the following day if they are blind but another can wait on the list because they still have functional vision even though they have a cataract.”

Meanwhile, Mvelase’s wife, Nomthandazo Nhlapho, said their life has been put on hold.

“Our life has changed,” she said. “We survive on a social grant and what the family provides us with.”

“We always pray that they operate on his one eye so that he can go back to work and so that he can be able to see what our little daughter looks like,” adds Nhlapho who gave birth to a baby girl 10 months ago that she said her husband has never seen.

Nhlapho has become Mvelase’s eyes, guiding him by the arm wherever they go. For a once independent man, he said this has been tough.
 
“I want to go back to work and work for my new born,” he said.

What you should know about cataracts

A cataract has little effect on vision at first and often develop so slowly that you are unaware of them. Eventually the entire lens becomes white and will cause blindness, which is usually reversible with an operation.

The procedure is carried out under general or local anaesthetic. Looking through an operating microscope, the surgeon makes a minute incision in the surface of the eye. The clouded lens is emulsified with an ultrasonic probe and suctioned out of the eye, usually leaving intact the rear wall of the transparent capsule that encloses the lens.

The new lens is placed behind the iris and up against the back wall of the capsule. Two tiny C-shaped arms attached to the lens hold the lens firmly in place. The incision is closed with tiny, nearly invisible stitches or in some cases no sutures are needed. The whole operation usually takes less than an hour.

Some of the causes of cataracts include:

- Ageing, about 75 percent of all cataracts are age-related.
- Exposure to ultraviolet (UV) radiation (e.g. from sunlight)
- Eye injuries. Sharp or blunt injuries may cause a cataract.
- Diabetes, especially when blood sugar is poorly controlled.  

Can it be prevented?

Wearing a wide-brimmed hat and sunglasses that filter out UVB rays from a young age slows the development of cataracts.

Read more:

Dozens go blind after surgery with suspected infected tools

Sunlight increases cataract and glaucoma risk

Cataract surgery may benefit people with dementia

Additional reporting by Health24

Health-e News is South Africa’s award-winning dedicated health news service producing news and in-depth analysis for the country’s print and television media.

 

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Optometrist

Megan Goodman qualified as an optometrist from the University of Johannesburg and is currently practising at Tygerberg Academic Hospital in Cape Town. She has recently completed a Masters degree in Clinical Epidemiology at Stellenbosch University. She has a keen interest in ocular pathology and evidence based medicine as well as contact lenses.

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