Cataracts

Sample PubMed cite¹

Guide to Cataracts

Cataracts

Cataract tutorial

Cataracts are a sign that something has disturbed the lens of the eye. In someone with sarcoidosis, the most likely cause is the sarcoidosis. Some other possibilities include eye injury, other kinds of eye infections, some medications (such as prednisone), etc.

If the cataracts do not affect your vision, there is no need to do anything about them. In fact, the surgery to remove the cataracts can stir up eye inflammationThe complex biological response of vascular tissues to harmful stimuli such as pathogens or damaged cells. It is a protective attempt by the organism to remove the injurious stimuli as well as initiate the healing process for the tissue., so it makes sense to postpone it. Some cataracts remain small for a very long time, and do not require removal.

It is pretty common for people with sarcoidosis to develop eye inflammation. A number of people on the Marshall ProtocolA curative medical treatment for chronic inflammatory disease. Based on the Marshall Pathogenesis. have had their uveitis resolve. Some have also had cataracts.

If your eye doctor thinks the cataracts are due to inflammation, then you have probably had inflammation in your eyes (undiagnosed, apparently). Inflammation in the eyes can cause cataracts.

Steroids taken as injections or eye drops can cause cataracts. There have been some studies on this, and the estimate is that something like 850 cumulative lifetime steroid eyedrops will result in cataract in 50% of people. High doses of oral steroids can make this happen much more quickly.

There is a possibility that you have (or have had) sarcoid inflammation in the eye. Not even all ophthalmologists have the very high resolution slit lamp that is needed to see inflammatory cells in the eye, so it is possible that the optometrist missed them.

Unfortunately, small cataracts can become big cataracts. You might want to schedule an exam with a specialist ophthalmologist to more thoroughly check out your eyes. It may be helpful to know that inflammatory eye disease (such as sarcoidosis can cause), steroids, and sun can contribute to cataract formation.

The Marshall Protocol should help by treating the sarcoidosis, which is likely to be the underlying cause of the cataract. Sometimes, however, one cannot tell what causes a cataract. ~Margo

Unfortunately, one of the causes of cataracts is prednisone. (Another is uveitis, which is more likely to strike people with Th1 disease.) My daughter developed cataracts in both eyes at age 12, from a combination of uveitis and prednisone use. She had one removed at 13, and one at 14. Both surgeries were successful; the later one, after more time on the MP, was smoother. She had lens implants in both eyes, which have been very satisfactory for her. (See Teen on MP.)

It is possible that you had a small area of cataract before, which has now spread to a more central area of the eye. If the cataract is on an edge of the eye, it may not affect vision at all.

The cataract, in itself, is not harmful to an adult (only to young children, whose brains need stimulation from the eye to make good connections from eye to brain). Since cataract surgery can also cause inflammation to the eye, it is better to postpone surgery until you feel you have made good progress on the MP. The eye surgeon needs to understand the risks, and take measures to control the inflammation. This situation makes cataract surgery is more complex than for older people with healthy eyes.

Cataract surgery

My daughter has uveitis due to sarcoidosis. She rapidly developed serious cataracts, which her ophthalmologist feels was due to the use of prednisone to attempt to control the uveitis. (This was before we knew about the MP.) We postponed the surgery as long as we could, until she was unable to read in one eye, and barely with the other. One cataract was removed, and then a year later, the other was removed. She has done fine recovering from the surgery, but each surgery caused increased eye inflammation. We estimate that each time, she lost about 8 to 10 months progress on the Marshall Protocol due to the surgeries and medications required by the surgeries.

At Teen on MP I’ve discussed my daughter’s cataract surgeries.

First, I’ll discuss the approach taken by experts, before there were any patients on the Marshall Protocol.

The standard approach to cataract surgery for people with a history of uveitis (taken by specialists in uveitis) is to delay surgery until the patient has had at least three months with no inflammation. Not all doctors insist on this, but then, many people have pretty bad outcomes from cataract surgery.

Some doctors won’t use a lens implant with uveitis patients, but many have had good results with that. There are many different types of lens implants available these days. I don’t know the technical issues relating to which ones are best. My daughter’s doctor recommended a heparin-coated plastic lens. There are some new lenses which change focus. Doctors don’t seem to be using these in uveitis patients, because they don’t know if the motions of the lens could cause problems. Over time, they will have more information about the pros and cons of these lenses.

In order to help ensure a good outcome, these doctors also often add an anti-inflammatory medication before the surgery, and continue it for some time afterwards (maybe 4 weeks). Eye surgery increases the risk of eye inflammation. The inflammation can seriously interfere with healing after the surgery. These anti-inflammatory medications include prednisone (oral, as eye drops, or as an injection around the eye), Remicade, methotrexate, etc. There is a new non-steroidal anti-inflammatory eye drop, Nevanac, which may be helpful in this situation. However, it is so new that one cannot really tell.

Now, to consider the patient on the Marshall Protocol:

The Marshall Protocol helps reduce the inflammation behind uveitis by getting at the bacterial cause. As the underlying inflammation is reduced because of killing off the bacteria, the risks of eye surgery should decrease for the uveitis patient. Since there haven’t been that many patients who have completed the Marshall Protocol, the actual numbers who have had eye surgery are quite small. Still, every on-the-ball ophthalmologist would much prefer the patient to have very little to no eye inflammation at the time of eye surgery. The Marshall Protocol can help patients reach that goal.

For any individual, the question remains as to whether he or she has reached the point of cure, or is simply doing much better than before. I think that great caution has to be taken not to provoke increased inflammation after the eye surgery.

Some general points regarding the eye surgery:

Cataract surgery is done in adults when the cataract is bothersome. (In contrast, in young children, cataract surgery can be essential because the growing brain needs to have input from the eyes to develop the proper visual pathways. In young children, if you wait too long for the surgery, it may be too late for the brain to develop these pathways.)

It is vitally important that any eye inflammation be very low or non-existent for a period of time (three months) before the surgery. After the surgery, there is a risk of increased ocular pressure. For the post-surgical period (1 to 2 months), the eyes need to be checked more frequently. Additional anti-inflammatory medication may be needed. In addition, eye drops that make the pupils move (dilate and then get smaller) are often recommended during this period. Inflammation in the eyes can cause adhesions to form, which can permanently change the shape of the pupils.

If you are planning to travel for the surgery, you should stay around for two or three weeks after the surgery, so the eyes can be checked and any problems addressed. I would have surgery on one eye and give that eye a year to heal before having surgery on the other eye.

I would also urge people to wait as long as possible before having cataract surgery, to allow them time to progress further on the Marshall Protocol.

Your cataract surgery will likely be easier, safer and more successful if you do the MP first (extrapolating from our personal experience).

If you need the surgery while you are in the middle of the MP, you can ask your doctor to discuss medication adjustments with Trevor Marshall.

My daughter had two cataract surgeries while on the MP, about fifteen months apart. She, too, developed cataracts due to anterior uveitis and steroid use. Both were successful, but the second one was more successful. We attribute some of that success to the progress she had made on the MP.

We were unable to wait on the surgery because her cataracts were so bad that she could barely read. ~Margo

Th1 inflammationThe complex biological response of vascular tissues to harmful stimuli such as pathogens or damaged cells. It is a protective attempt by the organism to remove the injurious stimuli as well as initiate the healing process for the tissue. increases risk of post-op inflammation

I'm glad that this doctor presented some other options. I'm inclined to agree with you that a more minor procedure (still surgery, but not as invasive) should be easier to tolerate. If you have to have it, make sure your doctor is aware that people with uveitis are much more likely to experience serious inflammation after the surgery than other people. Sometimes, an additional anti-inflammatory is needed (besides very frequent pred. drops). ~Margo

Members' experiences

-During an eye exam Dec. 20, the opthamalogist stated that he found absolutely no sign of cataracts. When asked if cataracts can be reversed, he responded with an unequivocable “no”. Interesting because at my last exam 2 years ago (just as I began the MP) another doctor noted the start of cataracts, rating them 1 on a scale of 1 to 10. ~DesertMarie (on MP 1yr, 3mo)