World Sight Day 2024: Interview with Professor Patrice Komi Balo, Ophthalmologist in Lomé

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Extract from the article: La cataracte est associée au vieillissement, étant la première cause de cécité réversible dans le monde. Cette pathologie oculaire très fréquente. La cataracte est un trouble de la vision qui touche le cristallin. Celui-ci s’opacifie et empêche les r

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«Cataracts are a treatable disease. People need to put their trust in conventional medicine rather than continuing to go to traditional healers»

Cataracts are associated with ageing, and are the leading cause of reversible blindness worldwide. It is a very common eye disease. Cataracts are vision problems that affect the crystalline lens. The lens becomes opaque and prevents light rays from reaching the retina, resulting in blurred vision. The condition develops slowly with age, and is one of the main reasons for eye surgery in Togo. Ophthalmologist Professor Patrice Komi Balo explains.

Santé-Education: What are cataracts?

Dr Patrice Komi Balo: Cataracts are caused by a loss of transparency in the crystalline lens, the structure inside the eye that enables objects to be focused correctly. Cataracts can affect the crystalline lens in different places: in the centre, on the side or in other places. When the lens of a person with cataracts loses its transparency, it can become white, yellow or black, and the difference can be seen with the naked eye in the patient's pupil. Unilateral or bilateral, cataracts can occur at any age. It can affect newborn babies, children, adolescents, adults and the elderly. Once a cataract has formed, it prevents vision.

How prevalent is cataract in Togo?

It is estimated that cataracts cause 50% of blindness. Cataracts lead to reversible blindness. After the operation, if the patient has no other problems or complications, they regain their sight.

What types of cataract are there?

There are three main types of cataract: firstly, senile cataract, which affects people aged 60 or over. This type of cataract is the most common worldwide and is the most frequently operated on.  Then there is traumatic cataract, which results from an injury to the eye. This could be a cut, a blow or a chemical burn that has damaged the lens. Finally, metabolic cataracts are caused by diabetes, among other things. People with diabetes, especially type 1, can be prone to eye problems.  Furthermore, the long-term use of corticosteroids to lighten the skin not only has harmful effects on the skin, but can also have consequences for the lens.

What causes cataracts in newborns and children?

Some children are born and develop cataracts because of an illness that occurred during pregnancy. This is known as congenital cataract. This can appear one month after birth or 3 to 4 years later.     These are either early-onset or very late-onset congenital cataracts. Although rare, congenital cataracts can appear at birth or accompany a congenital disease such as trisomy 21. In all cases, both eyes are affected.

When a child is born, his or her vision is not fully formed; vision develops gradually.  As soon as a child has a white spot in the eye, parents cannot be indifferent; they must either refer it to the midwife, the paediatrician or the ophthalmology department.

What are the symptoms of cataracts?

Cataracts are a painless disease whose most common symptoms include blurred vision that gradually darkens. In both children and adults, the eye cannot see, you see fog, you have a white spot in the eye which we call leukotomy; at this point you need to consult a doctor. You see blurred at a distance, you see smoke. Colour perception becomes duller. You also notice blurred vision; you have the impression that objects are behind a white veil.

Tell us about the risk factors

Senile cataracts are linked to ageing. As we age, our cells age too, so in the eyes ageing leads to oxidation: you feel a burning inside the eye. This oxidation causes chemical reactions that destabilise and disrupt the harmony and sequence of the cells in the lens, i.e. the way water enters and leaves the cell is altered. This affects the transparency of the eye. Congenital cataracts are often linked to an illness or infection that occurs during pregnancy.

Alcoholism, diabetes and obesity are risk factors, as is a diet low in fruit and vegetables. Smoking damages the proteins in the lens. Taking certain medicines can also cause cataracts.

What are the complications of cataract?

Blindness is the major complication when cataracts are not treated quickly or operated on.Cataracts can lead to glaucoma, the inflammation of part or all of the uvea, the intermediate membrane between the sclera and the retina.Visual acuity is reduced to the point of causing a real handicap in everyday life. The eye can become inflamed, the cataract becomes watery and swollen, and can cause tension to build up in the eyes.Or the cataract behaves like a ripe mango, it doesn't fall out to be picked, but it will be inside the eye.

Can this disease be prevented?You can delay the onset of this disease, but in the case of senile cataract, you can't prevent it because cataracts develop as you get older. But if we adopt a healthy lifestyle, the cataract will come very late. Aging well means having a balanced diet and managing stress well. Nutrition is an important factor in delaying cataracts.When it comes to preventing cataracts in children, it's important to make sure that pregnancy is managed properly.When a woman is pregnant, she should go and see her midwife or gynaecologist.

Is there anything I can do about this disease?

Cataracts are a treatable disease. The operation is carried out under very good conditions and the results are very good in over 90% of cases. And recovery is good.

People need to put their trust in conventional medicine rather than continuing to go to traditional healers.Because many of them don't operate on the cataract, they move it around or create serious complications, including lowering of the crystalline lens.I would advise people to trust conventional medicine.It's best to go and see an ophthalmologist. Any change in the quality of vision should be the subject of a consultation with an ophthalmologist.

Interview by Abel OZIH