Roach: Is cataract surgery safe for a 95-year-old?
DEAR DR. ROACH: I’m 95 years old and was wondering if it would be advisable to have cataract surgery at my age. I had a cataract removed from my left eye, and it was very successful. My eye doctor said I have a condition known as pseudoexfoliation in my right eye, in addition to the cataract. — S.D.
ANSWER: Surgery shouldn’t be undertaken lightly at any age, and especially not for people who are among our oldest. However, cataract surgery is one that has a very good record, even among quite elderly people. In a 2014 study of cataract surgery in over 200 people 90 years or older, 80 percent had good improvement in their vision.
If your overall health is good for 95 and the cataract is significantly affecting you, it is reasonable to consider. Pseudoexfoliation, a condition of deposition of fibers on internal structures of the eye, does make cataract surgery more difficult, but only your surgeon can give you a personalized assessment of your potential for complications in surgery.
DEAR DR. ROACH: Is viral meningitis deadly? — B.R.
ANSWER: Meningitis, infection of the lining of the brain, is feared because when it is caused by bacteria, in can be fatal, sometimes within hours. Vaccines have helped reduce mortality from bacterial meningitis.
Viral meningitis, sometimes called aseptic meningitis, along with other kinds of nonbacterial meningitis, is much less worrisome and is usually not fatal. However, it often is not clear from the clinical presentation alone. For this reason, a rapid evaluation of cerebrospinal fluid, from a lumbar puncture (“spinal tap”) needs to be done. Frequently, treatment for bacterial meningitis is begun immediately, and stopped after 48 hours or so if the results show it is viral meningitis.
The most common viruses to cause meningitis are enteroviruses (especially in the spring and fall), but herpesviruses, HIV and mumps virus also can cause meningitis. When the virus (especially Herpes simplex) infects not just the meninges, but the brain itself, it is called encephalitis or meningoencephalitis, and that is very dangerous. Herpes meningitis and meningoencephalitis are treated by antiviral drugs.
DEAR DR. ROACH: Since the invention of the television, in my opinion, we have become a more sedentary society. With the proliferation of video games, smartphones, computers, tablets, etc., it seems to me that the problem has only gotten worse.
Has anyone considered the greater increase now of online shopping as another example of the lack of exercise? I mean, even walking through a store must have some benefit. — N.M.
ANSWER: I agree that screens have had a significant impact on overall physical activity and are part of the cause of obesity. Shopping is not an issue I have seen mentioned, but I think you are right that it is another part of the issue. Further, I worry that all this screen time has made in-person connections less common, leading to a greater number of personal interactions but less-meaningful ones. This may have an implication on overall health.
On the other hand, the phenomenon of Pokemon GO was estimated in a scientific study to increase physical activity by 25 percent in users, a total of 144 billion extra steps in the U.S. over six weeks. So it is possible for smart devices to improve activity.