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CATARACT

WHAT IS IT?

A cataract is a clouding of the normally clear lens of the eye that causes loss of vision. Usually the cataract starts as a small opacity but becomes increasingly opaque over time. Less light can pass through it and gradually diminish the sight.

 

MISCONCEPTIONS ABOUT CATARACT:

 

Cataract is not:

1) a film over the eye.

2) caused by overusing the eyes.

3) spread from one eye to the other.

4) a cause of irreversible blindness.

 

CAUSES:

1) Aging(commonest)

2) Family History

3) Medical Problems, such as Diabetes

4) Injury to the eye

5) Medications, especially steroids

6) Previous eye surgery

7) Unknown factors

 

SYMPTOMS:

1) A Painless gradual blurring of vision;

2) Glare, or light sensitivity;

3) Poor night Vision;

4) Double vision in one eye;

5) Needing brighter light to read.

 

TREATMENT:

No Medical Treatment

 

SURGERY:

Surgery is the only way a catract can be removed with a success rate of over 95%. Modern cataract surgery is the single most common surgical procedure performed.

The Aim of cataract surgery is to remove the clouded lens and replace it with an artificial lens.

What happens if not treated if left untreated, senile cataract usually results in progressive decrease of vision and ultimately complete blindness. Complications may sometimes develop if catracts are left untreated too long.

 

WHEN SHOULD SURGERY BE DONE?

The time taken for cataract to develop varies from a few months to a few years. It is not true that cataract need to be "ripe" before they can be removed or that they need to be removed just because they are present. Cataract surgery can be performed as soon as the clouded lens interferes significantly with your comfort and normal daily activities like reading, watching TV, driving, cooking, etc. Based on your symptoms you and your ophthalmologist should decide together when surgery is appropriate.

 

How is Cataract detected?

By performing a thorough eye examination, your ophthalmologist can detect the presence of a cataract. A careful evaluation will also rule out any other conditions that may be causing blurred vision or other eye problems. Problems with other parts of the eye (such as cornea, retina or optic nerve) can be responsible for vision loss and may prevent you from having much or any improvement in vision after cataract surgery. If cataract is present, the decision whether or not to operate depends on a number of factors as discussed with you earlier.

 

What are the ways of removing the Cataract?

1) Extra capsular surgery (stitches)

2) Phacoemulsification (no stitches)

 

The extra capsular cataract extraction (ECCE) technique is the older of the two techniques. The cataract nucleus is removed in one place. This technique is well proven. However, it requires an incision in the eye wide enough for the whole cataract to fit through. This usually means a larger incision of about 9-10 mm. Stitches are needed to close the incision. Greater postoperative care is needed.

 

The second, newer, technique is called the Phacoemulsification(Phaco) technique. The cataract is first broken up inside the eye with a narrow ultrasound needle and the pieces are aspirated out. This technique requires a smaller incision size of only 3 mm. Small incision is less traumatic to the eye and recovery time after surgery becomes shorter. Stitches are usually not necessary.

 

WHAT IS AN INTRAOCULAR LENS?

The cataractous lens, which has been removed at surgery, has to be replaced to allow the eyes to focus light again. This is done by either, Cataract Spectacles or Intraocular lens (IOL)

 

CATARACT SPECTACLES:

Thick glasses worn in front of the eye after surgery to be able to see clearly if an intraocular lens has not been implanted. There are many disadvantages. Images are magnified and distorted

 

INTRAOCULAR LENS:

Transperent lens, which is inserted at the time of surgery. It replaces the cataract, which has been removed. It remains permanently in the eye, does not cause irritation and needs no maintenance. Advantages are that the patient need not wear thick cataract glasses. Images are clear and of normal size. A small spectacle correction is usually needed, however, for fine vision.

 

STAY IN HOSPITAL AFTER SURGERY:

In most cases, one need not stay long. The patient is admitted in the morning and discharged shortly after surgery. The procedure has become so routine that it is mostly performed as an outpatient procedure like a visit to a dentist. There may be few situations needing hospitalization. If so, they will be discussed with you.

 

CARE AFTER CATARACT SURGERY:

1) Use the eye drops as prescribed.

2) Be careful not to rub or press your eye.

3) Wear eyeglasses or an eye shield, as advised by your doctor.

4) Avoid strenuous activities until your ophthalmologist tells you to resume them.

 

CONCLUSION:

Cataracts are a common cause of decreased vision, particularly for the elderly, but they are treatable. Cataract surgery has become a relatively routine and safe operation performed on lakhs of people each year. The best option for you will be determines after a full examination.

 

For more information, consult our ophthalmologist