The lens of the eye is a biconvex, normally
transparent structure behind the pupil. It focuses light
rays into images on the retina, the light-sensitive lining
at the back of the eye. A cataract is opacity or clouding of
the lens. It prevents the lens from focussing light onto the
retina, hence, causing hazy vision. Aging and other factors
may cause the proteins in the lens to degenerate, forming
opaque (cloudy) areas. They usually develop slowly over
several years and are irreversible. As the cataract
advances, the cloudiness of vision increases over a period
of time until the vision is completely impaired. Advanced
cataract can cause blindness, but they can be successfully
treated with surgery.
What causes cataracts?
Although age-related changes are the primary
cause of cataract formation, these can be affected by other
factors. These include free-oxygen radicals, ultraviolet
radiation, smoking, alcohol, steroids, drugs like psoralens,
tamoxifen, phenothiazines, amiodarone, and mepacrine.
Medical disorders such as diabetes,
glaucoma, and certain metabolic conditions, can also
contribute to their formation. Physical injury to the eye
(such as a hard blow, cut, or puncture), intense heat or
cold, chemical burns, or radiation therapy can also cause
cataracts. Rarely, a baby is born with a congenital
cataract, usually because of an infection during pregnancy
or an inherited disorder. The closer people live to the
equator the greater the chance of developing cataracts.
How serious are cataracts?
According to the World Health
Organization, cataracts are the leading cause of blindness
around the world; an estimated 17 million people are
visually impaired because of them. The severity of cataracts
varies widely. When cataracts form at the outer edge of the
lens, they may interfere very little with vision. Those
located in the center of the lens, however, will cause
significant vision loss.
What are the symptoms?
The symptoms of cataract are
variable because they form in different ways. In most
patients, the initial symptoms of cataracts are
progressively cloudy vision, double vision, or both. Objects
may begin to look yellow, hazy, blurred or distorted. People
may experience increasing nearsightedness needing frequent
change of eyeglasses. Others may find that they need more
light to see clearly. Cataracts can cause other visual
disturbances – decrease of colour vibrancy, difficulty in
reading and coloured haloes around lights. People having
diffuse cataracts in the rear walls of their lenses are more
likely to experience glare, because their cataracts lead to
scattering of light. In later stages the decrease of vision
leads to blindness.
Can cataracts be prevented?
Cataracts that occur due to the
aging process cannot be prevented as the aging process
itself cannot be prevented. Using the eyes for reading and
similar activities have nothing to do with cataract
formation. Avoiding the use of eyes will not prevent
cataract. Till date as per all authentic medical research,
no medication exists to prevent or cure a cataract. The only
known treatment for cataract is surgery.
How are cataracts diagnosed?
The doctor will check the vision
and examine the lens for any signs of cataract. If the
patient is having a significant visual handicap, the surgeon
will advise surgery. In that case, a painless ultrasound
test is done to measure the length of the eye and determine
the power of replacement lens to be implanted during
surgery.
What is the treatment?
Early cataracts, if they lead to
near-sightedness, may be managed by prescribing stronger
eyeglasses or contact lenses. No medical treatment can
prevent or reverse the development of cataracts. Once a
cataract develops, surgical removal is still the only
remedy.
Cataract surgery is usually done as a day-care procedure
under local anaesthesia and takes about half an hour. A
cataract extraction with intra-ocular lens implantation is a
procedure in which the cataract is replaced with an
artificial lens implant.
What happens during the
surgery?
The surgeon makes a small cut in
the eye and removes the cloudy lens either by a routine
cataract procedure or by phaco-emulsification. In phaco-emulsification,
sound waves (ultrasound) are used to break the lens into
small pieces, using a thin titanium probe. The small pieces
can then be sucked out through the same probe. The surgeon
will put a plastic lens (called an IOL – Intra Ocular Lens
implant) in the eye. One or no stitch may be given and a
patch put over the eye.
What happens after the
procedure?
The patient is kept in the
recovery area for about an hour after surgery. It is normal
to feel slight itching, sticky eyelids, and mild discomfort
for a while after cataract surgery. Some fluid discharge is
also common.
Although, some activities are restricted after surgery,
reading and watching TV is allowed right away. Simple tasks
such as riding in a car, stooping over to put on shoes,
resuming normal work, and visiting friends can be done.
Water or other substances should not be allowed to get into
the operated eye. Accidental pressure to the eye should be
avoided. Eye-drops may be needed to help healing or to
prevent infection or swelling. In most cases, it takes about
3-6 weeks for the eye to heal. New glasses can be worn after
about a month.
What are the benefits of this
procedure?
Cataract surgery is very
successful. Nearly all patients enjoy better vision after
surgery, unless they have other eye problems. There are
numerous benefits of cataract surgery, many of which cannot
be measured statistically. These include improved colour
vision, greater clarity of vision, improved quality of life
- people can resume driving, reading, writing, watching
television, sewing, household work, and using a computer
after the surgery.
What are the risks of this
procedure?
Modern cataract surgery is one
of the safest of all surgical procedures. However some minor
complications that can occur include a slight drooping of
the eyelid, swelling around the eye, corneal haze,
reflections or slight distortion from the lens implant,
which are usually temporary. The chances for serious
complications are negligible. Possible serious complications
include severe inflammation, glaucoma (high internal eye
pressure), displacement of the implanted lens, haemorrhage,
retinal detachment and infection. Some of these rare serious
complications may cause poorer vision than before the
surgery or even blindness in the operated eye.
Cataract surgery
Eye_Examination
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