Cataract (Hindi: Safed Motia or Motiabind) is age related changes in the natural lens of the eye leading to opacification and consequently causing blurring of vision. It starts after 5th decade of life and usually progresses with the age.The symptoms of cataract can vary according to the area of the lens involved and the blurring is early and more pronounced when central part is opacified as compared to the peripheral part of the lens. The other other symptoms may be blurring of vision in bright light(Glare) , Coloured rings around the lights (Haloes), Multiple blurred images of an object (Polyopia), Blurring of vision in dim light, Difficulty in reading and driving, Repeated quick change in glasses power, eye strain and headache etc.Causes of cataract are injury (Traumatic cataract), Diabetes mellitus and various other diseases and thus can occur earlier also. In new born and infants it occurs due to genetic reasons or poor maternal health and diseases during pregnancy and then is called Congenital Cataract.
What is Cataract?
A cataract is an opacification of the natural transparent lens causing blurry, cloudy, or distorted vision. It usually occurs as normal aging process. The human lens is located just behind the iris, or the coloured part of the eye. A healthy lens is clear and flexible, allowing us to see focused images. The original meaning of “cataract” is “WATERFALL”, because the type of visual defect seen from cataractious eye is similar to as if you seeing through a waterfall.
Who can have Cataract?
Usually Cataract occurs in 50% of people by the age of 65 and in 95% by the age of 75. So, practically anybody and everybody can develop cataract, who lives long enough, so they are considered a normal part of the aging process, similar to greying of hair and aging of skin. Diabetes, steroid use, trauma, smoking, excessive alcohol consumption, obesity, hypertension excess levels of bad cholesterol (LDL) in the body and excessive sunlight or radiation exposure are certain factors can speed up cataract formation. Cataracts can develop in children due to some genetic or hereditary conditions or due to some problem during development of the foetus.
How do we know when we have Cataract?
Generally, many people discover they have a cataract only when they visit their eye doctor for new glasses. But there are some visual (symptoms) problems which might help us to know that Cataract is there. Common symptoms of cataracts include blurring of the vision. Colours may appear too dull or too bright and the same is felt for light. The symptoms vary according to the type of the cataract. The nuclear cataract causes a short term improvement in an individual’s vision. This phenomenon called the ‘second sight’. In contrast, sub-capsular cataract fails to exhibit symptoms unless fully developed.
Do we need to worry about the Cataract?
NO. The cataract usually develops very slowly and painlessly, and is age related process. So, we don’t to panic for it. Caution, this Does not mean One should not get cataract removed. One should get it removed in proper time after consulting your Ophthalmic surgeon. If Cataract is not treated, it may turn into complicated cataract, which is very difficult to treat and may even lead to permanent loss of vision.
What are the Treatment options for Cataract?
There are no known medicines to stop or reverse this change. Surgery is the only definitive treatment. Cataract surgery has an overall success rate of 97 percent or greater. With the use latest and advance Techniques developed over the period of time, this surgery has become most safe and with very high success rates.
What are the types of cataract surgery?
The Types of Cataract Surgeries done these are SICS, PHACO, MICS and FLACS. Most Commonly done preocedures among these are PHACO and MICS.
What happens when you have cataract surgery?
During Cataract Surgery, the natural Opacified lens is removed and replaced by new artificial human made lens (called Intra Ocular Lens) through small hole (or an incision). This is done with the use of highly advance machines. The techniques such as SICS, PHACO, MICS, and FLACS mainly differs in incision made through which opaque natural lens is removed and new Lens is inserted.
How long does it take to remove a cataract?
A Typically Uncomplicated cataract surgery often takes no longer than about 10 to 15 minutes to perform. But immediately after the surgery, you will need to rest in a recovery area until you are less groggy from anesthesia. Typically this takes about 30 minutes to an hour.
What are the precautions after cataract surgery?
For a safe and fast recovery from cataract surgery, take following precautions:
- Use Dark Glasses for a week after surgery.
- Take your medications and eye drops as prescribed your doctor for smooth recovery.
- Avoid sneeze or vomit right after surgery.
- Don’t do any heavy lifting or strenuous activity for a few weeks.
- Don’t drive on the first day.
- Avoid bending over, to prevent putting extra pressure on your eye.
- Don’t rub your eyes, which is a good idea even when you aren’t recovering from surgery.
- Don’t expose your eye to irritants such as dust, pollens and wind during the first few weeks after surgery.
- Avoid use of water on face like swimming or using a hot tub during the first week, to reduce risk of infection.
Be careful walking around after surgery, and don’t bump into doors or other objects.
What if You Cataract in both eyes?
Cataract Surgery is usually performed in one eye at a time. So, if one need’s cataract surgery in both eyes, the eye surgeon will wait for at least a few days to two weeks for your first eye to recover before performing a surgery on the second eye.
Phacoemulsification or PHACO is popular and most frequently performed surgery in present time world wide.The principle involves bracking of lens into small pieces , emulsifing it by ultrasound energy and then aspirating the lens matter, all done through a very small inscision. Thats why procedure is Stitchless. A handpiece with quartz crystals is used to produce the ultrasonic energy which moves the tip of 0.9 to 1.4 mm size back and forth to hit and emulsify the cataract.The whole procedure is performed through an incision size of 3.2 mm in the form of a self sealing tunnel which does not require any stitches for its closure. The “phaco probe” has both irrigation and aspiration through the 3.2 mm and a continuous flow of a balanced fluid goes into the eye and is aspirated out along with emulsified pieces of cataract. At our hospital, the procedure is performed under local anaesthesia so there is very less anaethesia associated complications. The procedure hardly takes 15 to 20 minutes time followed by swift and rapid recovery in no time.
PRECAUTIONS BEFORE & AFTER PHACO CATARACT SURGERY
It is advisable to maintain proper hygiene and cleanliness. No cosmetics should be used on the eye or face. There are no dietary restrictions required before or after cataract operation. Dietary restrictions for other systemic diseases should be observed. Splashing water in the eye to wash it is not to be done. Face can be washed and head bath can be taken with the eyes closed.
These are most commonly used IOLs which provide clear vision for all distances hence almost all the routine activities can be performed without the need for additional glasses. Rarely the patient may experience glare during nights postoperatively but usually gets adapted within a few months.
These IOLs correct the pre existing corneal astigmatism there by reducing the possibility of spectacle wear for distant vision post operatively.
These IOLs gives good quality of vision post operative due to the lens design, it also improves the contrast sensitivity of the patient and good night vision. These lenses also filter the harmful UV light and blue light which are said to be harmful to the retina.
These IOLs have flexible hinges that enables them to change focus for different distances hence providing clear distance, intermediate and near vision without glasses.