Despite rapid strides being made in the field of cataract eye surgery in the last few decades, it continues to remain the leading cause of reversible blindness in our country. We at The Eye Foundation have been pioneers in the field of cataract surgery offering cutting edge technology and a high standard of care to a large population.
How does Cataract form?
The natural crystalline lens of our eye is clear which allows light to be focused clearly on the retina. With ageing, this lens loses its transparency and gradually becomes clouded thereby imparing vision.
What are the causes?
Although most cataracts are related to aging, there are other types of cataract:
- Secondary cataract. Cataracts can form after surgery for other eye problems, such as glaucoma. Cataracts also can develop in people who have other health problems, such as diabetes. Cataracts are sometimes linked to steroid use.
- Traumatic cataract. Cataracts can develop after an eye injury, sometimes years later.
- Congenital cataract. Some babies are born with cataracts or develop them in childhood, often in both eyes. These cataracts may be so small that they do not affect vision. If they do, the lenses may need to be removed.
- Radiation cataract. Cataracts can develop after exposure to some types of radiation.
Who is at risk for cataract?
The risk of cataract increases with age. Other risk factors for cataract include:
- Certain diseases such as diabetes.
- Personal behavior such as smoking.
- The environment such as prolonged exposure to sunlight.
What are the symptoms associated with cataract?
Cataract is characterized by a painless, progressive decline in vision. Apart from decreasing vision patients with cataract even in the early stages may experience increased glare while driving at night or reading in dim illumination, difficulty in differentiating objects at a distance and the need for frequent change of glasses.
How is a cataract detected?
Cataract is detected through a comprehensive eye examination
Visual acuity test: The eye chart measures the vision for both distance and near vision. It quantifies the visual loss experienced by the patient.
Dilated eye examination: Drops are instilled in the eyes to widen or dilate the pupils. This allows detection and grading of the cataract. Moreover, the retina or the nerve of the eye is also examined for signs of damage or other eye problems. The effect of the dilating drops lasts for a couple of hours, during which time the patient may experience blurring of vision.
When does your cataract require treatment?
Cataract eye surgery can be performed at any stage once it starts interfering with the daily activities of the patient. With the advent of advanced techniques and technology, cataract surgery can be performed in a safe and effective manner even in the early stages and one need not wait for the cataract to mature. In fact more advanced and harder cataracts are associated with an increased incidence of complications.
What are the treatment options for cataract?
Surgery is the only and definitive treatment modality for cataract.
The various options available are as follows:
- Conventional Extracapsular Cataract Extraction (ECCE)
- Requires an incision of 10 – 12mm
- The cataractous lens is removed in a single piece
- A hard plastic intraocular lens is implanted
- Multiple stitches are required to close the wound
- Final glass prescription could take 6-10 weeks
- Small incision cataract surgery
- Requires a smaller incision of 5mm
- Cataract is removed manually and lens is placed
- No stitches
- Faster wound healing
- Micro incision cataract surgery, Over the years the size of the corneal incision made during cataract surgery has considerably reduced leading to faster visual recovery and reduced postoperative discomfort
- Requires a very small incision of about 2 mm
- The nucleus is emulsified into small pieces and removed
- A foldable lens is used allowing implantation into the eye without extension of the incision
- Walk-in walk-out procedure
- Painless, bloodless and stitch less surgery
- Can be done under topical anaesthesia
- LASER CATARACT SURGERY
This is the latest advancement in the field of cataract surgery where a laser is used to help make incisions and break the cataract into small pieces. This has greatly enhanced the precision and safety of cataract surgery making it bereft of any complications. To know more (CLICK HERE)
Types of intraocular lenses (IOL)
A majority of intraocular lenses implanted are monofocal lenses. These lenses have the capability of focusing light from a single distance. Normally distant objects are clear and one requires glasses for reading. The monofocal lenses are either rigid non foldable or foldable. The foldable lenses can be inserted through a small wound allowing faster visual recovery and reduced postoperative discomfort.
In certain situations, the patient may have a high cylinder or preoperative bend of the cornea. Monofocal lenses are unable to compensate for this, hence the patient requires glasses for distance vision postoperatively in addition to a reading power. Toric IOLs have the ability to correct the eye power both at the corneal and lenticular plane, thereby correcting the cylindrical power.
Multifocal lenses have different segments which focus light rays from various distances onto the retina. This affords a freedom of glasses for near, intermediate and distant vision to the patient.
FREQUENTLY ASKED QUESTIONS
Do I have cataract?
You may, if you are over 40 years of age and have blurred vision, light sensitivity or glare, poor night vision or fading of colors. These symptoms may differ based on the subtype of cataract.
What happens when I come for a checkup at the hospital?
During your visit to our our eye hospital in Bangalore or Coimbatore, first your vision will be checked by trained optometrists. Your pupils will then be dilated and you will be examined by a consultant, who will then discuss the nature of your cataract and your surgery options with you. The consultant will also evaluate your retina or the nerve of your eye. Prior to your cataract operation, you will need to undergo some routine medical and blood tests and an A-scan that will help the doctor to determine the power of the new lens to be implanted in your eye. You can then choose a convenient date for your eye surgery.
Is phacoemulsification long and painful?
No, the procedure is a simple day care one. The area surrounding your eye will be cleaned, and sterile drapes will be placed over you, exposing only the eye to be operated on. You might have a local anesthetic, which involves a small injection around your eye to keep the eye muscle relaxed during surgery or just drops instilled in your eye to numb it. This makes the surgery completely pain free. The whole process is usually under 10 to 15 minutes.
What do I need to do before the surgery?
It is good to wash your face thoroughly with soap and water before coming for surgery. Use the antibiotic eye drops prescribed to you before the surgery. You can eat a light breakfast on the morning of the surgery.
What happens after the surgery?
After surgery, a bandage or shield will be placed over your eye. You can resume normal, moderate activity as soon as you feel up to it. You should wear protective glasses while going out during the first week. You can bathe carefully from below your neck but do not wet the operated eye for 15 days. You are advised to gently clean the eyelids with a piece of cotton boiled in water or a sterilized tissue. There are no diet restrictions following the surgery.
How long do I have to stay in the hospital after my surgery?
You can return home soon after your cataract operation. A routine postoperative visit the next day is needed. However, if you desire to stay back with an attendant you can stay overnight in comfortable inpatient rooms at no extra charge in our eye hospital in Tamil Nadu or Bangalore.
How soon will I be able to see after the surgery?
In some cases, the patient is able to see clearly immediately after the surgery. Although, for most it takes about two to three days.
Will I require spectacles after the procedure?
You may need to wear glasses after the procedure. If a monofocal intraocular lens is implanted, you will require glasses for reading. A multifocal intraocular lens implantation on the other hand will give you freedom from glasses for a majority of your distance, intermediate and near activities.
What is the life of the implanted intraocular lens? Will I need to replace it?
The implanted intraocular lens is permanent and lasts for the entire lifetime.
When can I plan cataract surgery for the other eye?
Usually both the eyes are not operated on the same day. Once the visual recovery of the first eye is complete, the second eye surgery can be planned.