Cataract

What is cataract?

Within our eyes, we have a natural clear lens that helps us see. When this lens becomes yellow and cloudy, it is known as a cataract. As this clouding happens, it keeps light rays from passing through the lens and focusing on the retina which is a light-sensitive layer at the back of the eye. In its early stages, cataract may not cause a problem. The cloudiness may affect only a small part of the lens. However, the cataract may grow larger over time and affect more of the lens. This can make it harder for you to see. If less light reaches the retina, it becomes even harder to see.

What causes cataracts?

There could be several possible causes including:

• Smoking
• Diabetes
• Ultraviolet Radiation (sunlight) exposure
• Steroid use
• Trauma
• Congenital (genetic causes)

For many of the possible causes, more research is needed to set apart the effect of the disease from the effect of the medicines.

What are the symptoms of cataracts?

The following are the most common symptoms of cataracts. However, each person may experience symptoms differently. Symptoms may include:

• Cloudy or blurry vision
• Lights are too bright and/or give off a glare or a halo
• Poor night vision
• Double vision
• Colours seem faded
• Increased nearsightedness, increasing the need to change eyeglass prescriptions
• Distortion of vision

Often in the disease’s early stages, you may not notice any changes in your vision. As cataracts grow your eyesight will get worse slowly. Certain cataracts can also cause your close-up vision to get better for a short time. But your eyesight is likely to get worse as the cataract grows. The symptoms of cataracts may look like other eye conditions. If you have any of these symptoms, check with your eye doctor.

How to prevent cataract formation?

There is no scientifically proven method for preventing cataract formation. However, you can delay early cataract onset cataracts with the following:

• Using sunglasses to protect from ultra-violet (UV) light
• Eating a balanced diet
• Having good control of diabetes
• Refraining from smoking

How are cataracts diagnosed?

Cataract is detected through a comprehensive eye examination by an ophthalmologist.

What are the complications of cataracts?

A possible complication of cataract surgery is an “after-cataract”. An “after-cataract” happens when a part of the natural lens that is purposely not taken out during cataract surgery becomes cloudy and blurs your eyesight. Unlike a cataract, an “after-cataract” can be treated with a laser called YAG laser capsulotomy. Using a laser beam a tiny hole is made in the cloudy membrane behind the lens to let the light pass through. After-cataracts may develop months, or even years, after cataract surgery.

What are the treatment options for cataract?

Surgery is the only treatment for cataracts. Currently, there are no medical treatment options for cataracts.

How is cataract surgery performed?

Cataract surgery is one of the most common surgeries. It is also one of the safest and most effective. Surgery involves removing the cloudy lens with replacing it with a new artificial lens. If you have cataracts in both eyes, they are usually not taken out at the same time. Cataract surgery is performed while you are awake, and a special numbing eye drop is instilled, so that you wont feel any discomfort during the procedure.

The main technique used to remove a cataract is phacoemulsification.

In phacoemulsification:

• A small opening between 1.8mm and 2.75mm is first created on the cornea.
• An ultrasonic device is then introduced through this opening into the eye. This device breaks the cloudy lens up into small pieces and facilitates removal from the eye.
• After the cataract lens is entirely removed, an artificial lens implant is inserted to the same position.
• Most of the time, the wound does not require any stitching.
• This method of cataract surgery takes less than 20 minutes.
• This is a daycare surgical procedure hence your stay in the hospital is only 3 hours.
• Anaesthetic eye drops will be given to minimise pain. It is important to cooperate by not talking or moving your head and body during the surgery.

How long does cataract surgery take?

In our center, 100% of cataract surgeries are done after instilling anaesthetic drops (Topical Anaesthesia) with no injections. The surgery takes 10 to 20 minutes to complete, depending on the severity of the condition. You should also plan to spend up to 30 minutes following the surgery to recover from the effects of anaesthesia.

What should I expect after cataract surgery?

Within a few hours of the surgery, you will likely notice that colours are brighter, due to the removal of the clouded lens. However, your vision may be blurry during the first couple of days, and your eye may be slightly light-sensitive. Dryness, occasional itching, burning and/or red eyes are also common Most of these effects will end within a few days.

Your eye doctor will prescribe eye drops or medications to prevent or control inflammation, infection or high pressure of the eye. An eye shield is also recommended at bedtime to protect the operated eye.

You will also be scheduled for three or four follow-up appointments with your ophthalmologist to monitor your recovery progress. A month after the surgery, you will need an eye exam so you can be prescribed new eyeglasses.

How long does it take to recover from cataract surgery?

Most patients usually go back to work on light duty two or three days after surgery. However, full recovery from cataract surgery usually takes one to two months. This includes the time needed for the eye to adjust to the replacement lens and the restoration of your vision to its highest potential.

Are there potential cataract surgery complications?

Severe intraoperative and postoperative complications are possible but not likely and are usually manageable. Cataract surgery can restore your vision to its point prior to cataracts. However, a common development (in three out of 10 patients) following cataract surgery is an after-cataract. After-cataracts may develop weeks, months or even years after cataract surgery.

When to consider cataract surgery?

The progression of your cataracts will determine if surgery is needed. If your cataracts are causing difficulties with daily activities, such as reading, filling out checks/forms or driving, you should speak to your eye doctor about having cataract surgery.