CATARACT / GENERAL INFORMATION
Cataract is opacity of the eye lens located behind the iris (the Pupil). It can occur at any age.
Like a camera, the eye contain a lens which focuses the incoming light and forms a sharp image of what you are looking at on the back of the eye.
When a cataract forms, the normally clear and transparent lens becomes cloudy, blocks light, and causes the images to become faint, blurred and hazy.
The causes and symptoms of cataract:
This disease occurs for several reasons which include:
1. Aging process.
2. Exposure to severe blow or penetrating wound
3. Some chronic diseases such as diabetes.
4. The use of drugs containing steroids, whether topical medications to the eye or systemic.
5. In children, it might be hereditary or a result of an infection during pregnancy.
Symptoms of cataract are different from one individual to another, and include the following:
1. Gradual and painless decrease of vision.
2. Inability to tolerate bright light which may lead to double vision of light or light reflection.
3. Repeated need to change glasses.
4. Gradual change of the pupil color to white, which happens in advanced cases.
Cataract symptoms vary from one person to another are as follows:
1. Gradual weakness in sight without pain.
2. Inability to tolerate bright light, may lead to the emergence of double lights or for reflections of light.
3. Frequent need to change glasses.
4. Iris colour gradually changed to white and this is common in advanced cases.
The treatment of cataract:
If a large portion of the lens becomes cloudy, sight can be partially or completely. Since there are currently no medications or diets that can cure or prevent cataracts, the only effective treatment is to remove the clouded lens through surgery.
Common Types of Cataract Surgery:
- Phacoemulsification: the surgeon makes a tiny incision (no more than 2 – 3 mm) through this incision, the surgeon inserts a very small probe that transmits ultrasound waves to break up the cataract and suction out the fragments, the surgeon may or may not use stitches to close the incision. This is the most common type of cataract surgery nowadays.
- Extra-Capsular Cataract Extraction (ECCE): The surgeon in this process made an incision in the cornea or sclera (from 8 – 12 mm) remove the clouded lens from this incision. Then, stitches are used to close the incision. This procedure is used in very advanced cataracts which cannot be broken up by ultrasound waves.
- Femtosecond Laser for Cataract Surgery: this type of laser has the capability to break up the cataract by applying a number of laser pulses to the lens. Then, the surgeon makes a tiny incision to suction out the fragmented lens. This procedure has led to faster recovery time and high accuracy to make the eye incision.
Note: It is the common mistakes that some believe it should wait for complete loss of vision before seeking help or considering cataract surgery, which is not true at all, The cataract can be removed when vision is impaired enough to interfere with livelihood or quality of life.
HOW LENS REPLACED?
Once the cloudy lens is removed, light can again enter the eye freely, but the eye cannot focus light without a lens. Once the lens has been taken out during surgery, its job of focusing what you see must be taken over in some other way, following removal of the cataract, a substitute lens must be used to restore vision.
There are currently 3 ways to accomplish this:
1. Intraocular lens which is implanted during the cataract extraction surgery: Such lenses are 99% safe and enable patients to see objects in their real size and shape. They require no care or change and last a lifetime.
The most common types of intraocular lenses are:
- Monofocal Intraocular lens: improves far and intermediate vision, but requires reading glasses.
Multifocal lens: improves far, intermediate and near vision. Rarely, the patient needs reading glasses, but it needs to be implanted in both eyes and in selected cases, Where they are used in certain cases, the benefit of the patient's full advantage.
- Lenses with adjustable some degree of deviation (astigmatism): These lenses are used in certain situations based on the examination and evaluation of the doctor.
2. Contact lenses: which are placed on the surface of the eye. They enable the patient to see objects close to their real size. However, these lenses require much care.
Glasses whereby objects are seen bigger than they are as they look closer than they really are. They provide limited and central field of vision considering that the patient sees through the center of the glass.
Note: one of these substitute lenses is determined in consultation with the eye surgeon, as might be appropriate for each case.
PLANNING FOR CATARACT SURGERY
The doctor after your discussion and agreement will schedule a time for your operation, your doctor will request comprehensive medical and ophthalmological check up on you including ultrasonography and x-ray. Depending on the medical doctor’s report, the patient is scheduled for surgery if he/she is medically cleared for surgery.
Cataract extraction surgery takes only 30 minutes to one hour, and is normally done under topical or local anaesthesia. However, the doctor may find it necessary to do it under general anaesthesia in some cases. No matter whether it is local or general anaesthesia, the patient feels no pain during the procedure. The eye is patched for one night only and the patient can begin using the operated eye on the second day.
Post operatively, some drops are given to lessen the inflammation may usually occur after any surgery, and contribute to eye return to normal after several weeks.
POST OPERATIVELY, WRONG CONCEPTS ABOUT CATARACT (Note: It is never normal again)
1. Cataract is not white water as commonly known. It is the loss of clarity of the lens.
2. It is not true that cataract surgery is not performed until it becomes mature. It could be done at any time visual impairment cripples the patient to do his/her normal activities.
3. Cataract is a non-contagious disease and it does not move from one eye to the other, however, it may form in both eyes at the same time.
4. Cataract is not formed due to overstraining the eye such as excessive reading.
5. Cataract formation does not cause any pain, redness or excessive tearing.
6. Cataract cannot be treated with laser or medications. Surgery is the only possible way of treatment.
Revised November 2015