WHAT IS CATARACT?

The human eye has a natural lens, which is normally transparent and helps to focus the light on the retina and thus form a clear image. When this lens becomes cloudy, usually due to aging, it is called Cataract or Safed Motiya. This obstructs the light and causes vision to become hazy.
WHAT CAUSES CATARACT?
Aging is the commonest cause of cataract. As part of the natural aging process, the proteins in the lens get altered leading to opacification. At a younger age it may occur due to injuries, diseases like Diabetes, hypothyroidism, inflammation, radiation, medications like steroids. It can also be congenital & hereditary.
WHAT ARE THE SYMPTOMS?
The commonest symptom is a progressive blurring of vision. The vision maybe more hazy in bright or low light. Altered perception of colours, glare & sensitivity to bright light, difficulty in night driving, seeing multiple images, frequent changes in the power of glasses are some of the other problems that occur. Cataract usually develops in both eyes, but maybe more in one eye.
HOW CAN CATARACT BE TREATED?
Surgery is the only way to remove cataract. There are no medications, eye drops or exercises that have proven to delay development or cause cataract to disappear once they have formed. Glasses may temporarily help to improve vision, but the only definitive cure is surgery. Cataract cannot be treated by laser alone, a surgical incision is required.
HOW IS CATARACT SURGERY DONE?
Cataract surgery with intraocular implant is an extremely safe procedure. It is a daycare procedure taking just around half an hour. The different techniques are:
Conventional cataract surgery (ECCE) It requires a large incision of 10-12mm. The cataract is removed in one piece and replaced with a rigid IOL. Multiple stitches are applied and it takes upto 8-12 weeks before the final number of glasses is given as healing takes longer.
Phacoemulsification (Phaco) It is the latest stitchless, bloodless, painless procedure where high frequency ultrasound waves are used to emulsify the lens and suck out through a small incision of less than 3.2mm. A foldable IOL is then injected. With the latest advances, we now have Microphaco (MICS) where the incision size is even smaller around 2.2mm.
WHAT ARE THE ADVANTAGES OF PHACO?
  1. Stitchless, painless, bloodless, daycare procedure
  2. Small incision, early healing, faster recovery
  3. Early visual rehabilitation- can soon resume normal activities
  4. Reduced dependency on glasses
  5. No injection required
  6. Yields a stronger eye which is more resistant to injuries
  7. Less inflammation after surgery
WHAT IS THE SUCCESS RATE?
Over 95% patients vision improves after cataract surgery, but a small number may not improve substantially even though the surgery itself is successful due to other complicating problems like corneal opacity, unhealthy endothelium, glaucoma, squint, retinal diseases like diabetes & macular degeneration. These conditions limit the visual improvement, though surgery is still worthwhile. If the eye is healthy, the chances are excellent that you will have good vision after cataract surgery.
WHAT ARE THE POSSIBLE COMPLICATIONS?
Complications are rare but can include infection, inflammation, swelling of the cornea or retina. Cataract surgery is among the safest & most commonly performed operations the world over. However, the eye is an extremely delicate structure and each patient responds differently. Call your doctor immediately in case of any pain, redness or decrease in vision.
WHAT ARE THE TYPES OF INTRAOCULAR LENSES (IOL)?
  1. Nonfoldable lenses- These require a large incision, are made PMMA
  2. Foldable lenses-They go through a small incision < 3.2 mm, are made of acrylic or silcon
PREMIUM IOLs
  1. Asheric / Aberration free lenses: They give better contrast, sharpness and clarity than regular lenses.
  2. Toric lenses: They are advisable in patients who have significant astigmatism. They also correct the cylindrical power making the vision sharper.
  3. Multifocal lenses: They are specially designed to correct near, intermediate and distance vision so that the dependency on glasses is greatly reduced. Monofocal lenses, have a fixed power, so work best only at a particular distance.

FAQs

When is the best time to get operated?
Surgery is advisable when there is any limitation of normal activity such as reading, driving, or disturbed vision. Do not wait for the cataract to mature as it can lead to complications. There is no preferred season, surgery can be done anytime of the year.
What precautions are required after surgery?
Most patients can resume normal routine activities like walking, watching TV & reading the very next day and can return to work within a week or so. Strenuous activities should be avoided. There are no dietary restrictions except those advised for other conditions like diabetes. Be careful not to rub the operated eye and protect it from dust, smoke and injury. Use the medications as advised and have regular check ups.
When can the second eye be operated?
Once the eye is healing well and the outcome of vision in that eye is determined, the decision can be made regarding surgery on the other eye. It is not necessary to have a long gap between the two eyes.
Can cataract return?
Once removed the cataract does not recur. However, the membrane (posterior capsule) on which the IOL is stabilized may become thickened months to years after the original surgery. This may cause vision to again become hazy. A simple, painless outpatient Yag laser is done to permanently clean the capsule by making a small opening in it.
Will I need glasses after surgery?
Glasses are required to fine tune your vision especially for near work. In multifocal lenses the dependency on glasses is much reduced.
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