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Cataract
When the crystalline lens of the eye loses it’s transparency, this condition is called a cataract. Light easily passes through a normally clear lens, producing a sharp image on the retina; when the lens becomes cloudy, light cannot pass through as easily and vision is impaired. Having a cataract is like trying to look through a foggy window. Cataracts occur most commonly among people over 55 years of age.
Cataract develops because of a Chemical changes within the protein of the lens causes clouding and yellowish or brownish discoloration . While chemical changes seem to be part of the natural aging process, they may also be caused by injury, inherited tendencies, diseases , birth defects, and certain drugs.
There is no known prevention for cataracts that are a natural process of aging. However, there is growing evidence that exposure to Ultraviolet light (sunlight) and Cigarette smoking may speed their development. Avoiding excessive sun exposure and smoking is a sound preventive measure.
The cataract “Clouded lens” blocks light, casting a blurred image on the retina. This cloudiness may affect a part or all of the lens. The degree to which a person’s vision is affected by cataract formation depends on the location and degree of clouding. For instance , if the clouding starts on the side of the lens, vision may not be drastically affected for years , because peripheral vision is not used as much as central vision.
The natural history for cataract , is a slow progression over a matter of years. It starts with a very mild decrease in intensity of colors initially, and progress over time to start affecting the visual acuity , and at very advanced stages the individual can barely find his way. Since the decrease in vision took place over years, most patients do not have a good idea of how bad is there vision till they do the surgery in one eye ,and then they can compare the operated eye with the cataractus one.
A comprehensive eye health examination can detect cataract formation. After diagnosis , regular follow-up care is needed to assure the best possible correction for the level of impairment. In the early stages, prescription glasses can help you see better. And typically what happens is that patients who used to use glasses for reading, start reporting that they are able to read lately without the help of near glasses. This is a true observation, and this is attributed to a pure optical phenomena whereby the cataract start helping partially the patient to see better for near without the reading glasses. In time, however, a cataract may become so dense that good vision can no longer be maintained with prescription eyewear for distance and for near. At that time , surgery may be the best option to restore vision. Deciding when to have a cataract removed depends on a number of factors; the extent of clouding, the location of the cataract, and how much normal daily activities are impaired. For instance, if reading or driving abilities are impaired, surgery may be elected sooner than if such impairment have not yet been noticed.
The clouded lens is removed during cataract surgery, it is often replaced with an artificial lens implant( known as an intraocular lens implant or IOL ).The artificial lens has improved drastically with the boost in medical technology and there is a wide range of lenses that can be used. The most advanced ones are foldable lenses that provide the ability to have a very small wound in the eye to insert the lens, which can be as small as 3.2 mm. Because only one eye is operated at a time, the more impaired eye is usually done first. Surgery is often timed so that one eye has adequate vision while planning to do the other eye. Before going ahead with the cataract surgery, accurate calculations are taken for the power of the implanted lens. This can be done by measuring the axial length of the eye and the concavity of the Cornea , and using special formulas which will help in determining the refractive power of the implanted lens.
Cataract surgery has excellent surgical result nowadays due to the vast improvement in both the techniques and instruments used. Usually, there is no need to stay in-hospital, so it is an out patient procedure ( Around 4-5 hrs to Admit-do surgery-Discharge home).It can be done under local anesthesia or under general (according to the patient and Doctor’s preference) and the eye is patched after the surgery for one day. In most cases , vision improvement is noticed the first day after surgery, and an eye drop is going to be used for a while. It is a none painful and rewarding surgery for the patient. The advances in modern technologies allow using smaller incisions about 3 mm in length and that are so tiny they may not even require suturing. In non complicated cases , the preferred intraocular lenses are the foldable ones.
One week after surgery, wound is barely Visible
After a cataract surgery , the patient can resume normal daily activity in a couple of days, and a couple of office Follow-up visits are needed to make sure that the eye is responding properly to the procedure. In a couple of weeks, the wound site will not be apparent to the naked eye.
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