Brief about Cataract

What is Cataract

A cataract is a cloudiness or opacity of the eye’s natural clear lens. It obstructs the passage of light to the retina of the eye and impairs vision. When the lens develops cloudiness to the point that it impairs vision, it is called Cataract. It is like looking through a frosted glass.

Symptoms

  • Progressive and painless blurring of vision is the commonest symptom.
  • The blurring of vision may be more marked in bright light.
  • Brightness and contrast of the image decrease in early cataract. Some individuals experience glare while driving at night.
  • Colors may become less distinct. Later on the vision deteriorates and interferes in day to day activities.
  • Seeing multiple moons at night also suggests cataract.
  • Pain, itching, redness or watering of eye are not symptoms of cataract. Cataract usually develops in both eyes, but may progress at different rates.

1. Age-related cataract: Most cataracts are related to aging.
2. Congenital cataract: Some babies are born with cataracts or develop them in childhood, often in both eyes. These cataracts may not affect vision. If they do, they may need to be removed.
3. Secondary cataract: Cataracts are more likely to develop in people who have certain other health problems, such as diabetes. Also, cataracts are sometimes linked to steroid use.
4. Traumatic cataract: Cataracts can develop soon after an eye injury, or years later.

Currently there is no medical treatment to reverse or prevent the development of cataracts. Once they form, there is only one way to achieve clear vision again, and that is to physically remove the cataract from the eye.

It depends on quality of your vision. If the decrease in vision is interfering with your day to day social, personal or professional services, you should not wait. With good results it is not worth just managing with compromised vision.

Yes. Surgery is the only option. Medicines can not cure.

Cataract removal is one of the most common operations performed in the world today. It is also one of the safest and most effective. In about 90 percent of cases, people who have cataract surgery have better vision afterward.

As with any surgery, pain, infection, swelling and bleeding are possible, but very few patients have serious problems or complications. Your surgeon may prescribe medications for these effects. But in case of rare symptoms like excessive pain, vision loss, or nausea, and report these symptoms to your eye surgeon immediately.

Treatment available

MICS( Minimal Incision CatarcatSurgery-Phacoemulsification

It is no stitch small incision cataract surgery. The incision is only 1.8mm – 2.8mm long. Phacoemulsifier is special medical equipment that is used to remove cataract. The minute (2.6mm or smaller) incision is self-sealed and needs no suture or stitch to close it. The patient will be back to normal activities within a few days, including attending office or even doing heavy manual work.

There are 3 treatment options available for cataract:
MICS with Phaco Emulsification with Foldable lntraocular Lens Implantation SICS ECCE (conventional method)

I. Micro Incision Phaco Emulsification with Foldable lntraocular Lens Implantation
Cataract extraction by Phaco Emulsification through a 1.8 mm incision and implanting a Foldable lntraocular Lens is a definite technological advancement from the conventional surgery. The lens is injected into the eye through a small incision and it opens up within the eye like a flower.

Advantages:

Wound healing is very fastThe shorter overall duration of surgery Less postoperative discomfort Minimum post operative restrictions Wound stability is far better since the entire surgery is done through a very small opening (Suture Less)Induced astigmatism is minimalDecreases glare because of the superior surface quality of the lens
However, patients will need glasses for reading. If the patients don’t want to use the glasses, they can opt for multifocal IOL.

Il. SICS (Small Incision Cataract Surgery)

The clouded cataractous lens is extracted by fragmenting it into tiny pieces with ultrasound energy and aspirated out with a suction device. The cataract is removed through a small self-sealing wound. There are no sutures applied to the eye. The patient will need glasses for near vision.

Advantages:

Requires no stitches (Incision 2.8 mm) Is non-invasive and painless Early rehabilitation Less induced astigmatism Perfect early restoration of vision

111 ECCE (conventional method)

Requires an incision of 9 mmThe surgeon removes the clouded lens in one pieceA hard rigid lens is implanted, Multiple stitches are required
Increased risk of post-operative distorted vision and complications
Most patients require glasses for both distance and near vision

Toric IOLs (Intra-Ocular Lenses)

A significant proportion of the population has astigmatism (cylindrical refractive errors) that is not corrected with standard IOLs resulting in need for spectacles for both distance and near vision. With the availability of cutting edge technology it is possible today to implant such people with customized IOLs which have capability to correct the cylindrical errors as well. These IOLs are knows as TORIC IOLs and are available in both single focus and multifocal platforms. The use of these IOLs offers greater chances of spectacles free vision to the patient.

Pre and post Operative FAQs

Pre-Operative FAQs

You can go for work within 3-4 days. The lens is implanted / fitted inside the eye and is not affected by dusty environment.

Your cataract can progress and reach a stage where glaucoma may develop or may progress to a stage where suture-less surgery is not possible.

No. Early surgery gives you best vision, quick recovery and least complications. You get to enjoy best vision much earlier.

The lens stays with you for the rest of life. There is no need to clean, maintain or replace the lens after it has been implanted.

You can fly the next day. Do discuss your travel plans with the doctor.

There is really no treatment except surgery.

Avoid surgery of both eyes on the same day. Give some gap between surgery of both the eyes. When can I get the second eye operated? It will depend on the vision of the second eye. Second eye surgery can be planned within next 3-5 days.

Once a cataract has been removed, it cannot develop again. However, over time, patients may notice that their vision has once again become hazy. This condition, which can occur with any type of IOL, is known as secondary cataract, or posterior capsular opacification (PCO). Secondary cataracts can be easily treated with a simple laser procedure performed in OPD.

Your doctor will do some tests to measure the curve of the cornea and the size and shape of your eye. Also, doctors may ask you not to eat or drink anything after midnight or in the morning of your surgery

Post-Operative FAQs

You can go for a walk next day. Depending on your comfort and confidence, you can drive, exercise and even go to your office.

Avoid washing your face for two days. You can shave, shower or have head bath after that.

You should not touch your eyes for one day. There is no need for dark glasses. No additional protection is required at night. Do not miss the medicines prescribed to you.

You need two visits. The first visit is one day after surgery and the second is two weeks after surgery.

No. You can resume your normal diet after the surgery. The diabetics should strictly adhere to their recommended diet.

It is better to avoid hair dye and makeup for two weeks.

Oral tablets are required for a total of 5 days and eye drops need to be instilled for four to five weeks.

No. The lenses we use have built in UV filters.

It depends on your comfort levels. There is no restriction on watching TV.

Yes. Spectacles are prescribed for two weeks. You will get good functional vision after cataract surgery without glasses. Glasses may be required for distance in some cases. Reading or near-work glasses will be required by all cases. You do not need thick glasses. Even cases with Multifocal IOL may have little near vision number and may need glasses after surgery.

You can start as soon as you feel comfortable. Please remember that the operated eye will get prescription for glasses after two weeks.

Any time after two days.

Please avoid touching your eyes for a week.

Yes, after fifteen days with eyes closed

Every patient and his eyes behaves differently, but most patients typically see well enough to drive within a day after surgery. Ask your doctor how quickly he or she expects you to recover.

Most patients can resume basic activities like reading and watching TV the day after surgery, and can usually return to work within two to seven days. Doctors typically advise against any strenuous activity for two or more weeks. Results vary by patients; therefore ask your doctor what’s best for you.

Consult your doctor immediately if you have any issues particularly if you experience decreased vision or pain.

Usually patients feel some sensation which settles down within a few days after surgery. Rarely, some patients may experience foreign body sensation for 2-3 weeks. The surgeon usually prescribes lubricant eye drops which take care of the temporary sensation.

It’s normal to feel itching and mild discomfort for a while. Some fluid discharge is also common, and your eye may be sensitive to light and touch.

Operative FAQs

You total stay at hospital will be for about three hours.

We recommend you not to eat.

Please do not bring more than two attendants with you.

Thanks to numbing drops and medications to help you relax, the surgical procedure involves minimal discomfort.

You do not experience any pain during surgery.

The surgery takes about eight to ten minutes. You stay inside the operation room for 30 to 40 minutes.

Yes. You must keep taking any medicines you have been prescribed for any other disease. But surgen should be duly infomed.

You will be given eye drops to dilate your pupil before surgery. The area around your eye will be washed and cleansed. The operation usually lasts less than ten minutes and is painless. After the operation, a patch will be placed over your eye and you will rest for a while. Since you will not be able to drive, make sure you accompany someone.

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