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Cataract

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How does a cataract patient see?

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Cataract is a common eye condition in all areas of the world that generally affects adults 55 years of age and older. Cataract is a clouding of the natural lens inside the eye. It is a gradual loss of transparency of the lens that causes clouding. Because of this, light becomes distorted and fails to reach the back of the retina for proper formation of the image on the retina. If not treated properly, it can lead to blindness.

Types of Cataract

There are mainly three types of Cataract:

  • Subcapsular Cataract which begins at the back of the lens. People with diabetes, high nearsightedness, retinitis pigmentosa or those taking high doses of steroids may develop a subcapsular cataract.
  • Nuclear Cataract which forms in the nucleus, the center of the lens, and is due to natural aging changes and in those suffering high myopia.
  • Cortical Cataract which forms in the lens cortex, gradually extends its spokes from the peripheral of the lens to the center. Many diabetics develop cortical cataracts.

The lens of our eyes are found behind the iris and the pupil. It works much like the lens of the camera – it focuses light into the retina where the image is recorded. The lenses are also responsible for adjusting the eye’s focus so we can see clearly for both near and far objects.

The lens is mostly made up of water and protein. The protein is positioned in such a way that the light can perfectly pass through so we can see clearly. Through the years, some of the protein may mass up and start to cloud some area of the lens, which overtime may grow larger and cover more of the lens, clouding up the vision.

Cataracts can either be congenital or developed at a later age.

  • Acquired Cataracts: There are several factors that can cause acquired cataracts. Exposure to ultraviolet radiation, diabetes, hypertension, obesity and smoking among other things can all contribute to the formation of cataracts. For people under the age of 40, trauma to the eye is the most common cause of this. Secondary causes include chronic inflammation, some types of glaucoma and extreme nearsightedness.
  • Congenital Cataracts: Though people being born with cataracts are possible, these cases are quite rare. About one-third of congenital cataract cases are hereditary.

There’s no clear reason why our lenses change over time but certainly, aside from age, there are factors that can speed up the process. Because it develops very slowly and painlessly, most people are not even aware that they already have cataracts.

Some of the most common symptoms of cataracts are:
  • Blur or Dimness

Despite adjusting your eyeglasses or lenses, you still see things blurry or dimmed.

  • Faded or Dull Colors
Most colors appear dull and not as vibrant as others might see it.
  •  Poor Night Vision
Seeing at night becomes almost impossible especially while driving.
  • Halos around Lights
Headlights or street lights have a round halo or nonexistent glow when you look at them.
  • Sensitivity to Bright Light

Walking out into the bright sunlight is now painful and you may see exaggerated glare off of reflective surfaces like windshields.

Treatment

Cataracts can be treated differently depending on the severity of the case. You can improve your vision temporarily by using glasses or other visual aids. More progressed cases need cataract surgery in order to restore vision. Cataract surgery involves the removal of the eye’s defective lens and replacing it with an artificial intraocular lens (IOL). The procedure lasts between 15-30 minutes and is practically painless.

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Procedure Options

There are three options of removing the cataract:

Phacoemulsification or Phaco

The most commonly used technique, this is done by making a very small incision (2mm or smaller) on the side of the cornea. A probe which emits ultrasound waves is then inserted. This will soften and break up the lens until it can be removed by suction. Stitches are rarely needed in this operation as the incision is very small, hence giving faster recovery period.

Extracapsular Surgery

This type of surgery requires a larger incision and stitches because the cloudy part of the lens is removed in one piece. Though it has a longer healing time, more than 90% of patients who receive this type of procedure see 20/40 or better.

Intracapsular Surgery

Dating back to hundreds of years ago, this surgery is done by removing both the lens and the capsule. Today, Intracapsular Surgery is hardly ever performed and is generally reserved for cases in which the lens has been dislocated because of injury and an accompanying disease.

Benefits and Effects of Cataract Surgery

Different people experience different effects following the surgery so it is best to ask your eye surgeon about the immediate effects to be expected after the surgery.

Immediately Following Surgery

Cataract surgery is successful 90% of the time. But as with any kind of surgery, there will be discomfort or itchiness immediately after the procedure. This is normal and will wear off quickly.
Your doctor may also put some antibiotic drops in your eye to prevent infection, as well as anti-inflammatory drops to minimize swelling. In some cases, you might have to stay for one hour in the post-operating room for observation. Follow-up checkups will be scheduled accordingly.
You are highly advised to relax and avoid touching, rubbing or pressing your eye. Keep the protective patch on until it is fully healed or until the doctor advised so. Following the doctor’s prescriptions such as eye drops is important to avoid postoperative complications. Seeing glares and halos within the next 24 hours are also normal and will be gone eventually.

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