What Is Cataract?

The construction of our eye is very similar to that of a camera. Both have the same components inside them. Just like the camera our eye contains a ‘LENS’ whose function is to focus the rays of light entering the eye so that we may be able to see clearly. When this lens of our eye which normally is totally transparent, becomes cloudy and loses its transparency, a ‘CATARACT’ is said to have formed.

What are the Symptoms?

When the lens instead of focusing the light starts obstructing it then the main effect will naturally be the BLURRING OF VISION and this is the main symptom of cataract. The vision becomes progressively blurred as the cataract matures and a stage comes when the patient cannot see anything except light. The other symptoms of cataract are excessive feeling of GLARE, DOUBLE-VISION, DIFFICULTY IN READING in normal room lights and the blunting of colour perception.  There is never any pain, irritation, headache or redness.

Why does Cataract Form?

The development of cataract is a part of the normal human aging process and can be compared to the greying of hair with age. As we grow older the lens of our eye gradually becomes less transparent and even totally opaque leading to complete loss of vision in the affected eye. By the age of 60 years a majority of the population has some degree of cataract. The development of cataract is a very slow process and takes anything from a few months to a few years. It may even stop progressing after a certain stage, but these changes cannot be predicted.

Cataract can also form due to injury, due to metabolic diseases like diabetes, due to the prolonged use of drugs called steroids and some local eye diseases like iritis. Cataract can rarely even be congenital, that is, present since birth!

Can We Prevent Cataract?

Much research has been going on in this area, but till date no medicine is available that can be used to prevent cataract from developing. Many expensive medicines are available in the market claiming to have an effect on the development and progress of cataract but none of them has been scientifically proven to have any effect whatsoever on cataract. Although we cannot prevent or halt the growth of cataract we can still see better in spite of cataract if we go to a qualified person and get glasses tested. Glasses help to focus the rays of light entering the eye and to some effect can temporarily neutralise the effect of cataract. These glasses may need frequent re-testing as the cataract progresses, but they are helpful till the cataract matures sufficiently for operation.

When Should Operation Be Done?

Except for a few rare situations, cataract is not an emergency and enough time is available to the patient to plan his operation. The choice of when to get operated is the patient’s depending on his visual disability and need.

IT IS NO LONGER NECESSARY, AS IN THE PAST, FOR THE CATARACT TO BE FULLY MATURE OR ‘RIPE’ BEFORE IT IS OPERATED. Modern surgical techniques have revolutionised the operation of cataract and made it extremely safe. It is now possible to perform the operation at any stage of the cataract with equally good results. In fact allowing the cataract to become fully mature is now not preferred as it can lead to more complications during surgery than an immature cataract.

Taking these considerations into account it is recommended that surgery be performed as soon as the clouded lens begins to interfere significantly with the person’s comfort and normal daily activities.

Which Is The Best Season For Operation?

All seasons are ideal for cataract surgery. There is a big misconception among the people in India that cataract operation should only be done in the winter months. The results of surgery are equally good all through the year. Therefore while deciding about operation no thought should be given to the season.

What Can Be Expected from Cataract Surgery?

The results of modern cataract microsurgery techniques are extremely good and in a vast majority of cases normal eye-sight is restored completely. The complication rates are negligible and post-operative discomfort is minimal. It is due to these reasons that we can confidently advise patients to undergo early surgery and regain good vision.

In case the patient is suffering from some other eye disease like glaucoma, diabetic retinopathy or other retinal diseases all of which cause a reduction in vision then after cataract surgery only that part of the vision will be regained that had been lost due to the cataract. The vision that has been lost due to the other eye disease that was concurrently present will not recover after cataract operation. In spite of this it may be wise to undergo cataract surgery because after the removal of cataract it may be possible to treat the other conditions better than would be possible in the presence of cataract.

What Are the Modern Surgical Techniques?

In the modern method operation is done using an operating microscope by which the structures of the eye are magnified 10 times. This allows the surgeon to operate very precisely causing least amount of trauma to the delicate tissues of the eye. This, in turn, leads to less pain and discomfort in post-operative phase and recovery is faster.

EXTRA-CAPSULAR CATARACT EXTRACTION (ECCE) is the most common method in use today. The surgeon makes a 10 to 12 mm long incision in front of the eye and removes the front part of the lens ‘capsule’ and the whole ‘nucleus’. The back part of the capsule which is a thin transparent membrane is left behind. The wound is closed using 7 to 10 very fine stitches that don’t need to be removed later. The very latest technique which gives the best results is called ‘PHACO-EMULSIFICATION’ and is available only at a few highly advanced centres in the country including this hospital.

What Is Phako-Emulsification and Stitch-Less Cataract Surgery?

This is science’s latest gift to humanity by which cataract surgery has become even safer and the post-operative recovery even faster. In this technique the cataract is removed from the eye through a much smaller incision by first dissolving it inside the eye. This is made possible with the use of a very sophisticated computer-controlled machine that produces very high frequency sound waves which are used to break-up and dissolve the lens in the eye. This dissolved lens is then sucked out through a 3.5 mm long incision. A limitation of this procedure is that it cannot be done in fully mature, hard cataracts. It is ideal for immature cataracts. A special type of IOL is then inserted through this incision. Because the incision is so small no stitches are required in this method and the patient gets back 70-90 per cent of his vision the very next day. Post-operative restrictions and precautions are minimal. This latest technique is available in this hospital.

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