Blurry vision or difficulty seeing at night? Don’t let cataracts blind you! Speak to an expert ophthalmologist near you for the right treatment. A cataract that is left untreated can cause permanent blindness. Learn about cataracts and how to cure them in this article and consult a specialist before it’s too late.

What is a Cataract?

The eye’s lens is composed of water and proteins. When this protein form clumps, they prevent the lens from sending clear images to the retina. The cataract appears as a dense and cloudy area on the natural lens of the eye. It forms slowly and gradually and can appear in one or both the eyes. This condition is commonly witnessed in older people. Other reasons, including injury, trauma, ageing, radiation exposure, etc., can also distort the mechanism of the lens, leading to cataract which makes the lens thicker, denser, and translucent. As a result, the vision gradually declines over the years causing blurred vision.

Different Types of Cataracts

Based on the formation of the cloudiness on the natural lens of the eyes and its associated causes, the cataracts are broadly classified as six distinct types. The same are explained below:

Nuclear cataracts: Cataracts of this type are the most common. It starts at the center of the lens and turns yellow as it hardens, and then it spreads. It can make it difficult to see in areas with poor lighting and make driving a challenge. As the eye’s ability to focus changes, some people find that their near vision improves temporarily.

Cortical cataracts: The cataracts appear at the outside of the lens and grow inward. During the day or in the rain, these cataracts cause glare and halos. Near and far vision may suffer as a result. People who have diabetes are more at risk for this type of cataract.

Posterior Subcapsular cataracts: As the name suggests, these cataracts form on the backside of the lens. These cataracts may cause haloes or glares around lights, or even a smudge over the vision. Cataracts of this type usually develop faster in patients with diabetes or those taking oral steroids.

Congenital cataracts: There are cases where babies are born with cataracts, as well as cases where cataracts affect older adults. This condition can be genetic or caused by illnesses the mother contracted during pregnancy. The only time they should be removed is if they are blocking the baby’s vision and causing amblyopia.

Radiation cataracts: A significant factor contributing to this type of cataract is ultraviolet light from the sun. Spending a lot of time outdoors or receiving radiation treatment for cancer can result in radiation cataracts.

Traumatic cataracts: This type of cataract is caused by an injury to the eye.  Traumatic cataracts are caused by trauma to the ocular lens, either blunt or penetrating, which disrupts the lens fibres.

What are the different grades of cataract?

The progression of cataracts usually occurs gradually and takes years to complete. A cataract that becomes more severe over time will cover a larger portion of your natural lens. There are four levels of cataract severity:

Early cataracts are the first stage of cataracts in which the lens is nearly clear, but the ability of the lens to change focus is impaired. As a result, symptoms such as blurry vision, glare from lights, and increased eye strain may begin to appear.

– An immature cataract is when the protein on the lens starts to accumulate causing it to appear cloudy and slightly opaque. In addition to vision issues, light sensitivity may also occur. Seeing nearby objects with this cataract stage may require glasses or anti-glare lenses.

– A mature cataract is one where the lens opacity begins to decrease, and the cataract becomes more mature. There will be a milky white or amber tint to the lens, and vision will be greatly impacted as well.

– A hypermature cataract is the most serious type of cataract in which significant damage to the lens has taken place. When left untreated, hyper mature cataracts can cause inflammation or increased eye pressure, which can lead to glaucoma.

Top 10 Symptoms of Cataracts that You Should Aware

Cataracts mature over time and gradually start showing symptoms. As soon as you start experiencing vision loss, you should consult with a cataract specialist. Some of the first symptoms of cataracts are blurry vision, light sensitivity, and seeing haloes. Some of the common symptoms of cataracts are jotted down below:

  • 1. Cloudy eye lens
  • 2. Blurry or dim vision
  • 3. Seeing faded colours
  • 4. Yellowish vision
  • 5. Trouble seeing at night
  • 6. Halos surrounding light
  • 7. Increased sensitivity to glare
  • 8. Double vision
  • 9. Sensitivity to glare and light
  • 10. Difficulty in reading

What Causes of Cataracts?

Cataracts are formed when a cloudy structure appears over the natural eye lens such that the patient is not able to focus the light that enters the eye leading to blurry vision. The main causes of cataracts are discussed below:

  • 1. Ageing
  • 2. Smoking
  • 3. Exposure to radiation
  • 4. Diabetes
  • 5. Hypertension
  • 6. Trauma or injury
  • 7. Obesity
  • 8. Vitamin C deficiency
  • 9. Excessive consumption of medication or steroids
  • 10. Genetics or birth defects
  • 11. High alcohol consumption
  • 12. High myopia
  • 13. Previous eye surgery
  • 14. How are Cataracts Diagnosed?

Self-diagnosis: On the web, there are numerous self-tests you can use to diagnose a cataract. The tests usually only take a few minutes and will tell you whether you have cataracts or not. In addition to this, if you have cataracts, you will experience an opacification of the lens of your eye and a decline in vision over time. Knowing the symptoms of cataracts can help you detect whether one or both of your eyes are developing cataracts.

Doctor diagnosis: An ophthalmologist should be consulted if you suspect you have a cataract. A comprehensive eye examination and various tests will be performed by the eye doctor. First, the doctor will dilate your pupil so that he or she can see the internal parts of your eye. During a physical exam, a doctor will be able to see cataracts clearly if they have reached the chronic stage. Otherwise, diagnostic testing will be recommended, including

  • 1. Visual Acuity & Refraction Test: The purpose of both of these tests is to examine sharpness and vision clarity. Each eye is examined separately to detect impairment.
  • 2. Slit-lamp Examination: This exam is conducted using a microscope that emits intense lines of light (slits) that illuminate the cornea, the iris, and the lens. Under magnification, it allows an eye doctor to see the structures of the eye and detect any abnormalities, such as early-stage cataracts.
  • 3. Retinal Examination: In order to perform a retinal examination, the eye doctor dilates your pupils and examines the retina from behind. During this test, the doctor can see whether the light is reaching the retina or not. Ophthalmoscopes are generally used as early detection tools for cataracts.

Types of Cataract Surgeries

Cataract surgery (lens replacement surgery) is a method of removing the cloudy natural lens of an eye and replacing it with an artificial lens (also known as an intraocular lens). In this procedure, an ophthalmologist will either emulsify or remove the cataract by cutting out the lens under the influence of local or topical anaesthesia. It is a 10-15 minute surgery which does not require hospitalization. The advent of minimally invasive cataract surgery has improved the success rate of the procedure to more than 90%. A variety of cataract surgery techniques are available, including:

Phacoemulsification: During this type of cataract surgery, the natural lens that has to be removed is broken with the help of an ultrasound probe which is inserted through tiny incisions in front of the cornea. This is followed by inserting the probe into the lens where the cataract has formed. By using ultrasound waves, the probe emulsifies the cataract and suctions out the fragments without damaging other parts of the eye. This leaves the back of the lens intact to implant an artificial lens. The cornea is then stitched closed.

Microincision Cataract Surgery (MICS): During this advanced cataract surgery procedure, the entire lens is removed. The procedure is performed by creating a self-sealing scleral tunnel wound. A very small incision is made during this type of cataract surgery, and the procedure is performed with greater precision.

Extracapsular Cataract Extraction (ECCE): In this conventional cataract surgery, almost all of the lens is removed except the elastic lens capsule that is also known as the posterior capsule. The artificial lens is implanted after leaving it in place. In order to perform the procedure, an incision of 10-12 mm is made in the cornea or sclera.

Intracapsular Cataract Extraction (ICCE): During this type of cataract surgery, a large incision is made to completely remove the lens and lens capsule in ICCE. Following lens removal, the artificial plastic lens is sutured in either the anterior chamber or sulcus. Because of the size of the incision, this type of surgery is associated with many risks. Because of this, it is rarely performed in countries with readily accessible technologies such as microscopes.

Femtosecond Laser-assisted Cataract Surgery (FLACS): Laser surgery is another modern way to perform cataract surgery during which an incision is made using a laser through which the clouded cataract is removed. It is one of the safest and most effective techniques that is used these days to treat cataracts.

Types of IoLs

Choosing the right intraocular lens (IOL) is one of the biggest decisions cataract patients have to make. Lenses fall into two primary types: anterior chamber lenses and posterior chamber lenses. While the Anterior Chamber Lenses (ACIOL) are placed on top of the iris, the Posterior Chamber Lenses (PCIOL) are placed at the original position of the lens. For patients with intact posterior capsules, PCIOLs are a better choice than ACIOLs.

A range of PCIOLs is available on the market, including:

– Patients with monofocal lenses can see clearly at a certain distance, whether close or far, due to their single focal length.

– The multifocal lenses are the ones that correct farsightedness as well as nearsightedness simultaneously.

– The trifocal lens is also known as Extended Depth of Focus (EDOF), and it provides clear vision even at near, far, and all the intermediate distances in between.

Toric lenses are special types of lenses that correct each eye’s spherical and cylindrical powers.

During your consultation with the surgeon, you will learn more about these lenses and choose the most appropriate IOL for the surgery.

How Can I Prevent Cataracts?

Numerous studies have been conducted to determine if cataracts can be prevented or slowed. These studies indicate the following things may prevent cataracts to some extent:

  • 1. You will be able to detect cataracts and other eye problems at the earliest stage if you have regular eye exams.
  • 2. Avoid smoking as much as possible. Use medication, counseling, or other strategies to help you quit the smoking habit.
  • 3. Keep other health conditions in check, especially diabetes, which can increase your cataract risk.
  • 4. Ensure that your diet contains plenty of fruits and vegetables that are rich in antioxidants, fiber, vitamin, and mineral content.
  • 5. Protect your eyes from ultraviolet light by wearing sunglasses and avoiding exposure to it as much as possible.
  • 6. Limit your intake of alcohol because it can also increase your risk of cataracts.

Various Risks Associated with Cataract

During the surgery: Though cataract surgery poses minimal complications, the surgeon still watches out for the following risks:

  • 1. Eye inflammation
  • 2. Secondary cataract
  • 3. Bleeding
  • 4. Infection
  • 5. Bleeding
  • 6. Dislocation of artificial lens
  • 7. Drooping eyelid
  • 8. Glaucoma
  • 9. Loss of vision

When left untreated: The effects of cataracts are determined by the speed at which the disease progresses. Having cataracts at the beginning of your life will negatively impact your daily routine, preventing you from reading, working, driving, or enjoying any of your hobbies. In the long run, untreated cataracts can cause total blindness that is irreversible.

After surgery: It is normal for there to be no complications following surgery once the eye lens has been replaced. There may, however, be cases when cataract surgery does not improve vision. Usually, it occurs when other chronic conditions, such as glaucoma and macular degeneration, are present, which are responsible for causing the damage to the eye.

Post Cataract Surgery Care

You will experience no sensation in the eye immediately following cataract surgery. To protect the treated eye from dust, dirt, wind, sunlight, and other particles that can irritate it, the surgeon will wrap the eye in an eye patch. For the first few days, the surgeon will recommend you to these tips in order to ensure a quick, safe, and smooth recovery after cataract surgery:

  • 1. No water contact with eyes for 4-5 days
  • 2. No heavy load lifting or exercises for 4-5 days
  • 3. Use of glasses is mandatory for 2 weeks to avoid exposure to UV rays, dust and sunlight
  • 4. Not sleeping on side support of the body, in which eye cataract procedure conducted
  • 5. Do not indulge in activities that might cause damage to your eyes
  • 6. Don’t drive until recommended by your doctor
  • 7. Don’t wear make-up for a few weeks until told
  • 8. Intake and apply prescribed medicines as directed by your surgeon
  • 9. No eye smudging for 4-5 days
  • 10. Avoid straining your eyes by constantly watching digital screens

Frequently Asked Questions

Why can’t you drink water before cataract surgery?

Cataract surgery is performed under the influence of local or topical anaesthesia and under sedation, there is a chance of stomach acid going into your lungs, which can cause complications. Thus, it is advised that you should not drink or eat anything before cataract surgery.

How long does a cataract operation take?

Cataract surgery is a simple procedure that does not require any hospitalization. Usually, your opthamologist will take less than 15 to 20 minutes to complete the procedure. The patient can walk back home within an hour as soon as the patient recovers from sedation.

Does cataract surgery improve your vision?

The majority of people who undergo cataract surgery return to normal vision following the procedure. However, there are some people who have the risk of developing a secondary cataract after some years. In medical terminology, this common complication is known as posterior capsule opacification.

Is there a downside to cataract surgery?

Cataract surgery has a success rate of more than 90%. Also, due to technological advancements and when performed by expert ophthalmologists, cataract surgery has become absolutely risk free. However, one out of rare cases might develop complications of bleeding or infection due to unavoidable circumstances.

Is cataract caused by stress?

Stress results in an increase in oxidant production and oxidative damage. Therefore, long-term exposure to emotional or psychological trauma may enhance the risk of many diseases, including cataracts.

Can you remove cataracts without surgery?

There’s no way to eliminate cataracts and the only cure for cataracts currently available is cataract surgery, though some ophthalmologists are investigating alternatives.

Is cataract and motiyabind the same?

Yes, both cataract and motiyabind are the same which is defined as the blurring of the vision due to the gradual cloudy formation on the natural eye lens.

At what stage should cataracts be removed?

A. In most cases, you need cataract surgery if you are experiencing blurry vision or any of the other symptoms are interfering with your daily activities, such as driving or reading.

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