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November 07, 2019 Thursday 12:20:50 PM IST

Get Rid of Cataract

Health Monitor

Sight is one of the five basic senses and we perceive up to 80 percent of all impressions by means of our sight.

In day-to-day life, the significance of clear vision is very high.  All the indoor activities such as reading, stitching, cooking and cleaning require a good vision. When we go outdoors, we require a clear vision not just to move around, but also for reading the boards of buses, shops, to recognise people, etc. And, driving is a part of life for many.Incidence of cataract has been found to impair many aspects of driving performance.

Only an absolutely healthy eye can give absolutely clear vision. Among eye diseases, cataract is an important one.Cataract is responsible for 51% of world blindness. As people in the world live longer, the number of people with cataract is anticipated to grow.In India, cataract hits people earlier in life than in most other parts of the world. Almost half (45 percent) of cataract cases in India occur before 60 years of age.

  What is Cataract?


Cataract is clouding of the lens of the eye which prevents clear vision, due to a clumping of the protein elements of the lens or a discoloration. The normal lens, clear and transparent, sits behind the coloured iris and pupil and helps focus light on the retina, which converts the light images to electrical and chemical signals that are carried to the brain. A cataract blurs the image on the retina, producing a visual effect that is like looking through a window that is frosted or fogged with steam.

 

What causes Cataract?

 


Risk factors for cataract development include the following:

·         Diabetes or elevated blood sugar

·         Steroid use

·         Ultraviolet exposure


·         Smoking

·         Ocular diseases: Retinitis Pigmentosa, Uveitis, 

·         Ocular Trauma

·         Prior ocular surgery


·         Genetic predisposition 

Age related cataract is by far the most common type of cataract.

Symptoms of Cataract

 


·         Blurring of distantvision more than near vision (typically, but others may notice worsening of near vision more than distant vision)

·         ‘Second-sight’ phenomenon - some patients who had previously relied on reading glasses for reading may no longer need them once a nuclear sclerotic cataract starts to form. 

·         Poor vision in dark settings such as night driving

·         Decreased contrast and decreased ability to discern colors


·         Glare

 

Diagnosis

 


Cataract can be easily diagnosed by an Ophthalmologist by ‘Slit lamp’ examination. Only when other conditions are suspected, further ocular investigations are needed.

 

Prevention of cataract

 


·                    Use sun glasses to prevent ultraviolet rays

·                    In patients who require long-term steroid medications, use steroid- sparing medication

·                    Keep blood sugars under control in Diabetics

·                    Avoid smoking and tobacco use


·                    Take antioxidants in the form of plenty of fruits and vegetables

 

  Treatment for Cataract

 No medical treatment has been shown to be effective in the treatment or prevention of cataracts.If cataract is in the initial stages, vision can be corrected by spectacles. Surgery is indicated when cataract formation has reduced visual acuity to the level that it interferes with the patient's lifestyle and everyday activities, and when satisfactory functional vision cannot be obtained with spectacles. Some types of cataract, for example, one which causes more glare, need early surgery.


 A cataract which is not treated, can lead to total blindness in that eye gradually and in rare cases, can cause complications like raised intraocular pressure and pain in the eyes.

 Cataract Surgery

Before surgery, a few investigations are needed. The power of the lens to be placed inside the eye, needs to be measured. During the surgery, the cataractous lens is removed and an intraocular lens is placed in the lens capsule. Phacoemulsification is the standard procedure for cataract surgery. This uses ultrasound energy to break the cataract into particles small enough to aspirate through a handpiece. Since the wound size is 1.5 mm to 3 mm in this surgery, usually suturing is not required.

 Cataract surgery can be done on a day care basis. Patient can be discharged on the same day. After surgery, patients do not require a long period of rest.  Patients with other diseases like Diabetes, cardiac disorders and stroke also can undergo cataract surgery after clearance from the respective Physician. 


Intraocular lens

The lens implanted after cataract surgery is mainly of two types -monofocal and multifocal.Monofocal lenses provide good distance vision and most patients are not dependent on glasses for their daily activities.However, they typically require glasses for reading after cataract surgery. Multifocal lenses are designed to provide good unaided distance and near vision with less dependence on glasses.There are different lenses with different features like aspheric lens, toric lens, yellow lens etc. which are required in specific conditions.

 

 


 

Conclusion

Cataract surgery improves the performance of daily activities which are dependent on vision and improves the quality of life. In patients who have undergone cataract surgery, the number of falls and bone fractures are considerably reduced.Even patients who don't feel a significant visual blurring before surgery, realise after surgery that vision is more clear and colours are brighter.

The elderly lead an active life in today's world. Age is not a barrier to any activity including learning new things and travelling. Even mild cataract may cause a difficulty in leading an independent life by hampering activities like driving.Older people comprise the fastest growing sector of the driving population; this has important implications for road safety as the elderly are also reported to have high crash rates per distance travelled.  Cataract surgery has been shown to improve driving performance among them. Cataract surgery can thus be considered an important intervention for road safety for older people with cataract, and has the potential of usefully prolonging the period over which older people can drive, resulting in improved mobility and independence.


 Modern cataract surgery is not one to be afraid of.Cataract surgery is one of the most common surgical procedures performed around the world and has a very high success rate.Cataract surgery reduces subjective visual disability and helps to lead an independent life.


Dr.Anjana Devi R

The writer is  Consultant Ophthalmologist,Rajagiri Hospital,Aluva

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