Cataract – Is Surgery The Only Option To Remove Cloudiness On The Eye Lens?

Cataract – Is Surgery The Only Option To Remove Cloudiness On The Eye Lens?

If you are lucky enough to live longer, you will eventually develop an eye condition that will cause blurry or doubled vision. Let’s know everything about cataract and how it is causing blindness in millions of people around the world.

Cataract

It’s an eye condition in which cloudy area is formed on the natural lens of the eye. Cataracts are caused when the protein in the eye begin to form clumps preventing the lens from sending clear images to the retina. This makes the vision difficult for the people as they would fail to distinguish the object such as expression on a person’s face.

The condition develops slowly and steadily and eventually hinders vision. A person can experience cataract in one or both the eyes but usually it doesn’t form in both the eyes at the same time.

Does cataract affect only older people?

Cataract mostly develops with the aging and most common in older people, however it can also forms earlier in life. It is the leading cause of blindness around the world. According to WHO, about 255 million in the world are living with some kind of visual impairment, out of them 36 million are blind. In India, this condition affects 74 percent of people aged 60 and above.

Cataract is also the primary cause of blindness in about 5 million people in India, out of which 2/3 are women and over 80 percent of affected are above aged 50. The vast majority of people impacted by cataract come from the low-income background. Another study (National Blindness Survey) conducted in collaboration with AIIMS (All India Institute of Medical Sciences) showed that about 65 percent people surveyed randomly were having cataract.

Causes of cataract - Is age the only factor?

There are several reasons why and how cataract forms. The lens on which cataract forms a located behind the coloured part of the eye, known as iris. The light that passes into the eye is focused through the lens resulting in sharp and clear images on the retina. As a person age, the lenses in the eyes become inflexible, thicker and less transparent.

When cataracts continue to form, the blurring becomes denser blocking the light passing through the lens. This blurs the vision completely. This happens due to:

  • Smoking
  • Overproduction of oxidants, the molecules of oxygen chemically modified due to normal day to day life
  • Certain conditions such as diabetes
  • Ultraviolet radiation
  • Radiation therapy
  • Trauma

Classification of cataracts

There are various types of cataracts classified by the doctor on the basis of opacity location or clouding of the lens. These include:

Nuclear Sclerotic Cataract

The most common type of all, in nuclear sclerotic cataract yellowish cloud are formed on the central part of the lens or the nucleus. In certain cases, the affected person may see a temporary improvement, but gradually over the time the lens turns into dense yellow cloud hindering the vision.

Cortical cataracts 

These are wedge shaped cataract appearing on the edges of the nucleus i.e. part of the lens called cortex. Cortical cataract looks like wheel spokes pointing towards the center of the lens.

Posterior sub-capsular cataracts

This type of cataract tend to form faster than the other two affecting the back surface of the lens. Posterior sub-capsular cataracts causes light sensitivity, interferes the reading vision causing halos and glares around the light.

Congenital cataracts

Some babies are born with this condition while some others are affected in the first year of life. Congenital cataracts are less common.

Secondary cataracts

Sometimes cataract can develop due to certain disease or medication. It can develop following an eye surgery such as for glaucoma. Secondary cataracts can also develop due to the usage of steroid prednisone or some other medication.

Traumatic cataract

Cataract can develop as a result of direct injury to eye. It might develop immediately or form several years after the injury. It may also develop due to exposure to certain chemicals.

Radiation cataracts

This type of cataract forms after a person is exposed to radiation, such as when undergoing treatment for cancer or sometime to ultraviolet radiation. However, this occurs rarely.

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Symptoms of cataracts

The condition does not occur suddenly. Initially, you might be unaware of cataract as the cloudiness in the vision affects small part of the lens and then gradually spreading to other part of the lens. Then only the symptoms start appearing which include:

  • Dim or blurred vision
  • Increased difficulty seeing at night
  • A person would need brighter lights for reading and performing other activities
  • Dual vision in the affected eye
  • Colors will look like faded
  • Seeing halos (disc or circle) around the lights
  • Regular changes in prescription glasses or contact lens

Are there any risk factors of cataracts?

There are certain factors that can increase the likelihood of getting the disease including the one which cannot be prevented such as age and family history. Other factors include:

  • High blood pressure
  • Smoking
  • Obesity
  • Excessive use of alcohol
  • History of eye injuries
  • Diabetes
  • Too much exposure to sun
  • History of eye surgery
  • Exposure to radiation during cancer treatment

How is cataract diagnosed?

You will be undergoing comprehensive examination after you experience symptoms. The doctor will conduct various tests to evaluate your vision. These tests include:

  1. Visual acuity test – During this test, the doctor will tell you to read from a chart consisting of a series of letters. You will have to cover one eye at a time while the other read the letters on the chart.
  2. Slit-lamp test – A microscopic device consisting of high-intensity light will be focused on the eye to check the structures of the front part including cornea, lens and iris.
  3. Retinal test – In this procedure, the doctor will put drops into the eyes to wide open the pupils. The objective is to check the back of the eye i.e. retina. The doctor may use a special instrument known as ophthalmoscope or a slit lamp to determine the signs of cataract.
  4. Tonometry test – The doctor will use a painless puff of air in order to flatten the cornea and check the eye pressure.

How is cataract treated – Is surgery the only option?

Surgery is the only practical option for complete recovery of vision. However, if a person is unable to undergo surgery, the doctor or ophthalmologist may help him manage symptoms by suggesting stronger eyeglasses, sunglasses with anti-glare coating or magnifying glasses.

Surgical procedure is recommended when the cataract begin to interfere with your basic daily activities including reading or watching television. There are three types of surgeries:

  1. Phacoemulsification – This is the most common procedure today in which ultrasound waves are used in order to break up the lens apart and carefully remove the pieces through suction. Then an artificial lens is inserted into the eye followed by single stitching to close the wound.
  2. Extra capsular – This procedure is quite identical to the phacoemulsification but a much larger incision is made upto the cornea or nucleus. Multiple stitches may be required and after the procedure, an artificial intraocular lens is placed on the site of natural lens. Extra capsular is less commonly performed due to possible complications such as slow healing or fear of impairment.
  3. Intracapsular – This is a rare procedure during which the entire lens and its capsule is removed by making a larger incision. This surgery might be required in cases of trauma or eye injury.

The surgery takes only 15-20 minutes and is generally painless since you will be given anesthesia before that.

Outlook

If cataract is affecting your daily activities, it should be treated without delay as it could lead to blindness. The positive side is that the surgery of cataract is generally safe and has high success rate, up to 90 percent. One can immediately go home after surgery.

If you are facing the above mentioned signs and symptoms, you must meet the ophthalmologist today.

Sources

1. Cataract. read more
2. Cataract Surgery- March of Dimes. read more
3. Cataract status in India. 
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