All about Cataract and its treatment
A cataract is a disease of the eye. It occurs when the lens of the eye which is generally clear becomes dense and foggy that may result in blurry or decreased vision.
The lens of your eyes is located behind the iris (the part of the eye that is colored). The iris regulates and focuses light into the retina and sends signals to your brain to see the picture. Cataracts disrupt this vision by forming a cloud over the lens. Vision may be impaired depending on the location and size of the cataract.
The disease generally occurs in elderly people and gradually progresses with time. However, some cataracts may develop faster and may interrupt your vision, and may require cataract surgery.
Cataracts generally start developing during the age of 40, but the symptoms may take time to develop and may not appear until one reaches the age of 60.
Cataracts usually occur in both eyes. However, some people may develop the disease in one eye as well. It has been estimated that around 50% of elderly people develop the disease by the time they reach their 80s.
Prescription eyeglasses can provide some relief to blurred visions but cannot completely cure cataracts. Doctors can prescribe corrective glasses that can help in long-sightedness but eventually, patients will develop nearsighted vision loss. Refractive surgeries are also not helpful in curing cataracts. Doctors will examine the patient over time and if the symptoms worsen, they may prescribe a cataract surgery. Cataract surgery is the only cure for treating cataracts.
Causes of Cataracts
Cataract mainly occurs when the proteins of the lens break down and form clumps inside the lens. The protein lumps may disturb the normal vision of the eyes.
The most common causes of cataracts are:
- Diabetes: It has been seen that people with diabetes have a propensity to develop cataracts at an early age. Diabetic people have no control over their glucose levels. The lens releases an enzyme that helps to convert glucose into sorbitol. Elevated glucose levels trigger the lens to release more sorbitol that can affect the lens and make them opaque.
- Steroids: Some steroids used for the treatment of arthritis or other diseases like lupus can cause cataracts. Cataracts caused by steroids are called subcapsular cataracts and occur behind the lens and form opaque patches that restrict the light from entering the retina. These patches can cause light halos or glares and may cause difficulty in vision, especially during the night.
- Drug-induced cataracts: Certain drugs like phenothiazines and corticosteroids can cause lens opacity and cause cataracts.
- Traumatic cataracts: Cataracts caused due to a sharp penetration or blunt force may cause ocular trauma and damage the fibers of the lens. Blunt trauma occurs when there is a concussion that may lead to the swelling of the lens. Here, the lens is not damaged entirely but may deteriorate with time. A traumatic cataract occurs when the lens is damaged by sharp objects like needles and pins. Traumatic cataracts may occur due to injuries, accidents, or eye surgeries.
- Radiation cataract: Many patients who have undergone a bone marrow transplantation or total body irradiation (TBI) are susceptible to cataract formation and have a propensity to develop severe visual impairment (SVI). Radiation can damage the epithelial cells of the lens. The degree of opacity depends on the rate of exposure to radiation.
- Sun exposure: People with prolonged exposure to the harmful UV rays of the sunlight have a risk of developing cataracts. The UV rays damage the protein layers of the lens and cause opacity.
- Smoking: Research shows that heavy smokers have a chance of developing cataracts.
Family history: Individuals with close relatives who have developed cataracts in the past are at greater risks for developing the disease.
When to see a doctor? Here, we must remember that having difficulty seeing or blurry vision does not necessarily mean that you have cataracts. It may be due to other health issues as well. So, it is always advisable to seek the help of a medical practitioner who can do the proper diagnosis and tests and find out the real cause of the disease. We have outlined a few common symptoms of cataracts that may require immediate medical help.
- Cloudy, blurred, or smoky vision: During the initial stage, a patient may not find much difference in his vision. The vision may be slightly blurry or dim.
- Night vision difficulty: As the disease progresses, patients may develop a brown/yellow tinge and this may compromise the vision especially during the nighttime. Patients who have nighttime vision difficulty must avoid driving at night.
- Light sensitivity: Patients may develop extra sensitivity to bright lights like sunlight, street lights, lamps, etc.
- Halos: The opacity of the lens may result in the diffraction of light. This may cause the creation of halos or rings of light around sources of light like headlights, tube lights, bulbs, etc. These halos make it extremely difficult to drive at night. Patients may sometimes see halos of different colors as well.
- Double vision: Cataracts may cause diplopia or double vision. However, diplopia can be due to other diseases as well such as stroke, brain tumor, multiple sclerosis, etc.
- Change in eyeglasses: You may notice an increase in the visits to your eye doctor. You may need stronger eyeglasses to read.
- Blocks colors: The protein clumps in your lens may give a brownish or yellowish tinge and may block some of the colors. You may find it difficult to differentiate between certain colors.
- Nearsightedness: Cataracts can cause “second-sight”, a phenomenon that can improve myopia or nearsightedness where a patient can only see things very close to them.
- Difficulty seeing at night: Your night vision may be impaired. You may need brighter lights to read or see things during the night.
Once you visit your ophthalmologist, he/she will perform a number of tests to diagnose the disease and rule out other symptoms. Tests may include:
- Visual Acuity Test – The doctor will use a viewing device or a chart containing letters of various sizes to check your vision quality. The doctor will ask you to close one eye and read out the letters from different distances. This is a painless and simple method to see whether you have 20/20 vision or have developed any impairment.
- Slit-lamp examination – A microscope is used to magnify the eye so that the doctor can view your lens properly. The device is used to illuminate the parts of the eye like the iris, cornea, lens, and other parts to detect abnormalities in the eye.
- Pupil dilation – Here the doctor puts some eye drops in your eyes to dilate the pupil and increase its size to examine the lens clearly.
- Potential Acuity Test (PAM) – Doctors perform PAM to measure how much cataract surgery can improve the patient’s vision. It is similar to the visual acuity test but in PAM it uses a laser to project the letters into the eyes of the patient. Doctors expect a 20/40 reading instead of 20/20 in usual cases.
- Contrast sensitivity test – This is done to measure how light contrast and glare can reduce vision due to cataracts.
Treatment for Cataracts
Cataracts cannot be treated with medication. Therefore, surgery is the only option. The procedure involves the removal of the affected lens and implant artificial lens known as Intra-Ocular Lens (IOL).
The surgery is done on an outpatient basis, meaning there is no need for you to get admitted to the hospital. During the surgery, the doctor will use a local anesthetic around the affected eye to numb the senses. After the surgery, there might be some minor discomforts. If you have cataracts in both eyes, the doctor will operate on the other eye a few days after the healing of the first eye. In some cases, people who have eye problems may need to consult an optometrist and may need to adjust the power of the eyeglasses or wear contact lenses.
There are different surgical interventions for treating cataracts such as:
- Microincision cataract surgery: Here, the surgeon makes a microincision around 2.2 mm on the cornea of the affected eye to remove the affected lens. A foldable IOL is then inserted to replace the affected lens. It is a painless procedure that does not require any stitches and offers faster recovery.
- Phacoemulsification surgery: This is a traditional method of cataract removal and is the most common and safe way of cataract removal. The surgeon uses a scalpel to make a small cut around 2.8 mm on the cornea. The surgeon inserts an ultrasonic probe through the incision that will break the cataract into pieces which are then removed and replaced by a foldable IOL. No stitches are needed. The incision will seal automatically.
- Small incision cataract surgery: This is done when phacoemulsification is not possible due to the advanced stage of the cataract. Here, the incision is not made on the cornea, instead, a 6-mm scleral tunnel incision is made and the cataract is removed manually and is replaced by an IOL.
- Laser surgery: This procedure is more modern and does not require the surgeon to make an incision manually. It is very helpful in treating dense cataracts, vision correction is more accurate, and allows faster healing.
Here, the doctor makes an incision with a femtosecond laser with the help of OCT (optical coherence tomography) imaging that gives accurate images of the retina. Then phacoemulsification is done and the cataract is broken into tiny pieces with the help of ultrasound vibration. Next comes capsulotomy, where the broken lens parts are removed from the lens capsule and is replaced by IOL.
Post-op Care and Diet: Dos & Don’ts
After surgery, you will be provided an eye pad with a plastic shield which you may have to wear for several days. Your doctor will prescribe eye drops to remove inflammation or infection and to control eye pressure. You must be accompanied by a friend or family member during the procedure who will assist you to get back home. Here we have outlined some simple dos and don’ts that can boost your recovery after the surgery.
- Wash hands thoroughly before applying eye drops.
- Tilt your head and apply medication. Do not apply more than what the doctor has prescribed.
- Do light activities like watching television, walking, or reading.
- Wear your protective shield during sleep.
- Keep your eyes closed while bathing.
- Rest and relax to promote natural healing.
- Eat lean proteins, leafy vegetables, and fiber-rich foods.
- Do not touch your eyes, rub, or scratch them even if it is itching.
- Do not let water get into your eyes while bathing.
- Do not apply eyedrops with unclean hands.
- Do not swim or take hot baths at least for the first two weeks.
- Avoid driving during the first two days of your surgery.
- Keep away from strenuous exercise or activities.
- Avoid lifting heavy objects.
- Do not expose yourself to dust and grime.
- Avoid bumping into doors, handles, or sharp objects while walking.
Once you develop cataracts, the lens of your eyes becomes cloudy. This means that your vision is impaired. It can be very inconvenient and uncomfortable. Initially, you can manage cataracts with eyeglasses and stronger lighting. However, in case impaired vision gets in the way of your normal activities, you may have to undergo cataract surgery.
Benefits of Laser Surgery in Bangalore
- Less invasive
- Minor discomforts
- Affordable cost
- No hospitalization is needed
- Fast recovery
How can goficure help in the treatment of cataracts?
At goficure, we will help you undergo an effective and safe procedure to correct your cataract. We work with some of the most experienced specialists in cataract treatment in Bangalore. They have collectively administered hundreds of cataract treatments in Bangalore successfully. We recommend laser surgery to correct your cataracts because the procedure allows the surgeon to make a more precise and reliable incision in comparison with conventional surgery. Also, laser surgery is less invasive and there is no bleeding involved. The risk for complications is also greatly reduced by using laser energy and it also leads to faster recovery. At goficure, we will take care of everything that you need for a successful procedure. This starts with scheduling your appointment with the doctor, assisting you to get the correct diagnosis, and liaising with specialty hospitals in Bangalore where you will undergo the procedure. We will also make arrangements to have you picked from the hospital in one of our vans, prepare you for surgery, and drive you back home after the procedure. Goficure will also help you to get your insurance claimed, while our post-op care is one of the best in Bangalore. During the post-op consultation, our surgeons will undertake an assessment to determine that you are healing well. We will also make arrangements to have you work with leading nutritionists in Bangalore, who will develop personalized diet plans to promote faster healing.
Exclusive features you get with goficure
1. Dedicated Medi-Pal
A dedicated Medi-Pal is assigned to you. Your Medi-Pal will be your one point contact throughout the treatment and post-op period. They will always be available for you
2. Quick doctor’s appointments
After understanding your concerns, your Medi-Pal will schedule your consultation with a specialist doctor. Your doctor will carry out necessary tests and advise the course of treatment
3. Hassle-free treatment
If you opt to get the surgery done, goficure will take care of it completely. Right from booking your surgery, claiming your insurance to being with you throughout the procedure, your Medi-Pal will do it all
4. Post-op recovery support
Your Medi-Pal would ensure quick recovery. This includes booking your follow up consultations and helping you with doctor-recommended steps for diet & exercise
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